The decision as to whether or not a claimant has sustained injuries that are defined as minor injuries in the Motor Accidents Injuries Act 2017 is one of the most important decisions made in relation to a motor accident claim.
This decision will determine whether the claimant is entitled to statutory benefits after the first 26 weeks from the date of accident and whether they will be entitled to bring a claim for common law damages.
It is very important that claimants have their injuries investigated as thoroughly as possible during the first 26 weeks before this decision is made, wherever possible.
In addition to regular consultations with their treating doctor and other allied health workers, radiological investigations can be crucial in determining whether or not a claimant will fall into the minor injury category.
A recent case
Turner Freeman Lawyers recently acted for a claimant who alleged she sustained injuries in a motor vehicle accident. The insurer determined within the first 26 weeks that all of the claimed injuries were minor injuries as defined by the legislation, and therefore issued a decision denying statutory benefits after the first 26 weeks. Turner Freeman Lawyers challenged that decision in the Dispute Resolution Service (DRS), however the medical assessor determined that all of the claimant’s injuries were in fact minor injuries.
Turner Freeman Lawyers sought a review of that Medical Assessment Certificate on the basis that there was reasonable cause to suspect that the medical assessment was incorrect in a material respect. The basis of that application was that radiology of the claimant’s cervical spine demonstrated that the claimant had a disc protrusion with a central annular tear. It was submitted that a tear is defined in the legislation as a non-minor injury.
The proper officer accepted that the assessor had not sufficiently addressed the annular tear and accordingly referred the matter to a review panel. The review panel considered all of the evidence and in particular, looked at the claimant’s history prior to the motor vehicle accident. The review panel were ultimately satisfied that the motor accident had caused the annular tear, after taking into account the claimant’s pre-existing cervical spine condition.
What is important to note, is that had the claimant not undergone this investigation, it is likely that the decision that she had not sustained more than a minor injury would have been upheld and the Claimant would have been subsequently dis-entitled from statutory benefits and a common law damages claim.
For this reason, it is recommended that claimant’s regularly liaise with their doctor and seek approval of any necessary radiological investigations at the earliest opportunity where they are warranted and recommended by their medical professionals.
As always, where there is a dispute about a statutory benefits claim, the lawyers at Turner Freeman are able to assist in challenging and potentially overturning those decisions.