Legal Bulletin No. 230

Issued 26 September 2025

Welcome to the two hundred and thirtieth 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

Georges v Musico [2025] NSWSC 1085

Administrative law; review of medical assessment by review panel; judicial review of review panel decision; where medical assessment certificate revoked and replaced by review panel; whether review panel erred in applying psychiatric permanent impairment rating scale in Motor Accident Permanent Impairment Guidelines; Held – the amended summons filed 22 May 2024 is dismissed; no order as to costs.

Decision date: 23 September 2025 | Before: Griffiths AJ

Motor Accidents non-Presidential Member Decisions

Ahamed v QBE Insurance (Australia) Limited [2025] NSWPIC 469

Motor Accident Injuries Act 2017; claim for statutory benefits; assessment of contributory negligence under section 3.38; insurer alleged 20%; claimant disputed any contributory negligence; two police cars passed claimant; claimant collided with third police car (under lights and sirens) which entered a roundabout the wrong way (from the left); claimant did not hear or see police car and looked right before entering roundabout; dashcam footage from claimant’s car; evidence taken from claimant at preliminary conference; Held – claimant did not look to his left; he should have been aware of possibility of police car; he should have heard and seen it before he did; police car driver predominately to blame but claimant’s conduct contributed to the accident and contributory negligence assessed at 20%; Australian Broadcasting Tribunal v Bond, and Blacktown City Council v Hocking followed with regards to evidentiary matters; Veryyt v Schoupp referred to with regards to relevance of breach of the road rules; Sibley v Cais, and Manley v Alexander relied on regarding duty of care; Podrbersek v Australian Iron & Steel Pty Limited followed regarding assessment of degree of contributory negligence.

Decision date: 8 September 2025 | Member: Belinda Cassidy

Freitas v QBE Insurance (Australia) Limited [2025] NSWPIC 475

Motor Accident Injuries Act 2017; claim for statutory benefits; whether claimant wholly or mostly at fault; claimant riding motorbike when vehicle in front stopped suddenly due to the vehicle in front of it stopping with no brake lights; claimant braked but did not have ABS brakes and lost control of rear wheel (road was wet and slippery) before colliding with rear of vehicle in front; Held – claimant contributed to the accident by not adjusting the distance between him and the vehicle in front to take account of the wet weather; driver of van in front of the claimant did not contribute to the accident; driver of vehicle in front of the van did contribute to the accident by driving with defective brake lights; claimant’s contributory negligence assessed at 50%; claimant not wholly or mostly at fault; case of AAI Limited t/as GIO v Evic followed as to the approach to be taken in a dispute about wholly or mostly at fault.

Decision date: 11 September 2025 | Member: Belinda Cassidy

Abdo v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 476

Motor Accident Injuries Act 2017; claim for statutory benefits; claimant sought reimbursement for expenses incurred in respect of backyard building works; insurer declined; dispute under Schedule 2(3)(n) whether the works are a form of treatment and care within the definition of section 1.4 and therefore whether they are payable as a statutory benefit under section 3.24(1); claimant argued works were a “home modification” or a “rehabilitation” expense; insurer addressed whether they were home maintenance and therefore attendant care services; Held – building works are not a modification (change or alteration) of the claimant’s home to accommodate the claimant’s injuries; no evidence works were necessary as part of the claimant’s rehabilitation, and while part of home maintenance the project was significant and not an everyday task within the meaning of attendant care services; Fowler v Youi Pty Limited, Ellis v AAI Limited t/as AAMI cited re meaning of home modification; Haddad v Lifetime Care and Support Authority, and BLI v Allianz Australia Insurance Limited re meaning of attendant care.

