Respiratory injury claim
Respiratory injury after a motor accident
Lung contusion, aspiration, inhalation injury, diaphragmatic damage, pleural scarring or prolonged ventilation can leave respiratory impairment after a severe crash. Breathlessness alone does not set WPI. The CTP method classifies permanent respiratory function using objective physiology and careful interpretation of other conditions that can reduce exercise capacity.
Accident mechanism and diagnosis
How can this injury happen in a motor accident?
Blunt chest trauma
Seatbelt or crush force can cause lung contusion, pleural injury, pneumothorax, haemothorax or diaphragmatic rupture.
Fire, smoke or chemical inhalation
Airway burns and toxic exposure may cause acute respiratory failure and, in some cases, lasting airway or gas-transfer impairment.
Critical care complication
Aspiration, pneumonia, acute respiratory distress or prolonged ventilation can contribute to the permanent picture if causally linked to crash treatment.
The injuries that may actually occur
- pulmonary contusion with residual restriction
- pleural scarring or fibrothorax
- airway or inhalation injury
- diaphragmatic injury affecting ventilation
- post-traumatic respiratory failure or ARDS
- loss of lung tissue after surgery
Symptoms and functional effects to document
- shortness of breath at rest or exertion
- reduced walking, stair or work tolerance
- persistent cough or wheeze
- oxygen or ventilatory support needs
- fatigue associated with measured respiratory limitation
Urgent health warning
New or worsening breathlessness, blue lips, low oxygen levels, coughing blood, fainting or chest pain requires urgent medical assessment.
Medical evidence
What tests and findings matter?
The evidence must separate accident-caused lung dysfunction from pain-limited effort, smoking-related disease, cardiac limitation, obesity, deconditioning or an unrelated respiratory condition.
| Test or record | What it can establish | What it cannot establish alone |
|---|---|---|
| Spirometry | Measures FVC and FEV1 and can identify restrictive or obstructive physiology when technically valid. | Submaximal effort, pain and poor technique can make a low result unreliable. |
| Diffusing capacity (DCO) | Measures gas transfer and can identify permanent alveolar-capillary impairment. | Anaemia, smoking and technical factors can affect the result and require interpretation. |
| VO2 max or exercise testing | May measure functional exercise capacity where needed for Table 8 classification. | Cardiac, limb, pain and conditioning factors may reduce performance for non-respiratory reasons. |
| Imaging and respiratory records | CT, bronchoscopy, admission and treatment records establish the anatomical injury and course. | Residual imaging change does not set WPI without functional classification. |
A separate legal classification
Threshold injury is not the same as WPI
A diagnosed lung, pleural, airway or diaphragm injury may be non-threshold. Breathlessness caused only by chest-wall soft tissue pain or an unsupported symptom may not establish such an injury. WPI requires permanence and a separate Part 6 assessment.
A non-threshold classification does not set a WPI percentage. Conversely, a low or zero WPI assessment does not necessarily decide the threshold-injury classification. Physical and psychiatric WPI are assessed separately and cannot be combined to determine whether impairment is greater than 10%.
Motor Accident Guidelines Part 6
How is permanent impairment assessed?
Clauses 6.229-6.232 direct assessment to AMA4 Chapter 5 Table 8. Classification uses FVC, FEV1 and DCO or VO2 max. The assessor selects a specific percentage within the supported class and explains the choice; class 2, which spans 10-25% WPI, requires careful consideration.
| Assessment issue | CTP method | Important limit |
|---|---|---|
| Pulmonary physiology | Classify permanent impairment with AMA4 Chapter 5 Table 8 using valid FVC, FEV1 and DCO results. | Tables 2-7 may be replaced by substantial peer-reviewed reference standards where age or race would make them inaccurate. |
| Exercise capacity | Use VO2 max where clinically appropriate and interpret it with other causes of reduced capacity. | A low exercise result is not automatically respiratory impairment. |
| Specific WPI within a class | The assessor nominates and reasons a specific percentage within the Table 8 class. | A class range is not permission to select its upper end from symptoms alone. |
Verified Guidelines example or rule
Clause 6.231 verifies that respiratory class 2 spans 10-25% WPI and requires careful consideration. The medical assessor must nominate a specific supported percentage within the applicable class.
What may result in 0% or no assessable WPI?
- resolved lung contusion, pneumothorax or inhalation exposure with normal permanent function
- healed rib or sternum fracture without respiratory impairment
- breathlessness explained by another condition rather than accident-caused lung injury
- invalid or non-reproducible pulmonary testing
What may support a higher assessment if verified?
- consistent permanent reduction in FVC, FEV1 or DCO
- supported respiratory limitation on exercise testing
- ongoing oxygen, ventilation or intensive treatment needs attributable to the crash
- loss of lung tissue or pleural disease with corresponding functional deficit
Combination and overlap rules
- Table 8 already considers the respiratory impairment; symptoms are not rated separately.
- Cardiac impairment uses Chapter 6 and is combined only if distinct.
- Chest scarring or musculoskeletal restriction may use another method after overlap is removed.
What does not establish impairment by itself?
- breathlessness alone
- one poor-quality spirometry result
- an old CT scar without functional loss
- a healed chest fracture
Crash-specific examples
Lung contusion with normal follow-up tests
A severe admission can still resolve without permanent respiratory WPI if imaging and physiology return to normal.
Inhalation injury with persistent gas-transfer loss
Burn-unit and bronchoscopy records establish the exposure, while serial DCO and respiratory opinion support permanence and Table 8 classification.
Claim file preparation
Evidence checklist
Assessment source
Respiratory impairment assessment under NSW CTP
Assessment source: Motor Accident Guidelines Part 6, clauses 6.229-6.232; AMA4 Chapter 5, Table 8 (page 162).
Threshold injury: A supported lung, airway, pleural or diaphragm injury may be non-threshold; WPI still depends on permanent respiratory function.
What the assessor checks
- valid FVC, FEV1 and DCO
- VO2 max where applicable
- specific percentage within the supported class
- other causes of reduced exercise capacity
What does not establish the result by itself
- breathlessness
- imaging alone
- poor-quality tests
- acute severity alone
Official sources
Related NSW CTP guides
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Frequently asked questions
- Which tests are used for respiratory WPI?
- The Guidelines identify FVC, FEV1, DCO and, where appropriate, VO2 max under AMA4 Table 8.
- Does shortness of breath prove respiratory impairment?
- No. Objective testing and causal analysis are needed because pain, heart disease and deconditioning can also cause breathlessness.
- Is class 2 automatically 25% WPI?
- No. Class 2 is a range and the assessor must select and explain the specific supported percentage.
- Can healed rib fractures be included?
- Not unless they leave permanent respiratory dysfunction. The Guidelines expressly exclude uncomplicated healed fractures.
- Can respiratory and cardiac WPI be combined?
- Potentially, if each is a distinct permanent accident-caused impairment and overlap is addressed.