A serious crash can change a family’s life in a moment. When someone suffers a spinal cord injury, a severe brain injury or major burns, the questions come quickly. Who will pay for care? Will the house need changes? What happens to income?
If you or someone you love has suffered a catastrophic injury in a WA road accident, there is a dedicated support scheme designed to help. It is run by the Insurance Commission of Western Australia (ICWA). There may also be a right to claim compensation on top of that support.
This guide explains how the scheme works, who qualifies, and how it fits with a damages claim.
What is the Catastrophic Injuries Support Scheme?
The Catastrophic Injuries Support (CIS) Scheme provides treatment, care and support to people catastrophically injured in motor vehicle accidents in Western Australia.
It is a no-fault scheme. ICWA says it can provide necessary and reasonable treatment, care and support regardless of who was at fault, as long as the eligibility criteria are met.
The scheme is set up under the Motor Vehicle and Workplace Accidents (Catastrophic Injuries) Act 2016 (WA) and the Motor Vehicle and Workplace Accidents (Catastrophic Injuries) Regulations 2016 (WA).
Then vs now
Our earlier article on catastrophic injuries was written when the scheme covered road accidents only. Since then, the scheme has grown.
| When the scheme began | Today | |
| Road accidents | Covered for accidents from 1 July 2016 | Still covered |
| Workplace accidents | Not covered | Covered for accidents from 1 July 2024 |
| Name of Act | Motor Vehicle (Catastrophic Injuries) Act 2016 | Motor Vehicle and Workplace Accidents (Catastrophic Injuries) Act 2016 |
This article focuses on road accidents.
Who is eligible?
According to ICWA, the scheme covers people catastrophically injured in motor vehicle accidents in WA on or after 1 July 2016.
The eligible injury types are:
- spinal cord injuries
- traumatic brain injuries
- multiple amputations
- severe burns
- permanent traumatic blindness
Each injury type has detailed medical criteria set out in the Regulations. For example, not every brain injury will meet the definition; it must reach a certain level of severity. ICWA’s eligibility page links to the criteria.
Assessment is based on medical evidence. Your treating team is best placed to explain your diagnosis. We cannot give medical advice, but we can help you understand what the evidence means for eligibility.
Interim and lifetime participants
People accepted into the scheme are first accepted as interim participants. Under the Regulations, interim participation generally runs for 2 years from acceptance. It can be extended if ICWA is not satisfied the injury has stabilised. A decision is then made about whether the person becomes a lifetime participant. ICWA’s participation factsheet has more detail.
Is there a time limit?
Applications should be made as early as possible. Often the hospital team starts the process by completing the medical notification forms, but families should check an application has been made.
What does the scheme pay for?
The scheme focuses on treatment, care and support that is necessary and reasonable. Depending on a person’s needs, this may include medical and hospital treatment; rehabilitation, including physiotherapy and occupational therapy; attendant care and support workers; aids and equipment, such as wheelchairs; home and vehicle modifications; and support to take part in education, work or the community.
ICWA works with participants to plan their care through an allocated care services coordinator.
What the scheme does not cover
This is the part many families do not realise. The CIS Scheme is about treatment, care and support. It does not pay for lost wages or loss of future earning capacity, pain and suffering, or other financial losses.
Those losses may only be recoverable through a damages claim. For many families, lost income is the biggest financial worry after a catastrophic injury, so this gap matters.
Can you still make a damages claim?
In many cases, yes. Western Australia’s motor injury insurance is largely fault-based. If another driver was at fault, you may be able to claim damages under the Motor Vehicle (Third Party Insurance) Act 1943 (WA).
A damages claim can cover things the CIS Scheme does not, such as past and future loss of income, pain and suffering and loss of enjoyment of life, and some other out-of-pocket expenses.
The two systems are designed not to pay twice for the same care. Under the Act, a person is not eligible to join the CIS Scheme if they have already been awarded damages, by judgment or binding settlement, for their future treatment, care and support needs. This makes the order of steps important, so get advice before settling any claim.
Time limits for damages claims
Strict time limits apply in WA. You generally need to notify ICWA of your claim early and start court proceedings within the limitation period.
