Legal Bulletin No. 203
This bulletin was issued on 21 March 2025
Issued 21 March 2025
Welcome to the two hundred and third edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.
Court of Appeal Decision
Stolzenberg v Workers Compensation Nominal Insurer [2025] NSWCA 40
Workers compensation; medical assessment; medical assessment certificate; assessment of permanent impairment; whether Medical Assessor (MA) fabricated evidence or made factual errors resulting in jurisdictional error; whether MA failed to apply [1.32] of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment resulting in an error of law on the face of the record; whether Medical Assessor adopted wrong criteria in NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment resulting in jurisdictional error or error of law on the face of the record; whether MA had conflict of interest or decision was affected by actual or apprehended bias or he abused his power such that the assessment suffers from jurisdictional error; decision of delegate of President of Personal Injury Commission not to allow appeal to proceed to Medical Appeal Panel; whether limited time to submit application to appeal constituted denial of procedural fairness; whether decision was open to delegate; certificate of determination; whether certificate of determination tainted by jurisdictional error or error of law on face of the record in decision of delegate of President of Personal Injury Commission not to allow appeal to proceed to Medical Appeal Panel; Held – amended summons filed 14 October 2024 is dismissed.
Decision date: 17 March 2025 | Before: Stern JA, Griffiths AJA, and Price AJA
Supreme Court Decision
Matheson v Baptistcare NSW & ACT [2025] NSWSC 213
Administrative law; judicial review; medical appeal panel determination of permanent impairment; reductions for pre-existing injury and previous secondary psychological injury; whether appeal panel complied with requirements for exercise of its statutory function; statutory interpretation; whether guidelines for evaluation of permanent impairment inconsistent with Act; guidelines having effect in accordance with Act; statutory provisions to be read harmoniously; whether permanent impairment guidelines invalid to extent of inconsistency with operative provision of Workplace Injury Management and Workers Compensation Act 1998 (NSW) (1998 Act); reading that Act harmoniously with Workers Compensation Act 1987 (NSW) (1987 Act); workers compensation; psychological injury; determination of degree of whole person impairment; deduction for asymptomatic pre-existing psychological condition; disregard of secondary psychological injury; whether possible to apply section 65A of the 1987 Act without assessing permanent impairment with respect to injury subject to claim; interaction between 1987 Act, section 65A and section 323 of 1998 Act; Held – set aside the determination of the Medical Appeal Panel dated 17 May 2024; set aside the medical certificate issued by the Commission based on the appeal panel determination dated 17 May 2024; order that the first defendant pay the plaintiff’s costs in this Court.
Decision date: 18 March 2025 | Before: Basten AJ
Presidential Member Decisions
Commonwealth Steel Company Pty Ltd t/as Moly-Cop v Boccola [2025] NSWPICPD 19
Workers compensation; factual findings; application of principles from Whiteley Muir & Zwanenberg Ltd v Kerr (1966) 39 ALJR 505 in relation to factual findings; asserted error of fact and law in applying wrong test by requiring proof of actual causation of boilermaker’s deafness injury; consideration of Blayney Shire Council v Lobley (1995) 12 NSWCCR 52 and Commonwealth v Bourne (1960) 104 CLR 32; Held – the Certificate of Determination dated 17 June 2024 is confirmed.
