Legal Bulletin No. 206
This bulletin was issued on 11 April 2025
Issued 11 April 2025
Welcome to the two hundred and sixth 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.
Presidential Member Decisions
Townsend v CPB Contractors Pty Limited [2025] NSWPICPD 27
Workers compensation; whether worker suffered incapacity from injury; section 294 of the Workplace Injury Management and Workers Compensation Act 1998; rule 78 of the Personal Injury Commission Rules 2021; adequacy of reasons; Held – the appeal is rejected; the Amended Certificate of Determination dated 21 June 2024 is confirmed.
Decision date: 31 March 2025 | Before: Acting Deputy President Geoffrey Parker SC
Specialist Diagnostic Services Pty Ltd v Pandya [2025] NSWPICPD 28
Workers compensation; section 60 of the Workers Compensation Act 1987; whether proposed surgery reasonably necessary; Diab v NRMA Ltd [2014] NSWWCCPD 72, Rose v Health Commission (NSW) [1986] NSWCC 2, and Bartolo v Western Sydney Area Health Service (1997) 14 NSWWCCR 233 discussed; failure to respond to clearly articulated submissions; Wang v State of New South Wales [2019] NSWCA 263 discussed and applied; failure to provide adequate reasons; Pollard v RRR Corporation Pty Ltd [2009] NSWCA 110, State Rail Authority of New South Wales v Earthline Constructions Pty Ltd (In Liq) [1999] HCA 3, and Goodrich Aerospace Pty Limited v Arsic [2006] NSWCA 187 discussed and applied; Held – determination [3] and Order [1] of the Member’s Certificate of Determination dated 27 May 2024 are revoked; the Member’s Certificate of Determination is otherwise confirmed; the issue as to whether the surgery proposed by Dr Nair is reasonably necessary as a result of the injuries is remitted to a different non-presidential member for re-determination; the respondent (the applicant below) is to lodge with the Commission and serve on the appellant (the respondent below) an amended Index to the Application to Resolve a Dispute with attached annexures limited to the evidentiary documents that are relevant to the issues in dispute in this case within 21 days of the issue of this decision.
Decision date: 1 April 2025 | Before: Deputy President Elizabeth Wood
Redpath v State of New South Wales (Healthshare NSW) [2025] NSWPICPD 29
Workers compensation; failing to afford a party procedural fairness having regard to the principles in Dranichnikov v Minister for Immigration and Multicultural Affairs [2003] HCA 26; 197 ALR 389 and associated authorities; proof of injury pursuant to section 4(b)(ii) of the Workers Compensation Act 1987; application of Federal Broom Co Pty Ltd v Semlitch [1964] HCA 34; 110 CLR 626; competing medical cases and the duty to provide reasons; Eckersley v Binnie (1988) 18 Con LR 1; Archibald v Byron Shire Council [2003] NSWCA 292; Goodrich Aerospace Pty Ltd v Arsic [2006] NSWCA 187; 66 NSWLR 186; Held – the Certificate of Determination dated 14 May 2024 is revoked; the matter is remitted to a different non-Presidential member for redetermination.
Decision date: 2 April 2025 | Before: Deputy President Michael Snell
State of New South Wales (Secretary, Department of Education) v BNQ [2025] NSWPICPD 30
Workers compensation; Pre-Filing Statement struck out by order of the President; sections 151DA(3) and 151DA(4) of the Workers Compensation Act 1987, State of New South Wales (NSW Police Force) v Adams [2024] NSWPICPD 82, and Luke v McCarthy [2008] NSWWCCPD 123 considered and applied; order for de-identification of worker made pursuant to rule 132(1) of the Personal Injury Commission Rules 2021; Held – order pursuant to rule 132(1) of the Personal Injury Commission Rules 2021 that the respondent worker’s identity be de-identified for the purposes of this decision; the respondent claimant’s Pre-Filing Statement dated 13 July 2022 is struck out pursuant to section 151DA(3) of the Workers Compensation Act 1987; each party is to bear its own costs of these proceedings.
