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).
Motor vehicle accidents in Greater Sydney that result in spinal injuries require careful attention to legal procedures and evidence. A spinal injury may significantly affect daily life, work capacity and long-term wellbeing. Under the Motor Accident Injuries Act 2017 (NSW), claimants are entitled to treatment and care benefits, weekly income payments and, in some cases, damages for pain and suffering. However, common errors in claiming can reduce or delay compensation. These include failing to report the accident promptly, not seeking medical assessment within a reasonable timeframe, not preserving evidence such as photographs or witness details, and not understanding the distinction between statutory benefits and claims for damages. The legal framework in NSW does not automatically award compensation based on injury alone. The claim must meet statutory thresholds and be supported by medical evidence and procedural compliance.
The Motor Accident Injuries Act 2017 governs all CTP claims in NSW, including those involving spinal injuries. This law replaced the Motor Accidents Compensation Act 1999 and applies to all motor accidents occurring on or after 1 December 2017. For claims arising from accidents before that date, different rules may apply, and the claimant should seek independent advice. Under the current law, a claimant may receive treatment and care benefits and weekly income payments regardless of fault. However, to claim damages for non-economic loss (such as pain and suffering), the injury must exceed a threshold. For spinal injuries, this means the injury must be a threshold injury as defined in the Motor Accident Injuries Regulation 2017 and supported by medical evidence in the Motor Accident Guidelines.
A spinal injury may qualify as a threshold injury if it results in a permanent impairment of at least 10% of the whole person, or if it causes a permanent loss of function. Importantly, a spinal nerve-root injury that produces neurological signs other than radiculopathy may still be classified as a threshold injury under the Guidelines. Radiculopathy, such as numbness, tingling or weakness in a limb, must be confirmed by clinical and imaging evidence to meet the threshold. If the only injuries are threshold injuries, weekly benefits and treatment and care benefits are generally limited to 52 weeks under section 4.4 of the Motor Accident Injuries Act 2017. This does not mean the claim ends, but it limits the duration of statutory benefits unless the claim proceeds to damages.
Common mistakes that can undermine a spinal injury claim include:
- Failing to notify the CTP insurer within a reasonable time after the accident. While there is no fixed deadline, delays may affect the insurer’s ability to investigate and may be used to challenge the claim.
- Not obtaining a formal medical assessment from a qualified medical practitioner within a timely period. The assessment must be conducted by a medical practitioner who has not previously treated the claimant, as required by the Motor Accident Guidelines.
- Not preserving evidence such as photographs of the vehicle damage, scene conditions, or witness contact details. These may be critical if the claim proceeds to dispute.
- Assuming that a spinal injury automatically qualifies for damages. The claim must meet the threshold requirement and be supported by medical evidence showing permanent impairment or loss of function.
- Attempting to claim damages without first obtaining a certificate of capacity from a medical practitioner, which is required to establish the extent of the injury and its impact on work capacity.
A realistic example: A cyclist in Sydney’s Inner West was struck by a car at a roundabout in June 2024. The cyclist reported back pain and numbness in the left leg. Medical records confirmed a spinal nerve-root injury with neurological signs, but no radiculopathy. The claimant waited six months before seeking a medical assessment. The CTP insurer disputed the claim on the grounds that the injury did not meet the threshold because the assessment was delayed and no formal impairment assessment was conducted. The claimant was initially denied treatment and care benefits. After obtaining a second opinion and a formal impairment assessment, the claim was reinstated. This example illustrates how delay in medical assessment can create procedural hurdles, even when the injury is valid.
To avoid these issues, claimants should:
- Seek medical attention immediately after an accident, even if symptoms are mild.
- Request a formal medical assessment from a practitioner not previously involved in treatment.
- Notify the CTP insurer as soon as possible, ideally within 28 days.
- Keep a record of all medical appointments, correspondence, photographs and witness details.
- Apply for a certificate of capacity to assess work capacity and future earnings.
Time limits and procedural requirements may apply. For example, a claim for damages must generally be commenced within three years of the accident date, or within three years of the date the claimant first knew or ought to have known of the injury. This is critical for spinal injuries, which may not present symptoms immediately. If a claim is disputed, the claimant may seek review through the State Civil and Administrative Tribunal (SCAT) or, if necessary, the NSW Supreme Court.
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