Injury compensation lawyer Tumbi Umbi: threshold and beyond

An injury can be serious in human terms and still sit on the threshold side of the line, and the reverse can happen too. That can feel unfair. It helps to know the scheme's tests are about the type of injury and its lasting effects, not how much you've suffered. Knowing which test applies lets you and your doctors focus on the evidence that matters.

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.

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
• Changes in your condition since the last report
• Whether you disagree with the result, and the deadline to say so

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.

Getting the classification right early helps. If you have symptoms that could point to nerve involvement or a tear, such as numbness, weakness, locking or a joint giving way, describe them to your doctor. Whether tests are needed is a medical decision. If a diagnosis changes, make sure the insurer has the new evidence, because the classification may need to change with it.

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.

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%.

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.

• Imaging reports, such as X-ray, CT or MRI, where done
• Every Certificate of Fitness, in order
• Reports from a treating psychologist or psychiatrist, if any
• Any impairment assessment, and your response to it