Decision date: 2 April 2025 | Before: President Judge Phillips
Motor Accidents non-Presidential Member Decisions
O'Connor v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 112
Motor Accident Injuries Act 2017; assessment of claim for damages; claimant riding motor scooter; injuries to shoulders, right knee, lumbar spine, cervical spine, and hip; 7% whole person impairment; reason for cessation of employment; accurate and honest histories; right shoulder undisplaced fracture; left shoulder rotator cuff tears; harassed at work; work stress consequent on diminished work capacity; employment termination; mitigation of economic loss; assessment past economic loss; assessment future economic loss; intended retirement age of 72; damages assessed; Held – the insurer owed a duty of care to the claimant, breached that duty of care and the claimant sustained injury loss and damage as a result of that breach; under sub-sections 7.36(3) and 7.36(4) the amount of damages is $350,000.
Decision date: 19 March 2025 | Member: Hugh Macken
Martignago v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 121
Motor Accident Injuries Act 2017; 42-year-old claimant driving semi-trailer on narrow rural road; alleged unidentified vehicle veered into his lane causing claimant to lose control; Askarou v Nominal Defendant and Dimovski v GIO considered; burst fracture of L3; fracture of the ulna and radius of the left arm; claimant stoic; returned to work within 3 months of undergoing L2-L4 laminectomy; self-employed director and truck driver; established loss of income for one year; thereafter no objectively identifiable economic loss; Husher v Husher applied; Held – evidence corroborated by contemporaneous complaints; Container Terminals Australia Ltd v Huseyin, and Mason v Demasi considered; breach of duty of care by driver of unidentified vehicle; no contributory negligence; non-economic loss, past economic loss, past superannuation, and Fox v Wood assessed; buffer of $500,000 for future economic loss; Penrith City Council v Parks; AAI Limited v Chan cited; total damages of $1,011,729.
Decision date: 1 April 2025 | Member: Susan McTegg
Workers Compensation non-Presidential Member Decisions
Weber v Secretary, Department of Education [2025] NSWPIC 36
Workers Compensation Act 1987; claim for proposed treatment for right carpel tunnel and right cubital releases; injury on 30 August 2020 lack of complaints concerning a right wrist injury until 2024; respondent disputed liability; Held – award for the respondent; the applicant had not discharged his onus of proof that he sustained an injury to the right wrist; Chanaa v Zarour considered; Nguyen v Cosmopolitan Homes (NSW) Pty Limited applied.
Decision date: 7 February 2025 | Principal Member: Josephine Bamber
Milo v Arnotts Biscuits Ltd [2025] NSWPIC 88
Workers Compensation Act 1987; claim for permanent loss compensation pursuant to section 66 as a result of psychological injury arising out of or in the course of the applicant’s employment with the respondent; the respondent defended the claim relying on section 11A claiming that the conceded psychological injury suffered by the applicant was as a result of reasonable action taken against him with respect to discipline and/or dismissal; Held – the actions of the respondent with respect to discipline and dismissal were not the whole or predominant cause of the applicant’s psychological injury; applicant suffered primary psychological injury arising out of or in the course of his employment with the respondent; matter remitted to the President for referral to a Medical Assessor for assessment of permanent impairment as a result of such injury.
Decision date: 17 March 2025 | Member: Brett Batchelor
Holston v State of New South Wales (NSW Police Force) [2025] NSWPIC 108
Workers Compensation Act 1987; claim for lump sum compensation for psychological injury where the respondent admits injury but raises a defence under section 11A; Held – award for the applicant; the respondent had not discharged his onus of proof that the whole or predominant cause of the psychological injury was as a result of discipline; Hamad v Q Catering Pty Ltd applied.
