Over-Threshold (Non-Threshold) Injury: Unlocking Your Full Entitlements
In the NSW CTP scheme, injuries are classified as either "threshold" or "non-threshold" (often called over-threshold). This classification is the single most important factor in determining the long-term value of your claim and how long your benefits will last. General information only.
1) What is a Non-Threshold Injury?
Under Section 1.6 of the Motor Accident Injuries Act 2017, a threshold injury is limited to soft-tissue injuries and "minor" psychological injuries. Any injury that does not fit that narrow definition is considered "non-threshold".
Common examples of over-threshold injuries include:
- Fractures and broken bones.
- Nerve root compression (radiculopathy).
- Complete ligament or tendon ruptures.
- Traumatic brain injuries.
- Recognized psychiatric illnesses (like PTSD or Major Depression).
2) The 52-Week Cliff
If your injury is classified as a "threshold injury", your weekly income support and medical treatment payments will usually stop after 52 weeks. If your injury is classified as "non-threshold", these benefits can continue as long as you meet the other criteria.
3) Eligibility for Common Law Damages
You are only permitted to make a claim for a lump sum "common law damages" settlement if you have a non-threshold injury. This is a critical gateway. Without an over-threshold determination, your claim is limited to statutory benefits only.
4) Disputing the Insurer’s Decision
Insurers often classify injuries as "threshold" even when there is evidence to the contrary. If you disagree with the insurer’s classification:
- You must request an Internal Review.
- If the insurer does not change the decision, you must escalate the matter to a Personal Injury Commission Medical Assessor.
5) Why you should contact us immediately
The difference between a threshold and non-threshold injury can be worth hundreds of thousands of dollars over the life of a claim. If the insurer has called your injury "minor" or "threshold", contact us immediately to discuss a dispute. We can help gather the specific medical evidence needed to cross this gateway.
Frequently asked questions
- What does "over-threshold" mean in NSW CTP?
- It means your injuries do not fall into the "threshold injury" category (formerly minor injuries). This typically refers to physical injuries like fractures or nerve damage, or recognized psychiatric illnesses.
- Why is an over-threshold determination important?
- If your injury is non-threshold, you are entitled to statutory benefits (weekly payments and treatment) beyond 52 weeks, and you may be eligible to make a claim for common law damages.
- How do I prove my injury is over the threshold?
- You need specific medical evidence, such as specialist reports, imaging (MRI/CT scans), and clinical findings that satisfy the legal definitions under the Motor Accident Injuries Act 2017.