Decision date: 11 March 2025 | Before: Acting Deputy President Michael Perry
Tamworth Regional Council v Meredith [2025] NSWPICPD 20
Workers compensation; no error of law where there is evidence, if believed, that would support the Member’s finding; Nicolia v Commissioner for Railways (1971) 45 ALJR 465; Kostas v HIA Insurance Services Pty Limited [2010] HCA 32; alleged error of fact; Whiteley Muir & Zwanenberg Ltd v Kerr (1966) 39 ALJR 505 applied; drawing inferences from findings of fact; Flounders v Millar [2007] NSWCA 238 applied; the application of common or judicial knowledge; Strinic v Singh [2009] NSWCA 15 discussed; a party is bound by the conduct of its case in the proceedings below; University of Wollongong v Metwally (No. 2) [1985] HCA 28 applied; expert evidence; section 43 of the Personal Injury Commission Act 2020; the Commission is not bound by the rules of evidence; South Western Sydney Area Health Service v Edmonds [2007] NSWCA 16; Hancock v East Coast Timber Products Pty Ltd [2011] NSWCA 11; State of New South Wales (Fire and Rescue NSW) v Sinclair [2025] NSWPICPD 8 applied; Dasreef Pty Ltd v Hawchar [2011] HCA 21; Honeysett v The Queen [2014] HCA 29 distinguished; Held – leave to appeal an interlocutory order is granted pursuant to section 352(3A) of the Workplace Injury Management and Workers Compensation Act 1998; the Member’s Certificate of Determination dated 1 October 2024 is confirmed.
Decision date: 11 March 2025 | Before: Deputy President Elizabeth Wood
Motor Accidents non-Presidential Member Decisions
Saedi v Allianz Australia Insurance Limited [2025] NSWPIC 71
Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about childcare provided to the claimant’s dependant while she said she had treatment for her accident related injuries; claimant referred dispute as a medical assessment matter; insurer submitted childcare services were not related to claimant’s treatment or reasonable and necessary and were not treatment; matter referred to member as a miscellaneous claims assessment matter under Schedule 2(3)(n) for determination of whether childcare services were a form of treatment; claimant submitted childcare was “domestic services” and therefore a form of attendant care services which is a type of treatment recognised in the definition; claimant also argued childcare was domestic services which she had no capacity to provide and she was entitled to statutory benefits for it under section 3.26; disputes about section 3.26 are a matter for Merit Review under Schedule 2(1)(j); parties agreed that decision maker should determine both miscellaneous claims assessment matter and merit review matter; Held – the disputed child care services were not domestic services (one of the examples of attendant care services) and not any other form of attendant care services as they did not aim to assist the claimant with daily tasks; section 3.26(4) deems replacement domestic services provided to an injured person’s dependants as the provision of treatment and care for the injured person; the definition of treatment and care (and attendant services) is therefore not relevant in a section 3.26 dispute; the childcare service provided to the claimant’s dependant are on the facts and circumstances not domestic services within the meaning of section 3.26; the services were school preparation classes which were a form of education service; CAB v AAMI Limited t/as GIO referred to; Liverpool City Council v Laskar, Garzo v Liverpool / Campbelltown Christian School Limited, and Wormleaton v Thomas & Coffey Ltd (No 4) applied; if the childcare services in dispute were a form of domestic services Member held the claimant had no entitlement to statutory benefits as there was no evidence the claimant had provided the education services before the accident and the evidence did not support the services were provided for more than 6 hours a week and for 6 consecutive months.
Decision date: 28 February 2025 | Member: Belinda Cassidy
Fowler v Youi Pty Limited [2025] NSWPIC 82
Motor Accident Injuries Act 2017; dispute about whether the purchase of a new car was a form of “treatment and care” within the definition of section 1.4 and whether the claimant could recover the cost as a statutory benefit under section 3.24(1)(a); further dispute about whether the purchase of the new car was a “reasonable and necessary travel expense” to obtain treatment under section 3.24(1)(b); definition of treatment and care includes “home and transport modification” and “rehabilitation”; claimant had a Pajero at the time of the accident which could be modified to accommodate the claimant’s need for hand controls but which could not be modified to accommodate the claimant’s need for independent wheelchair stowage; claimant asked the insurer to fund the purchase cost and the insurer refused; the claimant purchased the vehicle out of an advance paid in his damages claim; Held – the purchase of a new car was not “transport modification” but was in the circumstances of the case part of the claimant’s “rehabilitation; there was insufficient evidence to establish whether the purchase of the new car would also be a cost-effective way of providing “travel expenses” in order for the claimant to pursue his treatment; Alcan (NT) Alumina Pty Limited v Commission of Territory Revenue (NT), SZTAL v Minister for Immigration and Border Protection, and Project Blue Sky Inc v Australian Broadcasting Authority referred to in respect of statutory interpretation; Transport Accident Commission (Victoria) v Hoffman and Others referred to in respect of approach to the new scheme; Allianz Australia Insurance Limited v Abawi referred to in relation to the “competing” objects of the Act; Grain Growers v Chief Commission of State Revenue (NSW) referred to in relation to the phrase “in connection with”.
