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).
If you're experiencing chronic pain after a motor accident in Western Sydney, understanding your rights under NSW's Compulsory Third Party (CTP) scheme is essential. Chronic pain claims require careful documentation and timely action to ensure you receive support for ongoing treatment and compensation. This article explains the early steps to take, the evidence needed, and how to navigate the claims process.
What You Can Claim for Chronic Pain
Under the Motor Accident Injuries Act 2017, injured road users can claim treatment and care benefits, weekly income payments, and compensation for long-term impairments. Chronic pain that persists beyond 52 weeks may qualify for ongoing support, but claims must demonstrate a direct link to the accident. SIRA guidelines state that chronic pain must be 'a consequence of the accident' and not pre-existing or unrelated.
Practical Steps After a Motor Accident
- Seek immediate medical attention to document your injuries. A medical report from a registered practitioner is critical to establish the connection between the accident and your chronic pain.
- Preserve evidence of the accident, including police reports, witness statements, and photographs of the scene.
- Notify your insurer as soon as possible. SIRA requires claims to be submitted within 52 weeks of the accident, though extensions may apply for complex cases.
Evidence for Chronic Pain Claims
Insurers will scrutinise medical records to assess whether your pain meets the 'threshold injury' definition under the Motor Accident Guidelines. This includes documenting:
- Ongoing pain that affects daily activities
- Medical treatment for chronic pain (e.g., physiotherapy, medication)
- A clear timeline linking the accident to your symptoms
SIRA advises keeping a pain diary to track flare-ups, sleep disruption, and how pain impacts work or family life. This helps demonstrate the severity and persistence of your condition.
Time Limits and Dispute Options
Claims for chronic pain must be submitted within 52 weeks of the accident, unless an extension is granted. If your insurer disputes your claim, you may need to:
- Request a review of your medical records
- Seek independent medical opinions
- Lodge a formal objection with SIRA
When to Seek Legal Advice
While many claims can be managed through SIRA, complex cases involving long-term impairments or disputes over chronic pain may require legal assistance. A solicitor can help challenge rejections, negotiate fair compensation, and ensure compliance with procedural deadlines.
Example Scenario
Consider a cyclist in Western Sydney who suffered a whiplash injury in 2023. After 52 weeks, they continue to experience chronic neck pain requiring regular physiotherapy. Their claim for ongoing treatment benefits would depend on medical evidence showing the pain is a direct result of the accident, not a pre-existing condition.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.