The National Injury Insurance Scheme Queensland (NIISQ) is a no-fault scheme that provides lifetime treatment, care and support to people who suffer catastrophic injuries in motor vehicle accidents in Queensland. The scheme is designed to support those with the most serious and permanent injuries, regardless of who caused the accident.
Key information:
- Applies to Queensland road accidents on or after 1 July 2016
- Provides medical treatment, rehabilitation and care for life
- Operates independently of fault-based compensation
- Covers only specified catastrophic injuries
This guide explains:
- What NIISQ is and how it works
- Which injuries qualify under the scheme
- How to apply for NIISQ support
- What treatment and care are covered
- How NIISQ interacts with CTP and common law claims
Let’s get started.
Understanding NIISQ: The Basics
What exactly is the National Injury Insurance Scheme Queensland?
Put simply, NIISQ is a government-funded scheme that provides lifetime care, treatment and support to people catastrophically injured in motor vehicle accidents in Queensland.
The scheme is funded through a levy on Compulsory Third Party (CTP) insurance premiums and operates under the National Injury Insurance Scheme (Queensland) Act 2016.
Unlike CTP claims or common law damages that compensate you for losses, NIISQ exists purely to fund your ongoing care needs.
Important: It doesn't compensate for pain and suffering or lost wages. Those damages must be claimed separately through CTP or common law claims.
Practical examples of what NIISQ covers:
- Medical and rehabilitation services:
- Specialist appointments
- Physiotherapy
- Occupational therapy
- Speech therapy
- Psychological services
- Attendant care: Personal support workers to help with daily activities like:
- Bathing
- Dressing
- Meal preparation
- Mobility
- Equipment and aids:
- Wheelchairs (manual and electric),
- Communication devices
- Hoists
- Prosthetics
- Specialised beds
- Home modifications:
- Ramps
- Widened doorways
- Accessible bathrooms
- Ceiling hoists installed
- Vehicle modifications:
- Hand controls
- Wheelchair lifts
- Modified steering systems
- Vocational training:
- Skills development
- Employment support
Why was NIISQ created?
Before July 2016, people with catastrophic injuries in Queensland usually relied on lump sum compensation through CTP or common law claims. While these payouts offered immediate financial relief, they often failed to cover the long-term cost of lifelong care.
Further issues:
- Lump sum settlements frequently ran out before care needs ended
- Catastrophic injuries often require decades of 24-hour support
- Younger injured people faced the highest risk of underfunding
How NIISQ solves these issues:
- Provides guaranteed lifetime funding for treatment, care and support
- Removes the risk of outliving compensation payments
- Recognises catastrophic injuries as permanent and lifelong
- Focuses on ongoing funded services rather than one-off cash settlements
Your Rights and Obligations
What you're entitled to under NIISQ:
- Reasonable and necessary treatment, care and support for your injury-related needs, funded for life (depending on status)
- Access to support regardless of who caused the accident
- Choice and control over your support services within the NIISQ funding guidelines, similar to NDIS principles
- Family support services, including respite care, to give family carers regular breaks from caring responsibilities
- Independent review rights if your NIISQ application is denied or your funding level is disputed
What you must do:
- Lodge a Notice of Accident Claim (NOAC) form with the CTP insurer within 9 months of the accident to protect your rights
- Apply for NIISQ participation as soon as possible after your injury
- Provide comprehensive medical evidence documenting that your injuries meet NIISQ's specific technical criteria
- Participate in regular assessments during the interim phase (first 2 years) to monitor your condition and determine lifetime eligibility
- Notify NIISQ of significant changes in your condition, care needs, or circumstances
Key deadlines:
- A CTP claim should be lodged within nine months of the accident.
- Apply for NIISQ within 12 months to access support as early as possible.
- 24 months after interim acceptance, NIISQ will reassess eligibility for lifetime participation.
- Any common law claim must be commenced within three years of the accident.
Common Scenarios and Questions
Do I automatically qualify for NIISQ if I am paralysed after a car accident in Queensland?
The facts: Not automatically. You must apply and provide medical evidence proving your spinal cord injury meets NIISQ's specific criteria.
What to do:
- Request comprehensive spinal assessments from specialised neurologists documenting your injury on the ASIA impairment scale (grades A, B, C, or D qualify)
- Obtain evidence of permanent neurological deficit and ongoing bladder or bowel dysfunction if you're aged 8 or older
- Lodge your NIISQ application with detailed medical reports, imaging results (MRI/CT scans), and functional assessments
- Continue your CTP claim process simultaneously; NIISQ approval doesn't replace your right to claim other damages
Important: According to recent data (2024), around 80% of claims were awarded for traumatic brain injury (TBI), with only around 17% for spinal cord injury (SPC).
Can I claim NIISQ if I was at fault in the accident?
The facts: Yes, NIISQ is a no-fault scheme, meaning it doesn't matter who caused the accident.
What to do:
- Apply for NIISQ regardless of fault or liability issues.
