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 been in a motor accident in the Blue Mountains or Nepean and have a pre-existing injury that worsened, you need to prove the aggravation to claim compensation. Under NSW CTP rules, evidence must show the accident caused a new or worsened injury. This article explains what records to keep, how to document your case, and when to seek legal help.
NSW CTP Rules for Pre-existing Injury Aggravation
New South Wales' Motor Accident Injuries Act 2017 governs CTP claims. To claim compensation for an aggravated pre-existing injury, you must demonstrate:
- The accident caused a new injury or worsened an existing one
- The injury meets the 'threshold injury' definition in the Motor Accident Guidelines
- The aggravation is directly linked to the accident
SIRA (State Insurance Regulatory Authority) requires claimants to provide medical evidence showing the pre-existing condition was worsened. This includes clinical records, imaging, and expert opinions. The location of the accident (Blue Mountains or Nepean) doesn't affect these requirements, but local medical facilities may have specific documentation practices.
Evidence to Keep for Your Claim
To support your claim, retain these records:
- Medical records: Obtain copies of all pre-accident and post-accident medical reports, including GP notes, specialist consultations, and imaging (e.g., MRI, X-rays). Highlight how the accident caused a new or worsened condition.
- Treatment plans: Document any new treatments, therapies, or medications started after the accident. Include dates and details of consultations.
- Expert opinions: A medical expert's report linking the accident to the aggravation is critical. SIRA's guidelines emphasize that this must show a 'causal connection' between the accident and the worsened injury.
- Accident details: Keep police reports, witness statements, and photos of the scene. These help establish the accident's circumstances and your involvement.
- Income records: If the aggravation affects your ability to work, provide payslips or employment records to support lost income claims.
Practical Steps for Claimants in the Blue Mountains and Nepean
- Seek immediate medical attention after the accident, even if you feel fine. Document all treatments and note any new symptoms.
- Request a copy of all medical records from your healthcare providers. Ensure records clearly link the pre-existing injury to the accident.
- Consult a specialist if your condition worsens. A report from a physiotherapist, occupational therapist, or doctor can strengthen your case.
- a Record your symptoms in a journal, noting when they started and how they relate to the accident.
- Notify your insurer as soon as possible. Delays can jeopardize claims, especially if the injury worsens over time.
Time Limits and Dispute Resolution
You have two years from the accident date to file a CTP claim under NSW law. However, delays in seeking medical treatment or documenting injuries may affect your case. If your claim is disputed, SIRA's dispute resolution process allows for reviews based on new evidence. Always seek legal advice if your claim is rejected.
When to Seek Legal Advice
A solicitor can help if:
- Your claim is denied
- You need to dispute a decision
- You're unsure how to document your case
- You have complex medical records to organize
Legal professionals can also help navigate SIRA's requirements and ensure your evidence meets the threshold for compensation.
Example Scenario
Imagine a cyclist in the Blue Mountains with a pre-existing knee injury. After a collision, they experience increased pain and reduced mobility. Medical records showing worsened symptoms and a doctor's report linking the accident to the aggravation would be essential. This example illustrates how to build a case using SIRA's evidentiary standards.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.