Decision date: 25 March 2025 | Principal Member: Josephine Bamber
Wright v Findex (Aust) Pty Ltd [2025] NSWPIC 113
Workers Compensation Act 1987; weekly compensation and medical expenses; whether the applicant’s accepted psychological injury was wholly or predominantly caused by the reasonable actions of the respondent with respect to performance appraisal and/ or discipline; the fact of the applicant’s injury is not in issue; the respondent alleges it was caused by reasonable actions and relies on section 11A; Held – when examining question of causation a commonsense evaluation of the causal chain must be undertaken; Kooragang Cement Pty Ltd v Bates followed; the defence under section 11A is two-pronged; the conduct relied on must not only be the whole or predominant cause of the injury at issue and it must also be reasonable; the reasonableness or otherwise of the conduct relied on is an objective matter to be decided having regards to what was appropriate in the circumstances; balancing the consequences of the conduct relied on against the reasons given for it; Ritchie v Department of Community Services applied; when having regard to the reasonableness of any conduct relied on the manner and timing of the conduct together with its outcome must be considered; Ivanisevic v Laudet Pty Ltd (unreported 24 November 1998 per Truss CCJ); the evidence discloses the applicant was subjected to ridicule and being addressed in an angry manner by his manager at a virtual meeting in front of several colleagues; in the circumstances, the conduct relied on by the respondent was not reasonable and the defence under section 11A must therefore fail; capacity for employment; assessment of the applicant’s assessment after a period of total incapacity; finding the applicant has capacity for employment on restricted hours and duties at a residual rate; respondent ordered to pay applicant weekly compensation and medical expenses.
Decision date: 26 March 2025 | Member: Cameron Burge
Mueller v Bunnings Group Ltd [2025] NSWPIC 114
Workers Compensation Act 1987; claim for weekly compensation for psychological injury where the respondent admits injury but raises a defence under section 11A; respondent also disputes that the applicant has an entitlement to weekly compensation asserting she has capacity for suitable employment; Held – award for the applicant; the respondent had not discharged its onus of proof that the whole or predominant cause of the psychological injury was as a result of discipline; Hamad v Q Catering Pty Ltd applied; finding that the applicant has no current capacity for employment and has an entitlement to weekly compensation pursuant to section 37(1).
Decision date: 27 March 2025 | Principal Member: Josephine Bamber
Zhou v Tos Food Supply Centre Pty Ltd [2025] NSWPIC 115
Workers Compensation Act 1987; calculation of the applicant’s pre-injury average weekly earnings (PIAWE); whether applicant was paid his wages partly in cash; Held – the applicant commenced employment with the respondent on 6 June 2024 and that the wages paid to the applicant included cash; the amount of the applicant’s PIAWE is $1,331.96.
Decision date: 28 March 2025 | Member: John Turner
Debs v Neuroscience Research Australia [2025] NSWPIC 116
Workers Compensation Act 1987; claim for lump sum compensation and medical expenses in respect of psychological injury due to bullying and harassment; applicant employed by the respondent for a period of time before resigning and accepting appointment as a visiting PhD student to conduct studies at respondent’s premises; whether during PhD studies the applicant was a worker/deemed worker; whether injury arose out of or in the course of employment; Held – applicant was not a worker or deemed worker while conducting her PhD studies; injury was not sustained in the course of employment; although injury arose out of employment, employment was not the main contributing factor to the injury; award for the respondent.
Decision date: 31 March 2025 | Member: Rachel Homan
Barnes v Woolworths Group Ltd t/as Primary Connect [2025] NSWPIC 118
Workers Compensation Act 1987; claim for costs of proposed L5/S1 anterior interbody fusion; liability for injury accepted; respondent disputed that surgery was reasonably necessary as a result of the injury; causation not in issue; Bartolo v Western Sydney Area Health Service, Diab v NRMA Ltd, and Rose v Health Commission (NSW) considered; Held – proposed surgery reasonably necessary as result of injury; award for applicant for costs of and incidental to proposed surgery.
Decision date: 31 March 2025 | Senior Member: Kerry Haddock
Cager v Smart Traveller Pty Ltd [2025] NSWPIC 119
Workers Compensation Act 1987; claim for surgical treatment to the L3/4 of the lumbar spine claimed to be consequential to a right hand and wrist injury; respondent disputed that the applicant had sustained consequential condition to the L3/4 disc; Kooragang Cement Pty Ltd v Bates, Kumar v Royal Comfort Bedding Pty Ltd, Nguyen v Cosmopolitan Homes, Jones v Dunkel, Onassis v Vergottis, and Watson v Foxman considered; inconsistencies in evidence both factual and medical; Held – applicant failed to discharge onus; award respondent in respect of the claim of consequential condition to the L3/4 disc of the lumbar spine and claim for surgery.
