Legal Bulletin No. 208
This bulletin was issued on 24 April 2025
Issued 24 April 2025
Welcome to the two hundred and eighth 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
Inner West Council v McQuade [2025] NSWPICPD 32
Workers compensation; the Personal Injury Commission’s power to refer a dispute as to permanent impairment for reassessment or re-consideration; section 329 of the Workplace Injury Management and Workers Compensation Act 1998; principles applicable; Target Australia Pty Ltd v Mansour; Milosavljevic v Medina Property Services Pty Ltd; Adriaansen v Dungog & District Retirement Living Limited; considered and applied; Held – the Member’s Certificate of Determination dated 25 June 2024 is revoked; the matter is remitted to a different non-presidential member for re-determination.
Decision date: 10 April 2025 | Before: Deputy President Elizabeth Wood
Kapp v St Josephs Village Limited [2025] NSWPICPD 33
Workers compensation; the monetary threshold to appeal; section 352(3) of the Workplace Injury Management and Workers Compensation Act 1998; Grimson v Integral Energy; Abu-Ali v Martin-Brower Australia Pty Ltd; Patrick Operations Pty Ltd v Watson; Sheridan v Coles Supermarkets Australia Pty Limited; Fletchers International Exports Pty Limited v Regan; Anderson v Secretary, Department of Education; O’Callaghan v Energy World Corporation Ltd; Hamilton v Sydney Water Corporation; Lambropoulos v Qantas Airways Limited discussed and applied; Held – the monetary threshold in section 352(3)(a) of the Workplace Injury Management and Workers Compensation Act 1998 is not satisfied, and there is no right of appeal.
Decision date: 10 April 2025 | Before: Deputy President Elizabeth Wood
Pemberton v Woolstar Pty Limited [2025] NSWPICPD 34
Workers compensation; psychological injury resulting from COVID-19 mask and vaccination policy; failure to respond to material argument; Dranichnikov v Minister for Immigration and Multicultural Affairs [2003] HCA 26 distinguished; Wang v State of New South Wales [2019] NSWCA 263 considered and applied; sufficiency of reasons for evaluative decision regarding reasonableness; rule 78 of the Personal Injury Commission Rules 2021; St George Leagues Club Ltd v Wretowska [2013] NSWWCCPD 64 considered and applied; failure to find date of injury; consequences of failure to adduce medical evidence on issue of whether injury was wholly or predominantly caused by actions within section 11A(1) of the Workers Compensation Act 1987; Hamad v Q Catering Limited [2017] NSWWCCPD 6 distinguished; Held – the Certificate of Determination dated 9 May 2024 is revoked; the matter is referred to a different non-presidential member for determination of whether the appellant’s entitlement to compensation for psychological injury is extinguished by the operation of section 11A(1).
Decision date: 11 April 2025 | Before: Acting Deputy President Paul Sweeney
Motor Accidents non-Presidential Member Decision
Atkinson v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 134
Motor Accident Injuries Act 2017; clause 99 of the Personal Injury Commission Rules 2021; insurer’s application for discretionary exemption from assessment under section 7.34(1)(b); preliminary assessment of claim; complex issues of causation, fault and liability; accident involving a stolen motor bike colliding with a car driven by insured; insured driver relied on the statutory defences in sections 52 and 53 of the Civil Liability Act 2022 (NSW) that the insured driver was responding to the unlawful taking of a motorcycle, and the insured driver’s actions were carried out in self-defence to protect the motorcycle from unlawful taking, destruction, damage or interference; Held – claim is not suitable for assessment because it involves complex legal and factual issues; issues of liability including contributory negligence; witnesses required to give evidence; witnesses cannot be compelled to attend an assessment at the Commission; recommendation made that the claim be exempted; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 7 March 2025 | Member: Ray Plibersek
Chowdhury v AAI Limited t/as GIO [2025] NSWPIC 135
Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether motor accident caused mostly or wholly by the fault of the claimant; sections 3.11 and 3.28; collision occurred when claimant attempted to change lanes; whether insured driver was travelling at a speed that was unsafe in the circumstances; whether the claimant indicated its intention to change lanes without giving insured driver sufficient time to react; claimant’s costs beyond the regulated amount permitted under section 8.10(4); payment of insurer’s solicitor and client costs permitted beyond the regulated amount under section 8.3(4); Held – motor accident was not caused wholly or mostly by the fault of the claimant.
