Legal Bulletin No. 242
This bulletin was issued on 19 December 2025
Issued 19 December 2025
Welcome to the two hundred and forty second 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.
Supreme Court Decision
JTE Enterprises Pty Ltd t/as Mount Gibraltar Preschool v Brown [2025] NSWSC 1502
Administrative law; jurisdictional error; whether reviewable error of law; whether Appeal Panel erred in characterisation of medical dispute; whether medical assessment of lower extremity following ankle injury can include knee; Held – the summons filed on 17 June 2025 is dismissed; the plaintiff is to pay the first defendant’s costs of the proceedings; no order is made as to costs in respect of the second and third defendants.
Decision date: 12 December 2025 | Before: Elkaim AJ
Presidential Member Decision
Hays Specialist Recruitment (Australia) Pty Limited v Akbawy [2025] NSWPICPD 83
Workers compensation; fact finding by Member; alleged injury to right knee; whether Member erred in finding the worker suffered a right knee condition; whether there was support in the evidence to make that factual finding; materiality of error; Mars Australia Pty Limited v Knight [2025] NSWCA 229 and Fisher v Nonconformist Pty Limited [2024] NSWCA 32; 114 NSWLR 1 discussed and applied; Held – the Certificate of Determination dated 10 June 2025 is amended to remove from Order 1 the reference to the right knee and to revoke Orders 3 and 4, but is otherwise confirmed; the matter is remitted to another Member for determination of whether there is consequential injury to the right leg and to determine whether the worker has incapacity.
Decision date: 9 December 2025 | Before: Acting Deputy President Geoffrey Parker SC
Motor Accidents non-Presidential Member Decisions
ETU v AAI Limited t/as AAMI [2025] NSWPIC 597
Motor Accident Injuries Act 2017; claim for statutory benefits under Part 3; insurer alleged claimant wholly or mostly at fault; claimant and insured riding motorbikes on private property; collision caused claimant to fall off and suffer injury; assessment conference held with evidence taken from claimant, insured, claimant’s son and owner of property; significant issue about whether volenti fit non injuria would have applied under section 4.18(1) or did apply under section 4.18(2); whether mandatory finding of contributory negligence required in statutory benefits claim by operation of section 3.38(2)(e); Held – section 4.18(2) did not apply; section 4.18(1) did apply; volenti would have been available and mandatory finding of contributory negligence required; contributory negligence assessed at 50%; claimant not wholly or mostly at fault; considered AAI Limited t/as GIO v Evic as to framework of decision making, Nicol v Whiteoak & Anor (no 2) as to defence of volenti, and Allianz Australia Insurance Limited v Shuk as to relative culpability and contributory negligence.
Decision date: 7 November 2025 | Member: Belinda Cassidy
Sultana v QBE Insurance (Australia) Limited [2025] NSWPIC 649
Motor Accident Injuries Act 2017; claim for statutory benefits under Part 3; dispute about painting of interior and exterior of the claimant’s home; claimant sought medical assessment on basis the house painting was treatment and care which the insurer had denied; insurer submitted painting the house was not an everyday task, not a type of domestic service, not a form of attendant care services, and not a form of treatment; dispute referred to member for determination under Schedule 2(3)(n); no preliminary or assessment conference held; Held – painting services requested was not an everyday home maintenance task and was not a domestic service; painting services were not a form of attendant care and therefore were not a form of treatment; there was no medical dispute that could be referred for medical assessment; BLI v Allianz Australia Insurance Limited considered and followed; Suttie v QBE Insurance (Australia) Limited, Haddad v Lifetime Care and Support Authority, Lau v QBE Insurance (Australia) Limited, Ellis v AAI Limited t/as GIO, and Choi v QBE Insurance (Australia) Limited referred to.
Decision date: 13 November 2025 | Member: Belinda Cassidy
AAI Limited t/as AAMI v Bowen [2025] NSWPIC 662
Motor Accident Injuries Act 2017; settlement approval; the claimant was injured on 25 August 2024; the claimant was not working at the time of the accident and was retired; Held – settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); settlement approved in the amount of $300,000.00 for non-economic loss.
Decision date: 8 December 2025 | Member: Philip Carr
AAI Limited t/as GIO v Ng [2025] NSWPIC 665
Motor Accident Injuries Act 2017; motor accidents settlement approval; claim for damages pursuant to Compensation to Relatives Act 1897 following the death of the claimant’s niece who was fatally injured in a motor vehicle accident; at the date of the accident the claimant was providing financial assistance to her sister in Indonesia; no allegation of contributory negligence; settlement comprised funeral expenses, past and future loss of financial services; Held – the proposed settlement is just, fair and reasonable; the proposed settlement is approved under section 6.23 (2)(b).
