Balance and dizziness claim
Vestibular injury and dizziness after a motor accident
Dizziness can arise from inner-ear injury, benign positional vertigo, brain injury, migraine, neck injury, medication or psychological factors. A CTP vestibular impairment assessment therefore requires a supported diagnosis and objective vestibular dysfunction. The symptom “dizzy” is not enough to select a WPI class.
Motor accident mechanism
What can happen in a motor accident?
Rear-end crash
Acceleration-deceleration can affect the vestibular system or cause concussion with overlapping dizziness.
Side-impact crash
Side impact may injure the temporal bone, inner ear or central balance pathways.
Motorcycle fall
Head impact can provoke positional vertigo, labyrinthine injury or central vestibular dysfunction.
Pedestrian impact
Direct head trauma and a fall may combine vestibular, visual, cervical and brain injury.
Injuries and diagnoses that may follow
- benign paroxysmal positional vertigo after trauma
- peripheral vestibular hypofunction or labyrinthine injury
- temporal bone or eighth cranial nerve injury
- central vestibular dysfunction associated with brain injury
- visual-vestibular or cervicogenic symptoms requiring differential diagnosis
Symptoms to record accurately
- spinning vertigo or positional attacks
- imbalance, veering or falls
- visual motion sensitivity and difficulty in busy environments
- nausea, oscillopsia or blurred vision with head movement
- driving, travel, stair or work-at-height restrictions
Urgent health warning
Sudden severe vertigo with weakness, speech difficulty, new severe headache, inability to walk or other focal neurological signs requires urgent medical assessment to exclude a central emergency.
Clinical evidence
What objective findings and records matter?
The record should distinguish peripheral from central vestibular dysfunction and identify whether tests reproduce the symptoms. Functional restrictions should match the diagnosed system rather than be inferred from dizziness severity alone.
| Record or test | What it can establish | What it cannot establish alone |
|---|---|---|
| ENT or neuro-otology examination | Assesses eye movements, nystagmus, head impulse, positional symptoms, hearing and neurological differential diagnoses. | A normal bedside test does not always resolve intermittent symptoms, but symptoms alone do not prove permanent dysfunction. |
| VNG, caloric, vHIT or positional testing | May objectively identify peripheral asymmetry, canal dysfunction or positional vertigo where clinically indicated. | An isolated abnormality must be clinically interpreted and causally linked. |
| Audiology and temporal-bone imaging | May identify associated hearing or structural inner-ear injury. | Hearing loss and vestibular impairment use separate applicable methods without overlap. |
| Balance and functional assessment | Records gait, falls risk, visual motion tolerance, travel and work safety. | Activity avoidance does not replace objective vestibular evidence for WPI. |
Part 5 classification
Is the injury threshold or non-threshold?
An objectively established accident-related vestibular injury is not an ordinary soft tissue injury and may support non-threshold classification. Dizziness without a diagnosed vestibular, brain, nerve or other non-threshold injury may remain associated with a threshold cervical or psychological condition.
Evidence consistent with a threshold classification
- dizziness without objective vestibular dysfunction
- symptoms attributed only to cervical soft tissue injury
- anxiety-related dizziness without a recognised psychiatric illness
- testing abnormality not linked to the accident or symptoms
Evidence that may support a non-threshold injury
- objective peripheral or central vestibular dysfunction linked to the accident
- temporal bone, inner-ear or eighth-nerve injury
- a supported traumatic brain injury causing central balance impairment
- another verified neurological injury explaining the balance deficit
Separate questions: threshold injury classification does not set WPI, and receiving statutory benefits does not automatically create a common law damages entitlement.
Part 6 permanent impairment
How is WPI assessed for this injury?
Clause 6.187 requires objective vestibular dysfunction. AMA4 section 9.2a supplies the method, while clause 6.188 corrects the higher class ranges. The assessor selects a class from objective findings and functional interference, not from dizziness intensity alone.
| Assessment question | Applicable method | Important limit |
|---|---|---|
| Objective vestibular dysfunction | Clause 6.187 requires objective evidence before vestibular WPI is assessed. | Dizziness, nausea or fear of movement alone cannot satisfy this requirement. |
| Class ranges | Clause 6.188 sets class 3 at 11-30% WPI, class 4 at 31-60% and class 5 at 61-95%, modifying AMA4 section 9.2a. | A class cannot be chosen without the full clinical and functional criteria. |
| Associated hearing or brain injury | Hearing and central neurological impairment are assessed under their own Part 6 methods. | The same balance function must not be counted twice. |
- Confirm a permanent vestibular diagnosis and objective dysfunction.
- Record whether the lesion is peripheral, central or mixed.
- Explain the effect on standing, walking, travel and ordinary activity within the class criteria.
- Assess associated hearing, visual or neurological impairment separately only where permitted.
- Account for successful treatment or resolution before final assessment.
What does not establish the result by itself?
- dizziness or nausea alone
- a symptom score alone
- one abnormal test without specialist interpretation
- fear of driving treated as vestibular loss
- combining the same balance problem under brain and vestibular methods
Accident-specific examples
Post-traumatic positional vertigo that resolves with treatment
The condition may have required treatment, but a resolved condition may produce no permanent vestibular WPI.
Persistent unilateral vestibular loss with gait difficulty
Objective testing and functional evidence may permit assessment under section 9.2a as modified by clauses 6.187-6.188.
Dizziness after concussion with normal vestibular testing
The symptom requires further differential assessment. It cannot be assigned a vestibular WPI merely because it began after the crash.
Claim file preparation
Evidence checklist
Assessment source
Vestibular injury WPI source
Assessment source: Motor Accident Guidelines v10.1 clauses 6.177-6.188, especially 6.187-6.188; AMA4 Chapter 9 section 9.2a only as modified by Part 6.
Threshold injury: Objective accident-related vestibular injury may be non-threshold. Dizziness alone does not establish the injury or impairment class.
What the assessor checks
- objective dysfunction requirement
- modified class 3-5 ranges
- separate hearing and neurological methods
- no symptom-only class selection
What does not establish the result by itself
- dizziness
- one unexplained test result
- activity avoidance
- double counting
Official sources
Related NSW CTP guides
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Frequently asked questions
- Is dizziness enough for vestibular WPI?
- No. Clause 6.187 requires objective vestibular dysfunction.
- Can positional vertigo be caused by a crash?
- It can follow head trauma. Positional examination, treatment response and specialist diagnosis should establish the condition and causation.
- What if vestibular testing is normal?
- The cause may be intermittent, central, migraine-related, cervical, medication-related or psychological. Further clinical assessment may be needed, but vestibular WPI cannot be assumed.
- Can hearing loss and balance impairment both be assessed?
- Potentially, under their separate applicable methods, provided the same functional loss is not counted twice.
- Does successful treatment end a statutory benefits claim?
- Not automatically. Treatment entitlement and permanent impairment are different issues. A resolved vestibular condition may nevertheless have required reasonable treatment.