Liverpool & Fairfield · CTP claim denied

CTP disputes and reviews for Lansvale

Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.

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 Lansvale 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.

Postcode: 2166

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Disputing a claim while living in Lansvale

If a truck on the Hume Highway or the M5 was involved and fault is disputed, evidence matters. Ask for an internal review within 28 days and include police details, photos and any witness statements. Languages spoken around Lansvale include Vietnamese, Arabic and Khmer. If English isn't your first language, a decision letter can be hard to follow. CTP Assist (1300 656 919) can arrange an interpreter so you understand it before the review deadline. There's no need to get to Liverpool, or anywhere else, to dispute a decision. From Lansvale, review requests are generally made in writing, the lawyer you speak with can advise by phone, and the claim check works by phone and online too.

Coming under Fairfield City Council makes no difference to a CTP dispute. The same review steps and deadlines apply in Lansvale as in any other part of NSW, because the scheme is statewide.

Region
Liverpool & Fairfield
Postcode
2166
Community languages
Vietnamese, Arabic, Khmer
Distance to Liverpool
~4 km
Local government area
Fairfield City 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?

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

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 injury was classed as a threshold injury
  • The crash is being treated as a work injury
  • Weekly payments were stopped or reduced
  • A treatment request was declined

Read next:Claim denied? Quick check

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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.

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

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”

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.

Paying for help with a review

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?

How to challenge a CTP decision, step by step

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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 28 days from a certificate

    Medical assessment review

    Medical assessment certificates can generally be reviewed, but the window is short: generally 28 days from the date the certificate is issued. Get advice quickly if you're considering it.

  6. 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.

When a dispute calls for 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

  • The dispute is heading to the Personal Injury Commission
  • Weekly payments were stopped and you can't work
  • You've missed the review deadline
  • The refusal is based on your claim being late

You may not need one

  • Your doctor can clearly answer the insurer's question in a report
  • The decision was about a small, one-off expense
  • 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?

  • For the wider question of whether a lawyer is worth it on a CTP claim at all, the CTP lawyer page for Lansvale is the better fit. CTP lawyer in Lansvale
  • When the real argument is how serious your injury is, the injury compensation page for Lansvale covers impairment and the threshold line. Injury compensation lawyer in Lansvale
  • If nothing has been decided yet and your claim is still being set up, the CTP claims page covers the lodging steps instead. CTP claims in Lansvale

Frequently asked questions

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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.

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