Decision date: 3 April 2025 | Member: Maurice Castagnet
Cherry v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 142
Motor Accident Injuries Act 2017; assessment of claim for damages; liability admitted; claimant suffered physical and psychological injury as a result of accident; treatment included multiple surgeries; agreed claimant cannot return to pre-accident work; claimant entitled to damages for non-economic loss; past economic loss agreed; whether claimant had any residual earning capacity; Held – claimant has no practical earning capacity; non-economic loss damages awarded in the sum of $430,000; total damages assessed at $2,032,143.
Decision date: 10 April 2025 | Senior Member: Brett Williams
Noori v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 143
Motor Accident Injuries Act 2017; damages; liability admitted; physical and psychiatric/psychological injuries; entitled to non-economic loss; claim for past and future economic loss; consideration of medico-legal examinations, vocational assessments, and lay evidence on reliability; lack of documentary evidence of past earnings; pre-accident average weekly earnings assessed based on contractor earnings; average weekly earnings used to calculate economic loss; continuing reduction of earning capacity; consideration and application of section 4.7; Held – damages assessed for non-economic loss, past economic loss as weekly loss, and future economic loss as buffer; claimant’s legal costs and disbursements assessed.
Decision date: 10 April 2025 | Member: Terence O'Riain
Insurance Australia Limited t/as NRMA Insurance v Gad [2025] NSWPIC 144
Motor Accident Injuries Act 2017; settlement approval; liability admitted by insurer; claimant suffered multiple injuries including psychiatric disability; 22% whole person impairment; claimant worked part-time at the time of the accident; initial offer of settlement submitted for approval was rejected and subsequent offer made of $315,000; claimant accepted final offer of settlement inclusive of deductions; Held – settlement approved.
Decision date: 10 April 2025 | Member: Alexander Bolton
AAI Limited t/as AAMI v Holstein [2025] NSWPIC 151
Motor Accident Injuries Act 2017; settlement approval; $330,000 non-economic loss only; 67-year-old pensioner; insurer conceded entitlement to non-economic loss; injuries include L1 burst fracture requiring L1 decompression and T11-L2 posterior fixation, with ongoing back pain, partial footdrop, and some sensory disturbance over dorsum of foot; pre-existing medical conditions including chronic kidney disease, diabetic neuropathy, congestive cardiac failure, and multilevel moderate degenerative disc disease; Held – settlement complied with clause 7.37 of the Motor Accident Injuries Guidelines version 9.3; approved under section 6.23(2)(b).
Decision date: 14 April 2025 | Member: Shana Radnan
Workers Compensation non-Presidential Member Decisions
Payne v Mercy Public Hospital Inc [2025] NSWPIC 137
Workers Compensation Act 1987; claim for weekly benefits of compensation and medical expenses due to psychological injury; respondent relies upon section 11A defence that any injury was wholly or predominantly caused by reasonable action taken or proposed to be taken with respect to discipline/and or performance appraisal; Northern NSW Local Health District v Heggie, Hamad v Q Catering Ltd, and Attorney General’s Department v K considered; Held – action taken by respondent was reasonable with respect to discipline and section 11A applies; award for the respondent.
Decision date: 9 April 2025 | Member: Diana Benk
Sternbeck v Secretary, Department of Education [2025] NSWPIC 138
Workers Compensation Act 1987; claim for bilateral hearing aids and desk microphone; whether applicant sustained noise induced hearing loss; whether employment caused a loss of hearing pursuant to section 17; Held – applicant’s expert evidence preferred; compensable injury pursuant to section 17; treatment reasonably necessary pursuant to section 60;award for the costs of supplying and fitting binaural digital hearing aids and a desk microphone in accordance with the current Workers Compensation (Hearing Aid Fees) Order.
Decision date: 9 April 2025 | Member: Rachel Homan
Borota v Transit Systems NSW Pty Ltd t/as Transit Systems [2025] NSWPIC 139
Workers Compensation Act 1987; psychological injury; whether applicant took himself out of the course of employment; serious and wilful misconduct; Tarry v Warringah Shire Council discussed; Karim v Poche Engineering Services Pty Ltd considered; Held – applicant suffered injury in the course of employment; did not take himself out of the course of employment; respondent’s defence of serious and wilful misconduct failed; award for weekly compensation and medical expenses made.
