Not every refused claim needs a lawyer. Some decisions are simple to challenge with better evidence, and some are right under the rules. What matters is acting within the deadline. If you're in Blakehurst and have received a decision you disagree with, our free claim check looks at what was decided, why, and what your realistic options are.
St George & Bayside · CTP claim denied
CTP claim rejected? Review options for Blakehurst
Insurers make decisions under the scheme rules. You can challenge them, and an independent lawyer can help.
Postcode: 2221
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- Helping people in Blakehurst & Kyle Bay
Your review path
Insurers make decisions under the scheme rules, and the scheme also sets out how to challenge them. These are the main steps and the timeframes that generally apply.
Step 1
Read the decision letter
Note the date you received it, what was decided and the reasons given. The date matters, because the time to ask for a review generally runs from when you receive the decision.
Within 28 days
Ask for an internal review
Request the review in writing, inside the 28-day window that generally applies. The insurer looks at the decision again, so explain clearly why you think it's wrong and attach anything it didn't have.
14 to 28 days
The insurer decides
Expect a review decision in about 14 days in most cases, 21 days for some medical and miscellaneous matters, and up to 28 days where the insurer needs more information.
If you still disagree
Apply to the Personal Injury Commission
If the internal review doesn't resolve things, you can generally apply to the Personal Injury Commission. It's independent of the insurer and decides disputes under the scheme rules.
28 days from a certificate
Medical assessment review
If your dispute goes to medical assessment and you think the certificate is wrong, a review must generally be sought within 28 days of the certificate being issued.
Any time
Conduct complaints go to the IRO
Unhappy with the insurer's conduct rather than its decision? Contact the Independent Review Office on 13 94 76, 8:30am to 5:30pm weekdays, or online. It's a separate path from a review.
General information, not legal advice. Timeframes are general, and some decisions follow different rules. Check your decision letter and get advice quickly.
What a review looks like from Blakehurst
If St George Hospital treated you and the insurer says your injury is threshold, the hospital's notes may show otherwise. Include anything relevant when you request an internal review. At around 16 km from the Sydney CBD, living in Blakehurst is no disadvantage in a dispute. Review requests generally go in writing, many Personal Injury Commission steps can happen by phone or online, and our claim check works the same way. People in Blakehurst, within Georges River Council, follow the same dispute path as everyone else in NSW: internal review first, generally within 28 days, then the Personal Injury Commission. Where you live doesn't change the deadlines.
- Region
- St George & Bayside
- Postcode
- 2221
- From the Sydney CBD
- ~16 km
- Local government area
- Georges River Council
A refusal isn't the end of the road
It's easy to read a refusal as the final word. Under the NSW CTP scheme, it's usually the first. Most decisions carry a right to internal review, and beyond that an independent tribunal, the Personal Injury Commission. What you need is a clear understanding of the decision and enough time to respond, which is why the 28-day window matters.
Read next:CTP claim denied?
Making your internal review count
Reviews are often decided on the papers, so what you send matters. If the decision was about your injury, ask your treating doctor to explain their findings in writing. If it was about earnings, send payslips or tax records. If it was about fault, include police details, photos and witness contacts.
After you ask, the insurer usually has 14 days to decide. Some medical and miscellaneous matters allow 21 days, and up to 28 days if the insurer needs more information. While you wait, keep sending updated Certificates of Fitness if you're off work, and keep a record of every contact about the review.
The 28-day window
The clock generally runs for 28 days from the day the decision reached you. Note the date the letter arrived, not just the date printed on it.
Read next:Insurer stopped my weekly payments
Complaints versus disputes
CTP Assist and the IRO are different services with different roles. CTP Assist, on 1300 656 919, gives information and support about claims. The IRO, on 13 94 76, handles complaints about how CTP insurers behave. Neither decides disputes about your entitlements; that's the job of internal review and the Personal Injury Commission.
Free claim check
Check your review options, free
No office visit and no charge for the check. A quick claim check by phone or online tells you whether a review is worth pursuing.
When a dispute calls for legal help
Some reviews are simple: supply the missing evidence and ask again. Others turn on legal questions or high stakes. Here's a general guide to which is which.
