Caring for people severely injured on the road

If you’ve been severely injured in a NSW motor accident, you may be eligible to become a Lifetime Care participant.

The Lifetime Care and Support Scheme pays for treatment, rehabilitation and care for people who have been severely injured in a motor accident in NSW.

We’re a no-fault scheme. This means we can provide support regardless of who was at fault in the accident, as long as you meet our eligibility criteria for both your motor accident and your injury.

Severe injuries that may be eligible for the Scheme include:

  • spinal cord injury
  • brain injury
  • amputations
  • burns
  • permanent blindness.

Eligibility for the Lifetime Care and Support Scheme

  1. You were injured in a motor accident in NSW on or after 1 October 2006 (for children under 16) or on or after 1 October 2007 (for adults)
  2. Your injury was caused by the motor accident and the accident meets the criteria in the legislation
  3. The type and severity of your motor accident injury meet the injury criteria. Each application is assessed against specific criteria outlined in the Lifetime Care and Support Guidelines.

How we assess injuries

Whether you’re eligible for the scheme is partly determined by the severity of your injury.

As part of the application process, your medical specialist will need to complete a medical certificate to confirm the severity of your injury. There may also be some specific assessments for your particular type of injury to help determine if your injury will meet our eligibility criteria. These will usually be completed by your treating team.

Below are the assessment tools we use for each type of injury that may be eligible for the Scheme:

  • Brain injuries and burns: FIM and WeeFIM
  • Spinal cord injuries: American Spinal Injury Association (ASIA) Scale
  • Amputations: no additional assessment tool, determined by the percentage loss of limb/s or assessment of equivalent impairment
  • Permanent Blindness: no additional assessment tool, you must be legally blind in both eyes.

    About the scheme

  • How it works

    If you meet the eligibility criteria for the Scheme, you’ll be accepted as an ‘interim participant’ and will receive support for two years.

    This means we’ll pay for the ‘reasonable and necessary’ treatment, rehabilitation and care you need as a result of your injury. You’ll also be provided with a coordinator who’ll be your contact at icare and help you receive the right services.

    Before you leave hospital, your treating team will work with you to identify and request the treatment, rehabilitation and care services you need to help you live at home and participate in your community.

    Before getting home, you should also be introduced to your case manager. Once you’re at home, they’ll help you identify your goals and support needs for both now and the longer term.

    Your case manager will help you choose appropriate people to provide the services you need and develop a plan with you to request approval of these services.

    Towards the end of the two-year period, an interim participant can apply to become a lifetime participant.

    Becoming a lifetime participant means we’ll continue paying for treatment, rehabilitation and care services that are considered ‘reasonable and necessary’ and related to your motor accident injury for the rest of your life.

  • What we pay for

    We pay for a range of treatment, rehabilitation and care services for participants. We can only pay for services that are considered ‘reasonable and necessary’ and related to your motor accident injury.

    We use a person-centred approach and will work with you to ensure your services are flexible and tailored to your life and needs.

    We also want to empower you by supporting you to have choice and control in identifying your goals and support needs.

    Whether a service request is for home modifications, physiotherapy, equipment or attendant care, it will be considered against our ‘reasonable and necessary’ criteria which include:

    • how it relates to your goals and will benefit and enable you to participate more fully in your life and community
    • how appropriate and suitable both the service and service provider are for your type of injury, your goals and individual needs and circumstances
    • how cost-effective it is
    • how it relates to your motor accident injury.

    Treatment, rehabilitation and care services can include things like:

    • medical treatment including pharmaceuticals
    • dental treatment
    • rehabilitation
    • ambulance transportation
    • attendant care and respite services
    • domestic assistance
    • aids and appliances
    • prostheses
    • educational and vocational training
    • home, vehicle and workplace modifications.

    There are certain things we can’t pay for. Please refer to our ‘reasonable and necessary’ information sheet below for further details.

  • How we are funded

    The Lifetime Care and Support Scheme is run by the Lifetime Care and Support Authority (which is a part of icare) and funded by a levy on NSW green slips (Compulsory Third Party insurance).

    The Lifetime Care and Support Scheme was established under the Motor Accidents (Lifetime Care and Support) Act 2006.

  • ACT motor accident injuries

    If you were severely injured in a motor accident in the ACT from 1 July 2014, you may be eligible for the ACT Lifetime Care and Support Scheme. Information about the ACT Scheme can be found at the ACT Treasury website.

    Lifetime Care has an agreement with the ACT Lifetime Care and Support Commissioner to pay for the treatment, rehabilitation and care for participants of the ACT Scheme on behalf of the Commissioner.

