If you or someone you love has been seriously injured in a car accident in Queensland, the National Injury Insurance Scheme (NIISQ) may be able to help. It is a no-fault government scheme that funds necessary and reasonable lifetime treatment, care and support for people with catastrophic injuries from motor vehicle accidents. Fault does not matter. If your injury qualifies, you can access support regardless of who caused the accident.
Our GPs at Southport Metro Medical Centre can help you understand whether NIISQ applies to your situation, assist with documentation, and coordinate referrals to the right specialists. We know navigating this after a serious injury is incredibly hard, and we want to make it as straightforward as possible for you and your family.
What Is NIISQ?
The National Injury Insurance Scheme Queensland started on 1 July 2016. It was set up because the old system of lump sum CTP payouts often ran out long before the care needs of seriously injured people did. NIISQ changes that by providing ongoing funded support for as long as it is needed, potentially for the rest of a participant’s life.
It is funded through a levy that Queensland drivers pay as part of their vehicle registration. It is separate from CTP insurance and from the NDIS, though participants can access both NIISQ and NDIS if they are eligible for both.
Key facts about NIISQ:
It is a no-fault scheme. Fault does not matter for eligibility.
It applies to accidents on or after 1 July 2016 in Queensland.
There is no age restriction and no citizenship or residency requirement.
Eligible participants enter as interim participants for up to two years, then are reassessed for lifetime participation.
It does not cover lost income or pain and suffering. Those are claimed separately through CTP or common law.
Who Is Eligible?
NIISQ covers people who sustain a serious personal injury in a motor vehicle accident in Queensland on or after 1 July 2016. The injury must fall within the defined categories set out in the NIISQ Act. These are:
- Traumatic brain injuryIncluding acquired brain injury from the accident
- Permanent spinal cord injuryMust meet specific neurological criteria under the ASIA scale
- Severe burnsCovering a significant percentage of the body
- Multiple or high-level limb amputationsOr the loss of use of limbs
- Permanent blindnessCaused by trauma from the accident
- Permanent brachial plexus injuryAffecting the nerve network running from the neck to the arm
If you are not sure whether your injury qualifies, that is exactly the kind of question our GPs can help with. We can review your situation, help you understand the criteria, and point you toward the right specialists for assessment.
Around 80% of NIISQ claims are for traumatic brain injury. Spinal cord injuries make up most of the remainder. If you or a family member experienced a head or spinal injury in a car accident, it is worth getting a proper assessment as early as possible.
What Does NIISQ Cover?
NIISQ funds necessary and reasonable treatment, care and support related to the eligible injury. This can include:
- Medical treatment
- Hospital care
- Rehabilitation
- Physiotherapy
- Psychology
- Specialist consultations
- Nursing care
- Personal care support
- Home modifications
- Vehicle modifications
- Mobility aids and equipment
- Respite care
- Carer support services
- Community participation
NIISQ does not cover lost income or compensation for pain and suffering. If you want to pursue those, you need a separate CTP claim or common law action. A lawyer experienced in personal injury can advise you on those options.
How to Apply
Most people with serious injuries from a car accident are admitted to hospital, and the hospital social worker will usually raise NIISQ with you and your family. If that has not happened or you were not hospitalised, here is what to do:
- Lodge a Notice of Accident Claim (NOAC) form This is the form you lodge with the CTP insurer of the at-fault vehicle. You should do this within 9 months of the accident to protect your rights. Your GP can help with the medical documentation required.
- Apply to NIISQ within 12 months Contact the NIISQ Agency on 1300 607 566 or visit niis.qld.gov.au to start your application. Apply as early as possible so treatment and support can be funded from the beginning rather than having to be paid out of pocket.
- Provide medical evidence You will need medical reports documenting that your injury meets the NIISQ eligibility criteria. Your GP, specialists and treating team all contribute to this. The stronger and more detailed the evidence, the smoother the process.
- Interim participation If accepted, you become an interim participant for up to two years. During this time NIISQ funds your treatment and care while your longer-term needs are assessed.
