A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If you've been injured in a car accident and are unable to work, you may be eligible to claim income loss under New South Wales' Compulsory Third Party (CTP) insurance scheme. This article explains how income loss claims work under the NSW CTP framework, including what types of income are claimable, how losses are assessed, and the evidence needed to support your case. It also outlines time limits and practical steps to take if your claim is disputed.
What Income Loss Means in a NSW CTP Claim
Under the NSW CTP scheme, income loss refers to wages, salaries, or other earnings you've lost due to an injury caused by a motor vehicle accident. This includes both direct income loss and reduced earning capacity if your injury prevents you from working as before. The New South Wales Motor Accident Injuries Act 2017 (MAI Act) governs these claims, and the State Insurance Regulatory Authority (SIRA) provides guidelines for assessing them.
When Income Loss May Become Relevant
Income loss claims typically arise when an accident results in injuries that prevent you from working for a period of time. This could include temporary injuries like whiplash or more severe injuries that require long-term recovery. The key is that your injury must have a direct connection to the accident and must affect your ability to earn income.
What Must Usually Be Shown for Income Loss
To claim income loss under the CTP scheme, you must demonstrate:
- A direct link between the injury and the accident - the injury must have occurred as a result of the motor vehicle accident.
- A loss of income - you must show that you have lost wages or are earning less than before due to the injury.
- Medical evidence - a medical practitioner must confirm that your injury has impacted your ability to work.
- Employment records - evidence such as payslips, employment contracts, or employer statements to support your income claim.
Documents, Assessments and Common Sticking Points
Supporting your income loss claim requires specific documentation. Key evidence includes:
- Medical records - detailing the nature of your injury, its impact on your work capacity, and recovery timeline.
- Accident reports - from police or the other party's insurer to establish the circumstances of the accident.
- Witness statements - if others can confirm your inability to work due to the injury.
- Income records - such as payslips, bank statements, or tax returns to show your pre-accident earnings.
One common challenge is proving the extent of your income loss. For example, if your injury results in a reduced capacity to work rather than complete inability, the claim may be limited to the difference between your pre-accident and post-accident earnings. SIRA guidelines emphasize that claims must be based on objective evidence rather than assumptions.
Practical Next Steps if Income Loss is in Dispute
If your income loss claim is disputed, you may need to:
- Request a medical assessment - a specialist may need to provide a detailed report on your work capacity.
- Seek independent evidence - such as a vocational assessment to determine how your injury affects your ability to work.
- Consult with a claims assessor - SIRA or the insurer may involve an independent expert to evaluate your claim.
- Consider mediation or dispute resolution - if the claim remains unresolved, you may need to escalate the matter through formal dispute processes.
Example: How Income Loss Claims Work in Practice
Consider a scenario where a driver sustains a soft-tissue injury in a car accident and is unable to work for six weeks. Their employer confirms they missed work during this period, and medical records show the injury caused temporary mobility issues. Under the CTP scheme, the injured person could claim the lost wages during this time, provided the injury is linked to the accident and the employer confirms the loss.
Time Limits and Final Considerations
The MAI Act sets time limits for making claims. Generally, you must notify the insurer within 90 days of the accident, though this can vary depending on the circumstances. For income loss specifically, the 52-week statutory benefit period applies to threshold injuries. If your injury is classified as a threshold injury, weekly benefits may be limited after 52 weeks unless you can demonstrate a longer-term impact on your earning capacity.
Next Steps
Income loss claims under NSW CTP insurance depend on the specific facts of your case. To request contact about your circumstances, complete the quick, no obligation enquiry form.