- Understand that while NIISQ is no-fault, your common law claim for additional damages (pain and suffering) may be affected if you were at fault
- Seek legal advice about how fault impacts your overall compensation strategy, even though it doesn't affect NIISQ eligibility
Important: Even if you were charged for causing the accident, you can still access NIISQ support if you have a qualifying catastrophic injury.
Are children eligible for NIISQ after a severe brain injury in a road accident?
The facts: Yes, there are no age restrictions, but children have different medical assessment criteria compared with adults.
What to do:
- Obtain pediatric-specific functional assessments
- For children aged 3-8 years with traumatic brain injury, ensure documentation includes Glasgow Coma Scale scores from admission and detailed brain imaging reports
- For children under 3 years, work with pediatric neurologists familiar with NIISQ's specialised criteria for infant brain injuries
- Understand that time limits for legal claims are generally suspended until your child turns 18, but don't delay applying for NIISQ funding to get the support your family requires
Important: Children's injuries may evolve as they grow, affecting their developmental milestones in ways that are difficult to predict. Early NIISQ participation ensures ongoing monitoring and adjustments in support as your child's needs change.
What happens after two years as an interim NIISQ participant?
The facts: At around 24 months, NIISQ will reassess your condition to determine if you qualify as a lifetime participant.
What to do:
- Maintain detailed records of all treatments, therapy sessions, and how your injury has impacted your daily activities throughout the interim period
- Attend all scheduled clinical assessments and provide requested medical updates on time
- If your condition has improved significantly, prepare for the possibility that lifetime status might not be granted (though this is uncommon with truly catastrophic injuries)
- If denied lifetime status, you have review and appeal rights. Seek legal advice immediately if this happens
Important: The interim period is not a trial. Most people with genuine catastrophic injuries who meet NIISQ eligibility criteria at the outset continue to meet them at the 24-month reassessment. What matters is that the updated medical evidence confirms the injury remains permanent and ongoing.
How does NIISQ affect my CTP or common law compensation claim?
The facts: NIISQ and CTP/common law claims run separately, NIISQ covers future care, while common law compensates you for pain, suffering and lost income.
What to do:
- Continue pursuing your CTP and common law claims alongside NIISQ
- Understand the critical choice point: you can either remain in NIISQ and claim only "non-care" damages through common law (pain/suffering, lost earnings) OR opt out of NIISQ to receive a lump sum for all future care in your settlement
- Never settle a common law claim without specialist advice about how it affects NIISQ participation; this decision is irreversible
- Work with experienced compensation lawyers who understand how to maximise both NIISQ and common law entitlements
Important: If you remain a NIISQ participant, any common law damages for future care costs will be reduced to account for the value of NIISQ-funded support. Damages for pain and suffering and loss of earning capacity are not affected.
Can I get both NIISQ and NDIS support?
The facts: Yes, but NIISQ is the "first payer" for accident-related needs. NDIS only covers unrelated disabilities.
What to do:
- Understand that NIISQ takes priority for all your support needs
- If you have pre-existing disabilities or develop non-accident-related conditions, NDIS may fund support for those specific issues
- Work with NIISQ and NDIS planners to clearly delineate which scheme funds what
- Don't assume you need NDIS. NIISQ funding principles are similar and may fully cover your accident-related needs
Important: NIISQ and NDIS operate under similar philosophies of participant choice and control, but NIISQ is specifically designed for motor accident injuries and often provides more comprehensive funding than NDIS.
Step-by-Step Process: Applying for NIISQ
- Seek immediate medical treatment after your accident – Stabilise injuries, begin rehabilitation, and ensure early symptoms and diagnoses are clearly documented.
- Lodge your Notice of Accident Claim within 9 months – Protect your right to CTP and common law compensation by notifying the relevant insurer.
- Obtain specialist medical assessments – Engage neurologists or rehabilitation specialists who understand NIISQ eligibility criteria.
- Submit your NIISQ application for interim participation – Provide all supporting medical reports, imaging, and functional assessments.
- Cooperate with NIISQ assessments – Attend medical examinations and respond promptly to requests for further information.
- Access interim NIISQ supports – Once approved, work with NIISQ to implement a care plan covering treatment and daily support needs.
- Keep records during the interim period – Maintain evidence of treatment, progress, and functional impact for reassessment.
- Undergo review at around 24 months – At this point, NIISQ will determine whether you qualify for lifetime participation.
- Progress CTP and common law claims in parallel – NIISQ does not replace compensation for pain, suffering, or financial loss. Always consider these options alongside NIISQ.
Documents you'll need:
- Medical reports from treating specialists that directly address NIISQ eligibility criteria and required clinical thresholds
- Diagnostic imaging such as MRI, CT scans, X-rays, surgical reports or burn photographs
- Functional assessment reports, including FIM or WeeFIM scores, ASIA Impairment Scale classifications, or vision testing
- Hospital and emergency records documenting Glasgow Coma Scale scores, coma duration, ICU admission and early treatment
- Accident and CTP documentation confirming the motor vehicle accident happened in Queensland, including police reports and NOAC (Notice of Accident Claim) forms
- Pre-existing medical records where relevant to distinguish accident-related injuries from prior conditions, or the worsening of such conditions
Legal Framework
Primary legislation: The National Injury Insurance Scheme (Queensland) Act 2016 and National Injury Insurance Scheme (Queensland) Regulation 2016 establish the NIISQ and define eligibility criteria for serious personal injuries.
