A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Gilead, this page explains how the NSW scheme draws the line between threshold and more serious injuries, and what whole person impairment measures. It is general information. Your own doctors' findings, and the insurer's decisions about them, are what count.
Macarthur & Wollondilly · Serious injury compensation
Serious injury? Injury compensation lawyer, Gilead
The threshold line and whole person impairment, explained without promises.
Postcode: 2560
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Serious injury care and records near Gilead
If a serious injury means trips along the Hume Motorway or Narellan Road for specialist care, keep a log. The injury's effect on getting around is part of the picture. Surgery, specialist follow-up or repeat imaging at Campbelltown Hospital all produce reports. Keep a list of what was done and when; if the severity of the injury is questioned later, those reports are where the answer starts. If scans, specialist reviews or surgery mean trips to Campbelltown, about 9 km away, keep a note of each trip and what it cost. Where you live needn't hold your claim back: advice and the claim check both work by phone and online, from home.
Living in the Campbelltown City Council area doesn't change the rules on serious injuries: the threshold line and whole person impairment work the same way across NSW. What differs from person to person is the medical evidence.
- Region
- Macarthur & Wollondilly
- Postcode
- 2560
- Nearest public hospital
- Campbelltown Hospital
- Distance to Campbelltown
- ~9 km
- Local government area
- Campbelltown City Council
Reading the threshold line
Think of this as a map, not a verdict. It shows the kinds of injury usually treated as threshold, and the findings that may take an injury beyond it. Only the medical evidence in your own claim can place you.
Usually treated as a threshold injury
- Sprains and strains of muscles, tendons or ligaments
- Whiplash-type neck pain with no nerve findings
- Bruising and soft tissue swelling
- A psychological injury the scheme classes as threshold
- Statutory benefits generally up to 52 weeks, for accidents from 1 April 2023
May be more than a threshold injury
- Nerve damage confirmed by a doctor
- A full or partial tear of a tendon, ligament, meniscus or cartilage
- A fracture, which is generally not a soft tissue injury
- A brain injury, or a diagnosed psychological condition beyond the threshold category
- Damages may be possible if another driver was at fault and you weren't mostly at fault
General information, not legal advice, and not medical advice either. The insurer decides on the medical evidence, its decision can be reviewed, and time limits apply.
Serious injury, in the scheme's language
In everyday speech, a serious injury is one that hurts a lot or takes a long time to heal. The CTP scheme uses narrower tests. The first is whether the injury is more than a threshold injury. The second, for some kinds of compensation, is how much permanent impairment it leaves, measured as whole person impairment. Pain matters to you, but the scheme looks at diagnosis and lasting effect.
Read next:Threshold vs non-threshold injury
When the injury isn't only physical
A crash can cause psychological injury as well as physical injury, and sometimes instead of it. Some psychological injuries are classed as threshold injuries; others are not, depending on the diagnosis. Anxiety, low mood, flashbacks or fear of driving are worth raising with your GP early, both for your own sake and so the injury is recorded and properly diagnosed.
Read next:Psychological injury after a crash
Serious injury and your future earnings
A serious injury can change more than the next few months of work. It can limit the kind of work you can do for years, or permanently. In a damages claim, that is called loss of future earning capacity, and it can be a significant part of a serious injury claim. It generally needs evidence from your doctors, your work history and sometimes vocational experts.
Read next:Statutory benefits vs damages
Is your injury serious enough to get advice?
The more serious and lasting the injury, the more likely the claim will involve impairment assessments, damages and long timeframes. Those are the areas where a lawyer tends to help. These lists are a rough guide.
Often worth talking to a lawyer
- You have a psychological injury as well as a physical one
- Your injury may stop you returning to the work you did before
- You have a fracture, a tear, nerve damage or a brain injury
- A pre-existing condition is being blamed for your symptoms
You may not need one
- Your question is about treatment options, not compensation
- Your injury is healing as expected and should resolve fully
- You were mostly at fault, so no damages claim is open to you
With a serious injury, the right treating team matters for recovery and evidence alike. We can point you to doctors and allied health experienced with CTP, including GPs who complete the Certificate of Fitness.
Not quite your situation?