Decision date: 11 December 2025 | Member: Philip Carr
Workers Compensation non-Presidential Member Decisions
Xie v Kae Lee Hong & Anor [2025] NSWPIC 653
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); applicant claimed weekly benefits payable under sections 36 and 37 of the 1987 Act and medical and related treatment expenses payable under section 60 of the 1987 Act resulting from alleged injury sustained to her left leg in a frank incident; the respondents disputed the applicant was an employee within the meaning of section 4 of the 1998 Act or a deemed worker within the meaning of Schedule 1, clause 2 of the 1998 Act; the respondents disputed the applicant sustained the alleged injury in the course of employment; the respondents disputed the applicant’s claimed pre-injury average weekly earnings; the respondents disputed the applicant’s capacity for work resulting from the alleged injury and entitlement to weekly compensation and the respondents disputed the applicant’s need for medical or related treatment for the alleged injury and entitlement to payment of her treatment; Held – the applicant was a worker within the meaning of section 4 of the 1998 Act or a deemed worker within the meaning of Schedule 1, clause 2 of the 1998 Act; the applicant sustained injury in the course of her employment; the applicant’s pre-injury average weekly earnings are $1,200; the applicant suffered an incapacity for work and has entitlement to weekly compensation payable under sections 36 and 37 of the 1987 Act; the applicant required medical or related treatment for the injury and has entitlement to expenses payable for same under section 60 of the 1987 Act.
Decision date: 4 December 2025 | Member: Jacqueline Snell
Macleod v State of New South Wales (TAFE NSW) & Ors [2025] NSWPIC 656
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for benefits in respect of the death of a worker; apportionment of lump sum payable under section 25(1)(a) of the 1987 Act; entitlement to interest under section 109 of the 1998 Act; consideration of who was dependent for support on the worker; TNT Group 4 Pty Limited v Halioris, and Aafjes v Kearney considered; consideration of appropriateness of apportionment agreed between the parties; consideration of interest entitlement; Pheeney v Doolan (No 2), and Kaur v Thales Underwater Systems Pty Ltd considered; Held – no other persons (including the second respondent and the third respondent) but the applicant, the fourth respondent, the fifth respondent and the sixth respondent were dependent for support on the worker; apportionment of the lump sum payable under section 25(1)(a) of the 1987 Act as agreed between the parties is approved; interest under section 109 of the 1998 Act is awarded (as agreed between the parties); the monies payable to the fourth, fifth and sixth respondents are to be paid in trust for their benefit to the NSW Trustee and Guardian; management fees in this regard also ordered in accordance with section 25(1)(A) of the 1987 Act; consent orders also made regarding claims pursuant to sections 25(1)(b) and 26 of the 1987 Act.
Decision date: 4 December 2025 | Member: Gaius Whiffin
Juklen v Blacktown City Council [2025] NSWPIC 657
Claim for injury to the lumbar spine and for declarations that proposed surgery to both the lumbar and cervical areas of the spine were reasonable necessary; whether cervical spine surgery required revision and further fusion of the adjacent segment; whether lumbar spine injured by subject incident; whether proposed lumbar surgery reasonably necessary; Held – lumbar spine injury found as contemporaneous material available; no explanation for artefact the subject of the 2023 certificate of determination that required a general opinion from a Medical Assessor; no explanation from treating surgeon as to diagnosis of adjacent segment pathology; neither medico-legal expert nor second opinion neurosurgeon indicated whether proposed surgery would be effective; Diab v NRMA Ltd test applied; injury to lumbar spine established but both operative procedures not reasonable necessary.
Decision date: 5 December 2025 | Member: John Wynyard
Mesgar v Beyond Care Pty Ltd [2025] NSWPIC 659
Workers Compensation Act 1987; section 60; reasonably necessary; Murphy v Allity Management Services Pty Ltd, Briginshaw v Briginshaw, Rose v Health Commission (NSW), Bartolo v Western Sydney Area Health Service, and Diab v NRMA Limited cited and applied; Held – the C5/6 anterior cervical discectomy and fusion and L5/S1 right sided microdiscectomy surgeries are reasonably necessary as a result of the accepted injuries; the bilateral lumbar and SIJ blocks are not reasonably necessary as a result of the accepted injuries; there is an award for the respondent in respect to the claim for bilateral lumbar and SIJ blocks; the respondent is to pay the costs of and incidental to C5/6 anterior cervical discectomy and fusion surgery and L5/S1 right sided microdiscectomy surgery pursuant to section 60.
