Denied, cut off or classified as a threshold injury? Start by reading the decision carefully and noting the date you received it. The internal review window is generally 28 days. People in Homebush South can handle much of a review in writing, and an independent CTP lawyer can help if the stakes are high. Our free claim check is a quick way to find out where you stand.
Inner West · CTP claim denied
Starting a CTP dispute from Homebush South
Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.
Postcode: 2140
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Challenging a decision from Homebush South
A crash on Parramatta Road, Victoria Road or in the WestConnex tunnels can lead to arguments about who was at fault. If the insurer's fault decision went against you, you can generally ask for an internal review within 28 days. Homebush South is about 3 km north-west of Burwood, but challenging a decision doesn't mean travelling there. Internal reviews are generally requested in writing, and our claim check runs by phone and online. People in Homebush South, within Strathfield Municipal 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
- Inner West
- Postcode
- 2140
- Distance to Burwood
- ~3 km
- Local government area
- Strathfield Municipal Council
Most decisions can be challenged
Before deciding what to do, pin down three things: exactly what was decided, the reasons given, and the date you received the letter. The first two tell you what evidence might change the outcome. The third starts the clock, because an internal review is generally requested within 28 days. With those in hand, choosing between a review on your own and getting advice becomes much clearer.
Read next:CTP claim denied?
Medical and threshold disputes
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”
How to request a review
An internal review is a fresh look at the decision by the insurer. Ask in writing, generally within 28 days of receiving the decision. Say which decision you disagree with, why you think it's wrong and what outcome you want. Attach anything new: a report from your doctor, hospital records, payslips or witness details.
Don't wait until the last days of the window to start. Specialist reports and records can take time to arrive, and a rushed request is usually weaker. If some evidence won't be ready in time, lodge the request within the deadline anyway and tell the insurer what else is on its way.
The 28-day window
The review deadline is short: generally 28 days from receiving the decision. If you're unsure which date counts, work from the earlier one.
Read next:Insurer stopped my weekly payments
Free claim check
Check your review options, free
A free, no-obligation claim check by phone or online. We'll look at the decision and the deadline, and connect you with an independent lawyer if needed.
The Personal Injury Commission
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
Complaints versus disputes
A dispute is about a decision, such as whether your claim is accepted. A complaint is about conduct, such as delays, unanswered calls or unclear letters. Complaints about the conduct of CTP insurers go to the Independent Review Office (IRO) on 13 94 76, 8:30am to 5:30pm weekdays, or online at iro.nsw.gov.au. The IRO doesn't fund lawyers for CTP claims.
The decisions behind many disputes
Not every decision is a flat refusal. Sometimes the claim is accepted but limited: benefits capped at 52 weeks, weekly payments set lower than you expected, or a particular treatment declined. These partial decisions can matter as much as a refusal over time, and most can be reviewed in the same way.
- The crash is being treated as a work injury
- Weekly payments were stopped or reduced
- Your pre-accident earnings were set lower than you expected
- The insurer says the injury wasn't caused by the crash
Read next:Claim denied? Quick check
What a dispute might cost
Because some disputes don't allow legal costs to be recovered, it's worth asking early whether paying for help makes sense in yours. For a straightforward review, you may manage alone with good evidence. For a threshold dispute that affects a damages claim, or a refusal of the whole claim, advice is more often worth it.
Read next:What does a CTP lawyer cost?
From decision letter to the Commission
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
Read the letter twice: once for what was decided, once for why. Write down the date you received it. If the reasons aren't clear, ask the insurer to explain them in writing.
Within 28 days
Ask for an internal review
For most decisions, you can ask the insurer for an internal review, generally within 28 days of receiving the decision. Say what you disagree with and include any new evidence.
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 internal review leaves the decision in place, the next step is generally an application to the Personal Injury Commission, an independent tribunal. What you're disputing decides which of its paths applies, such as merit review or medical assessment.
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.
Reviewing alone or with legal help
Many people handle an internal review themselves. Disputes that reach the Personal Injury Commission, or that affect a damages claim, are where legal advice more often helps.
Often worth talking to a lawyer
- You've missed the review deadline
- Your injury was classed as threshold and it affects a damages claim
- You were driving for work and the insurer has refused on that basis
- You've been found mostly at fault
You may not need one
- A treatment request was declined for lack of information you can supply
- Your doctor can clearly answer the insurer's question in a report
- You mainly want to complain about delays or communication
When treatment is declined, the fix is often a clearer explanation of why it's needed. We can connect you with doctors and allied health who know how the scheme assesses requests and what a Certificate of Fitness should record.
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 Homebush South
- If the dispute turns on whether your injury is more than threshold, the injury compensation page explains what the medical evidence needs to show. Injury compensation lawyer in Homebush South
- If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Homebush South. CTP claims in Homebush South
Frequently asked questions
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.
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.
Sometimes, but it's limited. For a statutory benefits dispute, legal costs are recoverable from the insurer only where the Regulation or the Personal Injury Commission allows, and some disputes allow no recovery at all. Ask any lawyer, before they start, what the costs position is for your specific dispute, and get it in writing.
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.
Not in the usual sense. If you were driving for work, or the crash otherwise happened in the course of your work, workers compensation through your employer's insurer is generally the claim to make first, and CTP statutory benefits are generally not payable where workers compensation is available. That's a question of which scheme applies, not a finding about your injury. A CTP damages claim against the at-fault driver's insurer may still be possible, so get advice. The work quick check is a sensible first step.
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.
CTP claim denied: suburbs near Homebush South
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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.