A workers compensation claim doesn’t always end with the first injury you reported. Sometimes, the real impact shows up later as a result of the initial injury. A new injury develops because you’re walking differently, relying on the other side of your body, complications arise during treatment, or ongoing pain begins to affect your mental health.
In NSW, these follow-on issues are often called secondary injuries or consequential conditions, and whether they’re covered usually depends on proving a clear link back to the original work injury.
What is a “secondary” or “consequential” condition?
A consequential condition is a medical condition that results from an accepted work injury, rather than being a brand-new, unrelated injury. According to SIRA, consequential conditions are common and can significantly affect entitlements.
Importantly, the key issue is usually whether there is a causal chain from the original injury to the later condition. SIRA’s guidance note refers to long-standing principles that an injury can “set in train a series of events” and if the chain is unbroken, compensation may follow.
How insurers assess secondary injuries
In practice, insurers tend to assess secondary injuries using three main questions:
- Is the original injury accepted (or likely to be accepted)?
In NSW, “injury” generally means a personal injury arising out of or in the course of employment.
- Is the later condition medically linked to the original injury?
Medical evidence is central. This usually includes your Certificate of Capacity, GP/specialist reports, imaging, and a clear explanation of how the later condition developed.
- Is there anything that breaks the causal chain?
Insurers often look for an intervening cause , like a new non-work accident. SIRA’s GN 2.7 also highlights that the burden of proof rests with the worker, meaning you generally need evidence strong enough to show the consequential condition “results from” the accepted injury.
Timeframes and what happens if the insurer disputes it
If an additional or consequential condition is raised, SIRA’s Standard of Practice outlines an insurer should seek clarification promptly and, if disputing, make a liability decision and notify the worker with a benchmark of 21 days for that decision
If the insurer declines to accept the secondary condition, you may be able to challenge the decision through the Personal Injury Commission (PIC), which handles workers compensation disputes.
Why secondary injuries matter for lump sums and long-term benefits
Secondary injuries can matter just as much as the original injury because they may open up or extend important entitlements under the NSW workers compensation system.
If the secondary condition is accepted as consequential to your work injury, you may be entitled to
- Reasonable and necessary medical treatment including specialist appointments, imaging, surgery, physiotherapy, psychology/psychiatry and prescribed medications
- Weekly payments if the condition affects your capacity for work
- Rehabilitation and return-to-work support.
- In more serious cases, a consequential condition can also increase your overall level of permanent impairment, which may affect eligibility for lump sum compensation and, where applicable, potential work injury damages pathways depending on your circumstances and thresholds
Don’t Let the “Second Injury” Become the Unpaid One
Secondary injury disputes often come down to how the evidence is framed, including timelines, treating doctor support, and clear causation.
That’s where the help of a trusted workers compensation lawyer can be valuable: they can coordinate medical evidence, respond to insurer objections, and guide you through the PIC dispute process if needed.