Often worth talking to a lawyer
- You've missed the review deadline
- You were driving for work and the insurer has refused on that basis
- Your injury was classed as threshold and it affects a damages claim
- Weekly payments were stopped and you can't work
You may not need one
- You agree with the decision once it's explained
- You mainly want to complain about delays or communication
- A treatment request was declined for lack of information you can supply
Many disputes turn on medical evidence. If you need a clear report on your diagnosis, or an up-to-date Certificate of Fitness, we can point you to doctors and allied health familiar with CTP claims.
Not quite your situation?
- If you're not sure a dispute is worth taking on with legal help, the CTP lawyer page explains when a lawyer tends to be worth it. CTP lawyer in Blakehurst
- When the real argument is how serious your injury is, the injury compensation page for Blakehurst covers impairment and the threshold line. Injury compensation lawyer in Blakehurst
- If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Blakehurst. CTP claims in Blakehurst
Disputing a threshold-injury decision
A threshold decision limits statutory benefits to 52 weeks for accidents from 1 April 2023, and it rules out a damages claim. A threshold injury is generally soft tissue, and it doesn't include nerve damage or a full or partial tear of a tendon, ligament, meniscus or cartilage. If your medical evidence shows one of those, the classification may be wrong.
Read next:Threshold injury disputesWhen the insurer says “threshold injury”
What the Commission does
Applying to the Commission is more formal than an internal review. There are forms, timeframes and evidence rules, and the insurer will usually have its own representatives. Many people get legal advice at this stage. Keep in mind that SIRA's free CTP Legal Advisory Service doesn't cover matters already at the Commission.
Read next:The Personal Injury CommissionPIC disputes explained
The decisions behind many disputes
Some decisions come up again and again. A claim may be refused because it was lodged late, or limited because the insurer says the injury is threshold or that you were mostly at fault. Weekly payments may stop, or a treatment request may be declined. Each raises its own evidence questions, and each can generally be reviewed.
- The crash is being treated as a work injury
- Weekly payments were stopped or reduced
- A treatment request was declined
- The insurer says the injury wasn't caused by the crash
Read next:Claim denied? Quick check
Legal costs in a dispute
Free help is limited once a dispute is under way. The CTP Legal Advisory Service that SIRA funds stops short of matters already at internal review or before the Personal Injury Commission. CTP Assist can still give general information. For advice on the dispute itself, you'll generally need an independent lawyer.
Read next:What does a CTP lawyer cost?
Frequently asked questions
Generally yes. If your dispute went to medical assessment at the Personal Injury Commission and you think the certificate is wrong, you can seek a review, but it must generally be sought within 28 days of the certificate being issued. The grounds for a review are generally limited, so it's worth getting advice quickly about whether a review is likely to be accepted.
Generally 28 days from receiving the decision. Ask in writing, say which decision you disagree with and why, and include any new evidence. Because the window is short, don't wait for every document before you lodge the request. If you're close to the deadline or past it, get advice quickly.
First, check the letter for the reason. Payments may stop because the insurer says you can work, because your benefit period has ended, or for another reason under the scheme rules. If you disagree, ask for an internal review, generally within 28 days. Keep your Certificates of Fitness up to date in the meantime, and get advice if you can't work.
Insurers make decisions under the scheme rules, and a refusal usually points to one of them. Common grounds include a claim lodged late, an injury classed as threshold, a finding that you were mostly at fault, or a view that the crash falls under a different scheme. The decision letter should give reasons, and those reasons tell you what evidence might change the outcome.
Only in part. SIRA's CTP Legal Advisory Service gives free advice on statutory benefits for accidents from 1 December 2017, but it doesn't cover matters already at internal review or the Personal Injury Commission, damages claims or older-scheme claims. It may help before you request a review. Once a dispute is under way, you'd generally need an independent lawyer.
Yes. You can generally ask for an internal review, then take the dispute to the Personal Injury Commission. The label generally covers soft tissue injuries and threshold psychological injuries; nerve damage, and a full or partial tear of a tendon, ligament, meniscus or cartilage, fall outside it. Evidence from your treating doctor or specialist is usually central to the outcome.
CTP claim denied: suburbs near Blakehurst
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CTP Lawyer is not a law firm. This page is general information, not legal advice; the independent lawyer you speak with can advise on your own situation.