Decision date: 12 March 2025 | Member: Belinda Cassidy
Workers Compensation non-Presidential Member Decisions
Laundy (Trading) Pty Ltd v Kopko [2024] NSWPIC 711
Workers Compensation Act 1987; following an accepted psychological injury the respondent was paid weekly benefits of compensation in accordance with medical certificates certifying total incapacity; consideration of the evidence; Held – finding that there was a change in employment that had affected the workers earnings within the meaning of section 58; the basis for this finding was the respondent had returned to work with another employer; no finding as to the quantification of any ‘refund’ or ‘ adjustment’ in respect of future payments as more financial material was required.
Decision date: 19 December 2024 | Senior Member: Elizabeth Beilby
Singh v Westpac Banking Corporation & Anor [2025] NSWPIC 73
Workers Compensation Act 1987; section 66 claim for primary psychological injury; alleged two injuries with two employers; disputed injury with later employer; consideration of aggravation; Secretary, New South Wales Department of Education v Johnson, and Ozcan v Macarthur Disability Services Ltd considered; Held – aggravation injury was sustained; referral to Medical Assessor for aggravation injury.
Decision date: 5 March 2025 | Member: Michael Wright
Georges v Barnardos Australia [2025] NSWPIC 74
Workers Compensation Act 1987; claim for weekly benefits and medical expenses as result of psychological injury; applicant claimed to have sustained injury due to respondent’s COVID-19 policy; respondent did not dispute injury but relied on section 11A defence with respect to discipline and/or the provision of employment benefits; consideration of Hamad v Q Catering Limited, Pirie v Franklins Ltd, Department of Education and Training v Sinclair, Ponnan v George Weston Foods Ltd, Temelkov v Kemblawarra Portuguese Sports & Social Club Ltd, Mason v Demasi, Davis v Council of the City of Wagga Wagga, Irwin v Director of Education, and Northern NSW Local Health Network v Heggie; Held – applicant’s injury was wholly or predominantly caused by respondent’s action with respect to discipline; respondent’s action was reasonable; award for the respondent.
Decision date: 6 March 2025 | Senior Member: Kerry Haddock
Ozer v ANZ Australia Pty Ltd [2025] NSWPIC 75
Workers Compensation Act 1987; permanent impairment compensation; whether harm to body system at issue is categorised as injury or consequential condition; difference between injury and consequential condition; the applicant suffered a fall in the course of her employment which caused a fractured head of her right humerus; she also claimed an injury to her right shoulder; the respondent accepted liability for a consequential condition to the right shoulder but disputed injury to that body system; applicant claimed consequential conditions to her neck and left shoulder which were disputed; Held – the applicant suffered injury to her right shoulder in the fall at issue; the contemporaneous material demonstrated the requisite sudden or identifiable pathological change necessary to find injury pursuant to section 4; Castro v State Transit Authority (NSW) referred to; the applicant is not required to identify pathological change sufficient to satisfy the requirements of section 4 in order to prove a consequential condition to her neck and left shoulder; Kumar v Royal Comfort Bedding Pty Ltd, Trustees of the Roman Catholic Church for the Diocese of Parramatta v Brennan, and Moon v Conmah Pty Ltd followed; the question of whether a consequential condition exists is one of causation; as such it is necessary to determine the question by way of a commonsense evaluation of the causal chain; Kooragang Cement Pty Ltd v Bates; the preponderance of the medical and lay evidence in this matter establishes the presence of consequential conditions to the neck and left shoulder; matter remitted to the President for referral of all claimed body systems to a Medical Assessor to determine the applicant’s whole person impairment.