Decision date: 10 April 2025 | Member: Parnel McAdam
Stone v State of New South Wales (NSW Police Force) [2025] NSWPIC 140
Workers Compensation Act 1987; claim by police officer for injury to left hip; whether familial genetic disposition had aggravated underlying osteoarthritis; whether 22-years of service in policing had aggravated underlying condition; whether failure to identify cause of left hip symptoms by treating GPs significant; Held – clinical notes not concerned with legal causation; Mason v Demasi, and Qannadian v Bartter Enterprises Pty Limited considered and applied; treating surgeon and medico-legal expert ad idem that policing duties caused injury; familial osteoarthritis affected only one hip; respondent opinion a bare ipse dixit.
Decision date: 10 April 2025 | Member: John Wynyard
Zarkovic v APA Monet Pty Ltd [2025] NSWPIC 147
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for payment of weekly compensation pursuant to section 37 of the 1987 Act and for medical expenses pursuant to section 60 of the 1987 Act; whether the applicant was a worker pursuant to section 4 of the 1998 Act or a deemed worker pursuant to section 5 of the 1998 Act and clause 2 of Schedule 1 to the 1998 Act; correct calculation for pre-injury average weekly earnings (PIAWE); Held – applicant a worker or deemed worker at the time of injury; PIAWE is $1,575.87 and subject to indexation; general order for medical expenses.
Decision date: 11 April 2025 | Member: Adam Halstead
Arora v Toyota Motor Corporation Australia Ltd [2025] NSWPIC 148
Workplace Injury Management and Workers Compensation Act 1998; claim for lump sum compensation; accepted left knee and lumbar spine injuries; disputed cervical spine and bilateral shoulder injuries; relevant date of injury for lump sum claim; Haddad v The GEO Group Australia Pty Ltd considered; Held – applicant sustained aggravated injuries to his cervical spine and bilateral shoulders; injuries arose from the same injurious incident being the nature of the duties performed by the applicant; injuries to be assessed together under section 322(3) with deemed date of injury 1 April 2022.
Decision date: 11 April 2025 | Member: Fiona Seaton
Smith v State of New South Wales (NSW Police Force) & Anor [2025] NSWPIC 149
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for psychological injuries; claims for weekly benefits compensation and treatment expenses pursuant to section 60 of the 1987 Act; consideration of whether the applicant sustained a psychological injury with the first respondent (in accordance with section 4 of the 1987 Act) as a result of incapacity in 2014 or 2015; confirmation that the applicant sustained a psychological injury with the second respondent (in accordance with section 4 of the 1987 Act); consideration as to the extent of the applicant’s entitlements and whether the Commission had jurisdiction to award entitlements pursuant to section 38 of the 1987 Act; consideration as to how to apportion liability between two injuries found pursuant to sections 22 and 22A of the 1987 Act; consideration as to whether delay by the applicant would affect his entitlements or the Commission’s ability to apportion by reference to sections 254 and 261 of the 1998 Act; NSW Police Force v Kearns and Anor, Sutherland Shire Council v Baltica General Insurance Co Ltd, Ferro v Mercon Group Pty Ltd, Inghams Enterprises Pty Ltd v Thoroughgood, P & O Berkeley Challenge Pty Ltd v Alfonzo & Ors, Demolon Pty Ltd v Parbury Building Products Ltd and Anor, Haddad v The GEO Group Australia Pty Ltd, and BHP Billiton Ltd & Anor v Bourke & Ors considered; Held – applicant sustained a psychological injury pursuant to section 4(b)(i) of the 1987 Act during the course of his employment with the first respondent; deemed date of the injury in accordance with section 15(1)(a)(i) of the 1987 Act is 13 August 2015; applicant also sustained a psychological injury pursuant to section 4(b)(ii) of the 1987 Act during the course of his employment with the second respondent; deemed date of the injury in accordance with section 16(1)(a)(i) of the 1987 Act is 29 March 2021; awards are made in favour of the applicant pursuant to sections 60, 36(1), 37(1), and 37(2) of the 1987 Act; the Commission does not have jurisdiction to determine the applicant’s entitlements pursuant to section 38 of the 1987 Act; pursuant to sections 22A(4) and 22A(5) of the 1987 Act the second respondent is to pay the applicant’s awards; pursuant to section 22 of the 1987 Act liability for the applicant’s awards is apportioned to the first respondent to the degree of two-thirds; sections 254 and 261 of the 1998 Act do not apply either to prevent the applicant’s awards being made or to prevent the apportionment findings being made.
