If a pre-existing injury worsens due to a motor accident, you may still be eligible for compensation under NSW's Compulsory Third Party (CTP) scheme. This article explains how the scheme handles aggravated injuries, what evidence is needed, and how to proceed in Bankstown.
How the NSW CTP scheme treats aggravated pre-existing injuries
Under the Motor Accident Injuries Act 2017, the CTP scheme covers injuries caused by motor accidents, including those that worsen existing conditions. However, eligibility depends on proving the aggravation. SIRA (State Insurance Regulatory Authority) guidelines state that the accident must have caused a 'material worsening' of the pre-existing injury. This means the aggravation must be more than temporary or minor.
For example, if a person with a pre-existing knee condition experiences a significant worsening of symptoms after a car accident, such as increased pain, reduced mobility, or new neurological signs, the injury may qualify. However, if the aggravation is minimal, like a brief flare-up of existing pain, it may not meet the threshold.
Evidence required to prove aggravation
To claim compensation for an aggravated pre-existing injury, you must provide:
- Medical records showing the original injury and its history
- Evidence of the accident, such as police reports, witness statements, or photos
- Medical opinions linking the accident to the worsened condition
- Documentation of how the aggravation affects your daily life or work capacity
SIRA requires that the aggravation be 'more than temporary' and result in a 'material worsening' of the injury. This is determined through medical assessments and expert opinions.
SIRA's eligibility criteria for aggravated injuries
SIRA's guidelines clarify that pre-existing injuries are not automatically excluded from claims. However, the following factors influence eligibility:
- Whether the aggravation is a direct result of the accident
- The nature and severity of the worsened condition
- Whether the injury meets the 'threshold injury' definition under the Motor Accident Guidelines
- The impact on your ability to work or perform daily activities
If the aggravation results in a 'threshold injury' (such as soft tissue damage or a spinal nerve-root injury), you may be eligible for weekly income payments and treatment benefits. However, if the injury does not meet the threshold, benefits may be limited after 52 weeks.
Practical steps for injured road users in Bankstown
- Seek immediate medical attention and document all treatment records
- Report the accident to the police and obtain an accident report
- Contact your doctor to assess whether the aggravation meets the threshold injury criteria
- Gather evidence of how the worsened condition affects your life
- Notify your insurer or SIRA about your claim
Time limits and when to seek advice
You have 52 weeks from the date of the accident to claim certain benefits under the CTP scheme. However, if your claim involves a long-term injury or dispute over eligibility, you may need to act sooner. Legal advice is recommended if:
- You're unsure whether your aggravation meets the threshold
- Your claim is being disputed by an insurer
- You need help navigating SIRA's application process
Next steps
CTP entitlements depend on the date of the accident, the nature of the injury, and the evidence you provide. To discuss your circumstances, complete the quick, no obligation enquiry form. Every claim depends on its own facts.