What this means for you:
- The legislation defines six specific injury categories with strict medical thresholds. Your injury must meet these exact criteria to qualify
- NIISQ operates as a "no-fault" statutory scheme separate from CTP insurance, though funded through CTP levies
- The Act provides legal protections ensuring eligible participants receive reasonable and necessary support for life (regardless of alterations in funding)
Be Aware of These Red Flags
- You've been offered a common law settlement without clear advice about how accepting it affects your NIISQ participation. Settlements often include opt-out clauses that terminate lifetime NIISQ support
- NIISQ has denied your application or refused lifetime participant status despite you meeting injury criteria. Your right to appeal is time-sensitive.
- Your interim funding is being reduced or cut before the 24-month reassessment, with no clear explanation or clinical justification
- You're approaching the 9-month CTP claim deadline without having lodged your Notice of Accident Claim. Missing this deadline can mean missing out on compensation
- You're being pressured to settle quickly by insurers or others before you fully understand your long-term care needs and NIISQ entitlements
Common mistakes to avoid:
- Delaying medical assessments or assuming your GP's reports are sufficient for NIISQ. The scheme requires highly specialised medical evidence from appropriate specialists
- Accepting a common law settlement without understanding the NIISQ implications. After all, you cannot "undo" a decision to opt out of lifetime care funding
- Assuming NIISQ approval means you don't need a lawyer. NIISQ covers care costs only, not compensation for pain, suffering, and lost income. A common law claim requires expert legal adivce
- Providing incomplete medical information to NIISQ or failing to disclose pre-existing conditions. These omissions not only cause delays but can also result in your claim being denied.
- Travelling overseas for extended periods without notifying NIISQ. Eligibility can be suspended if you're outside Australia for more than 3 months
When to Seek Legal Advice
Get advice as early as possible, especially if:
- You've suffered any potentially catastrophic injury in a motor vehicle accident in Queensland (spinal damage, severe head trauma, serious burns, amputation, eye injuries)
- You're navigating both NIISQ and CTP/common law claims simultaneously. These schemes interact in complex ways, and missteps in one can jeopardise the other
- Your NIISQ application has been denied, or you've been refused lifetime participant status despite believing you meet the criteria
- You're considering accepting a common law settlement. Never settle without specialised advice about how it affects your lifetime NIISQ funding
- You're unsure whether to remain in NIISQ or opt out for a lump sum. This irreversible decision requires careful analysis of your long-term care costs versus settlement amounts
- Someone is pressuring you to make quick decisions about your claim or settlement before you fully understand your rights
- You have questions about how NIISQ interacts with WorkCover (if your accident was work-related) or TPD insurance through superannuation
Why early advice matters:
- Expert legal advice clarifies your rights across NIISQ, CTP and common law claims
- Many people can access multiple compensation pathways at the same time, including lifetime NIISQ care and common law damages
- Early guidance helps secure rehabilitation and support sooner and ensures injuries meet NIISQ technical criteria
- Experienced lawyers know how to protect NIISQ eligibility when resolving common law settlements
- Legal support reduces the risk of missed deadlines, under settlements or procedural errors
- Decisions made early can affect decades of future care and funding, things that are vital for support and recovery
Key Takeaways
- NIISQ is a no-fault scheme providing lifetime care and support for catastrophic motor vehicle accident injuries in Queensland. You can qualify regardless of who caused the accident
- Only specific serious injuries qualify: permanent spinal cord injuries, traumatic brain injuries, severe burns, high-level or multiple amputations, permanent brachial plexus injuries, and permanent traumatic blindness, each with strict medical thresholds
- You must apply. NIISQ is not automatic. Even with qualifying injuries, you need comprehensive specialist medical evidence documenting that you meet the technical eligibility criteria
- NIISQ covers future care only. It doesn’t include payments for pain and suffering or lost income. You still need to pursue CTP and common law claims for other damages you feel entitled to
- Never settle a common law claim without specialist advice. You may inadvertently opt out of lifetime NIISQ funding that's worth far more than any lump sum settlement
- Time matters: lodge your CTP claim within 9 months, apply for NIISQ promptly, and get legal advice early to protect all your entitlements
Get Help Now
If you or a loved one has suffered a catastrophic injury in a motor vehicle accident in Queensland, early legal advice can help you understand NIISQ eligibility, access rehabilitation sooner, and protect your full compensation entitlements.
Contact Smith’s Lawyers today
- Call 1800 960 482 for a free, no obligation consultation
- No Win, No Fee, No Catch®: you pay nothing unless compensation is recovered
- Request a call back and speak with lawyers experienced in NIISQ, CTP and common law claims
We help Queenslanders secure NIISQ lifetime care while maximising compensation through CTP and common law. This means you can focus on recovery.
