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 pre-existing injury is worsened by a road accident, you may still be eligible for compensation under NSW's Compulsory Third Party (CTP) scheme. This article explains how the scheme evaluates claims where an existing medical condition is aggravated by a motor accident, focusing on regional NSW. Key factors include whether the aggravation is caused by the accident, SIRA's assessment process, and practical steps to support your claim.
How the NSW CTP Scheme Handles Pre-existing Injuries
Under the Motor Accident Injuries Act 2017, the CTP scheme covers injuries caused or aggravated by a motor accident. If your existing injury worsens due to the accident, it may qualify as a 'threshold injury' or a more severe claim. SIRA assesses whether the aggravation is directly linked to the accident, not the pre-existing condition itself. For example, if a pre-existing back injury becomes more severe after a collision, the scheme may cover the additional harm.
SIRA's Role in Assessing Aggravation Claims
SIRA evaluates claims by determining if the accident caused or worsened the injury. Medical evidence is critical. You must provide documentation showing the pre-existing condition and how the accident aggravated it. SIRA considers factors like medical reports, treatment records, and expert opinions. In regional NSW, claims are processed through SIRA's regional offices, which may take longer than metropolitan claims due to resource limitations.
Eligibility Requirements for Regional NSW
To qualify, the aggravation must be a direct result of the accident. If the injury was already present before the accident, the scheme will only cover the worsening part. For instance, if a person with a pre-existing knee condition experiences increased pain after a car crash, the claim would focus on the new symptoms caused by the accident. Regional NSW claims follow the same rules as city claims but may require additional steps to access support services.
Practical Steps for Regional Claimants
- Seek immediate medical attention to document the aggravation. Ensure your medical records clearly link the accident to the worsened condition.
- Preserve accident details like police reports, witness statements, and photographs.
- Notify SIRA within the required time limits (usually 3 years from the accident date).
- Gather evidence of pre-existing injuries, including medical records from before the accident.
- Consider a solicitor if disputes arise, as SIRA may require legal representation for complex cases.
Time Limits and Dispute Options
Claims must be submitted within 3 years of the accident. If SIRA disputes the aggravation, you can request a review or seek legal advice. In regional areas, delays in processing claims are common, so acting promptly is essential. Always confirm deadlines with SIRA or a legal professional.
When to Seek Independent Advice
If your claim involves complex medical evidence, disputes over aggravation, or overlapping injuries, consult a solicitor. Regional NSW claimants may face additional challenges accessing legal support, so early intervention can improve outcomes.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.