Decision date: 14 April 2025 | Member: Gaius Whiffin
Harrison v Bunnings Warehouse [2025] NSWPIC 152
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for permanent impairment lump sum compensation pursuant to section 66 of the 1987 Act; accepted elbow injury and accepted secondary psychological injury; whether applicant sustained a primary psychological injury in the nature of a disease pursuant to section 4(b)(i) and/or section 4(b)(ii) of the 1987 Act; what is the date of injury; whether the applicant’s claim is precluded by operation of section 254(1) and/or section 261(1) of the 1998 Act; Held – applicant sustained a primary psychological injury in the course of her employment with the respondent pursuant to section 4(b)(i) of the 1987 Act; the date of the applicant’s primary psychological injury is 15 October 2023; applicant’s claim is not precluded by operation of section 254(1) of the 1998 Act; applicant is not precluded from recovery of compensation by the operation of sections 261(1) of the 1998 Act; matter is remitted to the President for referral to a Medical Assessor for assessment of whole person impairment.
Decision date: 15 April 2025 | Member: Karen Garner
Motor Accidents Medical Review Panel Decisions
Insurance Australia Limited t/as NRMA Insurance v Moutrage [2025] NSWPICMP 250
Motor Accidents Compensation Act 1999; review of Medical Assessment Certificate (MAC); whole person impairment (WPI); Medical Assessor determined 18% WPI; review sought by insurer under section 63; consideration and application of clauses 1.5 to 1.7 of the Motor Accident Permanent Impairment Guidelines (the Guidelines) in respect of causation; clauses 1.50 and 1.116-1.132 of the Guidelines in respect of the assessment of permanent impairment; Held – MAC revoked; claimant sustained injuries that give rise to 10% WPI.
Decision date: 10 April 2025 | Panel Members: Member Anthony Scarcella, Dr Christopher Oates, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, Lower Limb, and Digestive System
Al Laimouni v QBE Insurance (Australia) Limited [2025] NSWPICMP 251
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant assessed as having 7% whole person impairment (WPI) for physical injuries; insurer relied on a traffic collision report which concluded there was no risk of injury in crashes producing such low levels of force; Held – Review Panel was satisfied on the balance of probabilities that the accident caused injury to the claimant’s head, cervical spine, thoracic spine and lumbar spine but not to his left and right shoulders and right sternoclavicular joint and for which no contemporaneous complaints were made by the claimant to his GP following the accident; Review Panel not satisfied that the advent of an umbilical hernia was causally related to the accident; MAC revoked; new certificate issued with a 0% WPI assessment.
Decision date: 10 April 2025 | Panel Members: Member Alexander Bolton, Dr Ian Cameron, and Dr Clive Kenna | Injury module: Spine, Upper Limb, Lower Limb, and Digestive System
Ward v AAI Limited t/as GIO [2025] NSWPICMP 256
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant suffered injury in a motor accident; threshold injury; whether a supraspinatus tear in the left shoulder found on MRI was caused by the motor accident; Held – Medical Assessment Certificate revoked; new certificate issued; injury to left shoulder is not a threshold injury.
Decision date: 14 April 2025 | Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr David Gorman | Injury module: Spine, and Upper Limb
Insurance Australia Limited t/as NRMA Insurance v Cooper [2025] NSWPICMP 257
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury; Review Panel found claimant’s pre-existing social anxiety disorder was aggravated by the motor accident and was therefore not a threshold injury; Todev v AAI Limited t/as GIO applied; claimant did not meet DSM-5-TR Criterion A for diagnosis of PTSD; Held – motor accident caused an aggravation of social anxiety disorder which is not a threshold injury; MAC revoked; new certificate issued.
Decision date: 14 April 2025 | Panel Members: Member Jeremy Lum, Dr Wayne Mason, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Webb [2025] NSWPICMP 258
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury; attempted carjacking; incident involved elements of a motor accident and criminal assault; Review Panel treated the motor accident and the assault as a single incident constituting the “motor accident” and without attempting to define the scope of the motor accident; AAI Limited v State Insurance Regulatory Authority of NSW, and Allianz Insurance Limited v Bell cited; Held – Review Panel found the motor accident caused the claimant’s PTSD and alcohol use disorder which are not threshold injuries; MAC confirmed.
Decision date: 14 April 2025 | Panel Members: Member Jeremy Lum, Dr Christopher Canaris, and Dr Matthew Jones | Injury module: Mental and Behavioural
Wharram v CIC Allianz Insurance Limited [2025] NSWPICMP 259
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); ruptured spleen requiring splenectomy; epigastric pain requiring surgery; stent inserted to address superior mesentery artery aneurysm; whether neurological hypoesthesia in the cutaneous nerve supply gives rise to whole person impairment; subsequent development of leukemia requiring all other medications to cease; majority decision of Medical Review Panel; clinical findings; trauma laparotomy; Held – MAC revoked; new certificate issued determining 7% whole person impairment.
