A fracture, nerve damage, a brain injury or pain that won't settle can change the course of a claim. For people in Sussex Inlet, 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.
South Coast & Shoalhaven · Serious injury compensation
Injury compensation lawyer Sussex Inlet: threshold and beyond
General information about serious injury claims in NSW, not legal or medical advice.
Postcode: 2540
- Free claim check, no obligation
- By phone & online, no office to visit
- Helping people in Sussex Inlet & Sanctuary Point
After a serious injury near Sussex Inlet
If Shoalhaven District Memorial Hospital, Milton-Ulladulla Hospital or South East Regional Hospital treated a serious injury first, obtain those early records, including any scans. If scans, specialist reviews or surgery mean trips to Nowra, about 30 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 Shoalhaven 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
- South Coast & Shoalhaven
- Postcode
- 2540
- Nearest public hospital
- Milton-Ulladulla Hospital
- Distance to Nowra
- ~30 km
- Local government area
- Shoalhaven City Council
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
- Another driver was at fault and a damages claim may be possible
- You have a psychological injury as well as a physical one
- Your injury has worsened since it was last assessed
- You're wondering whether your impairment could be more than 10%
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
- The insurer accepts the injury is more than threshold and benefits are flowing
Serious injuries need coordinated care. Ask us about doctors and allied health who understand CTP claims, from the Certificate of Fitness to ongoing rehabilitation and psychology.
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
- For what a claim can actually pay for, and the timing rules for damages, see the car accident compensation page. Car accident compensation in Sussex Inlet
- 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 Sussex Inlet
- 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 Sussex Inlet
Reading the threshold line
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.
Serious injury, in the scheme's language
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
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
Free claim check
Not sure how serious your claim is?
Free and no obligation. For a serious injury, we can connect you with an independent lawyer and with doctors experienced in CTP.
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 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
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
When whole person impairment is measured
Impairment is generally assessed once an injury has stabilised, meaning it's unlikely to change much with further treatment. Assessing too early can understate a serious injury. The insurer may arrange an assessment, your own doctors may give opinions, and if the insurer and you disagree about the degree of impairment, the Personal Injury Commission can carry out a medical assessment.
- Whether every injured body part is included
- How complete and current your medical records are
- Scans or tests your doctors have ordered
Read next:Insurer medical examinations
WPI: the percentage behind serious injury claims
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
Because serious injuries take time to show their full effect, evidence builds in layers. Early records show the injury happened and how bad it was. Later reports show how it has settled and what it has left behind. An independent lawyer can help spot gaps, but the underlying evidence comes from your treatment. Getting good care is also how good evidence is made.
- Operation and specialist reports
- Every Certificate of Fitness, in order
- Reports from a treating psychologist or psychiatrist, if any
- Any impairment assessment, and your response to it
Read next:Gathering medical evidence
Frequently asked questions
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.
Usually, yes, because most whiplash is soft tissue injury to the neck. But not always. If a doctor finds nerve damage, or a full or partial tear of a tendon or ligament, the injury may be more than threshold. Symptoms like arm pain, numbness or weakness are worth describing to your doctor. The insurer decides on the medical evidence, and its decision can be reviewed.
Possibly. A soft tissue injury with nerve damage, or with a full or partial tear of a tendon, ligament, meniscus or cartilage, is generally not a threshold injury. If yours is more than threshold, another driver was at fault and you weren't mostly at fault, you may be able to claim damages, including loss of earnings. Pain and suffering needs WPI of more than 10%.
Tell every doctor about it, 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, and ask your GP whether further review is needed.
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.
It's a percentage, often shortened to WPI, that a doctor gives to the lasting impairment an injury leaves. It's usually assessed once the injury has stabilised, and it measures impairment, not pain or lost income. The figure to know is 10%. Above it, damages for pain and suffering become possible and some timing rules for a damages claim change. At 10% or less, lost earnings can still be claimed if the other conditions for damages are met.
Injury compensation lawyer: suburbs near Sussex Inlet
Related reading
- Whole person impairment
- CTP damages claims
- Lump sum and damages claims
- Threshold disputes: a general guide
- Whiplash
- Traumatic Brain Injury
- Chronic Pain After a Car Accident
- Sciatica and Nerve Pain
- Pre-Existing Condition Aggravation
- South Coast & Shoalhaven: area guide
- CTP Lawyer Help in Wollongong & the Illawarra
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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.