NSW CTP – Permanent Impairment – Causation of Injuries


The purpose of ‘Part 6 of the Motor Accident Guidelines: Permanent impairment’ is to assess the level of permanent impairment caused by a motor accident in accordance with the Motor Accident Injuries Act 2017 (NSW) (the Act). This Part is based on the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA4 Guides).  

Part 6 of the Guidelines applies to the assessment of permanent impairment resulting from a motor accident injury that occurred on or after 1 December 2017 under the Act. 

Causation of Injury

Clause 2(a) of Schedule 2 of the Act establishes that the assessment of the degree of permanent impairment is a medical assessment matter. This evaluation must determine the degree of permanent impairment suffered by the injured person as a result of the motor accident. Therefore, all assessments of permanent impairment assume a determination of whether the injury is related to the accident in question. Medical assessors must be knowledgeable of the relevant provisions of the AMA4 Guides, as well as the common law principles that would be applied by a court or the Personal Injury Commission when evaluating such matters. 

The definition of causation provided in the AMA4 Guides, and in summary explains that causation refers to a physical, chemical, or biologic factor that contributed to the occurrence of a medical condition. It is necessary to confirm two things to determine whether a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has indeed done so: 

  1.  the alleged factor could have caused or contributed to the worsening of the impairment, which is a medical decision, and  
  2. the alleged factor did cause or contribute to the worsening of the impairment, which is a non-medical determination. This entails a medical decision and an informed non-medical judgement. 

There is no universal common test of causation that applies to all cases, but the recognized approach entails determining whether the motor accident caused or materially contributed to the injury (and associated impairment). The motor accident does not have to be the sole cause, as long as it is a contributing cause that is greater than negligible. In some cases, it may be beneficial to consider the question, “Would this injury (or impairment) have occurred if not for the accident?” However, this is not a definitive test and may be inapplicable in situations where there are numerous contributing factors. 

The CTP scheme is a complex one and if you have sustained injuries (physical and/or psychological injuries) from a motor vehicle accident, we highly recommend you seek legal advice. The Head of our NSW team, Jessica Cheung is an Accredited Specialist in Personal Injury Law. Depending on your claim, we can arrange medico-legal assessments to assess your permanent impairment as a result of the subject motor accident.  

If you believe you have sustained a personal injury and would like professional legal advice, reach out to Jessica and her team for a confidential discussion at no costs to you.   

*The intention and purpose of this article is to be used as a guide only. 

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