A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Nelson, 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. The findings in your own claim, and the insurer's decisions about them, are what count.
The Hills · Serious injury compensation
Nelson: when you might need an injury compensation lawyer
How serious injuries are measured in a CTP claim, and what those measurements change.
Postcode: 2765
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Nelson: work, travel and a serious injury
Commuters on Sydney Metro North West or the T-way whose serious injury has cut their hours should keep payslips from before and after the crash. The gap between them is the start of an earning capacity claim. A serious injury can change how far you can travel and how long you can sit or stand. If getting to Rouse Hill Metro station is now hard, note it; lasting limits like this are part of the picture a lawyer builds of your earning capacity. If the claim itself would mean trips to Windsor, about 11 km away, it doesn't have to. 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 Hills 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
- The Hills
- Postcode
- 2765
- Getting around
- Rouse Hill Metro station · Tallawong Metro station
- Distance to Windsor
- ~11 km
- Local government area
- The Hills Shire Council
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
- Your injury has worsened since it was last assessed
- You have a fracture, a tear, nerve damage or a brain injury
- You have a psychological injury as well as a physical one
- A pre-existing condition is being blamed for your symptoms
You may not need one
- The injury has settled with no lasting effect on your work or daily life
- Your injury is healing as expected and should resolve fully
- You want general scheme information that CTP Assist can give
If the insurer has classed your injury as threshold and you disagree, note the date of the decision. An internal review is generally due within 28 days of receiving it. Threshold injury disputes
Not quite your situation?
- Injured at work rather than on the road? That is usually a workers compensation claim, which runs under different rules from CTP. The free claim check 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 Nelson
- 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 Nelson
- 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 Nelson
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. The diagnosis describes 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
- Confirmed nerve damage
- 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.
What 'serious' means in claim terms
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. Reports prepared for you, for the insurer and, if there's a dispute, by 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
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When whole person impairment is measured
Impairment is generally assessed once an injury has stabilised, meaning it's unlikely to change much from here. Assessing too early can understate a serious injury. The insurer may arrange an assessment, you may obtain your own reports, and if the insurer and you disagree about the degree of impairment, the Personal Injury Commission can carry out a medical assessment.
- Whether the injury has stabilised
- Whether every injured body part is included
- Changes in your condition since the last report
Read next:Insurer medical examinations
When a crash affects more than the body
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. Make sure how you're coping is on the record, not just your physical injuries. 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
The threshold line and what takes an injury past it
The threshold line is a legal line drawn around medical facts. The diagnosis describes 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.
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 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
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
What shows an injury is serious
Serious injury claims rest on evidence gathered over time: records made from the day of the crash, reports on the injury as it develops, and later assessments of what it has left behind. Your own records add the human detail. Start collecting early, keep everything in date order, and make sure every injury is on the record, not just the worst one.
- The police report and your own account of the crash
- Every insurer decision about the injury, with its date
- Any reports prepared for the claim
- A diary of how the injury affects daily life
Read next:CTP damages claims
Frequently asked questions
Make sure it's on the record, even if it seemed mild at first. A brain injury isn't a soft tissue injury, so a diagnosed brain injury is generally more than threshold. Symptoms such as headaches, memory problems, fatigue or changes in mood can take time to show and are easy to put down to stress. Record them with dates as they appear.
It compares what you could have earned without the injury with what you can realistically earn now, over the years ahead. Evidence comes from your work history, payslips and tax records, and opinions about the work you can still do, sometimes from vocational experts. It's usually part of a damages claim, so the other conditions for damages need to be met. Keep records of every change to your hours, duties and roles.
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. Be open about the earlier condition rather than leaving it out.
Get the change 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.
Yes. Psychological injuries caused by the crash can be claimed along with physical injuries. Some are classed as threshold injuries and others are not, depending on the diagnosis. Make sure how you're coping, including sleep, mood and any fear of travelling, is recorded. Any diagnosis, and the reports that support it, become part of the evidence.
Each injury matters. Your claim should list every injury the crash caused, and all of them should be on the record, 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.
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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.