Canterbury-Bankstown · Serious injury compensation

Injury compensation lawyer Sefton: threshold and beyond

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 Sefton, 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: 2162

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Serious injury care and records near Sefton

Describing a serious injury accurately matters. If English isn't your first language, CTP Assist on 1300 656 919 can arrange an interpreter for your claim, so nothing is lost between you and your doctors. Surgery, specialist follow-up or repeat imaging at Bankstown-Lidcombe Hospital all produce reports. Keep a list of what was done and when; if the severity of the injury is questioned later, those reports are where the answer starts. If scans, specialist reviews or surgery mean trips to Bankstown, about 4 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.

Living in the City of Canterbury-Bankstown area doesn't change the rules on serious injuries: the threshold line and whole person impairment work the same way across NSW. What differs from person to person is the medical evidence.

Region
Canterbury-Bankstown
Postcode
2162
Nearest public hospital
Bankstown-Lidcombe Hospital
Distance to Bankstown
~4 km
Local government area
City of Canterbury-Bankstown

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 may stop you returning to the work you did before
  • Your injury has worsened since it was last assessed
  • You're wondering whether your impairment could be more than 10%
  • The insurer has classed your injury as threshold and your doctors disagree

You may not need one

  • Your injury is healing as expected and should resolve fully
  • 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

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
  • 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 Sefton
  • 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 Sefton
  • 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 Sefton

Reading the threshold line

Think of this as a map, not a verdict. It shows the kinds of injury usually treated as threshold, and the findings that may take an injury beyond it. Only the medical evidence in your own claim can place you.

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

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

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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

The timing of an impairment assessment

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.

  • Whether every injured body part is included
  • How complete and current your medical records are
  • Whether you disagree with the result, and the deadline to say so

Read next:Insurer medical examinations

Threshold injuries and beyond

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 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

WPI: the percentage behind serious injury claims

WPI turns a lasting injury into a percentage. A doctor examines you and rates the impairment under the assessment guidelines that apply to motor accident claims. The number doesn't reflect how hard your life has become; it reflects measurable impairment. Even so, it can decide important questions, especially whether damages for pain and suffering are possible.

It's easy to overstate the 10% line. You don't need more than 10% WPI to claim damages for past and future loss of earnings; you need an injury that's more than threshold, another driver at fault, and not to have been mostly at fault yourself. The 10% line decides pain and suffering, and it also affects some timing rules for a damages claim.

Read next:Can I claim damages? Quick check

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.

  • Hospital admission and discharge records
  • Imaging reports, such as X-ray, CT or MRI, where done
  • Operation and specialist reports
  • Reports from a treating psychologist or psychiatrist, if any

Read next:Gathering medical evidence

Frequently asked questions

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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.

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