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 road accident worsens a pre-existing injury, NSW CTP insurers must assess whether the aggravation qualifies for compensation. This article explains how the NSW CTP scheme handles such cases, what evidence is needed, and how treatment and rehabilitation planning works on the Central Coast.
How NSW CTP Handles Pre-existing Injury Aggravation
Under the Motor Accident Injuries Act 2017, CTP insurers must consider whether a road accident has aggravated a pre-existing condition. SIRA guidance states that claimants must prove the aggravation caused additional harm beyond the original injury. For example, if a person with a pre-existing back condition experiences increased pain or disability after a crash, the insurer will assess whether the aggravation meets the 'threshold injury' criteria under the Motor Accident Guidelines.
Key factors include:
- Medical evidence showing the aggravation worsened the injury
- Documentation linking the accident to the aggravation
- Evidence of additional treatment costs or lost income due to the aggravation
Practical Steps for Claimants on the Central Coast
To support a claim, injured persons should:
- Gather medical records from local Central Coast clinics or hospitals
- Obtain a specialist report detailing the aggravation's impact
- Keep records of treatment costs, including physiotherapy or specialist consultations
- Note any changes in mobility, pain levels, or daily functioning
Insurers may request a second opinion, so retaining all original medical records is crucial. Claimants should also inform their treating doctor about the accident to ensure accurate documentation.
Time Limits and Dispute Resolution
CTP claimants have 3 years from the accident date to pursue compensation under the Motor Accident Injuries Act 2017. However, time limits for specific benefits (like weekly payments) may be shorter. If an insurer disputes the aggravation, claimants can:
- Request a review of the insurer's assessment
- Seek independent medical advice
- Lodge a complaint with SIRA's dispute resolution team
When to Seek Legal Advice
Complex cases involving pre-existing injuries often require legal assistance. A solicitor can help:
- Navigate SIRA's claim process
- Challenge unreasonable insurer assessments
- Ensure all evidence is properly submitted
If your claim involves a pre-existing injury aggravated by a road accident, seek legal advice early to protect your rights. The Central Coast's medical facilities and local CTP insurers have specific procedures that must be followed correctly.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.