Decision date: 14 April 2025 | Panel Members: Member Hugh Macken, Dr John Garvey, and Dr Margaret Gibson | Injury module: Digestive System
Insurance Australia Limited t/as NRMA Insurance v Miller [2025] NSWPICMP 260
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); assessment of treatment and care; causation; C5/6 cervical discectomy and fusion; pre-existing cervical degenerative changes; neck, shoulder and arm; pain with upper limb paraesthesia; loss of sensation on the left in the C6 distribution; consistency in presentation; disc prolapse C5/6; compressing the left C6 nerve root: pre-existing degenerative disease aggravated by the motor vehicle accident; Held – discectomy and fusion relate to the injuries caused by the accident and is reasonable and necessary in the circumstances; MAC confirmed.
Decision date: 15 April 2025 | Panel Members: Member Hugh Macken, Dr Shane Moloney, and Dr David Gorman | Treatment Type: Surgery
Allianz Australia Insurance Limited v Sapateh [2025] NSWPICMP 261
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury ; treatment dispute; vehicle failed to stop at a stop sign and hit the driver’s side of the claimant’s car; airbags deployed and claimant was taken to hospital by ambulance; claimant suffered right shoulder and bilateral knee injuries; radiology showed a partial thickness tear to the right shoulder and cartilage change to the knees; Held – the motor accident caused the partial thickness supraspinatus tear which is not a threshold injury; pathology in the knees was not accident-related; no direct blow to either knee with no objective findings recorded; claimant’s request for consultation with an orthopaedic surgeon in relation to his knees found not causally related to the motor accident and not reasonable and necessary; MAC confirmed.
Decision date: 15 April 2025 | Panel Members: Member Jeremy Lum, Dr Mohammed Assem, and Dr Margaret Gibson | Injury module: Upper Limb, and Lower Limb
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); assessment of threshold injury and permanent impairment disputes; first insurer (NRMA) denied statutory benefits beyond 26 weeks on basis that all of claimant’s injuries are threshold injuries; second insurer (RACQ) admitted liability for the damages claim but did not concede that the claimant’s accident-related impairment exceeds the 10% threshold; Medical Assessor (MA) did not assess whole person impairment (WPI); found that all referred injuries were threshold or not caused by the subject accident; Review Panel found two signs of radiculopathy in lumbar spine and lower limbs; Held – MAC revoked and new certificate issued; assessed 11% WPI for lumbar spine and right ulnar neuritis.
Decision date: 16 April 2025 | Panel Members: Member Gary Victor Patterson, Dr Margaret Gibson, and Dr Christopher Oates | Injury module: Spine, Upper Limb, Lower Limb, and Digestive System
Allianz Australia Insurance Limited v Tirant [2025] NSWPICMP 266
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); degree of permanent impairment dispute; Medical Assessor (MA) diagnosed post-traumatic stress disorder and persistent depressive disorder; MA calculated 15% whole person impairment (WPI) on the psychiatric impairment rating scale; Review Panel made similar diagnoses but assigned a higher rating for adaptation; Held – Review Panel assessed 17% WPI; no issues of principle; MAC revoked and new certificate issued.
Decision date: 16 April 2025 | Panel Members: Member Gary Victor Patterson, Dr Christopher Canaris, and Dr Himanshu Singh | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
Tremelling v Secretary, Department of Education [2025] NSWPICMP 248
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); consideration of five of the six psychiatric impairment rating scales; role of the Medical Assessor(MA); State of New South Wales (NSW Department of Education) v Kaur discussed; section 323; MA took into account subsequent issues in error; section 323 redetermined; section 323 allows a deduction for an asymptomatic pre-existing condition; Vitaz v Westform (NSW) Pty Ltd applied; Held – MAC revoked and new certificate issued.
Decision date: 9 April 2025 | Panel Members: Member Parnel McAdam, Dr Graham Blom, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Keelan v Pearl Beach Real Estate Pty Ltd [2025] NSWPICMP 249
Workplace Injury Management and Workers Compensation Act 1998; matter remitted from Supreme Court; review of Medical Assessment Certificate (MAC); whether demonstrable error or incorrect application of criteria arising from failure to make reference to statement evidence describing a deterioration in the appellant’s psychological condition as relevant to the psychiatric impairment rating scale category of concentration persistence and pace; Held – Appeal Panel agreed with Court’s comments regarding error; appellant re-examined; MAC revoked and new certificate issued.
