Threshold & Non-Threshold Injury

What is a Threshold and Non-Threshold Injury?

The categorisation of an injury can significantly impact your income benefits, medical expenses, rehabilitation support, and other related costs and the compensation you may receive.



Here, we will explain some of the legal concepts around categorising your injury so you can be sure you are receiving the compensation appropriate to your conditions.

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CATEGORISING

YOUR INJURY

A non-threshold injury is:

  • Physical Injuries, such as:
  • Fractures
  • Nerve Injuries
  • Complete or partial ruptures to tendons, cartilage or ligaments
  • Spinal nerve damage that meets the criteria for radiculopathy


Psychological Injuries, such as:

  • PTSD
  • Depression


This is a legal concept. This means medical practitioners are unaware of the information required in order to satisfy the CTP insurer that the injured accident victim has sustained a non-threshold injury.


The CTP insurer will issue a liability notice nine months after your Application for Personal Injury Benefits has been submitted. This notice will indicate whether the CTP insurer considers you have suffered a threshold or non-threshold injury.

PHYSICAL INJURIES

The legislation defines a soft tissue injury as:


...an injury to tissue that connects, supports or surrounds other structures or organs of the body (such as muscles, tendons, ligaments, menisci, cartilage, fascia, fibrous tissues, fat, blood vessels and synovial membranes), but not an injury to nerves or a complete or partial rupture of tendons, ligaments, menisci or cartilage.


This includes soft tissue injuries commonly known as "whiplash" or "muscular strain."


Non-threshold physical injuries may include fractures, nerve injuries, complete or partial tendon, cartilage, meniscus, or ligament ruptures, or damage to the spinal nerve root that meets the criteria for radiculopathy.

Guy in a Wheelchair
CTP Claim Form on the table for Psychological Injuries

PSYCHOLOGICAL INJURIES

The legislation defines a threshold injury as a psychological or psychiatric injury that is not a recognised psychiatric illness. This includes adjustment disorder or acute stress disorder.


Post-traumatic stress disorder is a non-threshold injury.  In order to be diagnosed with post-traumatic stress disorder you must satisfy the criteria accordingly to the DSM-IV.


Non-threshold psychological or psychiatric injuries may encompass diagnosed conditions like depression or post-traumatic stress disorder (PTSD), or any other psychological or psychiatric illness defined in the latest edition of the 'Diagnostic and Statistical Manual of Mental Disorders,' with the exception of adjustment disorder and acute stress disorder.

At CTP Claim Guide, we are here to help you make sense of your CTP claim and support you in the process. Reach out to the team to get the compensation you deserve.

THRESHOLD INJURY DECISIONS

The interpretation of legislation governing CTP insurance claims can vary between claimants and CTP insurers, leading to disagreements and challenges. Insurers may interpret the law differently, impacting the benefits claimants receive. 


CTP insurers can also misclassify non-threshold injuries as threshold injuries. This can happen due to a lack of understanding of your injury and the impact it has had on you, a failure to properly consider medical information or time constraints due to significant caseloads. 


Incorrectly categorising an injury as a threshold injury can result in significant financial losses and a loss of your rights to make a lump sum compensation claim.

If you disagree with a decision made about your injuries it is important you request an internal review within 28 days of the decision. CTP Claim Guide can help.

THE PERSONAL INJURY COMMISSION

If you are dissatisfied with the outcome of the CTP insurer’s internal review decision then you must lodge an application with the Personal Injury Commission to challenge the decision.


It is critical that you include all medical documentation in support of your application so that the independent doctor appointed by the Personal Injury Commission can undertake an accurate assessment of whether or not you have sustained a threshold injury.


It's important to note that seeking legal assistance with challenging a threshold injury decision made by a CTP insurer does not come with any financial burden on your part. If you choose to engage a lawyer for a dispute, their fees will be covered by the CTP insurer.

FREQUENTLY ASKED QUESTIONS

  • What is a minor injury?

    The term minor injury was a legislative term used prior to 1 April 2023.  From 1 April 2023 this term was changed to ‘threshold injury’.


    While the injury may be minor within the definition it may have disastrous consequences for the claimant in their day to day life.

  • What is a threshold injury?

    The legislation says that a "threshold injury" is one or more of the following—


    1. A soft tissue injury,
    2. A psychological or psychiatric injury that is not a recognised psychiatric illness.

    (2) A "soft tissue injury" is an injury to tissue that connects, supports or surrounds other structures or organs of the body (such as muscles, tendons, ligaments, menisci, cartilage, fascia, fibrous tissues, fat, blood vessels and synovial membranes), but not an injury to nerves or a complete or partial rupture of tendons, ligaments, menisci or cartilage.

  • What is a non-threshold injury?

    An injury is classified as non-threshold when it falls outside the criteria for soft tissue or threshold psychological or psychiatric injury.


    Non-threshold physical injuries encompass various conditions, such as fractures, nerve injuries, complete or partial ruptures of tendons, cartilage, meniscus, or ligaments, and damage to the spinal nerve root meeting the criteria for radiculopathy.


    Similarly, non-threshold psychological or psychiatric injuries involve diagnosed psychological or psychiatric illnesses like depression or PTSD.

  • Can I dispute a CTP insurer’s decision about my claim?

    You must submit a request to the CTP insurer for an internal review within 28 days of receiving the decision.

  • When do I engage a CTP lawyer?

    We recommend that you engage an expert CTP lawyer from the very beginning of your claim.


    Should you wish to handle your claim on your own we recommend that you seek legal advice if:


    The CTP Insurer refuses to pay for treatment your doctor says you need.


    The CTP Insurer is not paying you what you think you should be paid for your lost income.


    The CTP Insurer sends you a notice that says they are not liable to pay you anything after the first 52 weeks.


    The CTP Insurer advises you that you may be entitled to make a common law lump sum damages claim.

  • What is a sustained injury?

    A "sustained injury" typically refers to an injury that has occurred and continues to have lasting effects over an extended period. It's an injury that doesn't heal quickly or entirely, often leading to prolonged pain, disability, or other long-term consequences.

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Submit the form below and we will have one of our expert CTP lawyers reach out to learn more about you and your circumstances and see if you are eligible. Start the CTP claim process now to get the compensation you deserve.

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