Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
If you've been in a motor accident and your existing injury has worsened, you may be eligible for compensation under NSW's Compulsory Third Party (CTP) scheme. This article explains how to document your claim, including specific steps for rural and remote areas where access to medical services may be limited. The NSW government's State Insurance Regulatory Authority (SIRA) provides clear guidelines for claims involving pre-existing injuries aggravated by accidents.
Proving Pre-existing Injury Aggravation
To claim compensation for an aggravated pre-existing injury, you must prove two key things: (1) you had a pre-existing injury, and (2) the motor accident worsened that injury. SIRA requires medical evidence showing a direct link between the accident and the increased severity of your condition. This includes:
- Pre-accident medical records documenting the original injury
- Post-accident medical reports detailing worsened symptoms
- Evidence of the accident (e.g., police reports, witness statements)
- Statements from healthcare professionals confirming the aggravation
Challenges in Rural NSW
Rural and remote claimants may face unique hurdles, such as limited access to specialists or delayed diagnosis. For example, a person with a pre-existing back injury who experiences increased pain after a car accident may need to rely on telehealth consultations or specialist referrals from regional hospitals. SIRA accepts evidence from accredited rural healthcare providers, but you must ensure records are comprehensive and clearly show the aggravation.
What Evidence Matters Most
SIRA emphasizes the importance of a clear causal connection. Key evidence includes:
- Pre-accident medical records (e.g., imaging, treatment notes)
- Post-accident medical records with specific details about worsened symptoms
- Accident reports from the NSW Police or private investigators
- Witness statements or photographs of the accident scene
- Income records if you've lost wages due to the aggravated injury
Time Limits and Disputes
You must notify your insurer within 52 weeks of the accident. If your claim is disputed, SIRA provides a formal review process. Rural claimants should seek legal advice promptly if their insurer rejects the claim or delays payment.
When to Seek Help
If you're unsure whether your injury meets the 'aggravation' threshold, consult a legal professional. SIRA's guidelines are complex, and rural claimants may need assistance navigating documentation requirements. For example, a claimant with a pre-existing knee injury who develops chronic pain after a collision may need a specialist to confirm the link.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.