A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Grafton, 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.
Northern Rivers & Clarence · Serious injury compensation
Injury compensation lawyer Grafton: threshold and beyond
How serious injuries are measured in a CTP claim, and what those measurements change.
Postcode: 2460
- Free claim check, no obligation
- By phone & online, no office to visit
- Helping people in Grafton & South Grafton
Serious injury care and records near Grafton
If Lismore Base Hospital, Grafton Base Hospital, Ballina Hospital or Byron Central Hospital treated a serious injury first, those admission records and scans are key evidence. A serious injury can make every trip to Coffs Harbour a major effort. Claim help can stay at home, where the check is done by phone and online and documents can generally be signed without travelling. If a serious injury means you need changes at home, or help getting around the Clarence Valley Council area, write down what you need and why. Treatment and care needs are part of what the insurer considers under the scheme.
- Region
- Northern Rivers & Clarence
- Postcode
- 2460
- Nearest public hospital
- Grafton Base Hospital
- Distance to Coffs Harbour
- ~71 km
- Local government area
- Clarence Valley Council
Threshold injury, or something more serious?
The scheme separates threshold injuries from more serious ones, and the difference shapes the whole claim. This is a general picture based on the scheme's definition. Your doctors describe the injury, the insurer decides where it falls, and that decision can be reviewed.
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.
When an injury counts as serious
Most people never need to think about impairment percentages. If your injury is serious, you probably will. The scheme's rules divide injuries by type first, threshold or not, and then, for some entitlements, by the degree of lasting impairment. This page explains both in general terms. Your own claim depends on your diagnosis and on the insurer's decisions, which can be reviewed.
Read next:Threshold vs non-threshold injury
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
Psychological injury and the threshold
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
Does a serious injury need a lawyer?
If your injury is more than threshold, it's worth at least one conversation with someone who knows the scheme. Whether you need more than that depends on your situation. Use these lists as a starting point.
Often worth talking to a lawyer
- An impairment assessment is coming up, or you disagree with one
- Your injury has worsened since it was last assessed
- Your injury may stop you returning to the work you did before
- The insurer has classed your injury as threshold and your doctors disagree
You may not need one
- You were mostly at fault, so no damages claim is open to you
- You want general scheme information that CTP Assist can give
- Your injury is healing as expected and should resolve fully
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?
- If the injury happened at work, including on the road for work, workers compensation is usually the scheme that applies first, not CTP. After a crash, a CTP damages claim may still be possible. 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 Grafton
- 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 Grafton
- 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 Grafton
What makes an injury more than threshold
The definition works by exclusion. An injury is generally threshold if it is soft tissue damage with no nerve damage and no torn tendon, ligament, meniscus or cartilage, whether the tear is complete or not, or if it is a psychological injury the scheme classes as threshold. Injuries outside that description, such as fractures, torn ligaments or brain injuries, are generally more than threshold.
Which side you're on matters. For accidents from 1 April 2023, statutory benefits for a threshold injury generally last up to 52 weeks. For accidents between 1 December 2017 and 31 March 2023, the limit was 26 weeks. If your injury is more than threshold and you weren't mostly at fault, benefits can generally continue for longer, and a damages claim may be possible.
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
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
The timing of an impairment assessment
There's usually no single moment when WPI is measured. Opinions may come from treating doctors, from doctors the insurer arranges, and, where the two sides disagree, from a medical assessment through the Personal Injury Commission. Timing matters, because injuries can improve or worsen for months. A lawyer can advise whether an assessment is premature before you rely on it.
- Whether every injured body part is included
- How complete and current your medical records are
- Whether you disagree with the result, and the deadline to say so
Read next:Insurer medical examinations
What shows an injury is serious
Because serious injuries take time to show their full effect, evidence builds in layers. Early records show the injury happened and how bad it was. Later reports show how it has settled and what it has left behind. An independent lawyer can help spot gaps, but the underlying evidence comes from your treatment. Getting good care is also how good evidence is made.
- Imaging reports, such as X-ray, CT or MRI, where done
- Operation and specialist reports
- Every Certificate of Fitness, in order
- Reports from a treating psychologist or psychiatrist, if any
Read next:Gathering medical evidence
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Tell us about your injury and what the insurer has decided. We'll say whether an independent lawyer would help.
Frequently asked questions
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.
It could. Tingling, numbness or weakness can sometimes point to nerve involvement, and confirmed nerve damage takes an injury outside the threshold definition. These symptoms can also have other causes, so it's a question for your doctor, who can decide whether tests are needed. Describe the symptoms precisely, note when they started, and make sure any diagnosis reaches the insurer.
More than one person may. Your treating doctors can give opinions, the insurer may send you to a doctor it chooses, and where you and the insurer disagree about the degree of impairment, a medical assessor at the Personal Injury Commission can decide it. Timing matters as much as who: an assessment made before the injury has settled can understate it. To challenge an assessment, see the CTP claim denied page, and act quickly because the deadlines are short.
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.
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.
It can. The insurer's decision is based on the evidence it has at the time. If a new diagnosis comes to light, such as nerve damage or a tear, the insurer can be asked to look at the classification again. If you disagree with a decision, there's a formal process to challenge it, starting with an internal review, and the CTP claim denied page explains those steps and their deadlines.
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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.