Decision date: 31 March 2025 | Member: Diana Benk
Henry v Henry's Transport Solutions Pty Ltd [2025] NSWPIC 120
Workers Compensation Act 1987; claim in relation to death of worker; finding that the deceased worker sustained injury pursuant to section 4(a) when he died of a heart attack while driving his truck; Held – that no compensation is payable because the employment was not a substantial contribution factor to his injury (section 9A); in the alternative, pursuant to section 4(b)(ii) the employment was not the main contributing factor to the aggravation, exacerbation, deterioration or acceleration of the coronary artery disease; in the further alternative, pursuant to section 9B no compensation is payable for the heart attack injury as the nature of the employment concerned did not give rise to a significantly greater risk of the worker suffering the injury than had the worker not been employed in employment of that nature; De Silva v Secretary, Department of Finance, Services and Innovation discussed and distinguished on the facts; award for the respondent.
Decision date: 1 April 2025 | Principal Member: Josephine Bamber
Motor Accidents Medical Review Panel Decisions
Czajka v Allianz Australia Insurance Limited [2025] NSWPICMP 59
Motor Accident Injuries Act 2017; review of medical assessment certificate; threshold injury; Review Panel examination revealed no radiculopathy in lumbar spine; David v Allianz considered and applied to documentation referring to disc bulge and foraminal stenosis; Review Panel found no radiculopathy from the time of the motor accident to date; Held – Medical Assessor’s determination of threshold injury affirmed; Medical Assessment Certificate confirmed.
Decision date: 4 February 2025 | Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Sophia Lahz | Injury module: Spine, Upper Limb, and Brain Injury
Hamdan v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 213
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury; alleged injury of post-traumatic stress disorder (PTSD) and/or specific phobia of driving; rear end collision; air bags not deployed; ongoing anxiety; difficulty in driving; low mood; no evidence of manic, psychotic, or perceptual abnormalities; associated panic attacks; long history of anxiety associated with driving going back to 1997; specific driving phobia; criteria not established for post-traumatic stress disorder; Held – MAC revoked.
Decision date: 27 March 2025 | Panel Members: Member Hugh Macken, Dr Surabhi Verma, and Dr Wayne Mason | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Chahine [2025] NSWPICMP 214
Motor Accident Injuries Act 2017; motor accident on 17 July 2019; review of Medical Assessment Certificate (MAC); rear-end collision; medical dispute related to whether the degree of permanent impairment of the psychological condition was greater than 10%; various medical opinions up to 2023 supported claimant suffering from a major depressive disorder; examination findings which included the claimant’s self-reporting and the clinical features apparent at that examination such as interaction, co-operation, attentiveness, movements, and formal thought processes conveyed through her speech; the Medical Assessors were of the view that there was no psychiatric condition present; other relevant and important matters in reaching this conclusion include the claimant’s reported history of symptomatology; Held – claimant no longer suffers from psychological condition; MAC revoked.
Decision date: 27 March 2025 | Panel Members: Principal Member John Harris, Dr Matthew Jones, and Dr Himanshi Singh | Injury module: Mental and Behavioural
Hamdan v AAI Limited t/as AAMI [2025] NSWPICMP 215
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury; alleged post-traumatic stress disorder (PTSD) and specific phobia of driving; no complaints of driving phobia immediate post-accident period; motor vehicle accident followed by assault and abuse; symptoms consistent with assault and subject motor accident; subsequent work injury; additional stresses not accident related; physical injuries being threshold injuries; mental state examination; current examination; post-accident injuries consequent on assault; unrelated medical conditions; subsequent workers compensation; criteria not established for PTSD; threshold injury; Held – MAC confirmed.
Decision date: 28 March 2025 | Panel Members: Member Hugh Macken, Dr Surabhi Verma, and Dr Wayne Mason | Injury module: Mental and Behavioural
Ahmad v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 221
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); extensive treatment and care dispute following motor vehicle accident on 5 September 2019; claimant suffered both physical and psychiatric injuries and as a consequence of her psychiatric disabilities; claimant was prescribed certain medication which caused dizziness and subsequently two falls possibly impacting her physical disabilities by way of injuries to her chest wall and right shoulder; Medical Assessor assessed whole person impairment at 0% and this was not challenged by the claimant; Held – Review Panel not satisfied that the treatment and care is required given that there is no need for the claimant to have ongoing specialist review where no surgical treatment is planned and the treatment would not provide any significant benefit to the claimant; Review Panel was satisfied that the treatment and care did relate to the injury caused by the accident but was not satisfied that it was reasonable and necessary; MAC revoked.