Decision date: 10 April 2025 | Panel Members: Member Rachel Homan, Dr Douglas Andrews, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric
Ibanez v Life Without Barriers [2025] NSWPICMP 254
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by not explaining why his assessment differed from the assessment of the appellant’s IME; whether MA correctly assessed the appellant’s impairment in self-care and personal hygiene, and in social and recreational activities; Held – the obligation of the MA to provide reasons did not require the MA to explain why his opinion differed from the opinion of another doctor; Appeal Panel held that the MA’s ratings of the appellant’s impairment in self-care and personal hygiene and in social and recreational activities were wrong; appellant re-examined; Appeal Panel assessed the degree of the appellant’s permanent impairment same as the MA; MAC confirmed.
Decision date: 11 April 2025 | Panel Members: Member Marshal Douglas, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Exton v Suttons Motors Waitara Pty Ltd [2025] NSWPICMP 255
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) found appellant had not suffered an injury contrary to the parties’ agreement; whether MA correctly applied the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); Held – MA accepted the appellant had suffered an injury but assessed the appellant had no permanent impairment from that injury; if the MA did find the appellant did not suffer an injury then the MA would have made an error; that error would not change the result as the appellant did not have a rateable impairment; Appeal Panel found that the MA correctly applied the Guidelines; appellant’s permanent impairment assessed at 0%; MAC revoked and new certificate issued.
Decision date: 11 April 2025 | Panel Members: Member Marshal Douglas, Dr Gerard Testa, and Dr Siddarth Sethi | Body system: Left Inguinal Hernia, Right Inguinal Hernia, Urinary and Reproductive System, Impotence, and Bladder
Nguyen v Real Pet Food Company Pty Ltd; Real Pet Food Company Pty Ltd v Nguyen [2025] NSWPICMP 262
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); time at which pre-existing condition must be present for a disease injury in order that section 323 can be engaged; whether Medical Assessor (MA) was correct to apply section 323; whether MA correctly applied Table 4.2 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); Held – MA erred by applying section 323 because the worker did not have a pre-existing condition; Appeal Panel held MA incorrectly applied Table 4.2 of the Guidelines; MAC revoked and new certificate issued.
Decision date: 15 April 2025 | Panel Members: Member Marshal Douglas, Dr Todd Gothelf, and Dr Tommasino Mastrioanni | Body system: Cervical Spine, Thoracic Spine, Lumbar Spine, and Scarring
Szilagyi v Blacktown City Council [2025] NSWPICMP 264
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the Medical Assessor (MA) erred in whole person impairment assessment of four of the psychiatric impairment rating scale categories namely self-care and personal hygiene, travel, concentration, persistence and pace, and employability; insufficient history from MA; re-examination required; Held – errors in some categories; MAC revoked and new certificate issued.
Decision date: 15 April 2025 | Panel Members: Member Deborah Moore, Dr John Lam-Po-Tang, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Motor Accidents Merit Review Decisions
Chih v AAI Limited t/as AAMI [2025] NSWPICMR 9
Motor Accident Injuries Act 2017; application to set aside insurer’s decision regarding payment of legal costs in respect of a medical assessment; claimant submitted that the insurer had no statutory right to assert that payment of costs should be anything less than the maximum regulated fee of 16 monetary units; Held – the “maximum” regulated legal costs for a medical dispute does not represent the mandatory amount recoverable for legal costs; section 8.10 specifies an entitlement to “reasonable and necessary” legal costs; determined on the evidence that reasonable and necessary legal costs total $600 plus GST.
Decision date: 17 March 2025 | Merit Reviewer: Elizabeth Medland
Meksass v Allianz Australia Insurance Limited [2025] NSWPICMR 12
Motor Accident Injuries Act 2017; merit review; costs dispute; other costs and expenses; medico-legal report; report not served or relied upon in proceedings before the Commission; sections 8.4 and 8.10 considered; principles of statutory interpretation; AAI Limited v Moon considered and applied; whether costs reasonable and necessary; Held – costs incurred in connection with the claim; costs reasonable and necessary; claimant entitled to recover costs from insurer under section 8.10.
Decision date: 11 April 2025 | Merit Reviewer: Bianca Montgomery-Hribar
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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