Recurring Injury and Workers Compensation in NSW

A recurring injury under workers compensation raises a question most injured workers hit sooner or later: the back, shoulder or knee settled, you went back to full duties, and three months later it is sore again. Is this the same claim, a flare-up, or a new injury? The answer changes what you report, who pays for treatment, and what happens next.

This is a different situation from a pre-existing condition aggravated by work, which has its own rules in NSW. Here we are talking about a problem that was already accepted as work-related and has come back.

Flare-up, recurrence or new injury

These three words get used loosely, and insurers treat them differently.

A flare-up is a temporary increase in symptoms in a condition that is still being managed, usually after a load spike. You are still on an open claim, treatment is ongoing, and the plan gets adjusted.

A recurrence is the same injury returning after the claim closed or treatment finished, without a clear new incident. The symptoms, location and behaviour look like the original injury.

A new injury involves a fresh incident, even if it affects the same body part. Lifting a box and feeling your back go is a new event, and it is usually lodged as a new claim with its own date of injury.

Which category applies is decided by the insurer based on the medical evidence, your doctor's view, and what you report. Describing what actually happened in plain detail gives them something to work with.

Report it, even if it feels minor

Tell your employer and get it in the register of injuries. If the original claim is still open, contact your case manager and your nominated treating doctor, who can update the certificate of capacity to reflect the change in capacity.

If the claim has closed, you generally need to notify the insurer again. In NSW a workers compensation claim is normally made within six months of the injury date, with provision for longer in some circumstances. For a recurrence, the date of injury can be contested, which is another reason to put the details in writing early rather than relying on memory months later.

If your claim has already closed

Access to medical and treatment expenses after weekly payments stop is time-limited in NSW and depends on your permanent impairment assessment. As a general rule, workers assessed at 10% whole person impairment or less have two years of further medical entitlement, those between 11% and 20% have five years, and those above 20% are not subject to that limit. Certain treatments, including some surgery and artificial aids, sit outside those caps.

Those rules have exceptions, and the figures that apply to you depend on your individual claim. Check with your insurer or SIRA before assuming treatment will or will not be funded. Your physiotherapist can also contact the insurer to request approval before sessions start, so you are not left guessing about cost.

Why injuries come back after a return to work

Several patterns show up repeatedly in clinic.

Capacity was restored enough for modified duties but not full duties. Someone cleared to lift 10kg occasionally goes back to lifting 20kg repeatedly, and the gap between those two demands is large.

Strength deficits never closed. Side-to-side differences of 15% or more in the injured limb are common at discharge if nobody measured them, and the weaker side absorbs the same work.

The task did not change. If the shoulder was injured by 200 overhead lifts a shift and you return to 200 overhead lifts a shift, the exposure is unchanged.

The return was too fast or too slow. Both matter. Long periods of avoidance reduce tissue tolerance, and a sudden jump back to full hours after months off is a large load increase in one step.

What assessment looks like after a recurrence

The second time around, the assessment is more detailed than the first. Expect objective measurement rather than a general check.

Strength testing with a dynamometer, comparing injured and uninjured sides. Range of motion measured in degrees. Functional testing that mirrors your job, such as repeated lifting to a set height, carries over a set distance, or sustained postures held to a time limit. A review of what the original rehab covered and where it stopped. And a look at the work task itself, including shift length, frequency, and whether the setup has changed.

From there the program is built around graded exposure to the load that triggered the problem, progressed on how you respond over the following day or two. Exercise physiology can be useful here when the issue is work conditioning and endurance over a full shift rather than a specific joint restriction.

What to tell your doctor

Bring specifics. When the symptoms returned, what you were doing, how the pain behaves across a shift, what you can and cannot manage now compared with before, and what duties you have been performing since the last certificate. That detail helps the certificate of capacity reflect your actual situation, which in turn affects what the insurer approves.

SportsFit Health & Rehab provides SIRA-registered physiotherapy and exercise physiology for injured workers in Five Dock and the Inner West, including people managing a recurrence of a previously accepted injury. Call the clinic to book an assessment.