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If you have sustained injuries from a motor vehicle accident and have prosecute a CTP claim for compensation, you must have heard from your solicitors that “we cannot get you assessed yet as we are waiting for your injuries to stabilize”. So, what does that actually mean?
Before an evaluation of permanent impairment is undertaken, it must be shown that the impairment has been present for a period of time, and is static, well stabilised and unlikely to change substantially regardless of treatment. The Motor Accident Guidelines state that permanent impairment is impairment that has become static or well stabilised with or without medical treatment and is not likely to remit despite medical treatment. A permanent impairment is considered to be unlikely to change substantially (i.e. by more than 3% whole person impairment (WPI) in the next year with or without medical treatment.
Clause 6.20 of the Motor Accident Guidelines further states the following:
“Generally, when an impairment is considered permanent, the injuries will also be stabilised. However, there could be cases where an impairment is considered permanent because it is unlikely to change in future months regardless of treatment, but the injuries are not stabilised because future treatment is intended and the extent of this is not predictable. For example, for an injured person who suffers an amputation or spinal injury, the impairment is permanent and may be able to be assessed soon after the injury as it is not expected to change regardless of treatment. However, the injuries may not be stabilised for some time as the extent of future treatment and rehabilitation is not known.”
It should be noted that the evaluation should only consider the impairment as it is at the time of the assessment. The evaluation must not include any allowance for a predicted deterioration, such as osteoarthritis in a joint many years after an intra-articular fracture, as it is impossible to be precise about any such later alteration. However, it may be appropriate to comment on this possibility in the impairment evaluation report.
A medico-legal doctor is only able to provide an assessment of WPI, if he/she is of the opinion that your condition has stabilised and unlikely to change substantially in the next year with or without medical treatment. Your level of WPI will determine whether you are entitled to make a claim for non-economic loss (general damages) for pain and suffering.
Once your condition has stabilised, an independent medical examination can then be arranged for a medico-legal doctor to conduct the assessment.
Generally speaking, the medico-legal doctor’s report will contain the following information:
If there is a dispute with the CTP insurer over your level of WPI, you can file an application with the Personal Injury Commission for them to appoint an independent Medical Assessor to conduct a medical assessment on your level of WPI. This assessment is generally binding on both parties, subject to appeals.
The CTP scheme is a complex one and if you have sustained injuries (physical and/or psychological injuries) from a motor vehicle accident, we highly recommend you seek legal advice. The Head of our NSW team, Jessica Cheung is an Accredited Specialist in Personal Injury Law. If you believe you have sustained a personal ijury and would like professional legal, reach out to Jessica and her team for a confidential discussion at no costs to you.
*The intention and purpose of this article is to be used as a guide only.