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 you've suffered a road trauma that worsened a pre-existing injury, you may be eligible for compensation under NSW's Compulsory Third Party (CTP) scheme. Proving aggravation requires specific evidence, including medical records and expert opinions. This article explains what records to preserve, how SIRA evaluates such claims, and when to seek legal advice.
Proving Pre-existing Injury Aggravation
Under the Motor Accident Injuries Act 2017, a claimant must demonstrate that a road trauma caused a 'material worsening' of a pre-existing condition. This requires:
- Medical evidence showing the pre-existing injury existed before the accident and worsened as a result.
- Expert opinion from a medical practitioner confirming the aggravation.
- Documentation linking the accident to the worsened condition.
For example, a person with a pre-existing back injury who develops new symptoms after a car crash must provide evidence that the trauma caused the deterioration.
What Records to Keep in Ashfield
To support your claim, preserve:
- Medical records from before and after the accident, including diagnoses, treatment history, and imaging.
- Accident reports from NSW Police or the Transport for NSW incident report.
- Witness statements from people who saw the accident.
- Photographs of injuries or vehicle damage.
- Income records if you've lost wages due to the worsened injury.
SIRA advises claimants to retain all records related to the pre-existing condition and the accident. This includes records of any prior treatments or consultations.
How SIRA Assesses Aggravation Claims
SIRA evaluates claims by:
- Reviewing medical evidence to determine if the aggravation is 'material'.
- Assessing the link between the accident and the worsened condition.
- Applying the 52-week rule - if only threshold injuries resulted, benefits may be limited after 52 weeks.
Claims where the aggravation is not 'material' may be denied. For example, a pre-existing knee injury that slightly worsens after an accident may not qualify if the worsening is minimal.
Time Limits and When to Seek Advice
You must notify your insurer within 52 weeks of the accident. If you're unsure whether your claim meets the criteria for aggravation, seek legal advice promptly. A solicitor can help you:
- Gather the necessary evidence.
- Challenge a refusal of your claim.
- Understand how SIRA assesses your specific case.
Next Steps
CTP claims involving pre-existing injuries depend on the date of the accident, the nature of the aggravation, and the evidence you provide. To request contact about your circumstances, complete the quick, no obligation enquiry form.