Threshold injury (Guidelines Part 5 — overview)
Part 5 of the SIRA Motor Accident Guidelines deals with threshold injury issues in the scheme. This page provides a general overview of how threshold injury issues arise, what evidence themes commonly matter, and how disputes are determined. General information only.
Key references on this page
1) Threshold injury definition (high level)
Threshold injury is defined in the Act (s 1.6) and interacts with scheme rules about benefit duration. The Guidelines provide guidance relevant to threshold injury handling and disputes.
2) Evidence themes that often matter
- contemporaneous medical records and objective findings
- specialist input where diagnosis is disputed
- consistency of history over time
- targeted reports addressing the legal definition
3) Dispute pathway (medical)
Threshold injury disputes commonly proceed through PIC medical pathways, usually after internal review.
Read: Threshold injury dispute, Internal review, and Merit vs medical assessment.
Frequently asked questions
- Is threshold injury the same as WPI?
- No. Threshold injury classification and WPI/permanent impairment are separate concepts used for different entitlement questions.
- Does threshold injury affect weekly payments?
- Threshold injury classification can affect benefit duration. Weekly payments can also be affected by earning capacity decisions and other rules.
- How is threshold injury decided?
- It is evidence-driven and often determined through PIC medical pathways in disputes.
- Do I need internal review first?
- Often yes. Many disputes start with an insurer internal review step.
- Where can I read the definition explanation?
- See our threshold vs non-threshold injury page for a plain-English explanation of the concepts.