Decision date: 31 March 2025 | Panel Members: Member Alexander Bolton, Dr David Gorman, and Dr Margaret Gibson | Injury module: Digestive System, Spine, Upper Limb, and Lower Limb; Treatment Type: Radiological Investigations, Medical Specialist Consultation, Physiotherapy Treatment, Facet/z Joint Injections, Domestic Assistance - Causation, Medical (Over the Counter), and Domestic Assistance - Reasonable and Necessary
Insurance Australia Limited t/as NRMA Insurance v Shorrock [2025] NSWPICMP 222
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); head-on collision; whether the degree of permanent impairment of the psychological condition was greater than 10%; claimant re-examined; no issues of principle; subsequent work injury to shoulder and knee; clause 6.34 of the Motor Accident Guidelines; Slade v Insurance Australia Ltd applied; no objective evidence that the work injury resulted in permanent impairment of the underlying psychiatric condition caused by the motor accident; Held – claimant suffers from chronic post-traumatic stress disorder; MAC confirmed.
Decision date: 31 March 2025 | Panel Members: Principal Member John Harris, Dr Wayne Mason, and Dr Matthew Jones | Injury module: Mental and Behavioural
Bojovic v Allianz Australia Insurance Limited [2025] NSWPICMP 223
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant suffered injury in a motor vehicle accident as a pedestrian on 6 April 2021; the dispute related to the assessment of whole person impairment (WPI) of a mild traumatic brain injury; cervical spine, thoracic spine, lumbar spine, right knee, and left shoulder; Medical Assessor assessed 6% WPI arising out of traumatic brain injury; Held – impairments described by claimant affect complex high-level tasks such as completing PhD; given academic performance and ability to sustain attention for four hours and despite a relative decline from previous function no WPI can attach to higher intellectual functions; no impairment of activities of daily living caused by mild traumatic brain injury and non-displaced occipital skull fracture; soft tissue injury to cervical spine, thoracic spine, lumbar spine, right knee, and left shoulder fully recovered and do not give rise to assessable permanent impairment; MAC revoked and certified injures caused by accident gave rise to 0% WPI.
Decision date: 31 March 2025 | Panel Members: Member Susan McTegg, Dr Adeline Hodgkinson, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, Lower Limb, Brain Injury, and Nervous System (Neurological)
Nadasy v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 224
Motor Accident Injuries Act 2017; review of Medical Assessment Certificates (MAC); degree of permanent impairment and treatment and care disputes; claimant was the seat-belted driver of a station wagon when his vehicle was struck from behind by the insured truck; claimant was able to alight from his vehicle and exchange details with the other driver; claimant recalls the onset of neck and low back pain over the next few days; insurer denied liability to pay statutory benefits beyond 26-weeks; Medical Assessor (MA) certified 10% whole person impairment (WPI) for accident-related injuries to cervical and lumbar spine; found various injuries not caused by subject motor accident; Review Panel made the same causation findings and confirmed WPI certificate; MA found weekly physiotherapy for spinal injuries not necessary or reasonable in the circumstances; Review Panel found proposed treatment necessary and reasonable for 3-months post-accident but not thereafter; the natural history of such soft tissue injuries is for recovery to occur within a 6-12 week window as rationale for recommended duration of the assistance; no issues of principle; Held – MAC relating to WPI confirmed; MAC relating to care revoked and replaced.
Decision date: 1 April 2025 | Panel Members: Member Gary Victor Patterson, Dr Sophia Lahz, and Dr Clive Kenna | Injury module: Spine, Upper Limb, and Lower Limb; Treatment Type: Physiotherapy Treatment
Allianz Australia Insurance Limited v Lounici [2025] NSWPICMP 225
Motor Accident Injuries Act 2017; review of medical assessment certificate; degree of permanent impairment; claimant suffered injury in a motor accident when she was struck as a pedestrian by the insured vehicle at speed; left hip-intertrochanteric fracture; left knee-medial patellofemoral ligament tear; onset of tinnitus and vertigo; admitted to hospital for 2-weeks including 8 days in intensive care; dispute about whether claimant sustained injuries to the cervical spine, lumbar spine, and shoulders; original assessment of permanent impairment of 21%; re-examination of the claimant; Held – original assessment of a degree of permanent impairment of 21% revoked and replacement certificate issued with a finding of a degree of permanent impairment of 23%.
