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 motor accident worsens a pre-existing injury, injured claimants in NSW must prove the aggravation to access compensation. This article explains how SIRA evaluates such claims, focusing on treatment and rehabilitation planning for Illawarra and South Coast residents. Key legal principles, evidence requirements, and regional considerations are outlined to help claimants understand their options.
How SIRA Assesses Pre-existing Injury Aggravation
SIRA evaluates whether a motor accident has aggravated a pre-existing injury by comparing medical evidence before and after the accident. Under the Motor Accident Injuries Act 2017, claimants must demonstrate that the accident caused additional harm beyond their original condition. Medical reports must clearly show:
- A documented history of the pre-existing injury
- Evidence of worsened symptoms post-accident
- A causal link between the accident and the aggravation
For example, if a claimant had a pre-existing knee injury and the accident caused a meniscus tear, medical records must show the tear was not present before the crash. SIRA may also consider expert opinions to establish this connection.
Rehabilitation Planning in Regional NSW
Illawarra and South Coast claimants may face unique challenges in accessing rehabilitation services. SIRA requires treatment plans to:
- Align with the claimant’s medical needs
- Include evidence of treatment options available in the region
- Demonstrate how rehabilitation reduces long-term disability
Claimants should:
- Document all treatment records, including specialist consultations
- Note delays in accessing regional services
- Provide evidence of how the accident impacted rehabilitation timelines
For instance, if a claimant required a specialist physiotherapist not available on the South Coast, this could affect compensation assessments. Rehabilitation plans must show how the accident worsened the injury’s impact.
Practical Steps and Evidence for CTP Claims
To support a pre-existing injury aggravation claim, gather:
- Accident reports detailing the incident
- Medical records showing pre- and post-accident conditions
- Witness statements about the accident’s severity
- Rehabilitation records, including therapy notes and specialist reports
- Income records to show lost earnings due to aggravated injury
Claimants should also notify their insurer promptly and request a copy of the claim form to ensure all aggravation details are included.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident if only threshold injuries are involved. However, if the aggravation results in a whole-person impairment, time limits may be extended. Disputes over aggravation assessments can be resolved through:
- SIRA’s internal review process
- Mediation services
- Legal representation for complex cases
Claimants should seek legal advice if their insurer disputes the aggravation or delays compensation.
When to Seek Independent Advice
Regional claimants may benefit from legal guidance to navigate:
- SIRA’s specific requirements for pre-existing injury claims
- Accessing specialist rehabilitation services in Illawarra and South Coast
- Understanding how aggravation impacts long-term compensation
Independent legal advice ensures claimants meet all procedural and evidentiary standards.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.