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 a motor accident worsens a pre-existing injury, injured road users in New South Wales must act quickly to claim compensation under the Compulsory Third Party (CTP) scheme. NSW law treats aggravation of a pre-existing condition as a separate claim from new injuries, requiring specific evidence to prove the accident caused the worsening. This article explains how to identify aggravation, what medical evidence is needed, and the steps to take within legal time limits.
What Constitutes Aggravation Under NSW CTP Laws?
Under the Motor Accident Injuries Act 2017, aggravation of a pre-existing injury means the accident caused the condition to worsen. This is distinct from a new injury. For example, if a person with a pre-existing back condition experiences increased pain or disability after a car crash, the aggravation must be medically proven. SIRA guidelines clarify that the accident must have directly contributed to the worsening, not merely coincided with it.
Proving Aggravation: Medical Evidence and Documentation
Claimants must provide clear medical evidence linking the accident to the worsened condition. This includes:
- Detailed medical records showing the pre-existing injury and its progression
- Specialist reports confirming the accident caused increased symptoms
- Before-and-after assessments comparing the injury's state pre- and post-accident
Doctors must specify how the accident aggravated the condition, not just that the person had an existing injury. SIRA requires this evidence to distinguish between a new injury and an aggravated pre-existing one.
Practical Steps for Injured Road Users
- Seek immediate medical attention after the accident, even if symptoms seem minor. Document all treatments and note how the injury has worsened.
- Preserve accident details like police reports, witness statements, and photographs of the scene.
- Notify your insurer within 52 weeks of the accident, as this is the statutory deadline for claiming benefits under the CTP scheme.
- Request a medical assessment from a specialist familiar with SIRA's aggravation criteria.
Time Limits and Dispute Resolution
Claimants must notify the at-fault driver's insurer within 52 weeks of the accident to claim benefits. If the injury worsens after this period, compensation may not be available. Disputes over aggravation often require expert medical opinions to determine if the accident caused the worsening. SIRA's guidelines state that claims must show a 'direct link' between the accident and the aggravated condition.
When to Seek Legal Advice
Complex cases, such as those involving multiple pre-existing conditions or disputes over medical evidence, may require legal assistance. A solicitor can help navigate SIRA's assessment process and ensure all evidence meets legal standards. Early legal advice is crucial to meet time limits and build a strong case.
Example Scenario
Consider a cyclist with a pre-existing knee injury who sustains a new injury in a collision. If the accident also aggravates the existing knee condition, the claim must prove the worsening was caused by the crash, not pre-existing degeneration. SIRA assesses such cases by evaluating medical evidence showing the accident caused increased disability.
Next Steps
CTP claims involving pre-existing injuries depend on precise legal and medical evidence. To request contact about your circumstances, complete the quick, no obligation enquiry form.