    Injury criteria

  • Permanent blindness

    You may be eligible for the Scheme if you’ve lost sight in both eyes and:

    • the loss of sight was caused by the motor accident; and
    • you are legally blind, defined by:
      • visual acuity on the Snellen Scale after correction by suitable lenses is less than 6/60 in both eyes; or
      • field of vision is constricted to 10 degrees or less of arc around central fixation in the better eye irrespective of corrected visual acuity (equivalent to 1/100 white test object); or
      • a combination of visual defects resulting in the same degree of visual loss as that occurring in either of the definitions above.
  • Burns

    You may be eligible for the Scheme if you have sustained burns and:

    • the burns were caused by the motor accident; and
    • you have full thickness burns greater than 40 per cent of your total body surface area, or greater than 30 per cent of your total body surface area if you are a child under 16 years; or
    • you have inhalation burns that have caused long term respiratory impairment; or
    • you have full thickness burns to the hand, face or genital area; and
    • one of the following criteria is met:
      • if over 8 years of age: a score of 5 or less on any of the items on the FIM or WeeFIM due to the burns; or
      • if aged from 3 to 8: a score two less than the age norm on any item on the WeeFIM due to the burns; or
      • if aged under 3 years: a medical certificate from a paediatrician or an appropriately qualified medical specialist otherwise approved in writing by us that states you will probably have permanent impairment due to the burns resulting in a significant adverse impact on your normal development.
  • Brain injuries

    The Lifetime Care and Support Guidelines define a traumatic brain injury as an insult to the brain, usually with an associated diminished or altered state of consciousness that results in permanent impairments of cognitive, physical and/or psychosocial functions.

    You may be eligible for the Scheme if you've sustained a traumatic brain injury and:

    • the brain injury was caused by the motor accident; and
    • the duration of Post Traumatic Amnesia (PTA) is greater than 1 week. If the PTA assessment is not available or applicable (for example, if the child is under 8 years of age, or the injured person has a penetrating brain injury), there must be evidence of a very significant impact to the head, causing coma for longer than one hour, or a significant brain imaging abnormality due to the motor accident; and
    • one of the following criteria is met:
      • if over 8 years of age: a score of 5 or less on any of the items on the FIM or WeeFIM) due to the brain injury; or
      • if aged from 3 to 8 years: a score two less than the age norm on any item on the WeeFIM due to the brain injury; or
      • if aged under 3 years: a medical certificate from a paediatric rehabilitation physician that states you will probably have permanent impairment due to the brain injury resulting in a significant adverse impact on your normal development. 
  • Amputations

    You may be eligible for the Scheme if you’ve had an amputation or amputations, or the equivalent impairment, caused by the motor accident that meet/s the criteria described below:  

    Criteria for multiple amputations

    The injury resulting in the amputations, or the equivalent impairment, was caused by the motor accident; and

    You have multiple amputations of the upper and/or lower extremities (or equivalent impairment or some combination), meaning that there is more than one of the following types of amputation at or above the level of:

    • a “short” transtibial or standard transtibial amputation, as defined by the loss of 50 per cent or more of the length of the tibia. This includes all other amputations of the lower extremity (such as knee disarticulation or transfemoral amputation) above this level;
    • a thumb and index finger of the same hand, at or above the first metacarpophalangeal joint. This includes all other amputations of the upper extremity (such as below-elbow or above elbow amputation) above this level;
    • there are multiple impairments, each of which is an ‘equivalent impairment’ to one of the types of amputation above. 'Equivalent impairment' means the functional equivalent to an amputation, resulting from an injury such as (but not limited to) brachial plexus avulsion or rupture, where paralysis exists and movement in the paralysed limb, or relevant part thereof, is minimal or non-existent due to the injury. 

    Criteria for unilateral amputation

    • The injury resulting in the amputation (whether amputation, or an equivalent impairment), was caused by the motor accident; and
    • You have one of the following:
      • forequarter amputation (complete amputation of the humerus, scapula and clavicle) or shoulder disarticulation;
      • hindquarter amputation (hemipelvectomy by trans-section at sacroiliac joint, or partial pelvectomy);
      • hip disarticulation (complete amputation of the femur); or
      • an equivalent impairment to one of the types of amputation above. 'Equivalent impairment' means the functional equivalent to an amputation, resulting from an injury such as (but not limited to) brachial plexus avulsion or rupture, where paralysis exists and movement in the paralysed limb, or relevant part thereof, is minimal or non-existent due to the injury. 
  • Spinal cord injuries

    The Lifetime Care and Support Guidelines define spinal cord injury as an acute traumatic lesion of the neural elements in the spinal canal (spinal cord and cauda equina) resulting in permanent sensory deficit, motor deficit and/or bladder/bowel dysfunction.

    You may be eligible for the Scheme if you’ve sustained a spinal cord injury and if:

    • the spinal cord injury was caused by the motor accident; and
    • there is a spinal cord injury resulting in permanent neurological deficit.