The CIS Scheme in WA: what it is, and what support at home looks like

A serious crash or workplace accident changes a lot at once. On top of the injury itself, you and your family are suddenly dealing with a scheme you may never have heard of.

If the injury happened in Western Australia, that scheme is usually the Catastrophic Injuries Support (CIS) Scheme. Here is how it works in plain English, and what support at home can look like once you are ready to leave hospital or rehab.

What the CIS Scheme is

The CIS Scheme is run by the Insurance Commission of Western Australia. It funds necessary and reasonable treatment, care and support for people who are catastrophically injured in WA — in some cases for the rest of their lives.

It is a no-fault scheme. It does not matter who caused the accident. What matters is whether the injury meets the scheme’s criteria. It covers:

• a motor vehicle accident in WA on or after 1 July 2016
• a workplace accident in WA on or after 1 July 2024

Which injuries it covers

The scheme covers five types of catastrophic injury:

• spinal cord injury
• traumatic brain injury
• multiple amputations
• severe burns
• permanent traumatic blindness

Each has detailed criteria under the Motor Vehicle and Workplace Accidents (Catastrophic Injuries) Act 2016. The Insurance Commission decides who is eligible — not your provider, and not us. If you think you or a family member may be eligible, raise it with the treating team as early as possible, because the application relies on medical information about the injury.

Interim and lifetime participation

If you are accepted, you start as an interim participant for at least two years. This gives your recovery time to become clearer, and the interim period can be extended.

If your injuries have stabilised and you still meet the criteria, you then become a lifetime participant, with support for the rest of your life.

Your Care Services Coordinator

You are allocated a Care Services Coordinator at the Insurance Commission. Their job is to work out with you which treatment, care and support is necessary and reasonable, and to approve it.

In practice, your coordinator is the person to talk to before anything new starts. Providers deliver what is in your approved plan, and must ask in writing before adding anything extra — for example equipment or more therapy.

What the scheme can fund

The test is always whether something is necessary and reasonable for your injury. Within that, support can include things like:

• nursing care at home
• attendant care — help with personal care and daily routines
• therapy and rehabilitation
• equipment and home modifications
• support to get back out into the community

What you receive depends on your own assessment and plan. If you are not sure whether something is covered, ask your Care Services Coordinator.

Coming home: what to ask a provider

Leaving hospital or rehab is where the scheme becomes real. Before you agree to a provider, ask:

• Are you a registered CIS Scheme provider?
• Can you reliably staff the hours in my plan, where I live? You want an honest yes or no, not “we’ll try”.
• Who oversees my care clinically, and how often will they see me?
• If my behaviour, mood or mental health has changed since the injury, who assesses that?
• Will you report to my Care Services Coordinator on time, using the Insurance Commission’s templates?
• What happens if a worker is sick or a shift cannot be covered?

A good provider can answer every one of these on the first call.

After a brain injury: when behaviour and mood change

After a traumatic brain injury, families often notice changes in behaviour, mood or patience before anything else. It can be hard to tell whether a change comes from the injury, pain, medication, a new health problem or low mood — and it is common to end up with several practitioners who never speak to each other.

Ask early for one clinician who can look at all of it together, and for a written strategy that everyone supporting you follows the same way. Consistency matters more than almost anything else.

How Clarity Care can help

Clarity Care is a registered CIS Scheme provider based in Mandurah. We visit you in person along the coast from Rockingham to Bouvard, and positive behaviour support is also available by telehealth.

We provide community nursing, behaviour and mental health support, attendant care and community participation. Every care plan is signed off by our Clinical Lead, a Registered Nurse who is also a Credentialed Mental Health Nurse and NDIS behaviour support practitioner.

We will also tell you straight away what we cannot do. We do not provide tracheostomy care, PEG or complex enteral feeding, or registered nursing on site around the clock.

Read about our CIS Scheme support, or call 0410 560 769.

Common questions

Does it matter who caused the accident?

No. The CIS Scheme is a no-fault scheme. Eligibility depends on the injury and when and where the accident happened, not on who was at fault.

Who decides whether I am eligible for the CIS Scheme?

The Insurance Commission of Western Australia. It covers spinal cord injury, traumatic brain injury, multiple amputations, severe burns and permanent traumatic blindness from a motor vehicle accident in WA on or after 1 July 2016, or a workplace accident in WA on or after 1 July 2024.

How long does the CIS Scheme support me?

Participants start as interim participants for at least two years. If the injuries have stabilised and the person still meets the criteria, they become a lifetime participant with support for the rest of their life.

Who approves my supports?

Your Care Services Coordinator at the Insurance Commission works out with you which treatment, care and support is necessary and reasonable, and approves it.

I live outside Mandurah. Can Clarity Care still help?

Nursing, attendant care and community participation are delivered in person along the coast from Rockingham to Bouvard. Positive behaviour support is also available by telehealth.

This article is general information. For questions about your eligibility or entitlements, contact the Insurance Commission of Western Australia.