Decision date: 12 September 2025 | Member: Belinda Cassidy

Workers Compensation non-Presidential Member Decisions

Elmasri v APEC Transport Pty Ltd [2025] NSWPIC 472

Workers Compensation Act 1987; claim for permanent impairment compensation for accepted psychological injury; employer argued worker also suffered secondary psychological injury; analysis of expert evidence; South Western Sydney Area Health Service v Edmonds, Grasa v Roads and Maritime Services, and Summers v Sydney International Container Terminals Pty Limited t/as Hutchison Ports; Held – worker suffered a primary psychological injury and did not also suffer a secondary psychological injury; matter remitted for referral to Medical Assessor.

Decision date: 10 September 2025 | Member: Catherine McDonald

Markovic v Zelimir Ostojic t-as Nickol's Painting Services & Anor [2025] NSWPIC 473

Workers Compensation Act 1987; previous determination on injury and deemed worker; section 33 weekly compensation; whether worker incapacitated for work during period after injury; medical evidence indicates incapacity; pre-injury average weekly earnings (PIAWE); dispute as to income; consideration of earnings, receipts, and income; method of calculating PIAWE, taxation records, and bank statement records; Held – applicant incapacitated for work; PIAWE determined with reference to bank statement records.

Decision date: 10 September 2025 | Member: Adam Halstead

Webster v TAFE NSW (North Coast Institute) [2025] NSWPIC 477

Workers Compensation Act 1987; section 60; reasonably necessary; as a result of an injury; material contribution; Rose v Health Commission (NSW), Bartolo v Western Sydney Area Health Service, Diab v NRMA Limited, and Murphy v Allity Management Services Pty Ltd considered and applied; Held – the anterior disc replacement at L4/5 and anterior interbody fusion at L5/S1 surgery recommended is reasonably necessary as a result of the accepted injury; the respondent is to pay the costs of and incidental to the anterior disc replacement at L4/5 and anterior interbody fusion at L5/S1 surgery recommended.

Decision date: 12 September 2025 | Member: John Turner

Ait Aiss v Vistamaze Pty Ltd [2025] NSWPIC 478

Workers Compensation Act 1987; section 60; reasonably necessary; as a result of an injury; Rose v Health Commission (NSW), Bartolo v Western Sydney Area Health Service, Diab v NRMA Limited, and Murphy v Allity Management Services Pty Ltd considered and applied; Held – hydrotherapy is not reasonably necessary as a result of the accepted work injury sustained; physiotherapy is reasonably necessary as a result of the accepted work injury sustained; award for the respondent in respect to the claim pursuant to section 60 for the costs of hydrotherapy; the respondent is to pay the reasonably necessary costs of physiotherapy treatment pursuant to section 60.

Decision date: 15 September 2025 | Member: John Turner

White v Strikeforce AMC Pty Ltd [2025] NSWPIC 479

Workers Compensation Act 1987; claim for injuries to left shoulder and consequent chronic regional pain syndrome; claim for proposed future treatment expenses pursuant to section 60 being the provision and the fitting of a tailored dynamic arm splint and a tailored arm sleeve (quoted at $2,077.49); consideration of applicant’s statements, medical reports and other treatment records, and claim correspondence; consideration of whether the proposed treatment is reasonably necessary medical treatment for the applicant as a result of her accepted injury to her left shoulder; Rose v Health Commission (NSW), Diab v NRMA Limited, and Murphy v Allity Management Services Pty Limited applied; Held – the treatment proposed for the applicant is reasonably necessary medical treatment as a result of her injury; respondent ordered to pay the quoted cost for the treatment.

Decision date: 16 September 2025 | Member: Gaius Whiffin

Yandell v Walpett Engineering Pty Ltd [2025] NSWPIC 480

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); permanent impairment compensation; whether the applicant suffered a consequential condition to his left hand as a result of accepted injuries to his left elbow, left forearm, and left wrist; Moon v Conmah Pty Ltd, Kumar v Royal Comfort Bedding Pty Ltd, Bouchmouni v Bakos Matta t/as Western Red Services, Kooragang Cement Pty Ltd v Bates, Kirunda v State of New South Wales (No 4), and Munce v Thomson Cool Rooms Pty Ltd considered and applied; Held – the applicant discharged the onus of proving on the balance of probabilities that there is a sufficient causal chain connecting the condition of his left hand to the accepted injuries to the left elbow, left forearm, and left wrist; matter remitted to the President for referral to a Medical Assessor under section 321 of the 1998 Act for assessment of whole person impairment of the left upper extremity (elbow, forearm, wrist and hand) and the skin (TEMSKI – scarring).

