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 were injured in a motor vehicle accident in Albury and have a pre-existing medical condition, you may be concerned about how your claim will be assessed. Under NSW CTP law, SIRA evaluates whether your injuries were aggravated by the new accident or are a separate injury. This article explains how SIRA distinguishes between pre-existing conditions and new injuries, the evidence needed to support your claim, and early steps to take after an aggravation.
How SIRA Assesses Pre-existing Injuries
SIRA uses medical evidence to determine whether your injury was aggravated by the new accident. If your pre-existing condition was already documented in medical records, and the new accident worsened it, SIRA may consider the aggravation as a new injury. For example, if you had a pre-existing back injury and the accident caused additional strain leading to new symptoms, this could be treated as a separate claim.
Key factors include:
- Medical records showing the pre-existing condition
- Evidence of the new accident causing additional harm
- Statements from medical practitioners about the aggravation
Evidence Needed for Pre-existing Injuries
To support your claim, you must provide:
- Detailed medical records of your pre-existing condition
- Documentation of the new accident (e.g., police reports, witness statements)
- Statements from doctors explaining how the accident aggravated your injury
- Any treatment records related to the aggravation
SIRA may also request a medical assessment to evaluate the connection between your pre-existing condition and the new injury.
Early Steps for Injured Road Users in Albury
If you believe your pre-existing injury has been aggravated:
- Seek immediate medical attention and ensure your doctor documents the aggravation.
- Report the accident to the police and obtain a report.
- Notify your insurer (or the at-fault driver’s insurer) about the aggravation.
- Keep all medical records and correspondence related to your claim.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim benefits for threshold injuries (minor injuries). If your aggravation results in a more severe injury, this timeline may not apply. However, you must notify SIRA within 52 weeks of the accident to claim benefits for threshold injuries.
If SIRA disputes your claim, you may:
- Request a review of their decision
- Seek independent medical opinion
- Consult a legal professional to challenge the assessment
When to Seek Advice
It is crucial to act quickly, as delays can affect your ability to claim benefits. If your pre-existing injury is complex or you are unsure how SIRA will assess your case, contact a legal professional. General information cannot determine whether a claim is available in an individual case.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.