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 claims after a motor accident in NSW require careful handling to ensure you receive the support you need. One of the most common mistakes is failing to document your pain adequately. Under the NSW Compulsory Third Party (CTP) scheme, chronic pain must be linked to the accident and supported by medical evidence. This guide explains how to avoid errors that could delay or reduce your claim.
Understanding CTP Rules for Chronic Pain
The Motor Accident Injuries Act 2017 (MAIA) governs CTP claims in NSW. Chronic pain is considered a 'threshold injury' if it meets specific medical criteria, such as persistent pain requiring ongoing management. SIRA (State Insurance Regulatory Authority) assesses claims based on the Motor Accident Guidelines, which define what constitutes a threshold injury. If your pain is classified as a threshold injury, you may be eligible for weekly income payments and treatment benefits for up to 52 weeks. However, claims for chronic pain beyond this period may require a separate assessment under common law.
Practical Steps to Avoid Common Errors
- Seek immediate medical attention: Document all injuries, including chronic pain, with a medical practitioner. Delaying treatment can weaken your claim. For example, if you experience persistent back pain after a car accident, a doctor’s note confirming the pain started post-accident is essential.
- Keep detailed records: Track your pain levels, medication use, and how the injury affects your daily life. SIRA requires evidence that your chronic pain is a direct result of the accident. A diary or journal can help demonstrate this.
- Notify your insurer promptly: Under the MAIA, you have 52 weeks from the accident date to claim statutory benefits for threshold injuries. Failing to notify your insurer within this timeframe may result in lost payments.
- a Follow SIRA’s procedures: SIRA evaluates claims based on the Motor Accident Guidelines. If your chronic pain is not classified as a threshold injury, you may need to pursue a common law damages claim, which requires separate legal steps.
When to Seek Legal Advice
If your chronic pain persists beyond 52 weeks or you believe your claim has been undervalued, consult a solicitor. Common mistakes include:
- Not understanding the difference between statutory benefits and common law damages.
- Failing to provide sufficient evidence linking your pain to the accident.
- Missing deadlines for submitting claims.
Hypothetical Example
Consider a Balmain resident who suffered a whiplash injury in a car accident. They experience chronic neck pain requiring ongoing physiotherapy. If the pain is classified as a threshold injury, they may receive weekly payments for 52 weeks. However, if the pain worsens and affects their ability to work beyond this period, they may need to pursue a separate claim for long-term impairment.
Next Steps
Chronic pain claims can be complex, especially when navigating SIRA’s guidelines. To ensure your claim is handled correctly, complete the quick, no obligation enquiry form to request contact about your circumstances. Every claim depends on its own facts, and time limits may apply.