Decision date: 6 March 2025 | Member: Cameron Burge
Bedford v N Alchin & H Doll t/as Nathan Alchin Shearing [2025] NSWPIC 76
Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act); Personal Injury Commission Act 2020 (PIC Act); application to amend Certificate of Determination for “obvious error”; slip rule considered; section 57 of the PIC Act considered; section 325(3) of the 1998 Act considered; Grafton Aged Care Home Pty Limited v Wilkes, Wang v Fuji Xerox Australia Pty Limited, Newell v John Bruce trading as Tarawa Rural Partnership, Mansour v Bankstown Trotting & Recreational Club, and McGowan v Secretary, Department of Education and Communities considered; Held – the Certificate of Determination dated 15 October 2024 does not contain any “obvious error” for the purposes of section 57 of the PIC Act; the Medical Assessment Certificate dated 9 September 2024 does not contain any “obvious error” for the purposes of section 325(3) of the 1998 Act; the application to amend the Certificate of Determination dated 15 October 2024 is denied.
Decision date: 7 March 2025 | Member: John Turner
Keshavarz v CPB Contractors Pty Ltd [2025] NSWPIC 77
Personal Injury Commission Act 2020 (PIC Act); rescind prior Certificate of Determination; section 57 of the PIC Act; Riverina Wines Pty Ltd v Registrar of the Workers Compensation Commission of NSW & Ors, and Samuel v Sebel Furniture Limited considered; Held – the applicant’s application to rescind the Certificate of Determination dated 21 March 2024 is refused.
Decision date: 10 March 2025 | Member: Mitchell Strachan
Beattie v Infrabuild Wire Pty Ltd [2025] NSWPIC 78
Workers Compensation Act 1987; section 60; claim for the cost of treatment; bilateral hearing aids; whether reasonably necessary as a result of undisputed noise induced hearing loss; respondent contends minor contribution only by occupational and that hearing loss insufficient; differing results of audiograms and medical opinion relied upon by the applicant and respondent; Taxis Combined Services (Victoria) Pty Ltd v Schokman, Murphy v Allity Management Services Pty Ltd, Bluescope Steel v Sekulovksi, and Diab v NRMA Insurance Ltd cited; Held – respondent liable for the provision of bilateral hearing aids; reasonably necessary due to work related noise exposure.
Decision date: 10 March 2025 | Member: Adam Halstead
Fry v Secretary, Department of Education [2025] NSWPIC 79
Workers Compensation Act 1987; claim for weekly compensation and incurred treatment expenses for two psychological injuries; defence pursuant to section 11A(1) raised in respect of second injury; whether incapacity relates to first or second injury; Held – the respondent failed to discharge its onus with respect to section 11A(1); incapacity resulted from both injuries; at parties’ request further opportunity provided to lodge signed consent orders quantifying the entitlement to weekly compensation; general order for medical expenses.