Decision date: 8 December 2025 | Member: John Turner
Cook v R & J Plant Hire Pty Ltd [2025] NSWPIC 660
Workers Compensation Act 1987; claim for continuation of weekly payments after 130 weeks; applicant has returned to work on a nine day fortnight; whether applicant is, and is likely to continue indefinitely to be, incapable of undertaking further additional employment or work that would increase his current weekly earnings for the purposes of section 38(3)(c); whether evidentiary onus discharged; Held – Roberts v University of Sydney applied; while there was a possibility the applicant could, at some point, increase his hours, the evidence from the applicant’s expert and treating doctors was sufficient to satisfy the requirements of section 38(3)(c); award for the applicant.
Decision date: 8 December 2025 | Senior Member: Rachel Homan
Kruse v Woolworths Group Pty Ltd [2025] NSWPIC 661
Workers Compensation Act 1987; claim for medical treatment; section 60; undisputed workplace injury to lumbar spine; lumbar spine fusion surgery sought by applicant worker; respondent employer disputes the surgery is reasonably necessary; Rose v Health Commission (NSW) considered; incorrect test applied by independent medical examiner qualified by the respondent; Held – requested surgery accepted as reasonably necessary as a result of the workplace injury; employer to pay cost of L3 to S1 spinal fusion.
Decision date: 8 December 2025 | Member: Adam Halstead
Saad v High Powered Transport Pty Ltd [2025] NSWPIC 663
Workers Compensation Act 1987; claim for proposed lumbar surgery; respondent disputes the surgery is reasonably necessary treatment as a result of the workplace injury; Held – notwithstanding the risks of the proposed surgery finding made that weight should be afforded to the opinion of the longstanding treating neurosurgeon; Held – finding made that the L4/5 anterior PSOA fusion and L4/5 posterior decompression fusion surgery is reasonably necessary treatment as a result of the injury in the course of the applicant’s employment with the respondent; order made that the respondent is to pay the costs of the proposed surgery recommended, being L4/5 anterior PSOA fusion and L4/5 posterior decompression fusion.
Decision date: 9 December 2025 | Member: Josephine Bamber
Vo Ha (Fernandez) v Healthshare NSW [2025] NSWPIC 664
Workers Compensation Act 1987; weekly compensation; claim in relation to disputed psychological injury; applicant alleges she suffered a psychological injury in the course of her employment as a result of the impact of a COVID-19 vaccination mandate; respondent disputed liability on the basis that the applicant had not suffered an injury and secondly that if there was an injury it had been wholly or predominantly caused by the respondent’s reasonable conduct; applicant worked in the health industry and was subject of a COVID-19 vaccine mandate in or about 2021; applicant declined to be vaccinated; respondent issued show cause letters to the applicant from time to time, and she eventually made a claim for psychological injury; the respondent made no substantive submissions on the question of injury; the only substantive issue for determination was section 11A; given the applicant worked in a public department her pre-injury average weekly earnings (PIAWE) was also in issue; Held – the respondent’s conduct was not reasonable despite being the whole cause of the applicant’s injury; the defence under section 11A therefore fails; the applicant’s PIAWE as revealed by source documentation was $2,916 per week; the respondent is to pay the applicant weekly compensation for total incapacity for the period claimed.
Decision date: 9 December 2025 | Member: Cameron Burge
Motor Accidents Medical Review Panel Decisions
QBE Insurance (Australia) Limited v CYY [2025] NSWPICMP 938
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; Medical Assessor certified social anxiety disorder and adjustment disorder caused by the accident gave rise to impairment greater than 10%; claimant examined; Held – Review Panel diagnosed somatic symptom disorder and adjustment disorder with depressed mood secondary to chronic pain; Review Panel satisfied claimant’s psychological injuries were caused by the accident; degree of permanent impairment resulting from claimant’s psychological injuries caused by the accident is 6%, which is not greater than 10%; MAC revoked.
