A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Kensington, 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.
Eastern Suburbs · Serious injury compensation
Kensington: when you might need an injury compensation lawyer
How serious injuries are measured in a CTP claim, and what those measurements change.
Postcode: 2033
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After a serious injury near Kensington
If a serious injury means regular follow-up, the Eastern Suburbs Line, light rail and buses can get you there. Keep a list of each specialist you see and what they found. Hospitals serving the area include Prince of Wales Hospital. For a serious injury, the records from the first admission, including imaging and any surgery, carry weight because they show the injury before recovery began. If scans, specialist reviews or surgery mean trips to Bondi Junction, about 3 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.
If a serious injury means you need changes at home, or help getting around the Randwick City Council area, write down what you need and why. Treatment and care needs are part of what the insurer considers under the scheme.
- Region
- Eastern Suburbs
- Postcode
- 2033
- Nearest public hospital
- Prince of Wales Hospital
- Distance to Bondi Junction
- ~3 km
- Local government area
- Randwick City Council
Reading the threshold line
Where an injury falls against the threshold line affects how long statutory benefits can last and whether damages are possible. The comparison below is general. Symptoms alone don't decide it; the medical diagnosis does.
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
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
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
The threshold line and what takes an injury past it
The threshold line is a medical line drawn by legal rules. Your doctor diagnoses the injury; the scheme's definition decides which side it falls on. Sprains, strains and whiplash without nerve findings usually sit on the threshold side. Confirmed nerve damage, a tear, a fracture or a brain injury generally takes an injury beyond it. The insurer makes the call, and you can challenge it.
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 scheme has been amended over time, most recently for accidents from 1 April 2023. Rules change, so check the current rules for your accident date.
Read next:Threshold injury disputes
Serious injury: when legal advice helps
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 may stop you returning to the work you did before
- Another driver was at fault and a damages claim may be possible
- You have a psychological injury as well as a physical one
- You have a fracture, a tear, nerve damage or a brain injury
You may not need one
- The injury has settled with no lasting effect on your work or daily life
- The insurer accepts the injury is more than threshold and benefits are flowing
- Your injury is healing as expected and should resolve fully
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?
- 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
- For what a claim can actually pay for, and the timing rules for damages, see the car accident compensation page. Car accident compensation in Kensington
- Before any of this, if the real question is which scheme or kind of claim covers your injury, the compensation lawyer page is the place to begin. Compensation lawyer in Kensington
- 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 Kensington
When an injury limits your work for years
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
Who assesses impairment, and when
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.
- How complete and current your medical records are
- Changes in your condition since the last report
- Whether you disagree with the result, and the deadline to say so
Read next:Insurer medical examinations
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
What shows an injury is serious
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.
- Operation and specialist reports
- Every Certificate of Fitness, in order
- Reports from a treating psychologist or psychiatrist, if any
- Records of how the injury affects your work
Read next:Gathering medical evidence
Free claim check
Check where a serious injury leaves your claim
Tell us about your injury and what the insurer has decided. We'll say whether an independent lawyer would help.
Frequently asked questions
Generally, no. A threshold injury is generally a soft tissue injury, and a broken bone isn't soft tissue. So a fracture caused by the crash will usually take the injury beyond the threshold, although the insurer still decides on the medical evidence. If you have a fracture along with soft tissue injuries, make sure the fracture is clearly recorded on every certificate and report.
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.
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.
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.
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.
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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.