Decision date: 10 March 2025 | Member: Rachel Homan
Emami v Transit Systems [2025] NSWPIC 80
Workers Compensation Act 1987; claim for psychological injury; claims for weekly benefits compensation and treatment expenses pursuant to section 60; consideration of applicant’s and witnesses’ statements, video footage, medical reports and other treatment records, claim correspondence, as well as factual material; respondent accepts that the applicant sustained a psychological injury to which his employment was the main contributing factor and accepts that the applicant has no current work capacity as a result but relies upon a defence to his claim pursuant to section 11A; consideration of whether the respondent can establish that the applicant’s psychological injury was wholly or predominantly caused by action taken or proposed to be taken by it with respect to performance appraisal or dismissal or discipline; consideration of whether the respondent can establish the reasonableness of the actions taken or proposed to be taken by it with respect to performance appraisal or dismissal or discipline; Northern NSW Local Health Network v Heggie, Nguyen v Cosmopolitan Homes, Pirie v Franklins Limited, Department of Education and Training v Sinclair, Manly Pacific International Hotel Pty Limited v Doyle, Insurance Australia Group Services Pty Limited v Outram, Ponnan v George Weston Foods Limited, Temelkov v Kemblawarra Portugese Sports and Social Club Limited, Smith v Roads and Traffic Authority of NSW, Drca v KAB Seating Systems Pty Ltd, Melder v Ausbowl Pty Limited, Buxton v Bi-Lo Pty Ltd, Ritchie v Department of Community Services, Secretary of the Department of Foreign Affairs and Trade v Styles & Anor, Trustees of the Roman Catholic Church for the Diocese of Maitland-Newcastle v Broad, and Rail Corporation NSW v Aravanopules considered; Held – the respondent has failed to establish (pursuant to section 11A) that the applicant’s psychological injury was wholly or predominantly caused by reasonable action taken or proposed to be taken by it with respect to performance appraisal or dismissal or discipline; awards for the applicant for weekly benefits compensation and expenses pursuant to section 60.
Decision date: 10 March 2025 | Member: Gaius Whiffin
Brazil v State of New South Wales (NSW Police Force) [2025] NSWPIC 81
Workers Compensation Act 1987; applicant claims permanent impairment compensation payable under section 66 resulting from injury to his left lower extremity (left hip) being an aggravation of a disease injury arising out of or in the course of his employment with the respondent; the applicant also claims pain and suffering compensation payable under section 67; the applicant’s claim is declined with alleged injury placed in issue; Held – the applicant sustained injury to his left lower extremity (left hip) being an aggravation of a disease injury arising out of or in the course of his employment with the respondent with his employment being a substantial contributing factor to injury; the applicant’s claim for permanent impairment is remitted to the President for referral to a Medical Assessor for assessment of permanent impairment resulting from the injury; the applicant’s claim for pain and suffering compensation is stood over until the Medical Assessment Certificate is issued and the appeal period has past.
Decision date: 11 March 2025 | Member: Jacqueline Snell
Motor Accidents Medical Review Panel Decisions
AAI Limited t/as GIO v BTU [2025] NSWPICMP 55
Motor Accidents Compensation Act 1999; insurer’s application for review of medical assessment under section 63; dispute about whether psychiatric impairment was greater than 10%; where Medical Assessor certified accident caused psychological condition gave rise to a permanent impairment that is greater than 10%; application by insurer for re-examination by medical members of the Review Panel to be undertaken in person rather than by audio-visual link; application of the rule in Jones v Dunkel in relation to a medico-legal report not served by insurer; Held – insurer’s application for in person examination rejected; no inference drawn in accordance with the rule in Jones v Dunkel; claimant had a pre-existing adjustment disorder and pre-existing impairment; accident resulted in aggravation of pre-existing condition; impairment as a result of accident not greater than 10%; certificate revoked and new certificate issued.
Decision date: 31 January 2025 | Panel Members: Senior Member Brett Williams, Dr John Baker, and Dr Michael Hong | Injury module: Mental and Behavioural
Insurance Australia Limited t/as NRMA Insurance v CMK [2025] NSWPICMP 145
Motor Accident Injuries Act 2017; review of medical assessment under section 7.26; dispute about whether degree of permanent impairment of the claimant that has resulted from the psychological injury caused by the accident is greater than 10%; where Medical Assessor certified that post-traumatic stress disorder (PTSD) and persistent depressive disorder caused by the accident gave rise to a permanent impairment of 15%; Held – the claimant developed PTSD as a result of the accident; the PTSD gave rise to a 5% permanent impairment; certificate of assessment revoked and new certificate issued certifying that the degree of permanent impairment of the claimant that has resulted from the psychological injury caused by the accident is not greater than 10%.