Decision date: 1 April 2025 | Panel Members: Member Maurice Castagnet, Dr Mohammed Assem, and Dr David Gorman | Injury module: Spine, Upper Limb, and Lower Limb
Zalghout v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 226
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant was injured in a motor vehicle accident; whether the injuries sustained were threshold injuries; degree of whole person impairment (WPI); Review Panel conducted an examination and considered the factors contributing to the injury according to clause 6.6 of the Motor Accidents Guidelines; Held – MAC revoked; Review Panel determined that the cervical spine, thoracic spine, right shoulder, left shoulder, and lumbar spine injuries were threshold injuries; total WPI of 12%.
Decision date: 1 April 2025 | Panel Members: Member Terence Stern OAM, Dr Drew Dixon, and Dr Les Barnsley | Injury module: Spine, and Upper Limb
Insurance Australia Limited t/as NRMA Insurance v Kavakci [2025] NSWPICMP 227
Motor Accident Injuries Act 2017 (MAI Act); review of medical assessment; threshold injury; where Medical Assessor (MA) found panic disorder caused by the accident not a threshold injury; whether proceedings should have been dismissed; scope of dispute; whether insurer denied procedural fairness; Mandoukos v Allianz Australia Insurance, and AAI Limited trading as GIO v Amos applied; Held – insurer agitated dismissal for the first time in written submissions provided for the review; Review Panel does not have power to dismiss application; insurer’s submission that because no specific diagnosis was referred for assessment the Review Panel cannot go beyond the description in the application of “psychological injury” rejected; ambit of the dispute was whether the claimant suffered a psychological injury as a result of the accident and if so whether that injury was a threshold injury for the purposes of the MAI Act; specific diagnostic criteria included in DSM-5 serve as guidelines to be informed by clinical judgement and not meant to be used in a rigid cookbook fashion; insurer afforded an opportunity to address the issues in dispute; no denial of procedural fairness; the claimant suffered both specific phobia (driving), and an adjustment disorder as a result of the accident; specific phobia (driving) is not a threshold injury; adjustment disorder is a threshold injury; Medical Assessment Certificate revoked as the Review Panel’s findings about diagnosis of injury differ from those of the MA; new certificate issued.
Decision date: 2 April 2025 | Panel Members: Senior Member Brett Williams, Dr Michael Hong, and Dr Himanshu Singh | Injury module: Mental and Behavioural
Insurance Australia Limited t/as NRMA Insurance v Azzam [2025] NSWPICMP 228
Motor Accident Injuries Act 2017; permanent impairment dispute; claimant was pedestrian when she was hit by a car causing her to fall and land on her back; claimant sustained fractures to both knees and a right shoulder rotator cuff tear; claimant had significant pre-existing symptomatic knee and right shoulder conditions; there was no dispute that the accident-related right knee fracture was 5% whole person impairment (WPI); Held – Review Panel found the left knee fracture was not present in the radiology before the motor accident; left knee undisplaced tibial plateau fracture therefore caused by the motor accident and assessed at 2% WPI; pre-accident shoulder radiology showed a partial rotator cuff tear while post-accident showed a complete tear; right shoulder injury also causally related to the motor accident; consideration of pre-existing impairment deduction was difficult as claimant had a fall four months before motor accident and injured her right shoulder; hospital notes detailed restricted motion in flexion, extension, and abduction; no recordings in relation to adduction, internal, and external rotation; no indication of goniometer used or reliability of measurements for impairment evaluation; Review Panel concluded data not reliable and cannot be used for pre-existing impairment deduction; right shoulder assessed as 4% WPI; surgical scarring was 2% WPI; therefore total impairment was 13% WPI; Medical Assessment Certificate revoked; new certificate issued.
