Changes to the NSW CTP scheme

Thomas O’Neill, Psychology Council Member, Clinical Psychologist

Following extensive review and collaboration between stakeholders, the NSW Government has introduced new Compulsory Third Party (CTP) Green Slip reforms. The purposes of these are many, but predominantly focus on the need to improve support for those injured on NSW roads and to reduce the costs of CTP Green Slips to vehicle owners.

The Motor Accidents Injuries Bill was passed by the NSW Parliament on 30 March 2017 and the new CTP scheme commenced on 1 December 2017. The new scheme replaces prior legislation that had been in place in NSW for 18 years and was considered to be no longer serving injured workers and policy holders as optimally as it could.

The new scheme focuses on early intervention, support and assistance, a no-fault system for minor injuries and, as with the workers compensation wing of the State Insurance Regulatory Authority (SIRA), promotes wellness behaviour, resumption of usual function, including recovery at work. Its faster and more streamlined claims process also aims to ensure that injured people receive the help they need promptly.

The new scheme is a significant shift from the older system that often maintained ill health through adversarial processes, claims for lump sum payments and fraud. Fraud will now be managed by defining benefits for soft tissue injuries and minor psychological injuries, hence reducing incentives to abuse the system. The changes have also given the scheme more authority to investigate fraud, with increased penalties for those lodging and supporting fraudulent and exaggerated claims.

The following information has been provided by SIRA to the Psychology Council of New South Wales to assist treatment providers to understand the core changes to the scheme and what this means for their clients, provision of psychological treatment services and compliance with administrative processes.

Many thanks to Mr Peter Hukins, Manager of Health Service Provider Performance, CTP Claims and Customer Outcomes, Motor Accidents Insurance Regulation, SIRA for providing this information.

New CTP Green Slip scheme puts injured people first

The new CTP Green Slip scheme is to better support people injured on NSW roads. The new scheme is focused on early support and recovery, with a six-month safety net for injured people – regardless of whether the injuries are physical or psychological, or who was at fault in the accident.

If you have a client who has been injured in a motor accident in NSW after 1 December 2017, their benefits can include:

  • reasonable medical and treatment expenses;
  • weekly income payments if they need time off work;
  • vocational rehabilitation programs; and
  • commercial attendant care services.

SIRA regulates motor accident CTP insurance in NSW.

SIRA recognises that an emotional response to a trauma such as a motor accident is normal, and not necessarily indicative of an ongoing or serious illness or disorder that would prevent an injured person from returning to work and their usual activities within a short period of time.

What your clients need to know

Your clients don’t need to lodge a claim to access early treatment. They can receive up to two sessions from an allied health provider, such as a psychologist, simply by notifying SIRA of the accident via the SIRA website. They will need to know the insurer of the at-fault vehicle.

The injured person must lodge a claim within three months of the date of accident. However, to receive early weekly income payments, they should lodge the claim within 28 days from the date of the accident. If they lodge their claim after 28 days, they will not receive back pay for loss of income from the date of accident.

Your client will not need to engage a lawyer to lodge a claim or to receive initial benefits. The new CTP scheme is no-fault for the first six months. This removes the need for insurers and lawyers to determine fault and negotiate compensation, which can add years to settlement timeframes and result in more stress for injured people when they should be focusing on recovery.

Benefits can continue for up to two years, provided the person has more than a minor injury and they were not at fault in the accident. Medical, treatment and care benefits may continue as required, for life if needed.

The treating doctor will be required to complete a certificate of fitness for clients every 28 days. You may also be asked to provide information to the insurer, which will help your client get the treatment and other benefits they need to recover.

The easiest way to make a claim is to contact CTP Assist on 1300 656 919 or by email: ctpassist@sira.nsw.gov.au

CTP Assist can provide information and answer questions about the new scheme, connect your client with the right insurer, help them fill in claim forms and provide support throughout the claims process.

What you need to know

To provide services to people under the CTP scheme, you will need to complete an allied health recovery request (AHRR) and submit it to the CTP insurer for consideration. It should include specific, measurable, attainable, relevant and timely (SMART) goals that focus on functional outcomes to provide the direction for treatment. A rationale for treatment services also needs to be provided on the AHRR.

Reasonable and necessary treatment is defined by the CTP scheme as:

  1. directly related to the injuries sustained in the motor vehicle accident or work related incident;
  2. aimed at helping the injured person get back to their usual activities;
  3. appropriate for the type of injury;
  4. provided by an appropriately qualified health professional; and
  5. cost effective.

SIRA’s Treatment Advice Centre provides information for professionals working in the scheme. Look under Clinical framework for the delivery of health services for more information on psychological injuries and the use of SMART goals.

The Motor accidents guide for allied health practitioners and SIRA’s A-Z page provides practical information about working in the scheme, including the forms you will need.

A free online training module for allied health practitioners includes information about both the current and the previous schemes, and takes less than an hour to complete.

CTP Assist can also provide you with additional information about the new scheme.

Contact CTP Assist on 1300 656 919 or by email: ctpassist@sira.nsw.gov.au

More information is available at www.sira.nsw.gov.au. If you wish to find more specific information on injured people’s benefits, health services, recovery plans and dispute resolution processes it can be found on the following link:  

http://www.sira.nsw.gov.au/claiming-compensation/motor-accidents-injury-claims/from-1-december-2017/personal-injury-benefits