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 you've suffered a road accident that worsened a pre-existing injury in New South Wales, you may be eligible for compensation under the Compulsory Third Party (CTP) scheme. Proving this requires careful documentation. This article explains what evidence to collect, how SIRA evaluates such claims, and practical steps to take in Armidale.
What Evidence Is Needed to Prove Pre-existing Injury Aggravation?
Under NSW CTP laws, claims for aggravated pre-existing injuries must show the accident worsened your condition. Key evidence includes:
- Medical records showing your pre-existing injury (e.g., scans, diagnosis notes, treatment history)
- Accident reports detailing how the collision occurred
- Expert medical opinions linking the accident to your worsened condition
- Before-and-after medical assessments comparing your condition pre- and post-accident
- Witness statements or incident reports supporting your account
SIRA evaluates these claims by assessing whether the accident caused a 'material worsening' of your condition. For example, if a pre-existing back injury led to new neurological symptoms after a crash, this could qualify.
What Records Should You Retain in Armidale?
In Armidale, retaining specific documents is critical. Prioritize:
- Original medical records from your GP, specialists, or physiotherapists
- Copies of all accident-related correspondence with insurers or authorities
- Photographs of the accident scene (if safe to do so)
- Witness contact details and statements
- Income records if you've lost earnings due to the aggravation
If your injury required surgery or specialist treatment post-accident, ensure you have all pre- and post-accident medical records. SIRA may request these to assess the claim.
How Does SIRA Evaluate Aggravated Pre-existing Injuries?
SIRA uses the Motor Accident Guidelines to determine if your injury meets the 'threshold injury' criteria. If your aggravation results in a new injury that meets these thresholds, you may qualify for:
- Weekly income benefits
- Treatment and care benefits
- Compensation for ongoing impairment
However, if your aggravation only worsens an existing condition without meeting new injury thresholds, benefits may be limited. For instance, if your pre-existing injury was already classified as a 'threshold injury' and the accident only caused a temporary flare-up, SIRA may not award additional benefits.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim benefits for injuries that meet the threshold. However, claims for aggravated pre-existing injuries may have different timelines depending on the nature of the aggravation. If your condition worsens after this period, you may need to seek legal advice to explore options.
Disputes over aggravation claims are common. If your insurer disputes your claim, consider consulting a solicitor to review your evidence. Legal professionals can help you understand whether your case meets the legal criteria for compensation.
Practical Example: A Hypothetical Scenario
Imagine a person with a pre-existing knee injury who experiences a flare-up after a car accident. Medical records showing the original injury, post-accident scans showing increased swelling, and a doctor's opinion linking the accident to the flare-up would strengthen the claim. This example illustrates how evidence must clearly show a connection between the accident and the worsened condition.
Next Steps
CTP claims involving pre-existing injuries require meticulous record-keeping. In Armidale, ensure you retain all medical and accident-related documents. If your insurer disputes your claim or you're unsure about your options, seek legal advice. Every claim depends on its own facts.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.