Northern Beaches · Serious injury compensation

Mona Vale injury compensation lawyer: serious injuries

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

A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Mona Vale, 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.

Postcode: 2103

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Treatment and evidence close to Mona Vale

Northern Beaches Hospital, Mona Vale Hospital or Royal North Shore Hospital may have treated a serious injury. Ask for the imaging and specialist reports, not just the discharge summary. Scans and surgery may mean travel, but claim help doesn't have to. Mona Vale is about 23 km from the Sydney CBD, and the claim check runs by phone and online. Many lawyers work with seriously injured people the same way. For people in the Northern Beaches 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
Northern Beaches
Postcode
2103
Nearest public hospital
Northern Beaches Hospital
Distance to Dee Why
~8 km
Local government area
Northern Beaches Council

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

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

Long-term earning capacity

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

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

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

  • Another driver was at fault and a damages claim may be possible
  • You have a fracture, a tear, nerve damage or a brain injury
  • Your injury has worsened since it was last assessed
  • Your injury may stop you returning to the work you did before

You may not need one

  • The injury has settled with no lasting effect on your work or daily life
  • 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?

  • 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 Mona Vale
  • 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 Mona Vale
  • 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 Mona Vale

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 the injury has stabilised
  • Whether every injured body part is included
  • How complete and current your medical records are

Read next:Insurer medical examinations

When the injury isn't only physical

The scheme treats psychological injury seriously, but it still sorts it by diagnosis. A threshold psychological injury is generally handled like a threshold physical one. A more serious diagnosed condition may take the claim beyond the threshold. Because the difference turns on the diagnosis, the opinion of a treating psychiatrist or psychologist can matter a great deal.

Read next:Psychological injury after a crash

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

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.

  • Every Certificate of Fitness, in order
  • Reports from a treating psychologist or psychiatrist, if any
  • 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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