Back or neck pain since your accident

1. What a collision actually does to a spine

A vehicle impact loads the spine faster than the muscles guarding it can respond. The seatbelt does its job and holds the trunk, the head and pelvis keep moving, and the segments in between absorb the difference in a fraction of a second. Four things take that load: the muscles and their attachments, the ligaments and joint capsules that limit how far each segment travels, the discs between the vertebrae, and the nerve roots running out through the gaps.

Which of those four bore the most of it is not obvious from the outside. Pain is a poor guide, because a strained muscle can be agonising and an irritated nerve root can be almost painless while quietly weakening a limb. Time is a poor guide too. Spinal symptoms after a crash characteristically arrive the next morning rather than at the scene, and a person who felt fine at the roadside is not a person who was not hurt. This is why the examination is worth doing properly and worth doing early.

2. Soft tissue, nerves and ruptures

Section 1.6 of the Motor Accident Injuries Act 2017 defines a threshold injury, and section 1.6(2) does the work for spines. It says soft tissue means injury to connecting or supporting tissue, then names the tissues, then removes two things from the definition. Those exclusions are the whole distinction.

There is one further wrinkle that only ever comes up in the spine, and it catches people out. The Regulation brings an injury to a spinal nerve root back inside the threshold category where it manifests in neurological signs other than radiculopathy. So the presence of some neurological sign is not by itself the answer. Radiculopathy is the finding that carries weight, and radiculopathy is a specific clinical picture rather than a description of pain. That is precisely the level of detail an examination either records or does not.

Source: Motor Accident Injuries Act 2017 s 1.6; SIRA, Providing allied health services in the NSW CTP schemes — FAQs (updated 2 December 2025). Checked September 2026.

3. Why the examination and the imaging decide so much

The insurer does not classify your injury by looking at you. It classifies it by reading what your treating practitioners wrote, and it does not have to make the decision that turns on it until nine months after the claim is made, when it must notify you whether it accepts liability for benefits after the first 52 weeks. That gap between when findings are recorded and when they are considered is the single most consequential thing on this page. Findings recorded in weeks one to eight are what the decision in month nine is made from, and nobody can go back and examine you as you were in week two.

Imaging has a specific and limited job in that. It is requested where the history and examination point to something a scan would change, not as a routine and not as reassurance. Plenty of painful spinal injuries after a collision show nothing on imaging, and plenty of scans show degenerative change that was there long before the crash. What a scan can do is confirm or exclude a structural injury when the clinical picture raises one. What the examination does, at every review, is record range of movement, neurological testing, provocation and the direction of travel over time.

Source: Motor Accident Injuries Act 2017 s 6.19(2). Checked September 2026.

4. The doctor and the physiotherapist, working together

The doctor takes the history that establishes mechanism, examines the spine including a full neurological screen, decides whether imaging is warranted, writes the first Certificate of Fitness, and sets the treatment direction. The physiotherapist then carries the recovery: restoring movement segment by segment, loading the deep stabilising muscles that switch off after an injury, and rebuilding tolerance for the specific things your work and your life demand of you.

We keep them in step, so the second appointment does not begin with you retelling the story. Findings carry forward, the treatment request reflects what the doctor examined, and each review measures against the last rather than starting fresh. That continuity is not a nicety. Clause 4.157 of the Motor Accident Guidelines treats an insurer's request for a medical examination as ordinarily reasonable where the treating practitioner has not responded to a request for information or where the information provided was inadequate. When the treating records answer the insurer's questions, there is less reason for another opinion.

Source: SIRA, Motor Accident Guidelines 4.157. Checked September 2026.

5. Getting the treatment paid for

Funding runs on requests and deadlines. Treatment is payable where it is reasonable and necessary in the circumstances and relates to the injury. Once a request lands, the insurer has to decide it as soon as possible, and in no case later than 10 days after it arrives. Where the request is approved and an account is rendered, payment follows within 20 days of the invoice reaching the insurer. Before a claim is lodged there is a narrow pre-claim allowance in the first 28 days for one GP consultation and two allied health treatment sessions, at the insurer's discretion.