Decision date: 6 March 2025 | Panel Members: Senior Member Brett Williams, Dr Christopher Canaris, and Dr Matthew Jones | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Abana [2025] NSWPICMP 146
Review of medical assessment; degree of permanent impairment; major depressive disorder of mild severity; psychosocial history; migrated to Australia 2007; claimant never worked in paid employment in Australia; non-proficient in English; prior medical history cardiac angioplasty; lower inverted disc prolapse; not treated with any psychiatric medication prior to the motor accident; relevant conditions since the accident; current symptoms include depressed mood, insomnia, and diminished ability to concentrate; not prescribed anti-depressant medication; medical documentation examination contrary to Review Panel findings; continuing functioning; causation and reasons; Held – psychological symptoms could be caused by severity of the motor accident the claimant experienced; whole person impairment 7%; negligeable effect in somatic relief and functional improvement; Medical Assessment Certificate revoked.
Decision date: 6 March 2025 | Panel Members: Member Hugh Macken, Dr John Baker, and Dr Gerald Chew | Injury module: Mental and Behavioural
AAI Limited t/as GIO v Adnan [2025] NSWPICMP 151
Review of medical assessment; whole person impairment (WPI); persistent complex bereavement disorder; major depressive disorder; psychological injury following death of son; pre-accident medical history; deterioration of psychological conditions; issues as to consistency of presentation; activities of daily living; claimant no longer participates in religious cultural festivals; student visa; whole family invited by the insurance company to come to Australia; documentation displaying deterioration of condition; difficulties with examinations; conflicting medical material; psychiatric treatment descriptions; limited psychiatric treatment; Held – the injury caused by the motor accident gave rise to a permanent impairment of 7%.
Decision date: 10 March 2025 | Panel Members: Member Hugh Macken, Dr Atsumi Fukui, and Dr Gerald Chew | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Akkaoui [2025] NSWPICMP 152
Motor Accident Injuries Act 2017; motor accident on 5 February 2022; high speed collision; the dispute related to whether the degree of permanent impairment was greater than 10% and a treatment dispute concerning proposed surgery to the cervical spine; claimant re-examined; claimant suffered multiple rib fractures, lacerations, right thumb fracture, and other soft tissue injuries; clamant had further right thumb surgery two days prior to examination with Review Panel; impairment not stabilised; all body parts should be assessed together (section 3.21); grounds of review raised issues only with permanent impairment; review not limited and includes treatment dispute; Allianz Australia Ltd v Ellul applied; surgery for cervical spine not necessary due to absence of relevant neurological signs; signs consistent with recent examinations by other Medical Assessors; treatment dispute determined; Held – claimant’s degree of permanent impairment not stabilised due to recent surgery; Medical Assessment Certificate of permanent impairment revoked; assessment of treatment dispute confirmed.
Decision date: 11 March 2025 | Panel Members: Principal Member John Harris, Dr Christopher Oates, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, Lower Limb, and Brain Injury
QBE Insurance (Australia) Limited v Joyan [2025] NSWPICMP 153
Motor Accident Injuries Act 2017; the claimant was injured in a motor vehicle accident on 19 November 2020; the insurer wholly admitted liability for the claim; medical dispute as to whether the injuries sustained in the accident exceeded 10% whole person impairment (WPI); on 19 March 2024 the Medical Assessor determined that the claimant did not have a WPI greater than 10%; review of medical assessment; Held – Review Panel revoked the certificate of Medical Assessor; claimant’s condition had not stabilised and her injuries are likely to improve by at least 3% in the period of 12 months from the date of examination.