Decision date: 16 September 2025 | Member: Anthony Scarcella

Motor Accidents Medical Review Panel Decisions

CWN v AAI Limited t/as GIO [2025] NSWPICMP 591

Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; referred injuries include cervical spine, thoracic spine, lumbar spine, both shoulders, and consequential injury to the right ankle; claimant involved in prior and subsequent motor accidents; previous injuries to the cervical spine and lumbar spine; subsequent injuries to the cervical spine and right shoulder; original assessment of permanent impairment of 0%; re-examination by the Review Panel; Held – MAC revoked; permanent impairment assessed at 7%; subsequent injury to the right ankle not related to the motor accident.

Decision date: 11 August 2025 | Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr David Gorman | Injury module: Spine, Upper Limb, and Lower Limb

CWN v Allianz Australia Insurance Limited [2025] NSWPICMP 592

Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) under section 7.26; dispute about whether the injuries caused by the accident were threshold injuries; whether the motor accident caused a supraspinatus tear and/or a labrum tear in the right shoulder; re-examination by the Review Panel; Held – MAC revoked; injury to right shoulder caused by the motor accident is not a threshold injury.

Decision date: 11 August 2025 | Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr David Gorman | Injury module: Spine, and Upper Limb

Celvavinayagan v Allianz Australia Insurance Limited [2025] NSWPICMP 697

Motor Accident Injuries Act 2017; insurer’s review of Medical Assessment Certificate (MAC) under section 7.26; whole person impairment (WPI) dispute; psychiatric injury; claimant injured in bus accident as bus driver; original medical assessor diagnosed a major depressive disorder with anxious distress and a somatic symptom disorder; claimant had pre accident psychological symptoms; Held – accident could have and did cause or contribute to the development of psychological symptoms; Review Panel diagnosed a somatic symptom disorder and gave reasons for their being no post-traumatic stress disorder and no depressive disorder; psychiatric impairment rating scale (PIRS) does not permit assessment of impairment for a somatic symptom disorder therefore no assessable impairment; MAC revoked.

Decision date: 11 September 2025 | Panel Members: Member Belinda Cassidy, Dr Melissa Barrett, and Dr Ankur Gupta | Injury module: Mental and Behavioural

Anjoul v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 699

Motor Accident Injuries Act 2017; review of single medical assessment by Review Panel; two disputes; whether injuries caused by the motor accident are threshold injuries for the purposes of the Act and whether the injuries caused by the accident give rise to a permanent impairment that is greater than 10%; whether infraspinatus tear of the shoulder was caused by the motor accident; Held – injuries to the cervical spine and lumbar spine are threshold injuries; injury to the right shoulder is a non-threshold injury due to tear of infraspinatus tendon; significant history of pre-existing issues to the spine and shoulders; comparison of pre and post-accident radiology; found the tear more likely to have been caused by the accident due to contemporaneous complaint; assessment of cervical and lumbar spine revealed a DRE Category I impairment giving rise to 0% whole person impairment (WPI); 1% WPI of the right shoulder; claimant did suffer an injury that is not a threshold injury and WPI of 1% is not greater than 10%; medical certificate revoked; new certificate issued.