Decision date: 27 November 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Wayne Mason, and Dr Steven Yeates | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Choi [2025] NSWPICMP 952
Motor Accident Injuries Act 2017; threshold injury dispute; whether non-threshold injuries can result from a very minor motor accident; “egg-shell skull principle” in Tame v New South Wales referred to; low energy motor vehicle impact not determinative of causation; entire factual matrix including particular circumstances of the claimant must be considered; degenerative asymptomatic conditions that are rendered symptomatic from the motor accident satisfies causation of injury; Held – Review Panel satisfied diagnosis of radiculopathy in the cervical spine and lumbar spine by surgeons following the motor accident meant injuries are not threshold injuries.
Decision date: 4 December 2025 | Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr David McGrath | Injury module: Spine, Upper Limb, and Lower Limb
CBC v AAI Limited t/as GIO [2025] NSWPICMP 953
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; consideration of pre-existing psychological injury; Medical Assessor (MA) assessed 8% permanent impairment caused by the accident calculated based on an assessment of 13% current permanent impairment and a 5% pre-existing impairment; claimant examined by MA’s on Review Panel; Held – Review Panel satisfied that an exacerbation of a pre-existing adjustment disorder was caused by accident; Review Panel not satisfied that other psychological injuries were caused or exacerbated by the accident; Review Panel assessed 10% permanent impairment caused by the accident calculated based on an assessment of 17% current permanent impairment; deduction of 7% pre-existing permanent impairment; same substantive conclusion as MAC but otherwise different conclusions; MAC revoked.
Decision date: 5 December 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Melissa Barrett, and Dr Himanshu Singh | Injury module: Mental and Behavioural
Olgun v QBE Insurance (Australia) Limited [2025] NSWPICMP 965
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant sustained alleged injuries to her neck, left shoulder, lumbar back, and left knee as a result of a motor accident; original Medical Assessor (MA) did not accept causation of the lumbar spine and left knee injuries; left shoulder was assessed at 7% whole person impairment (WPI); agreement between parties that left shoulder impairment is 8% WPI; dispute in Review Panel proceedings narrowed to causation of lumbar spine and left knee injuries; factors weighing against causation included pre-existing lumbar symptoms just weeks before subject motor accident; pre-existing symptoms described as chronic; nil lumbar spine complaints until one-month after the motor accident; delayed onset of alleged recurrent disc prolapse at L5/S1; lumbar spine complaints made in the context of chronic lower back pain; claimant’s recollection at Panel re-examination of lumbar spine complaints considered; Held – Panel not satisfied on balance, recurrent disc prolapse at L5/S1 was causally related to the motor accident; left knee injury consequential to lumbar spine injury not accepted; State Government Insurance Commission v Oakley considered; third scenario applied (no causal connection); MAC revoked due to change in WPI percentage.
Decision date: 10 December 2025 | Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Rhys Gray | Injury module: Spine, Upper Limb, and Lower Limb
Workers Compensation Medical Appeal Panel Decisions
BWW v Atlassian Pty Ltd [2025] NSWPICMP 821
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal by claimant from assessment for psychological injury; whether fresh evidence should be admitted and other submissions regarding the Medical Assessor’s (MA) reasoning considered; Held – fresh evidence established that claimant arrested and issued with apprehended violence order against his companion; gravity of such deterioration sufficient to render MAC otiose; MAC revoked as maximum medical improvement (MMI) now not possible for six-months.
Decision date: 22 October 2025 | Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Taylor v Land & Natural Resources [2025] NSWPICMP 945
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of psychological injury under the psychiatric impairment rating scale (PIRS); appeal with respect to self care and personal hygiene, social and recreational activities, and concentration, persistence and pace; application to rely on statement about examination; Lukacevic v Coates Hire Operations; principles of assessment under the PIRS; Jenkins v Ambulance Service of NSW, Chalkias v New South Wales, and Tradieh v LM Hayter and Sons Pty Limited; Held – MAC confirmed.
Decision date: 2 December 2025 | Panel Members: Member Catherine McDonald, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric
Bedano v Secretary, Department of Education [2025] NSWPICMP 946
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); the appellant raised nine grounds of appeal and only three relating to the psychiatric impairment rating scale (PIRS) assessments; Held – Appeal Panel found no error in first six grounds of appeal, and no error in PIRS except for the category of concentration, persistence and pace; MAC revoked.