Decision date: 11 March 2025 | Panel Members: Member Terence Stern OAM, Dr John Giles, and Dr Adrian Vertoudakis | Injury module: Ear, Nose, Throat and Related Structures
Taouk v QBE Insurance (Australia) Limited [2025] NSWPICMP 154
Motor Accident Injuries Act 2017; permanent impairment; review; insurer’s application; Medical Assessor’s (MA) certificate dated 9 May 2024 assessed cervical-thoracic spine at 5% permanent impairment; accident 3 December 2020; MA declined causative link with accident and referred neck pain causing impaired bilateral shoulder active range of movement (AROM); claimant applied for review; claimant re-examined; causation; application of Nguyen v The Motor Accidents Authority of NSW & Zurich Australian Insurance Ltd (Nguyen)principle disputed; claimant made consistent best effort to demonstrate AROM; consistent with previous examinations; accident significant intervention; no objective evidence of pre-accident permanent impairment; 11% permanent impairment; combined impairment certificate; Held – secondary restriction of AROM in the shoulders due to the cervicothoracic spine injury; Nguyen principle applied; different causation and permanent impairment findings to original assessment; Review Panel revoked and replaced original medical certificate and combined impairment certificate; permanent impairment greater than 10%.
Decision date: 12 March 2025 | Panel Members: Member Terence O’Riain, Dr Michael Couch, and Dr Drew Dixon | Injury module: Spine, Upper Limb, and Lower Limb
Sharma v QBE Insurance (Australia) Limited [2025] NSWPICMP 155
Motor Accident Injuries Act 2017; degree of permanent impairment and threshold injury dispute; claimant’s three year old daughter was a pedestrian hit by a car; child let go of her father’s hand and ran ahead when a car hit her; child sustained injuries to her leg; incident was witnessed by the claimant; her daughter admitted to Westmead Hospital for surgical treatment; child required four separate surgical interventions over a period of about fourteen days; insurer admitted liability for the claim but did not concede that the claimant’s psychiatric condition was related to the subject accident; Medical Assessor found that the accident caused an adjustment disorder which is a threshold injury and did not assess whole person impairment (WPI); Held – Review Panel found the claimant suffered accident-related post-traumatic stress disorder (PTSD) which is not a threshold injury; Review Panel assessed 0% WPI; Medical Assessment Certificate revoked.
Decision date: 13 March 2025 | Panel Members: Member Gary Victor Patterson, Dr Mathew Jones, and Dr Michael Hong | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
Belavic v State of New South Wales (Hunter New England Local Health District) [2025] NSWPICMP 142
Workplace Injury Management and Workers Compensation Act 1998; whether demonstrable error or incorrect application of criteria in Medical Assessor’s (MA) finding that 50% of whole person impairment (WPI) to be “apportioned” to a subsequent aggravation; whether MA erred in making a deduction pursuant to section 323 where there was asymptomatic pre-existing early osteoarthritic change; Held – Appeal Panel agreed; Medical Assessment Certificate revoked.
Decision date: 3 March 2025 | Panel Members: Member Rachel Homan, Dr Christopher Oates, and Dr Roger Pillemer | Body system: Left Lower Extremity (Knee)
Francis v State of New South Wales (NSW Police Force) [2025] NSWPICMP 143
Appellant submits that the Medical Assessor erred in his whole person impairment (WPI) assessment of four of the categories of the psychiatric impairment rating scale (PIRS) namely self-care and personal hygiene, social and recreational activities, social functioning, and concentration, persistence and pace; Held – Appeal Panel found no error except in the category of concentration, persistence and pace; Medical Assessment Certificate revoked.
Decision date: 6 March 2025 | Panel Members: Member Deborah Moore, Dr Douglas Andrews, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric
Adamson v State of New South Wales (NSW Police Force) & Anor [2025] NSWPICMP 144
Psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under four of the psychiatric impairment rating scale (PIRS) categories; Held – Appeal Panel did not find error; Medical Assessment Certificate confirmed.
