Threshold injury vs non-threshold injury (NSW CTP)
In NSW CTP claims, insurers often raise “threshold injury” because it can affect how long statutory benefits are payable. A separate concept is whether an injury is non-threshold (sometimes called “above-threshold”).
Non-threshold injury ≠ WPI > 10%. WPI (whole person impairment) and the 10% threshold is a separate entitlement test.
- Threshold injury (s 1.6): soft tissue injury and/or non-recognised psychological/psychiatric injury (subject to regulations/guidelines).
- Non-threshold injury: any injury that is not a threshold injury.
- WPI > 10%: a separate impairment threshold used for certain entitlements.
Key point: non-threshold injury is not determined by a WPI percentage. Non-threshold injury ≠ WPI > 10%.
1) Threshold injury (Motor Accident Injuries Act 2017 s 1.6)
At a high level, threshold injury includes soft tissue injury and certain psychological/psychiatric injury that is not a recognised psychiatric illness, as defined in s 1.6 and modified by any applicable regulations/guidelines.
Insurers may classify injuries as threshold injuries to apply benefit duration rules. The correct classification is evidence-driven.
2) Non-threshold injury (above-threshold injury)
Non-threshold injury is any injury that is not a threshold injury. Depending on the facts and medical evidence, examples may include fractures, nerve injuries, ruptures, and recognised psychiatric illness.
The label is not about severity alone — it is about whether the injury meets the defined threshold injury criteria.
3) What the classification affects
- Duration of statutory benefits (weekly payments and treatment), depending on your circumstances.
- Dispute pathways (threshold injury disputes are commonly medical disputes).
If your weekly payments have been reduced or stopped, see weekly payments stopped.
4) Evidence that commonly matters
- Contemporaneous GP/hospital records and objective findings
- Specialist reports addressing diagnosis and criteria
- Imaging where relevant (and clinical correlation)
- Functional evidence over time
Evidence should be targeted to the legal definition — volume alone rarely helps.
5) How threshold injury disputes are determined (PIC)
Threshold injury disputes are commonly determined through the NSW Personal Injury Commission medical pathways.
Frequently asked questions
- What is a threshold injury (MAI Act s 1.6)?
- Under the Motor Accident Injuries Act 2017 (NSW) s 1.6, a threshold injury includes a soft tissue injury and/or a psychological or psychiatric injury that is not a recognised psychiatric illness (subject to regulations and guidelines).
- What is a non-threshold injury (above-threshold injury)?
- A non-threshold injury is any injury that is not a threshold injury. Examples can include fractures, nerve injuries, ruptures, and recognised psychiatric illness, depending on the evidence and how the definitions apply.
- Is non-threshold injury the same as WPI > 10%?
- No. Non-threshold injury ≠ WPI > 10%. These are separate legal concepts used for different entitlement questions.
- What does the threshold injury classification affect?
- Threshold injury classification can affect the duration of statutory benefits (weekly payments and treatment). The exact impact depends on your circumstances and insurer decisions.
- How are threshold injury disputes decided?
- Threshold injury disputes are commonly determined through the NSW Personal Injury Commission medical pathways, based on the medical evidence and the applicable definitions/guidelines.