A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
The 2017 reforms to NSW’s Compulsory Third Party (CTP) motor accident compensation scheme significantly altered how chronic pain claims are assessed and compensated. Under the new framework, claimants must demonstrate that their chronic pain meets specific medical criteria outlined in the Motor Accident Guidelines. This article explains the key changes, how SIRA evaluates chronic pain injuries, and practical steps for claimants in Greater Sydney.
Key Changes to Chronic Pain Claims After 2017
The 2017 reforms replaced the previous scheme with the Motor Accident Injuries Act 2017 (MAIA), shifting focus from subjective pain reports to objective medical evidence. Chronic pain claims now require documentation of neurological signs, treatment records, and specialist assessments. SIRA’s revised approach prioritizes injuries that meet the 'threshold injury' definition under the Motor Accident Guidelines, which includes chronic pain caused by spinal nerve-root injuries or radiculopathy with specified clinical signs.
How SIRA Assesses Chronic Pain Injuries
SIRA evaluates chronic pain claims by reviewing medical evidence to determine if the injury qualifies as a 'threshold injury' under the MAIA. This involves assessing:
- Medical records showing a direct link between the accident and chronic pain
- Specialist reports confirming neurological signs or radiculopathy
- Evidence of ongoing treatment or management plans
Claimsants must also demonstrate that their pain persists beyond the 52-week statutory benefit period, as weekly payments are generally limited after this timeframe unless the injury meets specific impairment thresholds.
Practical Steps for Claimants
To pursue chronic pain compensation, claimants should:
- Document all medical evidence - Keep records of consultations, scans, and specialist reports.
- Obtain a specialist assessment - Neurologists or pain management experts can confirm if the injury meets SIRA’s criteria.
- Submit a detailed claim form - Complete the SIRA application form with specific references to chronic pain symptoms and their connection to the accident.
- Monitor claim progress - SIRA typically takes 6-12 months to assess complex claims, so regular follow-up is essential.
Time Limits and Dispute Options
Claimants must notify SIRA within 52 weeks of the accident to access statutory benefits. However, claims for compensation (not just benefits) are not time-barred, though delays may affect evidence collection. If a claim is disputed, claimants can request a review or seek independent medical opinions to challenge SIRA’s decision.
Example: Chronic Pain Claim in Greater Sydney
Consider a motorcyclist who suffered a spinal injury in a 2023 accident. Their chronic back pain, confirmed by MRI scans and a neurologist’s report of radiculopathy, meets the threshold injury definition. SIRA would assess whether the pain persists beyond 52 weeks and whether it impacts daily activities, determining eligibility for ongoing compensation.
When to Seek Legal Advice
While SIRA handles most claims, complex cases involving disputes, workers’ compensation overlaps, or interstate accidents may require legal assistance. A solicitor can help navigate SIRA’s assessment process, challenge denied claims, or negotiate fair compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.