What happened: A review panel upheld a finding that a driver's post-traumatic stress disorder from a 2024 crash was not a threshold injury under NSW motor accident law.
Who's involved: Insurance Australia Limited trading as NRMA Insurance and a claimant driver.
What's at stake: Ongoing entitlement to injury benefits beyond 52 weeks under the Motor Accident Injuries Act 2017.
Why it matters: CTP claims teams relying on delayed symptom reporting to contest PTSD diagnoses now face a panel ruling that a three-month gap is "not unusual."
Where it stands: Decided - the review panel affirmed the original medical assessor's certificate.
He has nightmares three or four times a week. He wakes up screaming. He cannot drive through an intersection without his chest tightening and his hands shaking.
And he cannot remember the collision that started all of it.
A NSW Personal Injury Commission review panel has ruled that a driver's psychological injury from a February 2024 car accident amounts to post-traumatic stress disorder - not a minor "threshold injury" that would have cut off his accident benefits after 12 months.
NRMA Insurance had argued that the driver took too long to report psychological symptoms and that earlier, milder diagnoses from his GP told the real story. The panel disagreed.
The ruling means the driver keeps his entitlement to treatment and care benefits under the Motor Accident Injuries Act 2017 - the NSW law governing compulsory third-party insurance claims. Under that Act, if a person's only injuries from an accident are classified as "threshold injuries" (previously called minor injuries), their benefits stop after 52 weeks. PTSD is not a threshold injury. Adjustment disorder and acute stress disorder are.
That distinction - and where this driver's condition falls - was the entire fight.
The driver, a 44-year-old office assistant and part-time videographer, was travelling through an intersection in Condell Park, Sydney, in February 2024 when another vehicle ran a red light and struck his car. Both cars were written off. His 2012 Volkswagen was valued at $7,600; the other vehicle, a 2019 Toyota, at $32,400.
He has no memory of the impact. He recalls being helped from the car, drifting in and out of consciousness, and waking on a hospital gurney. He was told he had been "T-boned pretty hard" and could have died.
His initial injury claim listed only physical problems - whiplash, seatbelt lacerations, rib and chest pain. At his first GP visit a week later, there was still no mention of anything psychological.
It was not until May 2024 - roughly three months later - that his GP added a diagnosis of acute stress-related mood disorder. He was not referred to a psychologist until August 2024, nearly six months after the crash.
NRMA pointed to that timeline. The insurer argued the driver's own medical records supported a threshold-level condition at most - not PTSD. It cited capacity certificates showing he could work his pre-accident hours of 20 per week, had no noted driving limitations by mid-2024, and was independent in all self-care. The insurer also submitted that the original medical assessor had simply accepted the driver's self-reported symptoms without adequate scrutiny.
The driver's treating psychologist painted a different picture across multiple reports from May to November 2024. She documented nightmares, social withdrawal, persistent fatigue, hypervigilance, and avoidance behaviour, with standardised psychological distress scores that reached the extremely severe range for depression, anxiety, and stress. By July 2024, she had assessed his symptoms against every diagnostic criterion for PTSD and concluded each was met.
When the review panel examined the driver by videoconference in September 2026 - two and a half years after the accident - his presentation was consistent with that diagnosis. He described nightmares of being chased or reliving the crash. He could manage only short local drives. He had stopped editing video, stopped going out for dinner, stopped attending his children's play dates. His intimate relationship with his wife had broken down. Tasks at work that once took an hour now took three.
He remained employed only because his mother - the GP whose practice he worked at - was understanding.
"Any other job, I'd get fired," he told the panel.
The panel addressed NRMA's central argument head-on. A three-month delay before a driver reports psychological symptoms to a GP is "not unusual," the medical assessors found, and a further three-month wait before referral to a psychologist is equally unremarkable.
The panel also turned the insurer's own evidence against it. The earlier GP diagnoses of acute stress disorder were themselves untenable, the panel reasoned, because acute stress disorder by definition cannot last longer than one month - yet those diagnoses were made three months after the crash.
On the question of whether the driver's daily life was significantly impaired - the specific point NRMA had challenged - the panel pointed to his difficulties driving, his reluctance to leave home, his reduced involvement with his family, and his concentration and energy problems at work. It found "ample evidence" of persistent symptoms throughout the clinical records.
The panel affirmed the original medical assessor's certificate. The driver's PTSD is not a threshold injury.
For CTP claims handlers assessing psychological injury disputes, the decision is a reminder that delayed symptom reporting does not, on its own, defeat a PTSD diagnosis - and that earlier threshold-level diagnoses from GPs may carry less weight than a treating psychologist's sustained, criteria-based assessment over time.