Decision date: 3 December 2025 | Panel Members: Member Deborah Moore, Professor Nicholas Glozier, and Dr Graham Blom | Body system: Psychological/Psychiatric
Jetstar Airways Pty Ltd v Azad [2025] NSWPICMP 947
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal panel; figures recorded in MAC inconsistent with findings of impairment; reference made to incorrect table in American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5); demonstrable error identified; Appeal Panel unable to determine on material presented in MAC; re-examination required; reassessment in accordance with re-examination findings; Held – MAC revoked.
Decision date: 4 December 2025 | Panel Members: Member Parnel McAdam, Dr Alan Home, and Dr Doron Sher | Body system: Right Shoulder, and Left Shoulder
Maher v Lone Pine Jack Pty Ltd [2025] NSWPICMP 948
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal against assessment of left lower extremity and left upper extremity; Appeal Panel accepted that Medical Assessor failed to refer to the position of the appellant’s heel in which the subtalar joint had been ankylosed and had not assessed range of motion in the left ankle; Appeal Panel found error and application of incorrect criteria in assessment of left ankle and subtalar joint; no error in respect of assessment of peripheral nervous system and left upper extremity; appellant re-examined; Held – MAC revoked.
Decision date: 4 December 2025 | Panel Members: Member Carolyn Rimmer, Dr David Crocker, and Dr Drew Dixon | Body system: Left Lower Extremity, Left Upper Extremity, and Scarring (TEMSKI)
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); claim by employer against 15% whole person impairment (WPI) finding for psychological injury; whether Medical Assessor (MA) failed to consider employer’s expert; whether MA failed to give adequate reasons; Held – employer’s expert evidence was not before the MA; MAC a nullity; matter reverted to the President.
Decision date: 4 December 2025 | Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
EME Roofing Pty Ltd v Punit [2025] NSWPICMP 950
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of injury to right upper extremity referred by reference to fingers, hand, and wrist as well as scarring; Medical Assessor considered that worker had lost movement of his elbow and shoulder and assessed as a percentage loss of function of the whole upper extremity; Skates v Hills Industries Limited; re-examination; Held – MAC revoked.
Decision date: 4 December 2025 | Panel Members: Member Catherine McDonald, Dr Paul Curtin, and Dr Drew Dixon | Body system: Right Upper Extremity, and Scarring (TEMSKI)
Gordon v State of New South Wales (Fire & Rescue NSW) [2025] NSWPICMP 954
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); medical appeal; challenge to psychiatric impairment rating scale (PIRS); admission of fresh evidence being a report of a treating psychologist; admission of evidence rejected; consideration of PIRS of self care and personal hygiene, social and recreational activities, and travel; re-examination; error identified but finding on re-examination same as Medical Assessor; Held – MAC confirmed.
Decision date: 5 December 2025 | Panel Members: Member Parnel McAdam, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Serco Australia Pty Ltd v Mamidyala [2025] NSWPICMP 955
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by failing to consider the impairment the respondent had from a secondary psychological injury in the circumstance where there was no agreement between the parties or determination by the Commission that the respondent had suffered a secondary psychological injury; Held – MA did not err; MAC confirmed.
Decision date: 5 December 2025 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Moghareb Ghorbanali v S Pars & B Pars [2025] NSWPICMP 956
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal against assessment of permanent impairment relating to sleep disorder and permanent impairment relating to right shoulder; whether Medical Assessor (MA) wrongly engaged paragraph 2.20 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); whether MA adequately explained reasons for finding appellant’s obstructive sleep apnea had been cured; Held – Appeal Panel found MA wrongly engaged paragraph 2.20; MA did not adequately explain his reasons for finding appellant’s obstructive sleep apnea had been cured; appellant re-examined; MAC revoked.
Decision date: 5 December 2025 | Panel Members: Member Marshal Douglas, Dr James Bodel, and Dr Mark Jones | Body system: Respiratory System, Right Upper Extremity, and Cervical Spine
Newcombe v Regis Aged Care Pty Ltd [2025] NSWPICMP 957
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by not diagnosing the appellant has complex regional pain syndrome (CRPS); whether MA erred by not assessing appellant’s permanent impairment by reference to the criteria for CRPS; whether MA erred with respect to the points he scored pursuant Table 17-35 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5) for the appellant’s knee replacement; whether MA provided adequate explanation for the points he scored; Held – MA was correct not to diagnose the appellant with CRPS because appellant did not meet all the criteria of item 3 of Table 17.1; MA was correct not to rate the appellant’s impairment by reference to CRPS; MA did not provide adequate explanation for the points he scored pursuant to Table 17-35 for the appellant’s knee replacement with respect to her pain; appellant re-examined; Appeal Panel scored the same points for the appellant’s pain as the MA did; MAC confirmed.
