When an injury from a motor accident is serious, two questions shape the claim. Is it more than a threshold injury? And how much lasting impairment does it leave? The answers affect how long benefits can run and whether damages are possible. If you're in Kempsey and your injury is serious or not improving, our free claim check looks at where you stand and whether an independent lawyer would help.
Mid North Coast · Serious injury compensation
Injury compensation lawyer Kempsey: threshold and beyond
Your doctors describe the injury. The scheme's rules decide what that means for your claim.
Postcode: 2440
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After a serious injury near Kempsey
The first records of a serious injury may sit with Port Macquarie Base Hospital, Coffs Harbour Health Campus, Manning Hospital, Kempsey Hospital or Macksville Hospital. Ask for imaging reports too. Kempsey is about 40 km north of Port Macquarie. With a serious injury, travel is often the hardest part of the week, so the claim check and any legal advice can happen by phone and online instead. If a serious injury means you need changes at home, or help getting around the Kempsey Shire Council area, write down what you need and why. Treatment and care needs are part of what the insurer considers under the scheme.
- Region
- Mid North Coast
- Postcode
- 2440
- Nearest public hospital
- Kempsey District Hospital
- Distance to Port Macquarie
- ~40 km
- Local government area
- Kempsey Shire Council
Is your injury serious enough to get advice?
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
- Your injury has worsened since it was last assessed
- You're wondering whether your impairment could be more than 10%
- You have a psychological injury as well as a physical one
- Another driver was at fault and a damages claim may be possible
You may not need one
- Your injury is healing as expected and should resolve fully
- You want general scheme information that CTP Assist can give
- Your question is about treatment options, not compensation
If you're not sure your injury has been fully investigated, a doctor experienced with CTP can help. We can suggest doctors and allied health familiar with the Certificate of Fitness and serious injury care.
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
- For what a claim can actually pay for, and the timing rules for damages, see the car accident compensation page. Car accident compensation in Kempsey
- 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 Kempsey
- If the insurer has already decided your injury is threshold and you want to challenge it, the CTP claim denied page sets out the steps. CTP claim denied in Kempsey
Which side of the threshold line your injury may fall
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
Two measurements do most of the work when an injury is serious. One is the threshold line, which separates soft tissue and some psychological injuries from everything else. The other is whole person impairment, a percentage that describes lasting impairment. Between them, they affect how long statutory benefits can run and what a damages claim, if you have one, can include.
Read next:Threshold vs non-threshold injury
What whole person impairment is
Whole person impairment, or WPI, is a percentage that describes how much a lasting injury affects the body as a whole. It isn't a measure of pain, and it isn't a measure of what you've lost. It's a medical assessment made under set guidelines once an injury has stabilised. In a CTP claim, WPI matters mainly for damages: non-economic loss is only available where WPI is more than 10%.
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
Free claim check
Free claim check for a serious injury
Call (02) 7238 7379 or request a callback. We'll go through your diagnosis, your dates and any assessment deadlines with you.
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
- Changes in your condition since the last report
Read next:Insurer medical examinations
The threshold line and what takes an injury past it
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.
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 an injury limits your work for years
Earning capacity compares what you could have earned without the injury with what you can realistically earn now. For a tradesperson with a damaged shoulder, or an office worker with a brain injury, that gap can be large and long-lasting. Record every change to your working life: hours, duties, roles you can no longer do. Those facts sit alongside the medical evidence.
Read next:Statutory benefits vs damages
Mental health after a serious crash
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
What shows an injury is serious
The most persuasive serious injury claims usually have consistent evidence: the same injuries described the same way, from the hospital to the GP to specialists, with no unexplained gaps in treatment. That consistency comes from telling each doctor the full story and following treatment plans. If a report leaves something out, ask the doctor about it rather than letting it pass.
- Hospital admission and discharge records
- Operation and specialist reports
- Every Certificate of Fitness, in order
- Reports from a treating psychologist or psychiatrist, if any
Read next:Gathering medical evidence
Frequently asked questions
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.
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.
Usually, yes, because most whiplash is soft tissue injury to the neck. But not always. If a doctor finds nerve damage, or a full or partial tear of a tendon or ligament, the injury may be more than threshold. Symptoms like arm pain, numbness or weakness are worth describing to your doctor. The insurer decides on the medical evidence, and its decision can be reviewed.
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.
Possibly. A soft tissue injury with nerve damage, or with a full or partial tear of a tendon, ligament, meniscus or cartilage, is generally not a threshold injury. If yours is more than threshold, another driver was at fault and you weren't mostly at fault, you may be able to claim damages, including loss of earnings. Pain and suffering needs WPI of more than 10%.
Injury compensation lawyer: suburbs near Kempsey
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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.