Facial injury claim
Facial injury and facial scarring after a motor accident
Glass, an airbag, dashboard contact, road impact or facial fracture can leave scars, asymmetry, tissue loss or facial nerve dysfunction. CTP assessment separates facial scarring from scars elsewhere and uses the method that best captures permanent appearance and facial function after treatment.
Accident mechanism and diagnosis
How can this injury happen in a motor accident?
Glass or sharp-edge laceration
Broken glass or interior trim can cause deep cuts, retained foreign material, infection and irregular permanent scars.
Airbag or dashboard impact
Blunt trauma may fracture facial bones, injure soft tissue or facial nerves and require fixation or reconstructive surgery.
Motorcycle or pedestrian road impact
Abrasion, degloving, tissue loss and contamination can require grafting and leave contour or pigment change.
The injuries that may actually occur
- facial laceration, abrasion or tissue loss
- orbital, zygomatic, nasal or mandibular fracture
- facial nerve injury with weakness or paralysis
- skin graft, flap or reconstructive surgery
- permanent contour, pigmentation or symmetry change
Symptoms and functional effects to document
- tightness, sensitivity, itching or altered sensation
- difficulty closing an eye, smiling or controlling the mouth
- chewing, speech or nasal-airway problems from associated fracture
- distress about visible difference or social attention
- restriction from scar contracture near the eye, mouth or neck
Urgent health warning
Facial trauma with vision change, airway difficulty, uncontrolled bleeding, clear fluid from the nose, facial weakness or inability to close an eye requires urgent assessment.
Medical evidence
What tests and findings matter?
The permanent result should be documented after wound healing and reconstructive treatment. Standardised photographs, operative reports and examination of facial movement are more useful than a brief note saying only that a scar is visible.
| Test or record | What it can establish | What it cannot establish alone |
|---|---|---|
| Standardised clinical photographs | Show length, width, colour, contour, location, visibility and change over time under consistent lighting. | A casual photograph does not measure facial function or establish permanence by itself. |
| Plastic or maxillofacial report | Documents tissue loss, fracture repair, grafts, prognosis and available revision treatment. | The fact surgery occurred does not fix a WPI percentage. |
| Facial nerve examination | Tests forehead, eye closure, smile and lower-face movement by branch and identifies functional asymmetry. | Subjective numbness alone is not total facial nerve impairment. |
| CT and operative records | Establish fracture pattern, fixation, structural loss and reconstructive procedure. | Hardware or a healed fracture is not automatically assessable without permanent effect. |
A separate legal classification
Threshold injury is not the same as WPI
A laceration, fracture, tissue loss or facial nerve injury may be more than a soft tissue threshold injury depending on the exact diagnosis and statutory definition. A superficial soft tissue injury that heals without a qualifying structural or nerve injury may remain threshold. WPI is considered separately.
A non-threshold classification does not set a WPI percentage. Conversely, a low or zero WPI assessment does not necessarily decide the threshold-injury classification. Physical and psychiatric WPI are assessed separately and cannot be combined to determine whether impairment is greater than 10%.
Motor Accident Guidelines Part 6
How is permanent impairment assessed?
Clauses 6.189-6.191 require facial scarring and disfigurement to be assessed separately from scarring elsewhere. The assessor may use AMA4 Chapter 13 skin/scar criteria and/or AMA4 Chapter 9 section 9.2 for the face. Facial nerve dysfunction is considered under Chapter 9 Table 4, where the Guidelines clarify that total means all facial nerve branches.
| Assessment issue | CTP method | Important limit |
|---|---|---|
| Visible facial scar or disfigurement | Apply AMA4 Chapter 13 and/or Chapter 9 section 9.2, selecting the method that fits the permanent facial result. | Do not count the same cosmetic feature under both methods. |
| Facial nerve dysfunction | Use AMA4 Chapter 9 Table 4 with branch-specific clinical findings. | The Guidelines clarify that total facial paralysis means all branches, not one weak movement. |
| Scars elsewhere | Assess non-facial scarring separately, then combine only as Part 6 permits. | Multiple skin scars are not each rated and added as isolated lesions under clause 6.263. |
What may result in 0% or no assessable WPI?
- a fine healed scar with no qualifying disfigurement, symptoms or functional restriction
- a fracture that heals without permanent facial function or appearance change
- reported numbness without supported nerve or skin impairment
- a scar likely to materially change because treatment is incomplete
What may support a higher assessment if verified?
- permanent conspicuous contour, colour or tissue loss
- facial nerve weakness affecting eye closure, oral control or expression
- scar contracture affecting facial movement or an adjacent body function
- multiple facial injuries with distinct cosmetic and functional consequences after overlap is removed
Combination and overlap rules
- Facial scarring is assessed separately from scarring elsewhere before valid combination.
- A contracture affecting eye, mouth, jaw or neck function may require another chapter, but the same loss cannot be counted twice.
- A diagnosed psychiatric injury related to disfigurement is assessed separately under PIRS.
What does not establish impairment by itself?
- the presence of any scar
- a pre-treatment wound photograph only
- a fracture plate shown on imaging
- embarrassment without assessment of the physical scar and any separate psychiatric diagnosis
Crash-specific examples
Cheek laceration repaired in emergency
The original wound proves trauma, but permanent assessment uses the healed contour, colour, sensitivity and facial function after treatment.
Facial fracture with weak eye closure
CT and operative notes establish the fracture; branch-specific facial nerve findings identify whether a separate functional impairment remains.
Claim file preparation
Evidence checklist
Assessment source
Facial injury and scarring assessment under NSW CTP
Assessment source: Motor Accident Guidelines Part 6, clauses 6.189-6.191 and 6.258-6.266; AMA4 Chapter 9 section 9.2 and Table 4 (pages 229-230); AMA4 Chapter 13.
Threshold injury: A structural facial, fracture or nerve injury may be non-threshold; superficial soft tissue injury requires the statutory threshold test.
What the assessor checks
- facial and non-facial scars assessed separately
- Chapter 9 and/or Chapter 13 method
- branch-specific facial nerve examination
- permanent post-treatment appearance and function
What does not establish the result by itself
- a scar merely being present
- an acute wound photograph
- surgery alone
- subjective asymmetry without examination
Official sources
Related NSW CTP guides
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Frequently asked questions
- Is every facial scar assessable as WPI?
- No. A healed scar can be rated 0% where it does not satisfy the applicable cosmetic or functional criteria.
- Can photographs be used in the assessment?
- Yes. Consistent dated photographs help document appearance, but clinical examination, prognosis and function are also important.
- Is facial nerve weakness assessed as scarring?
- Not necessarily. Facial nerve function has a Chapter 9 method and must be supported by branch-specific examination.
- Can a facial scar and a body scar both be assessed?
- They are assessed separately and then combined where Part 6 permits, without double counting.
- Does scar revision delay WPI assessment?
- Assessment should reflect a permanent and sufficiently stable result. Planned treatment that may materially change the scar can make assessment premature.