Decision date: 2 April 2025 | Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Clive Kenna | Injury module: Skin, Upper Limb, and Lower Limb
Allianz Australia Insurance Limited v Alkuheli [2025] NSWPICMP 229
Motor Accident Injuries Act 2017; permanent impairment dispute; claimant was front seat passenger of a car when the driver had a sneezing fit and drove into a telegraph pole; claimant claims post-traumatic stress disorder (PTSD) from the motor accident; medical assessment under review found PTSD as 15% whole person impairment (WPI); Review Panel noted pre-accident history of depression and anxiety in 2014 and 2018 (less than two years before motor accident); Held – Review Panel satisfied there was a pre-existing diagnosis of major depressive disorder however WPI assessment was 0%; the accident-related PTSD was assessed as 6% WPI; Medical Assessment Certificate revoked and issued a new certificate.
Decision date: 2 April 2025 | Panel Members: Member Jeremy Lum, Dr Christopher Rikard-Bell, and Dr Gerald Chew | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
State of New South Wales (NSW Police Force) v Ralph [2025] NSWPICMP 207
Application of the psychiatric impairment rating scale (PIRS); consideration of the PIRS of concentration, persistence and pace, and social and recreational activities; worker engaged in activities including attending gym and visiting friends; extent to which Ballas v Department of Education (State of NSW) applies to the consideration of that activity (Lancaster v Foxtel Management Pty Ltd and Botha v Secretary, NSW Department of Customer Service discussed); adjustment for the effect of treatment per clause 1.32 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021; Zoric v Secretary, Department of Education & Ors applied; Held – Medical Assessment Certificate revoked.
Decision date: 26 March 2025 | Panel Members: Member Parnel McAdam, Dr John Lam-Po-Tang, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Vranic v Workers Compensation Nominal Insurer (iCare) & Anor [2025] NSWPICMP 208
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the Medical Assessor erred in whole person impairment (WPI) assessment of three of the psychiatric impairment rating scale (PIRS) categories, namely self-care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace; Held – fresh evidence rejected; Appeal Panel found error in two categories appealed; MAC revoked; new certificate issued.
Decision date: 26 March 2025 | Panel Members: Member Deborah Moore, Dr Graham Blom, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Yeboah v Australian Foundation for Disability [2025] NSWPICMP 209
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether medical dispute between the parties included the degree of the appellant’s permanent impairment from scarring in the circumstance where scarring was not particularised in the application or in the referral to the Medical Assessor (MA); whether MA erred by not assessing the degree of appellant’s permanent impairment from scarring; Held – Appeal Panel held that the claim for compensation the appellant made had attached to it a report detailing she had impairment from scarring and given that the respondent disputed liability to meet that claim the medical dispute between the parties included whether the appellant had any permanent impairment from scarring; MA erred by not assessing scarring; appellant re-examined; MAC revoked and issued a new certificate.
Decision date: 26 March 2025 | Panel Members: Member Marshal Douglas, Dr Todd Gothelf, and Dr Margaret Gibson | Body system: Left Lower Extremity, Right Lower Extremity, and Scarring
Ho v Luk Fook Jewellery and Goldsmith (Australia) Pty Ltd [2025] NSWPICMP 210
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); Medical Assessor (MA) assessed the appellant as DRE lumbar category III with 10% whole person impairment (WPI) of the lumbar spine; MA made no allowance for activities of daily living (ADL); appellant submitted that the MA erred in not applying an additional loading for ADL; MA made no reference to ADL assessment reports of occupational therapists; finding by MA of no diminution in previous recreational and sporting activities inconsistent with the evidence; Held – Appeal Panel satisfied that there was a failure to provide adequate reasons in failing to apply an additional loading for interference with ADL; appellant re-examined; MAC revoked; new certificate issued.
Decision date: 27 March 2025 | Panel Members: Member Carolyn Rimmer, Dr Chris Oates, and Dr Roger Pillemer | Body system: Lumbar Spine, and Skin Scarring
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC) psychological injury; referral to Medical Assessor provided two dates of injury; State Government Insurance Commission v Oakley applied; injury fell within second category and first respondent responsible; Held – MAC revoked and issued a new certificate.
Decision date: 27 March 2025 | Panel Members: Member Catherine McDonald, Dr John Baker, and Dr Graham Blom | Body system: Psychological/Psychiatric
AKD NSW Pty Ltd v Friend [2025] NSWPICMP 212
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); medical appeal; challenge to two of the psychiatric impairment rating scales (PIRS); social and recreational activities, and concentration, persistence and pace; worker attending Men’s Shed on a regular basis; specifics of attendance involve multiple areas of functioning; Ballas v Department of Education (State of NSW), Lancaster v Foxtel Management Pty Ltd, and Botha v Secretary, NSW Department of Customer Service considered; Held – MAC revoked; new certificate issued.