Decision date: 8 December 2025 | Panel Members: Member Marshal Douglas, Dr James Bodel, and Dr David Crocker | Body system: Left Lower Extremity
Frost v State of New South Wales (Hunter New England Local Health District) [2025] NSWPICMP 958
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment by Medical Assessor (MA) of 14% whole person impairment (WPI) of right lower extremity (knee); appeal on basis of error in application of Table 16-10 of American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5) in not addressing use of amitriptyline and its effects on sensory deficits; no requirement for MA to assess nature and extent of sensory deficits with or without use of amitriptyline for purpose of classifying sensory deficit; Appeal Panel agreed with Grade 2 rating; Appeal Panel found no failure to make an adjustment for effects of medication as amitriptyline was not a long term treatment and has not resulted in apparent substantial or total elimination of the permanent impairment; Held – MAC confirmed.
Decision date: 8 December 2025 | Panel Members: Member Carolyn Rimmer, Dr Robert Kuru, and Dr Sophia Lahz | Body system: Right Lower Extremity
Secretary Department of Education v D'Aubert [2025] NSWPICMP 959
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); the appellant essentially submitted the Medical Assessor (MA) misapplied section 323 in that the correct approach was to apply a 50% deduction; Appeal Panel did not consider the MA misapplied section 323 when he applied a 10% deduction; Held – MAC confirmed.
Decision date: 9 December 2025 | Panel Members: Member Jacqueline Snell, Dr Andrew Porteous, and Dr Robert Kuru | Body system: Left Lower Extremity
Pettett v State of New South Wales (Northern Sydney Local Health District) [2025] NSWPICMP 960
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of psychological injury under the psychiatric impairment rating scale (PIRS); Medical Assessor directed to exclude whole person impairment (WPI) resulting from subsequent injury; appeal with respect to self care and personal hygiene, travel and social functioning; principles of assessment; Jenkins v Ambulance Service of NSW, Tasevski v Westpac Banking Corporation, Chalkias v New South Wales, and State of NSW v Kaur considered; analysis of contemporaneous records; Held – MAC confirmed.
Decision date: 9 December 2025 | Panel Members: Member Catherine McDonald, Dr John Baker, and Dr Graham Blom | Body system: Psychological/Psychiatric
Cunningham v Transport for NSW [2025] NSWPICMP 961
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from decision of a Medical Assessor; psychological injury; Ferguson v State of New South Wales, and NSW Police Force v Daniel Wark considered; no error established with respect to self-care and personal hygiene; error established with respect to concentration, persistence and pace and employability; Held – MAC revoked, new MAC issued.
Decision date: 9 December 2025 | Panel Members: Member Mitchell Strachan, Dr Michael Hong, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric
Thomas v Sydney City Council [2025] NSWPICMP 962
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); injury to left upper extremity (wrist) and digestive system (hernia); claim for permanent impairment; worker appealed both assessments on grounds which included inadequate reasoning; Appeal Panel could discern no error in either assessment noting the reasons given were adequate and amounted to a clear path of reasoning which clearly showed that the Medical Assessor had exercised his clinical expertise in accordance with his clinical findings on the day of examination and upon which he was entitled to rely; Held – MAC confirmed.
Decision date: 9 December 2025 | Panel Members: Member Jane Peacock, Dr Margaret Gibson, and Dr Siddarth Sethi | Body system: Left Upper Extremity, and Digestive System
Motor Accidents Merit Review Decisions
AAI Limited t/as GIO v Hamza [2025] NSWPICMR 37
Motor Accident Injuries Act 2017; merit review; dispute under section 6.24; whether a request for further documents and information including unredacted bank statements, taxation records, and employer contact details is reasonable and whether the claimant has a reasonable excuse for failing to comply; inconsistencies and anomalies in the evidence; incomplete evidence; unreliable evidence; validity of the evidence in question; insurer seeks further documents to determine the claimant’s pre-accident weekly earnings (PAWE) (Schedule 1, clause 4(1)), the claimant’s post-accident loss of earnings for the purpose of payment of weekly benefits under Division 3.3, and to determine the validity of the claim and whether any part of the claim may be fraudulent; Held – the insurer’s request for further information and documents is reasonable and the claimant does not have a reasonable excuse for their failure to comply.
Decision date: 5 December 2025 | Merit Reviewer: Katherine Ruschen
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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