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).
Chronic pain from a motor accident can significantly impact daily life, affecting your ability to work, exercise, or perform routine tasks. In New South Wales, claims for chronic pain under the Compulsory Third Party (CTP) scheme require specific evidence to support your case. This article explains how chronic pain affects daily activities, what evidence is needed, and how insurers assess your claim under NSW law.
How Chronic Pain Affects Daily Activities
Chronic pain following a motor accident may limit your ability to engage in everyday tasks such as cooking, cleaning, or commuting. It can also disrupt sleep, reduce concentration, and cause emotional distress. Under NSW CTP rules, insurers evaluate how your pain impacts your quality of life and functional capacity. For example, if you can no longer work due to pain, this may affect your claim for income loss or ongoing treatment.
Evidence to Support Your CTP Claim
To strengthen your chronic pain claim, gather documentation that shows:
- Medical records confirming your diagnosis and treatment
- A doctor’s statement linking your pain to the accident
- Records of how your pain affects daily activities (e.g., difficulty lifting objects, prolonged rest periods)
- Witness accounts or employer statements about changes in your work performance
SIRA guidelines emphasize that chronic pain must be 'reasonably foreseeable' and 'likely to persist' to qualify for ongoing benefits. Insurers may request a medical report detailing your pain’s severity and how it limits your activities.
How NSW CTP Insurers Assess Chronic Pain
NSW CTP insurers use the Motor Accident Guidelines to assess pain and suffering. They consider factors such as:
- The type and duration of pain
- Your ability to perform daily tasks
- Emotional and psychological impacts
- Medical treatment received
For example, if you experience persistent back pain that prevents you from walking long distances, this may qualify as a 'threshold injury' under the Motor Accident Injuries Act 2017. However, insurers may dispute claims if there is no clear connection between your pain and the accident.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim certain benefits, such as weekly income payments. After this period, insurers may argue that your injuries are no longer 'threshold injuries' and reduce benefits. If you disagree with an insurer’s decision, you can:
- Request a review of your claim
- Seek mediation through the NSW Civil and Administrative Tribunal (NCAT)
- Lodge an appeal with the NSW Supreme Court
When to Seek Legal Advice
Chronic pain claims can be complex, especially if your insurer disputes the link between your injury and the accident. A solicitor can help you:
- Gather and present evidence effectively
- Challenge decisions that reduce or deny benefits
- Navigate time limits and procedural requirements
If your claim involves chronic pain affecting daily activities, it’s important to act promptly. Document your symptoms, seek medical confirmation, and contact a legal professional if your insurer refuses to pay.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.