NT Motor Accidents Compensation Commission

NT Motor Accidents Compensation Commission

Frequently Asked Questions

Getting Started
 
Where can I find a claim form? 
Under the Making a claim section, hospitals in the NT or contact TIO MAC Department who will email or post a claim form to you. 
How do I lodge a claim?
A completed claim form can be  faxed, emailed or posted to the TIO MAC Department. If you need assistance with completing a claim form, contact the TIO MAC Department. Keep in mind time restrictions do apply.
What timeframes apply to making a claim?
Claims should be made as soon as practicable after the accident, and no later than 6 months after the date of the accident.

If you are claiming a variation in your benefits, your claim should also be made as soon as practicable and no later than 6 months after the change in circumstances giving rise to your claim for variation.

Please refer to section 31 of the Motor Accidents (Compensation) Act
What information do I need to provide to TIO when submitting my claim?
The general claim form will ask you to provide:

Bank Account details

A signed Authority to obtain information about your injury Medical Certificate, completed by your General Practitioner (GP) if you are unable to work the last two pages of the claim form called Form 2.3, which is required to be completed by your employer. Alternatively if you are self-employed you can supply TIO with copies of Payslips or recent Tax Returns

Any additional documentation that may assist in confirmation and assessment of the accident circumstances and your injuries. Any additional documentation to support relationships and/or dependency.
What am I covered for?
See the MAC Scheme Benefits section.
Why do you have to wait for the Police Crash Report?
The Police Crash Report confirms the accident circumstances, which are necessary to determine your entitlement to benefits.
Why do you have to wait for the Coroner Findings?
The Coroner Findings confirm the accident circumstances, which are necessary to determine your entitlement to benefits.
Why do you need to know what my Blood Alcohol Concentration (BAC) was at the time of the accident?
This is an important factor in assessing your entitlement to benefits, as the involvement of alcohol in the motor accident can reduce or exclude benefit entitlements
If I have a motor accident while working, can I elect to claim MAC entitlements instead of Workers Compensation entitlements?
If you have a compensable claim under a Workers Compensation Scheme then you will have no entitlement to MAC benefits.
General
 
Do I have to notify Centrelink of my claim/benefits?
Yes. If you are in receipt of Centrelink benefits and you are entitled to more than just medical expenses under the MAC Act you must notify Centrelink.
Who will you discuss my claim with?
TIO adheres to Privacy Principles to restrict access to your claim information. Your claim information will be used only for the purpose of assessment of your claim. For example, TIO will consult with your treatment providers and others who have direct involvement in your rehabilitation to assist you in your recovery.

We will also regularly collect your personal information from certain parties to enable us to determine any new or continuing entitlement to benefits. E.g. Police, Hospital or Medical Practitioners, Employer or previous Employer.

See our Privacy Policy or fact sheet  for further information.
Do I take my medical receipts to Medicare for rebate?
No. TIO will provide full reimbursement of receipts for reasonable treatment expenses. Keep your receipts to claim reimbursement and request a reimbursement form from your claims officer.
How long will it take for me to receive reimbursement for my out-of-pocket expenses?
Once received by the TIO MAC Department, your claim for reimbursement will take up to 5 working days to action. You will then need to allow time for your bank to process this payment into your bank account, which can take up to 3 working days.
If the accident occurred in the Northern Territory, can I take legal action against the person who ran into me?

No, not for your injuries. Where injury benefits are payable under the MAC Act, you will not have a right to legal action against anyone for those injuries. See section 5 of the MAC Act.

However, you can take legal action for vehicle or other property damage.
Are legal fees covered? Are legal fees covered?
No. Any legal expenses you incur in pursuing your claim are not covered under the MAC Scheme. The exception to, where a dispute arises in respect of your claim and the dispute is referred to the NT Motor Accidents Tribunal. If this occurs, the Tribunal may order that payment of your legal costs be made from the MAC Scheme.
If I move interstate will my claim continue?
Yes. You just need to keep TIO advised of your residential, postal and phone contact details, so we can continue to assist you with your recovery and pay any ongoing claim entitlements.
If I leave the country can I still receive benefits?
 No, as injury benefits are not payable outside Australia. For some severe injuries, entitlements may be commuted (paid to you in a lump sum) if leaving the country.
Treatment and Rehabilitation
 
