Blue Mountains · Serious injury compensation

Injury compensation lawyer Lawson: impairment explained

Your doctors describe the injury. The scheme's rules decide what that means for your claim.

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 Lawson and your injury is serious or not improving, our free claim check looks at where you stand and whether an independent lawyer would help.

Postcode: 2783

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After a serious injury near Lawson

For a serious injury, the first scans and specialist notes from Blue Mountains District ANZAC Memorial Hospital, Springwood Hospital, Nepean Hospital or Lithgow Hospital matter. Ask for copies. If scans, specialist reviews or surgery mean trips to Katoomba, about 12 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. For people in the Blue Mountains City Council area, as anywhere in NSW, the test for a serious injury comes from the scheme's rules and your medical evidence, not from where you happen to live.

Region
Blue Mountains
Postcode
2783
Nearest public hospital
Springwood Hospital
Distance to Katoomba
~12 km
Local government area
Blue Mountains City Council

Which side of the threshold line your injury may fall

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

Threshold injuries and beyond

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.

The line also decides whether common law damages are open. With only a threshold injury, they generally aren't. With a more serious injury, you may be able to claim damages if another driver was at fault and you weren't mostly at fault. That is why a threshold decision is often the most important decision the insurer makes about a serious injury.

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

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.

An assessment above 10% opens damages for non-economic loss and changes some timing rules as well. But many people with genuine, lasting injuries are assessed at 10% or less. That doesn't mean the injury isn't real, or that there is no damages claim. Economic loss, such as lost earning capacity, can still be claimed where the other conditions are met.

Read next:Can I claim damages? Quick check

Does a serious injury need a lawyer?

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

  • The insurer has classed your injury as threshold and your doctors disagree
  • You have a psychological injury as well as a physical one
  • You have a fracture, a tear, nerve damage or a brain injury
  • An impairment assessment is coming up, or you disagree with one

You may not need one

  • You were mostly at fault, so no damages claim is open to you
  • The insurer accepts the injury is more than threshold and benefits are flowing
  • 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?

  • 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 Lawson
  • 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 Lawson
  • 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 Lawson

Mental health after a serious crash

Serious physical injuries often bring a psychological toll: sleeplessness, anxiety, depression or trauma symptoms. These can be part of your claim in their own right. Tell your doctor how you're coping, and ask about psychology if it would help. Whether a psychological injury is threshold or more is a medical and legal question, and the insurer's decision on it can be reviewed.

Read next:Psychological injury after a crash

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
  • Scans or tests your doctors have ordered
  • Changes in your condition since the last report

Read next:Insurer medical examinations

Long-term earning capacity

Weekly payments cover lost income for a limited time. For a serious injury, the bigger question is the future: will you be able to return to your old job, at the same hours and pay? If not, a damages claim may include past and future economic loss, provided the conditions for damages are met. That part of a claim doesn't depend on WPI above 10%.

Read next:Statutory benefits vs damages

The evidence a serious injury claim needs

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.

  • Imaging reports, such as X-ray, CT or MRI, where done
  • Operation and specialist reports
  • Records of how the injury affects your work
  • Any impairment assessment, and your response to it

Read next:Gathering medical evidence

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