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).
If a motor accident worsens a pre-existing injury, you may still be eligible for NSW CTP compensation. Under the Motor Accident Injuries Act 2017, claims depend on whether the accident caused a new injury or aggravated an existing one. This article explains how NSW assesses such cases, what evidence is needed, and time limits to consider.
How NSW Defines Aggravation of a Pre-existing Injury
NSW CTP rules consider whether the accident caused a new injury or worsened an existing condition. Aggravation occurs when the accident leads to a new injury, or when a pre-existing injury becomes more severe. For example, if a car crash causes a pre-existing back injury to worsen, this could qualify as an aggravation.
SIRA (State Insurance Regulatory Authority) guidance states that claims must show the injury was caused by the accident. This requires medical evidence linking the aggravation to the motor accident. A pre-existing injury alone, without aggravation, does not qualify for CTP benefits.
What Evidence Proves Aggravation?
To claim compensation for an aggravated pre-existing injury, you must provide:
- Medical records showing the pre-existing condition and its worsening after the accident
- Evidence the accident caused the aggravation (e.g., accident reports, witness statements)
- Medical opinions confirming the aggravation is a new injury, not a recurrence
For instance, if a person had a knee injury from a previous fall and then a car accident caused additional damage, a doctor must confirm the new injury was caused by the accident.
Time Limits and Eligibility for CTP Benefits
CTP claims must be made within 52 weeks of the accident if the injury is a 'threshold injury' (a minor injury under the Motor Accident Guidelines). However, if the aggravation results in a more severe injury, benefits may continue beyond 52 weeks.
Under s 4.4 of the Motor Accident Injuries Act 2017, weekly benefits and treatment payments are limited after 52 weeks only if the injury is a threshold injury. If the aggravation causes a more serious injury, the 52-week limit does not apply.
When to Seek Legal Advice
If your claim is disputed or you're unsure about eligibility, contact SIRA or a solicitor. Claims involving pre-existing injuries can be complex, as insurers may argue the injury was not aggravated by the accident.
Next Steps
CTP entitlements depend on the accident date, injury type, and evidence. To discuss your circumstances, complete the quick, no obligation enquiry form.