A threshold injury is a soft tissue injury, or a psychological injury that is not a recognised psychiatric illness, as defined in section 1.6 of the Motor Accident Injuries Act 2017 (NSW). If all of your injuries are threshold injuries, your statutory benefits generally stop 52 weeks after the accident and you cannot claim damages. You can challenge the insurer's decision.
After a car accident in NSW, one decision shapes your CTP claim more than almost any other: whether the insurer classes your injuries as threshold injuries. Until 1 April 2023 these were called minor injuries. The name changed, but the effect did not. The classification decides how long your benefits last and whether you can ever claim a lump sum.
What counts as a threshold injury?
Under section 1.6 of the Act, there are two types.
Soft tissue injuries. An injury to tissue that connects, supports or surrounds other structures or organs, such as muscles, tendons, ligaments, menisci, cartilage, fascia, fibrous tissue, fat, blood vessels and synovial membranes. Whiplash, neck strain and a sore back are the most common examples.
Threshold psychological or psychiatric injuries. A psychological or psychiatric injury that is not a recognised psychiatric illness. SIRA also treats two diagnosable conditions, adjustment disorder and acute stress disorder, as threshold injuries.
What is not a threshold injury?
The Act carves out some injuries that might sound like soft tissue injuries. According to SIRA, these are not threshold injuries:
- fractures
- injuries to nerves, including damage to a spinal nerve root that meets the criteria for radiculopathy
- a complete or partial rupture of a tendon, ligament, meniscus or cartilage
- a recognised psychiatric illness, such as post-traumatic stress disorder (PTSD) or major depressive disorder
One non-threshold injury changes the whole claim. The insurer classifies each injury separately. If even one of your injuries is not a threshold injury, your claim is not a threshold injury claim. Section 4.4 only bars damages where a person's only injuries were threshold injuries.
Why the classification matters
Weekly income payments. Threshold injuries only: up to 52 weeks after the accident (s 3.11). At least one non-threshold injury, and not mostly at fault: up to 104 weeks, or longer while a damages claim is pending (s 3.12).
Treatment and care. Threshold injuries only: up to 52 weeks after the accident (s 3.28). At least one non-threshold injury, and not mostly at fault: continues after 52 weeks while reasonable and necessary.
Claim for damages (lump sum). Threshold injuries only: not available (s 4.4). At least one non-threshold injury, and not mostly at fault: available if another person was at fault. Pain and suffering requires permanent impairment greater than 10%.
How does the insurer decide?
The decision is based on the diagnosis of your injury, not on how severe your symptoms are or how much the injury is affecting your life. Your treating doctor or health professional makes the diagnosis, and the insurer then decides the classification, taking that evidence into account. The insurer tells you its decision and reasons in a liability notice. Under section 6.19 of the Act, it must say whether it accepts liability for benefits beyond the first 52 weeks within 9 months of your claim.
How do you challenge a threshold injury decision?
Step 1: Ask for an internal review. Ask the insurer to reconsider its decision within 28 days of receiving the liability notice. Include any new medical information, such as a specialist report or a formal diagnosis.
Step 2: Refer the dispute to the Personal Injury Commission. If the review does not change the decision, the dispute is usually a medical dispute. It goes to an independent medical assessor at the Personal Injury Commission. The Commission has reminded parties that applications must include medical evidence supporting the injury classification you are asking for.
Step 3: Review of the medical assessment. In some cases a medical assessment can be reviewed by a Review Panel of the Commission.
Threshold decisions we have overturned
In one matter, our client was a passenger on a bus involved in an accident. The insurer accepted she was not at fault but classed her injuries as threshold. Using her treating psychologist's diagnosis and treatment notes, we asked for an internal review, and the insurer reversed its decision. That kept her entitled to benefits beyond 52 weeks and to a potential damages claim. Read the case study.
In another, our client developed psychological symptoms after a rear-end collision involving her husband and young child. A Personal Injury Commission Review Panel revoked the original medical assessment and found she had major depressive disorder, a non-threshold injury. Read the case study.
Practical steps to protect your claim
- See your GP as soon as possible after the accident, and keep attending.
- Tell your doctors about every symptom, including pain that spreads, numbness, sleep problems, anxiety and low mood.
- Ask about a referral to a specialist, psychiatrist or psychologist if symptoms persist.
- Keep every letter from the insurer, and note the date you received each liability notice.
- Get advice before the 28 day internal review window closes.
If you have received a threshold injury decision, our motor vehicle accident lawyers can review it. Call 02 8046 9700.
Frequently asked questions
Is whiplash a threshold injury?
Usually, yes. Whiplash is generally a soft tissue injury. But if the accident also damaged a nerve, for example a spinal nerve root injury that meets the criteria for radiculopathy, that injury is not a threshold injury.
Is a threshold injury the same as a minor injury?
Yes. The term minor injury was replaced with threshold injury from 1 April 2023. At the same time, access to benefits for these injuries was extended from 26 to 52 weeks.
Can my injury be reclassified later?
The classification follows the diagnosis. If later medical evidence shows a different diagnosis, such as a nerve injury, a ligament tear or a recognised psychiatric illness, that evidence can support a review or a dispute. Get advice about the time limits that apply to your claim.
Is anxiety after a car accident a threshold injury?
It depends on the diagnosis. Anxiety symptoms that do not amount to a recognised psychiatric illness, as well as adjustment disorder and acute stress disorder, are threshold injuries. A diagnosed condition such as PTSD or major depressive disorder is not.
This article is general information only and is not legal advice. Entitlements depend on your circumstances and the date of your accident. The law stated is current at October 2026 for accidents covered by the Motor Accident Injuries Act 2017 (NSW).
