In New South Wales (NSW), the classification of injuries sustained in motor vehicle accidents plays a pivotal role in determining the compensation and benefits an injured party may receive. The Motor Accident Injuries Act 2017 (MAIA) delineates between "threshold" and "non-threshold" injuries, each carrying distinct implications for claimants.
Threshold Injuries: Definition and Implications
Threshold injuries, previously termed "minor injuries," encompass
- Soft Tissue Injuries: These involve damage to tissues that connect, support, or surround other structures or organs, such as muscles, tendons, ligaments, menisci, and cartilage. Common examples include sprains, strains, and whiplash injuries. Notably, this category excludes injuries involving nerve damage or complete or partial ruptures of tendons, ligaments, menisci, or cartilage.
- Psychological or Psychiatric Injuries: This includes psychological or psychiatric injuries that are not recognised psychiatric illnesses, such as adjustment disorder and acute stress disorder.
Individuals with threshold injuries are entitled to statutory benefits for up to 52 weeks following the accident. These benefits encompass weekly income support payments, medical and treatment expenses, and domestic and personal care services. However, claimants with threshold injuries are generally precluded from pursuing lump sum compensation claims for pain and suffering or for past and future economic losses.
Non-Threshold Injuries: Definition and Entitlements
Non-threshold injuries are those that exceed the criteria set for threshold injuries and typically involve more severe harm. Examples include:
- Physical Injuries: Fractures, nerve injuries, complete or partial ruptures of tendons, ligaments, menisci, or cartilage, and damage to the spinal nerve root meeting the criteria for radiculopathy.
- Psychological or Psychiatric Injuries: Recognised psychiatric illnesses such as post-traumatic stress disorder (PTSD) or major depression.
Claimants with non-threshold injuries may be eligible for extended statutory benefits beyond the initial 52-week period, including ongoing medical treatment, rehabilitation support, and income support payments. Additionally, they may pursue common law damages for pain and suffering, as well as for past and future economic losses, provided certain conditions are met.
Assessment and Disputes
At first instance, the insurer will provide an opinion on whether an injury is classified as threshold or non-threshold based on medical evidence, including diagnoses provided in certificates of fitness and supporting medical information.
Disputes over injury classification are not uncommon. In such instances, you have the right to request an internal review by the insurer and, if necessary, escalate the matter to the Personal Injury Commission for an independent medical assessment.
Understanding the distinction between threshold and non-threshold injuries is crucial for individuals involved in motor vehicle accidents in NSW, as it directly influences the scope and duration of compensation and benefits available under the MAIA. Given the complexities involved in injury classification and the potential for disputes, seeking legal advice from lawyers experienced in NSW motor accident compensation law is advisable to ensure that your rights and entitlements are fully protected.