- Lifetime participation review Before the two-year interim period ends, NIISQ reviews whether you are eligible for lifetime participation. If approved, your treatment, care and support continues to be funded for life.
Important timeframes to know:
Lodge your NOAC with the CTP insurer within 9 months of the accident.
Apply to NIISQ within 12 months of the accident.
Request an internal review of any eligibility decision within 28 days of receiving it.
How Our GPs Can Help
Navigating NIISQ while dealing with a serious injury is genuinely difficult. Our GPs can support you and your family through the process in a number of practical ways.
- Injury assessment and documentation
- Medical reports for the application
- Referrals to appropriate specialists
- Ongoing medical management
- Physiotherapy referrals
- Psychology referrals
- Coordinating your care team
- Explaining the process clearly
- Support for family members
- CTP claim documentation
NIISQ and the NDIS
NIISQ and the NDIS are two separate schemes. NIISQ is specifically for people catastrophically injured in motor vehicle accidents in Queensland. The NDIS is a Commonwealth scheme for people with permanent disability from any cause.
If you were already registered with the NDIS before your accident, or you join after, you can potentially access both. The two schemes cover different things and it is worth getting advice on how they interact in your specific situation. Your NIISQ support planner can help coordinate with your NDIS plan.
Frequently Asked Questions
Does fault matter for NIISQ?
No. NIISQ is a no-fault scheme. It does not matter who caused the accident. As long as your injury meets the eligibility criteria and the accident happened in Queensland on or after 1 July 2016, you can apply regardless of fault.
What is the difference between NIISQ and a CTP claim?
NIISQ funds your ongoing treatment, care and support. It does not compensate you for lost income or pain and suffering. A CTP claim is where you seek compensation for those losses. They are separate processes and you can pursue both at the same time.
How long does NIISQ support last?
You start as an interim participant for up to two years. Before that period ends, NIISQ reviews your eligibility for lifetime participation. If approved, support continues for the rest of your life. For children under four when accepted, the review happens when they turn six.
My family member was seriously injured in an accident. What do we do first?
If they are in hospital, speak to the hospital social worker as soon as you can. They deal with NIISQ regularly and can guide you through the application. You should also lodge a Notice of Accident Claim with the CTP insurer within 9 months, and apply to NIISQ within 12 months. Call us on (07) 5612 7830 if you would like to talk through the medical side with one of our GPs.
Can someone from another state access NIISQ?
Yes. There is no citizenship or residency requirement. If the accident happened in Queensland on or after 1 July 2016 and the injury meets the eligibility criteria, anyone can apply regardless of where they normally live.
What if my NIISQ application is rejected?
You can request an internal review within 28 days of receiving the decision. If you are still unhappy with the outcome you can then apply for an external review through the Medical Assessment Tribunal or QCAT depending on the nature of the dispute. Getting legal advice from a personal injury lawyer at this point is a good idea.
Does NIISQ cover psychological injuries?
NIISQ covers treatment and care related to the eligible physical injury, which can include psychological support as part of that care. However psychological injury alone, such as PTSD without one of the defined physical injuries, does not qualify for NIISQ. Those injuries would be pursued through a CTP claim instead.
Can I access NIISQ if I was at fault in the accident?
Yes. NIISQ is no-fault. Even if you caused the accident, you can still access NIISQ support if your injury meets the eligibility criteria. This is one of the key differences between NIISQ and a CTP claim, where fault matters significantly.
Useful Contacts
- → NIISQ Agency — niis.qld.gov.au
- → NIISQ Agency phone: 1300 607 566
- → Motor Accident Insurance Commission — maic.qld.gov.au
- → CTP doctors and motor vehicle accident GP care at Southport Metro
- → Mental health support
- → Physiotherapy
Need help understanding your options after a serious accident?
Our GPs are here to help. Open 7 days at Australia Fair Metro, ground floor, 58 Scarborough St, Southport.