Decision date: 6 March 2025 | Panel Members: Member Jane Peacock, Dr Graham Blom, and Dr Michael Hong | Body system: Psychological/Psychiatric
Appeal from psychiatric injury assessment of 8% whole person impairment (WPI); whether Medical Assessor (MA) gave sufficient reasons regarding five out of the six psychiatric impairment rating scale (PIRS) categories; whether fresh evidence be admitted; Held – fresh evidence rejected as having no prima facie value; Lukacevic v Coates Hire Operations Pty Limited applied; error found in social and recreational activities category as MA relied too heavily on desktop investigation without explaining why relevant evidence ignored; similarly concentration, persistence and pace category rating revoked as MA had called claimant’s credit into question without giving adequate reasons as to why she ignored relevant evidence; Bayside Council v Ware considered; Medical Assessment Certificate revoked.
Decision date: 7 March 2025 | Panel Members: Member John Wynyard, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric
Tyers v Graphic Packaging International Inc [2025] NSWPICMP 148
Whether the Medical Assessor (MA) provided sufficient reasons for his assessment; Held – Appeal Panel held that because the MA did not record in his findings from his examination the anatomical areas in which the appellant exhibited dysesthesia from the referred peripheral nerves the MA did not provide sufficient reasons to explain his assessment; appellant re-examined; Medical Assessment Certificate revoked.
Decision date: 7 March 2025 | Panel Members: Member Marshal Douglas, Dr John Garvey, and Dr John O’Neill | Body system: Right Lower Extremity, Right Ilioinguinal Nerve (Consequential), Right Iliohypogastric Nerve (Consequential), Right Genitofemoral Nerve (Consequential), Left Lower Extremity, Left Ilioinguinal Nerve, Left Iliohypogastric Nerve, and Left Genitofemoral Nerve (Consequential)
Narooma Sporting & Services Club v Tague [2025] NSWPICMP 149
Assessment under the psychiatric impairment rating scale (PIRS) of travel, and concentration, persistence and pace; worker was able to travel to new areas as part of her employment; worker had memory difficulties and relied on notes and prompting to participate in assessment; Held – worker had no or minor restriction in travel; worker had moderate restriction in concentration, persistence and pace; Medical Assessment Certificate revoked.
Decision date: 7 March 2025 | Panel Members: Member Parnel McAdam, Dr Ash Takyar, and Dr Graham Blom | Body system: Psychological/Psychiatric
Hall v Smick Group Pty Ltd [2025] NSWPICMP 150
Psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under two of the psychiatric impairment rating scale (PIRS) categories because of an inadequate path of reasoning; Held – Appeal Panel found error and a re-examination was considered necessary; Medical Assessment Certificate revoked.
Decision date: 10 March 2025 | Panel Members: Member Jane Peacock, Dr John Lam Po-Tang, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Motor Accidents Merit Review Decision
Kirkman v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMR 7
Motor Accident Injuries Act 2017; miscellaneous claims assessment; claimant’s application for merit review in respect of insurer’s determination the claimant was not entitled to receive weekly statutory benefits when residing in Germany from the period 1 June 2024 to 7 January 2025; statutory benefits are payable for the purposes of section 3.21 providing the claimant satisfies section 3.21(2)(a)-(b); if so he is entitled to payment of weekly statutory benefits; claimant relied upon the decision in Bax v Insurance Australia Ltd (t/as NRMA Insurance) which stated it is necessary to determine whether the claimant has a loss of any capacity that is likely to be of a permanent nature, and a loss of earning capacity is likely to be of a permanent nature if it can be shown that the loss of any capacity is likely to continue for an indefinite period; Held – determined the claimant had a loss of earning capacity which was likely to be of a permanent nature in respect of the period he was residing in Germany from 1 June 2024 to 7 January 2025; the reviewable decision is set aside; the insurer shall pay the claimant back pay of weekly payments from 1 June 2024 to 7 January 2025 totalling $128,168.
Decision date: 11 March 2025 | Merit Reviewer: David Ford
This publication is for information only. The publication is not legal advice. The information provided is not a substitute for reading the decisions. The Commission does not accept liability for the information in this publication or for way the information is used.
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