What treatment is covered?
The MAC scheme is able to cover the cost for a variety of treatments such as physiotherapy, occupational therapy, chiropractic and psychological treatment. Before commencing this treatment, you should have a referral from your treating doctor or specialist. Please note that MAC will only support clinical-based therapy. Please refer to the Medical, Hospital and Rehabilitation Benefit Fact Sheet for more information. 
How long will my treatment be covered for?
MAC will continue to fund treatment until you recover from your injury. Treatment should provide long term benefit rather than short term relief and needs to be supported by medical opinion that the treatment will provide medical improvement and aid in your recovery.
Can I be treated privately?
Yes. Being treated privately will ensure you can continue to see the same treatment provider throughout your recovery. This might be your nominated treating GP who you would usually see if you were sick, or a physiotherapist who is located at the hospital. Please advise the treatment provider about your claim and provide them with your claim number.
Where do I go for treatment?
MAC and TIO do not recommend particular treatment providers such as GPs or physiotherapists. However, we do advise that your treatment provider must be a qualified health professional.
How can you help me return back to work?
TIO claims officers will assist you by providing you with a Vocational Rehabilitation provider. Services provided include a worksite assessment, where the provider may meet with your employer to arrange suitable duties for you to return to. The provider can also complete a workstation assessment to ensure your working environment is safe for your injuries and your recovery. For further information please contact your TIO claims officer.
Do I still have to do a return to work program if I am unfit?
The return to work process is part of your recovery. We will consult with vocational rehabilitation providers and your treating doctors to plan a return to work which is appropriate for you and takes into account your abilities and the effects of your injury.
What if my doctor certifies me medically unfit for work for a long period of time such as 2 months?
If you have an entitlement to Loss of Earning Capacity benefits (Section 13 MAC Act), TIO will pay these benefits to you for all periods for which you have been certified unfit to work.
What do I need to do to get reimbursement of my medical expenses?
In order to approve treatment costs, TIO requires details about what treatments you are receiving and how they are helping you to recover. We also need to know details about your medical condition to be able to determine your benefit entitlements correctly. If your doctor does not provide TIO with this information (e.g. if he or she fails to provide medical certificates and reports on request), there is a risk that TIO will not reimburse you for your costs. Also, because TIO makes decisions on your claim based on the information provided to us, it is in your best interests to ensure we are not missing important information.
Remember to keep all your original receipts and only send the copies to TIO.
What if I can get treatment in my local area?
If you live remotely and the treatment you require for your injuries isn't available within this area, we can assist with making arrangements for you to seek this treatment elsewhere. It is important that you have a referral for the treatment from your treating doctor or specialist before we can make these arrangements.
What if my doctor says they don't do compensation claims?
You can offer to pay your doctor upfront and then seek reimbursement from the MAC scheme. Before you do this, you should discuss the matter with TIO first and ask to have the treatment approved.
Entitlements
 
How much will I get paid if I am unfit to go back to work?
The MAC Act provides for Loss of Earning Capacity benefits, which is different to actual loss of earnings. For an illustration of how these are calculated, see the Level of Benefits fact sheet.
Will I get a lump sum payment?
This is only payable where a person injury is medically assessed to be permanent and stable, and results in at least a 5% whole person impairment. Permanent Impairment assessments are made by appropriate medical specialists and are usually reviewed approximately 6 to 12 months post-accident. However, this is dependent upon the nature of the injuries sustained and in some cases the assessment may be made at a later date.
For more information please refer to the Loss of Earning Capacity Benefits fact sheet.
Can I get someone to help me at home?

Yes, if your injuries and circumstances are such that you require assistance at home. This assessment will be made by an Occupational Therapist or other suitably qualified practitioner, following a visit to your home.

For further information about Attendant Care download the relevant fact sheet

Attendant Care for accidents which occurred prior to 1 July 2014.

Attendant Care for accidents which occurred after 1 July 2014.
Disputes
 
What if I disagree with a decision TIO has made?
There are three review processes. You will be provided with information about how to access these review processes each time TIO sends you a decision.
Also refer to the Review of Decisions section on this website.
Which review type should I choose?
If you are unsure, you may wish to start by asking for an internal review. If you are not satisfied with the outcome of this, you can request a further review by the Designated Person (a designated TIO officer other than the person who conducted the internal review). Both reviews are free of charge.
I have been told I am eligible for some benefits but not others. Why is that?

Eligibility for benefits is determined by the MAC Act. Depending on the circumstances of the accident, you may not be entitled to certain benefits. These circumstances include driving behaviours such as drink-driving and not wearing a seatbelt. They can also include failure to hold a valid licence or vehicle registration. For more information see the Exclusions and Benefit Reductions fact sheet.

If you disagree with TIOs decision about your eligibility, you can request to have the decision reviewed. You should send in any information you have which supports your request.

For more information see the Having a decision reviewed fact sheet.
 My doctor disagrees with the medical information TIO has based its decision on.

TIO can only make decisions based on the information available to us. Ensuring you and your doctor share relevant information with us will assist us to make an appropriate decision based on all of the medical evidence, in the first instance.

Sometimes medical practitioners will have different opinions about a patient. If this happens, TIO will make a decision based on the opinion which best fits with the rest of the information available.

You can seek a review of the decision TIO makes. To support your review request, you can include a report by your doctor explaining the reasons substantiating their opinion and why they disagree with the other doctor(s).
How long does a review take?
We aim to complete internal reviews within 30 calendar days and Designated Person reviews within 30 business days. This time may be extended if the reviewer needs more information to enable them to make a thoroughly informed decision.
What timeframe apply to asking for a review?
You have 90 days from when you become aware of the decision. Generally, this will be 90 days from when you receive our decision via letter or email.
Do I need a lawyer?
TIO has designed the review process so that you do not need a lawyer. However, you are welcome to have a lawyer assist you if you choose. TIO recommends you discuss with your lawyer in advance how you will pay for any legal costs. There is no automatic entitlement to have your legal expenses covered by TIO.
Can I get a second opinion?
You are always free to consult another doctor at your own expense and send their report in to TIO. If TIO believes it was reasonable for you to seek a second opinion and the information is relevant and of an acceptable standard, then we will consider reimbursing you the cost.
Alternatively, you can ask TIO to consider seeking a second opinion as part of your review request. It will help if you can tell us the problems you see with the first opinion and why it would be reasonable for TIO to ask for a second opinion.
Can I talk to you about someone else's claim?
Only if we have permission from that person. If the claimant can't give permission, for example, if they are too young or their injuries prevent them from doing so, we will need to be satisfied that you are an appropriate contact person.