What gets a spinal treatment request approved is a request that reads like a plan: measured findings, a stated functional goal, a defined number of sessions and a review point. What gets one declined is a request describing the same session repeated indefinitely with nothing measured. Our treatment approvals page takes that process apart in full.

Source: SIRA, Motor Accident Guidelines 4.78, 4.79 and 4.106; Motor Accident Injuries Act 2017 s 3.24. Checked September 2026.

6. Keeping the certificate chain unbroken

If you are claiming weekly payments, you have to supply certificates of fitness for work covering the whole period you claim for, along with a declaration about your employment. No certificate can cover more than 28 days, and each one has to state the expected duration of unfitness. The first has to come from your treating medical practitioner. Every one after that may be written by a medical practitioner or by your treating physiotherapist or psychologist.

For a back or neck injury that arrangement is the difference between an unbroken chain and a gap. Your physiotherapist is usually the practitioner who has seen you most recently and knows exactly what your capacity is this fortnight, and the Guidelines allow them to say so on the form. Gaps have consequences: where a claimant does not comply, the insurer may suspend weekly payments, but it must first warn you in writing, set out the consequences, give you not less than seven calendar days to remedy it, and provide the Independent Review Office's contact details. Our Certificate of Fitness guide covers the form in detail.

Source: Motor Accident Injuries Act 2017 s 3.15; SIRA, Motor Accident Guidelines 4.61 to 4.63, 4.68 and 4.69. Checked September 2026.

7. Weekly payments, and how long everything runs

Weekly payments replace part of what you have stopped earning, and the proportion tapers as the claim ages. The first entitlement period runs for 13 weeks from the day after the accident and pays at 95 per cent. The second entitlement period covers the 65 weeks that follow, carrying you to week 78, and pays at 80 per cent if you are not working at all or 85 per cent if you have some capacity and are using it. In both cases the percentage applies to the shortfall between your pre-accident weekly earnings and what you are able to earn now.

Duration comes back to the classification. A threshold injury puts a hard edge on the calendar at 52 weeks for weekly payments and 52 weeks for treatment and care, and being wholly or mostly at fault does the same. Fall outside the threshold definition without being mostly at fault, and the weekly payment horizon extends to 104 weeks while treatment and care carry on for as long as they stay reasonable and necessary. Two spines that hurt the same amount can sit on either side of that line, which is exactly why the clinical record is the thing worth getting right.

Source: Motor Accident Injuries Act 2017 ss 3.6, 3.7, 3.11 and 3.28. Checked September 2026.

8. Booking an appointment

Dates first. Report the crash to police as soon as you can, within 24 hours if anyone was hurt and police did not attend, and keep the event number, because the insurer needs a report made within 28 days to verify the claim. Lodge your statutory benefits claim within 28 days if you want weekly payments back-dated, because a later claim does not get them for the period before it was made. Three months from the accident is the hard limit for making the claim at all. Those three sentences are the most useful thing on this page for anyone reading it in the first fortnight.

Then call us. We book you in with a doctor who examines the spine and writes the first certificate, line up a physio for the recovery, and a psychologist if the crash left something more than a sore back. We get you to a doctor who can give the insurer the full medical picture. If a decision on your claim still needs reviewing after the insurer's internal review, or your injury is not a threshold injury and a damages claim may be open to you, we put you in touch with a compensation lawyer if you need one. If you were driving for work when it happened, start with our work-related car accident page instead, because two schemes may be in play.

Sources: SIRA, Guide for people injured in a motor vehicle accident; NSW Road Rules 2014 r 287 (classic.austlii.edu.au/au/legis/nsw/consol_reg/rr2014104/s287.html); Motor Accident Injuries Act 2017 s 6.13. Checked September 2026.