Missing a deadline can end a claim. If you are unsure, get advice early. Our article on how the ICWA claims process works sets out the steps. You can also read our overview of how to make a car accident claim in WA.
What if the injured person caused the crash?
Because the CIS Scheme is no-fault, a driver who caused their own accident may still receive lifetime treatment and care if they meet the criteria. This was one of the biggest changes the scheme brought to WA.
However, a driver who was entirely at fault generally cannot bring a damages claim, because there is no other party to claim against. Where fault is shared, a damages claim may still be possible but reduced. Our article on the challenges in WA road accident claims explains how fault disputes arise.
Claims from regional and remote WA
Many serious crashes happen on country roads, far from Perth. After emergency treatment, people may be flown to a Perth hospital and then return home to a regional town.
Distance should not stand in the way of good legal help. A catastrophic injury claim involves a lot of paperwork: medical reports, employment records, care assessments and correspondence with ICWA. Much of this can be managed electronically.
For families in the Pilbara, the Goldfields, the South West or the Wheatbelt, working with a firm that can run the entire claim remotely can save long trips and lost days. Video meetings can be arranged around hospital visits and therapy sessions. Documents can be signed and shared online, with originals posted only when the law requires it.
A simple example
Here is a made-up example. It is not about a real client.
James, 34, was a passenger in a car that was hit by a speeding driver near Joondalup. (Our car accident lawyers in Joondalup help people across the northern suburbs.) He suffered a spinal cord injury and now uses a wheelchair.
The hospital team helped James apply to the CIS Scheme, and he was accepted as an interim participant. The scheme funded his rehabilitation, a support worker and changes to his home.
But James could no longer work as an electrician, and the scheme did not replace his income. With legal help, James also made a damages claim against the at-fault driver’s insurer. That claim sought compensation for his lost earnings and his pain and suffering.
Two systems, working side by side, gave James the best chance of a secure future.
Practical tips for families
A catastrophic injury is overwhelming. These steps can help:
- Confirm a CIS application has been made. Ask the hospital social worker.
- Keep a record of all expenses, appointments and time off work, including family members’ time.
- Get a police report number and details of any witnesses.
- Don’t sign documents from an insurer until you understand them.
- Get legal advice early about a damages claim, especially about time limits and how it interacts with the scheme.
- Look after yourselves. Carers need support too. Ask the hospital about counselling and carer support services.
- Keep a simple diary. Note pain levels, sleep, mood and daily struggles. It helps doctors, and it can help your claim.
Common mistakes to avoid
- Assuming the scheme covers everything. It does not replace lost income.
- Assuming fault doesn’t matter. It matters for a damages claim.
- Settling a damages claim without advice on how it affects scheme participation.
- Waiting until care is sorted before thinking about a claim. Time limits keep running.
Practical takeaways
- The CIS Scheme is no-fault. It can fund treatment, care and support whoever caused the crash.
- Five injury types are covered: spinal cord injury, traumatic brain injury, multiple amputations, severe burns and permanent traumatic blindness.
- Road accidents from 1 July 2016 are covered.
- Participation starts as interim, generally for 2 years, before a lifetime decision.
- The scheme does not pay for lost income or pain and suffering.
- A separate damages claim may be possible if another driver was at fault.
- Time limits apply. Act early.
How Gajic Lawyers can help
Gajic Lawyers brings more than 30 years of compensation experience to road accident claims in Western Australia. We act on a No Win No Fee basis, and your first consultation is free. Our technology-driven, paperless process means we can handle your claim end-to-end without you or your family attending an office. That is ideal when you are in hospital, in rehabilitation, or living in regional WA. We work alongside the CIS Scheme, so your care is supported while we pursue the compensation your family may be entitled to. Interpreters are available if you need one.
Has someone in your family suffered a catastrophic injury on a WA road? Call Gajic Lawyers on (02) 9890 5885 or visit gajic.com.au for a free consultation. Learn more about our motor vehicle accident lawyers in Perth.
This article is general information only and does not constitute legal advice. For advice specific to your circumstances, please contact Gajic Lawyers.
