How NSW CTP law handles pre-existing injuries worsened by a motor accident
If you were involved in a motor accident in New South Wales and your pre-existing injury was made worse by the crash, you may still be entitled to compensation under the Compulsory Third Party (CTP) insurance scheme. The Motor Accident Injuries Act 2017 (MAIA) allows compensation for injuries that are aggravated by a motor accident, even if the injury existed before the crash. This means that if your back pain, arthritis, or another medical condition was made significantly worse by the accident, you may be able to claim for the additional harm caused.
The law does not require that the injury be new or entirely caused by the accident. It is sufficient that the accident contributed to a worsening of your condition. This applies whether you were a driver, passenger, pedestrian, cyclist or motorcyclist in Greater Sydney or elsewhere in NSW. The focus is on the impact of the accident on your health and functional capacity, not on whether the injury was present before.
What must be proven to claim for aggravated pre-existing injury
To claim compensation for a pre-existing injury that was aggravated by a motor accident, you must establish a clear link between the accident and the worsening of your condition. This requires medical evidence showing that the accident caused or contributed to a measurable increase in your symptoms, disability or need for treatment.
SIRA’s guidelines state that a medical practitioner must provide an opinion on whether the accident caused or contributed to the aggravation. This opinion should be based on clinical findings, diagnostic imaging, and a review of your medical history. The assessment must consider whether the symptoms you have now are different from those you had before the accident, and whether the changes are consistent with the accident’s impact.
Key evidence includes:
- A medical report from a treating practitioner that details your pre-accident condition and any changes since the crash
- Diagnostic tests such as MRI or X-ray showing new or worsened structural findings
- A record of increased pain, reduced mobility, or loss of function that began or worsened after the accident
- Documentation of additional treatment required since the accident, such as physiotherapy, medication, or specialist consultations
How compensation is assessed when a pre-existing injury is aggravated
Compensation under the CTP scheme is not limited to new injuries. If your pre-existing injury was aggravated, you may be entitled to:
- Treatment and care benefits for ongoing medical treatment
- Weekly income payments if you are unable to work due to the aggravated condition
- Damages for pain and suffering, loss of enjoyment of life, and future care needs, if your injury meets the threshold for damages
The amount of compensation depends on the severity of the aggravation and its impact on your daily life and capacity to work. If the aggravation results in a whole person impairment (WPI) of 10% or more, you may be eligible to claim damages under the MAIA. The WPI is assessed by an independent medical assessor using the Motor Accident Guidelines.
However, you may still receive treatment and care benefits and weekly income payments for up to 52 weeks, as the law limits these benefits when only threshold injuries are present.
Common mistakes made by claimants with pre-existing injuries
Many people who have pre-existing injuries make errors that can weaken their claim. These include:
- Failing to report the accident to the insurer within a reasonable time
- Not seeking medical treatment immediately after the accident
- Not keeping a record of symptoms, treatment, and any changes in function
- Assuming that because they had a condition before, they cannot claim for any worsening
- Not providing a clear medical opinion linking the accident to the aggravation
A common mistake is to believe that a pre-existing condition automatically disqualifies a claim. This is not true. The law recognises that accidents can worsen existing health issues, and compensation is available for the additional harm caused.
Another mistake is to delay seeking medical assessment. The longer you wait, the harder it becomes to prove that the accident caused or contributed to the worsening of your condition. Medical evidence is strongest when obtained close to the accident.
Practical steps to take after a motor accident involving a pre-existing injury
If you have a pre-existing injury and were involved in a motor accident, take the following steps:
- Seek medical attention as soon as possible, even if you feel only mild symptoms
- Inform your doctor about your pre-accident condition and any changes since the crash
- Keep a daily record of your symptoms, pain levels, and any limitations in daily activities
- Take photographs of any visible injuries or damage to property
- Gather contact details of any witnesses to the accident
- Notify your CTP insurer about the accident and your claim, including details of your pre-existing condition
- Request a copy of any medical reports or assessments from your treating practitioner
These steps help build a clear and credible record of how the accident affected your health. The more complete and timely the evidence, the stronger your claim will be.
When to seek independent legal advice
If your pre-existing injury was aggravated by a motor accident, you may benefit from speaking with a legal professional who understands the Motor Accident Injuries Act 2017 and SIRA’s guidelines. An experienced adviser can help you:
- Understand whether your claim is likely to succeed
- Identify the type of evidence that will support your claim
- Navigate the process of making a claim, including how to respond to insurer inquiries
- Challenge a decision that denies your claim or limits your benefits
Legal advice is particularly important if your claim involves a complex medical history, a dispute over causation, or a request for damages. The law allows for review and dispute resolution if you disagree with an insurer’s decision, but these processes must be initiated within strict timeframes.
Hypothetical example: A common scenario in Greater Sydney
Sarah, a 52-year-old office worker from Sydney’s Inner West, had chronic lower back pain due to a herniated disc diagnosed in 2020. In June 2024, she was a passenger in a car that was rear-ended at a traffic light in North Sydney. After the crash, her back pain worsened significantly. She visited her GP the next day and was referred for an MRI, which showed a new disc bulge not present before.
Her treating physiotherapist confirmed that her ability to sit, stand, and walk had declined since the accident. She was unable to return to work for six weeks and required ongoing treatment. Her medical reports clearly linked the new disc changes and functional decline to the accident.
Sarah’s claim for aggravated pre-existing injury was supported by medical evidence and a WPI assessment of 12%. She was awarded treatment and care benefits, weekly income payments, and damages for pain and suffering.
Next steps for your claim
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.