Decision date: 27 March 2025 | Panel Members: Member Parnel McAdam, Dr Doug Andrews, and Dr Graham Blom | Body system: Psychological/Psychiatric
Hosie v Azzurri Services Pty Ltd [2025] NSWPICMP 216
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC) assessment of scarring; applicant suffered burns to his left leg and hand; consideration of Table 8-2 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5); whether appellant fell into class 1 or higher; consideration of activities of daily living under Table 1-2 of AMA 5; Held – appellant appropriately assessed under class 1 of Table 8-2; best fit under the TEMSKI criteria; 4% whole person impairment; MAC revoked; new certificate issued.
Decision date: 28 March 2025 | Panel Members: Member Parnel McAdam, Dr Michael McGlynn, and Dr Paul Curtin | Body system: Skin (Scarring)
Jawish v Hanson Construction Materials Pty Ltd [2025] NSWPICMP 217
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) found that the appellant had not suffered an injury to urethral system; whether MA had regard to all relevant evidence; Held – MA found appellant had not suffered an injury to his urethral system which was contrary to the parties’ agreement and was an error; Appeal Panel found that MA did not engage with a report of appellant’s treating urologist which was relevant evidence; MA’s failure to engage with that was an error; appellant re-examined; MAC revoked; new certificate issued.
Decision date: 31 March 2025 | Panel Members: Member Marshal Douglas, Dr John Carter, and Dr David Crocker | Body system: Lumbar Spine, Urinary System, and Reproductive System
Dela Torre Ventoso v The Jewellery Group Pty Ltd [2025] NSWPICMP 218
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); medical Assessor (MA) assessed 0% whole person impairment (WPI) of the right lower extremity (ankle and hindfoot) and 7% WPI of the lumbar spine as a result of an injury; appellant submitted that the MA failed to assess impairment of the right lower extremity (ankle and hind foot) and failed to measure range of motion of the ankle and hind foot on his examination; MA found that the appellant had a very dramatic response to examination which could not be explained on orthopaedic grounds and was inconsistent with observations made during the examination; Held – Appeal Panel is satisfied that the MA explained the methodology and rationale of his assessment; Appeal Panel satisfied that the failure to measure range of motion in the ankle and hind foot did not amount to a demonstrable error or the application of incorrect criteria; MAC confirmed.
Decision date: 31 March 2025 | Panel Members: Member Carolyn Rimmer, Dr James Bodel, and Dr Tommasino Mastroianni | Body system: Right Lower Extremity (Ankle and Hindfoot), and Lumbar Spine
State of NSW (Fire and Rescue NSW) v Maclean [2025] NSWPICMP 219
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the Medical Assessor (MA) incorrectly assessed the respondent with Class 3 moderate impairment with respect to the psychiatric impairment rating scale (PIRS) category of social and recreational activities, incorrectly assessed the respondent with Class 3 for the PIRS category of concentration, persistence and pace, incorrectly assessed the respondent with Class 4 for the PIRS category of employability, and incorrectly made an adjustment of 1% whole person impairment for the effects of treatment; Appeal Panel accepted the MA erred in incorrectly assessing the respondent with Class 3 moderate impairment with respect to the PIRS category of social and recreational activities; Held – MAC revoked and issued a new certificate.
Decision date: 31 March 2025 | Panel Members: Member Jacqueline Snell, Dr Graham Blom, and Dr Ash Takyar | Body system: Psychological/Psychiatric
BOC Ltd v Rees [2025] NSWPICMP 220
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; causation of impairment; section 323; clause 11.10 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); challenge to two of the psychiatric impairment rating scales (PIRS); PIRS re-examined; Coca-Cola Europacific Partners API Pty Ltd v Pombinho applied; Held – Medical Assessor erred in application of section 323; MAC revoked and issued a new certificate.
Decision date: 31 March 2025 | Panel Members: Member Parnel McAdam, Dr John Lam-Po-Tang, and Dr Michael Hong | Body system: Psychological/Psychiatric
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