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 a road accident worsens a pre-existing medical condition, claiming compensation under NSW's Compulsory Third Party (CTP) scheme can be complex. This article explains how to avoid common errors when seeking CTP benefits for aggravated injuries in Ballina, based on SIRA's approach to pre-existing conditions.
How SIRA assesses pre-existing injury aggravation
Under the Motor Accident Injuries Act 2017, SIRA evaluates whether a road accident has worsened a pre-existing condition. Key factors include:
- Medical evidence showing the pre-existing injury existed before the accident
- Proof the accident caused additional harm or prolonged recovery
- Documentation linking the aggravation to the accident
SIRA requires clear evidence that the accident significantly worsened the condition, not just caused a new injury. For example, a pre-existing back injury that becomes more severe after a collision would qualify, while a new unrelated injury would not.
Common mistakes to avoid
- Failing to document pre-existing conditions - Keep medical records, treatment history, and diagnosis dates from before the accident. Without this, insurers may dispute the claim.
- Not seeking immediate medical attention - Delayed treatment can weaken the case. Seek care promptly after the accident and inform medical staff about pre-existing injuries.
- Ignoring SIRA's 52-week rule - If only threshold injuries (minor soft tissue injuries) are involved, benefits typically stop after 52 weeks. Aggravated injuries may qualify for longer support, but this depends on medical evidence.
- Blaming the accident for all symptoms - SIRA distinguishes between injuries caused by the accident and those unrelated. Claims must show a direct link between the accident and the worsened condition.
Evidence to strengthen your claim
To prove aggravation, gather:
- Medical records showing pre-existing injury dates and treatment
- Accident reports and witness statements
- Statements from treating doctors explaining how the accident worsened the condition
- Income records if the injury affects earning capacity
Time limits and when to seek advice
CTP claims must be submitted within 52 weeks of the accident, though extensions may apply for complex cases. If your claim involves pre-existing injuries, consult a legal professional before the 52-week mark to ensure all evidence is properly prepared.
When to contact a legal expert
Seek advice if:
- Your injury worsened significantly after the accident
- You're unsure how to prove the aggravation
- You've received a letter from SIRA denying your claim
- You need help navigating the 52-week time limit
CTP claims involving pre-existing injuries require careful handling. By avoiding these common mistakes and gathering strong evidence, you can improve your chances of securing fair compensation under NSW law.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.