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).
Complex regional pain syndrome (CRPS) following a motor vehicle accident can result in long-term disability and significant impact on daily life. In New South Wales, claims for CRPS under the Compulsory Third Party (CTP) insurance scheme are governed by the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017. These laws set out the conditions under which a person may access treatment and care benefits, weekly income payments, and damages. The legal framework does not assume fault, but it does require that the injury be directly caused by the accident and that the claimant meets the statutory thresholds for compensation. For individuals in the Illawarra and South Coast regions, common errors in CTP claims for CRPS often stem from misunderstanding these thresholds, delaying medical reporting, or failing to preserve critical evidence. These mistakes can affect eligibility for benefits and reduce the chance of a successful claim.
A claim for CRPS must be supported by medical evidence that demonstrates a neurological condition arising from the accident. The Motor Accident Injuries Act 2017 defines a threshold injury as one that results in a permanent impairment of at least 10% of the whole person, or a condition that prevents the person from returning to work for more than 52 weeks. CRPS may qualify as a threshold injury if it causes lasting functional impairment, but it must be shown that the condition is not solely attributable to pre-existing factors. The Motor Accident Guidelines clarify that a diagnosis of CRPS must be confirmed by a medical practitioner and supported by clinical signs such as changes in skin colour, temperature, swelling, or motor dysfunction. Simply having a diagnosis is not enough, evidence of ongoing, objective symptoms is required.
One common mistake in the Illawarra and South Coast is delaying the formal notification of a claim. Under the Motor Accident Injuries Act 2017, a claim must be made within three years of the accident. However, the sooner a claim is lodged, the better the chance of receiving timely treatment and care benefits. Delaying notification may result in a gap in weekly income payments or a delay in accessing specialist treatment. Another frequent error is failing to seek medical assessment within a reasonable timeframe after the accident. The law does not require a claim to be made immediately, but medical evidence is strongest when obtained soon after the incident. In regional areas like the Illawarra and South Coast, where access to specialists may be limited, it is important to document the initial injury and any worsening symptoms over time.
Evidence that supports a CRPS claim includes medical reports from neurologists, pain specialists, or physiotherapists; imaging results such as MRI or bone scans; records of treatment including physical therapy and medication; and a diary of symptoms, pain levels, and functional limitations. Claimants should also preserve any correspondence with insurers, accident reports, and details of witnesses. In regional NSW, where motor vehicle accidents may occur on rural roads or in private driveways, it is essential to confirm that the location and use of the vehicle fall within the scope of CTP coverage. The law does not automatically cover every incident involving a car, factors such as whether the vehicle was in motion, the nature of the road, and the driver’s role must be assessed.
A third common mistake is assuming that a CTP claim for CRPS will automatically result in a damages award. Under the Motor Accident Injuries Act 2017, damages are only available if the injury is a threshold injury and the claimant has met the 52-week impairment test. If a person’s only injuries are threshold injuries, weekly benefits and treatment and care benefits are generally limited after 52 weeks. This means that long-term CRPS cases may not qualify for damages unless they result in a permanent impairment of at least 10% of the whole person. The Motor Accident Guidelines provide a framework for assessing impairment, and a qualified medical assessor must complete a whole person impairment (WPI) assessment. Claimants should not assume that a diagnosis of CRPS equates to a WPI of 10% or more, this must be independently verified.
Another frequent error is not seeking independent medical advice before accepting a settlement offer. Insurers may propose a lump sum payment based on a preliminary assessment, but this may not reflect the full extent of future treatment needs or long-term disability. In regional areas, where access to specialist care may be limited, it is especially important to obtain a second opinion from a medical practitioner experienced in chronic pain conditions. The claimant should also be aware that a settlement may affect future entitlements, including access to lifetime care or additional benefits under other schemes.
A hypothetical example: A 42-year-old driver in Wollongong was involved in a rear-end collision on the Princes Highway in 2025. She developed severe pain, swelling, and stiffness in her left leg within two weeks. A neurologist diagnosed her with CRPS Type 1. She delayed seeking medical treatment for six months, which weakened her evidence of a direct link between the accident and the condition. Her insurer later disputed the claim, arguing that the delay undermined the credibility of her symptoms. The claim was eventually accepted, but only after a medical review confirmed the onset of symptoms aligned with the accident timeline.
The legal framework for CTP claims in NSW is consistent across regions, including the Illawarra and South Coast. However, regional differences in access to healthcare, insurer practices, and local court procedures may affect how claims are managed. The Motor Accident Injuries Act 2017 and SIRA’s guidance apply uniformly, but claimants must act promptly and document all aspects of their injury and recovery. Time limits and procedural requirements may apply. To request contact about the next step, complete the quick, no obligation enquiry form.