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 a motor accident worsens a pre-existing injury, claimants on the Central Coast must navigate complex legal rules to secure compensation. Under NSW CTP laws, aggravation of a pre-existing condition can entitle injured persons to benefits, but common errors can jeopardise claims. This article explains how SIRA assesses such cases, outlines critical evidence to gather, and highlights practical steps to avoid costly mistakes.
What Constitutes Aggravation of a Pre-existing Injury?
NSW CTP compensation rules treat aggravation as a new injury if the accident worsens an existing condition. The Motor Accident Injuries Act 2017 (s 4.4) defines 'injury' to include conditions that worsen due to an accident. SIRA guidelines clarify that aggravation must result in additional harm, such as increased pain, reduced mobility, or new symptoms not present before the accident. For example, a pre-existing back injury that becomes more severe after a car crash could qualify as an aggravation.
Common Mistakes Claimants Make
- Failing to Document Pre-existing Conditions: Claimants must provide medical records proving the injury existed before the accident. Without this, insurers may argue the injury was caused solely by the crash. A Central Coast claimant with a history of knee surgery must submit old medical notes to establish the pre-existing condition.
- Not Seeking Immediate Medical Attention: Delayed treatment can weaken a claim. If a pre-existing injury worsens after the accident, prompt medical evaluation is essential to link the aggravation to the crash. For instance, a pedestrian with a pre-existing ankle injury who delays seeking care after a collision may struggle to prove the worsening condition.
- Ignoring SIRA’s Aggravation Guidelines: SIRA’s Motor Accident Guidelines specify that aggravation must produce 'new and additional' harm. Claimants must demonstrate that the accident caused a measurable worsening, not just a temporary flare-up. A claimant with a pre-existing migraine condition must show the accident triggered more frequent or severe attacks.
Critical Evidence for Aggravation Claims
To support a claim, Central Coast claimants should gather:
- Medical records showing the pre-existing injury and its worsening after the accident
- Accident reports detailing the incident’s circumstances
- Witness statements or photographs of the scene
- Medical opinions linking the aggravation to the crash
- Income records if the injury affects earning capacity
SIRA requires evidence that the aggravation is 'more than a temporary worsening' and results in 'additional consequences' such as prolonged treatment or disability. A claimant with a pre-existing spinal condition who requires surgery after a crash must provide pre- and post-accident medical assessments to show the aggravation.
When to Seek Legal Advice
Time limits and procedural rules can complicate aggravation claims. For example, the 52-week statutory benefit period under s 3.28 of the Motor Accident Injuries Act 2017 may apply if the aggravation is a 'threshold injury' (a soft-tissue injury with minimal impairment). Claimants must also avoid disputes over contributory fault, which SIRA assesses under s 4.4.
On the Central Coast, claimants should consult a solicitor if:
- The injury worsens significantly after the accident
- Medical records are incomplete or disputed
- The claim faces a dispute over aggravation
- The claimant needs help navigating SIRA’s assessment process
Practical Steps to Strengthen Claims
- Secure medical documentation immediately after the accident
- Report the incident to the relevant insurer within 28 days (s 3.11 of the Act)
- Keep records of all treatment and expenses
- Avoid making statements that could imply fault
- Request a formal assessment from SIRA if the claim is disputed
Conclusion
Pre-existing injury aggravation claims require careful navigation of NSW CTP rules. Common mistakes include poor documentation, delayed medical care, and misunderstanding SIRA’s assessment criteria. On the Central Coast, claimants must act swiftly to preserve their rights. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.