- Hurt at work, or in a crash while you were working? That is usually a workers compensation claim first, which is a different scheme from CTP. Tell us what happened and we can point you to the right help. Free claim check
- If you want to know what compensation can include and when it is paid, the car accident compensation page sets out the whole package. Car accident compensation in Gilead
- If the question is still which sort of claim you have at all, start with the compensation lawyer page before going further. Compensation lawyer in Gilead
- To dispute a threshold decision the insurer has made, see the CTP claim denied page for the review process and its deadlines. CTP claim denied in Gilead
The threshold line and what takes an injury past it
From 1 April 2023, the scheme uses the term threshold injury, which replaced the old term minor injury. A threshold injury is generally a soft tissue injury, a threshold psychological injury, or both. Soft tissue here means muscles, tendons, ligaments and similar tissue. Nerve damage is excluded, and so is a full or partial tear of a tendon, ligament, meniscus or cartilage.
Getting the classification right early helps. If you have symptoms that could point to nerve involvement or a tear, such as numbness, weakness, locking or a joint giving way, describe them to your doctor. Whether tests are needed is a medical decision. If a diagnosis changes, make sure the insurer has the new evidence, because the classification may need to change with it.
Check the date of your accident
The threshold rules and benefit periods depend on when your accident happened. Check which rules apply to your date before relying on any general statement.
Read next:Threshold injury disputes
When whole person impairment is measured
In a serious injury claim, impairment often comes into focus well after the crash, once treatment has run its course. The Personal Injury Commission handles medical assessment where the insurer and the injured person disagree. If you think an assessment is wrong, the steps to challenge it are set out separately, and the deadlines are short, so act promptly.
- Whether every injured body part is included
- Scans or tests your doctors have ordered
- Whether you disagree with the result, and the deadline to say so
Read next:Insurer medical examinations
WPI: the percentage behind serious injury claims
People are often surprised by how technical WPI is. It is assessed under guidelines that rate specific impairments, such as lost movement in a joint, and express the result as a whole-body percentage. More than 10% is the key line in CTP claims, because damages for non-economic loss, meaning pain and suffering, are only available above it. Loss of earnings doesn't need that level.
Because so much can turn on a few percentage points, WPI assessments are often contested. Your treating doctors, the insurer's chosen doctor and, if there's a dispute, a medical assessor through the Personal Injury Commission may reach different figures. Keep every report, and get advice before accepting an assessment you think is wrong.
Read next:Can I claim damages? Quick check
The evidence a serious injury claim needs
Serious injury claims rest on medical evidence gathered over time: hospital records, imaging, operation reports, specialist opinions, and treating doctors' notes that track your progress. Your own records add the human detail. Start collecting early, keep everything in date order, and make sure each doctor knows about all your injuries, not just the one they're treating.
- Hospital admission and discharge records
- Imaging reports, such as X-ray, CT or MRI, where done
- Operation and specialist reports
- Reports from a treating psychologist or psychiatrist, if any
Read next:Gathering medical evidence
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Frequently asked questions
Not always. Whether scans are needed is a medical decision, and many injuries are diagnosed by examination. Where your doctor recommends imaging, it can show things an examination can't, such as a fracture, a tear or signs of nerve compression, and that can affect how the injury is classified. Keep copies of every imaging report, and don't arrange scans just for the claim.
Generally, yes, for the worsening the crash caused. A pre-existing condition, like arthritis or an old back injury, doesn't stop a claim, but the insurer may argue that some of your symptoms would have happened anyway. Clear evidence helps: records of how you were before the crash, and how you've been since. Tell your doctors about the earlier condition rather than leaving it out.
Tell every doctor about it, even if it seemed mild at first. A brain injury isn't a soft tissue injury, so a diagnosed brain injury is generally more than threshold. Symptoms such as headaches, memory problems, fatigue or changes in mood can take time to show and are easy to put down to stress. Record them, and ask your GP whether further review is needed.
Tell your doctor about the change, get it recorded, and make sure the insurer receives the new evidence. An earlier assessment may no longer reflect your condition, and in some circumstances the injury may be looked at again. Whether and how that happens depends on the stage of your claim and the rules for your situation, so this is a good point to get advice.
Each injury matters. Your claim should list every injury the crash caused, and your doctors should record all of them, not just the worst. The threshold limits generally apply where all your injuries are threshold injuries, so one injury that is more than threshold can change the whole claim. How several injuries are rated for impairment is technical, so get advice if it matters to you.
It's a percentage, often shortened to WPI, that a doctor gives to the lasting impairment an injury leaves. It's usually assessed once the injury has stabilised, and it measures impairment, not pain or lost income. The figure to know is 10%. Above it, damages for pain and suffering become possible and some timing rules for a damages claim change. At 10% or less, lost earnings can still be claimed if the other conditions for damages are met.
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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.