Decision date: 11 September 2025 | Panel Members: Member Elizabeth Medland, Dr David Gorman, and Dr Drew Dixon | Injury module: Spine, and Upper Limb

Allianz Australia Insurance Limited v Borbidge [2025] NSWPICMP 700

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); permanent impairment dispute; motor accident involved rear impact causing the claimant’s vehicle to be lifted up and the claimant pushed forward in the cabin; claimant assessed by original Medical Assessor as having 11% whole person impairment (WPI) for injuries to the cervical spine, lumbar spine, and residual scarring from lumbar spine decompressive surgery; Held – Review Panel found 5% WPI for the lumbar spine decompression surgery as there were no two signs of radiculopathy; surgical scarring TEMSKI best fit principle; 0% WPI; pre-existing symptoms reported but no objective evidence for any deduction to be made; MAC revoked; new certificate issued.

Decision date: 11 September 2025 | Panel Members: Member Jeremy Lum, Dr Les Barnsley, and Dr Sophia Lahz | Injury module: Spine, and Skin

QBE Insurance (Australia) Limited v Georgopoulos [2025] NSWPICMP 703

Motor Accident Injuries Act 2017; assessment of threshold injury under section 1.6(3); the claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) found the claimant sustained post-traumatic stress disorder and alcohol use disorder caused by the accident (a non-threshold injury); insurer sought review; Held – alcohol use disorder resolved; having regard to decisions of David v Allianz Australia Ltd, and Lynch v AAI Ltd can satisfy test as to threshold injury at any time since accident; found alcohol use disorder (resolved) is a non-threshold injury; claimant also suffered post-traumatic stress disorder (a non-threshold injury); certificate of MA confirmed.

Decision date: 12 September 2025 | Panel Members: Senior Member Susan McTegg, Dr Wayne Mason, and Dr Alan Doris | Injury module: Mental and Behavioural

Insurance Australia Limited t/as NRMA Insurance v BNR [2025] NSWPICMP 705

Motor Accidents Compensation Act 1999; review of medical assessment under section 63; Medical Assessor found persistent depressive disorder, post-traumatic stress disorder, and panic disorder caused by the accident gave rise to a permanent impairment of greater than 10%; observations made in QBE Insurance (Australia) Limited v BPO endorsed; Held – the claimant developed panic disorder and somatic symptom disorder as a result of the accident; psychiatric impairment rating scale (PIRS) must not be used to measure impairment due to somatoform disorders or pain; the panic disorder resulted in a permanent impairment of 9%; certificate revoked; the accident caused permanent impairment not greater than 10%.

Decision date: 15 September 2025 | Panel Members: Senior Member Brett Williams, Dr Steven Yeates, and Dr John Baker | Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decisions

El-Nayef v Greenacre Medical Centre [2025] NSWPICMP 691

Workplace Injury Management and Workers Compensation Act 1998; assessment of impairment of the lumbar spine; appellant worker submitted that the Medical Assessor (MA) made a demonstrable error in failing to assess residual radiculopathy post-surgery and that his reasons were inadequate; MA found in accordance with his examination findings on the day of assessment that there is no rateable impairment for radiculopathy in accordance with paragraph 4.27 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021 (the Guidelines); this was adequately explained when the Medical Assessment Certificate (MAC) is read as a whole; MA is entitled to rely on his clinical findings on the day of assessment and has applied the correct criteria to assess impairment; no error; Held – Appeal Panel considered that the reasoning given by the MA was adequate; MAC confirmed.

Decision date: 9 September 2025 | Panel Members: Member Jane Peacock, Dr Tim Anderson, and Dr Michael Davies | Body system: Lumbar Spine, Upper Digestive Tract, Lower Digestive Tract, and Anus

Philip Leong Stores Pty Ltd v Ngo [2025] NSWPICMP 692

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); claim by employer that Medical Assessor (MA) erred by applying the contralateral provisions of American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5) (Chapter 16.4) and the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021 (Chapter 2.20) as his finding  was based on a consequential condition that had not been alleged; Held – MA doing no more than he was required to by the terms of both guidelines; causation a legitimate finding in these circumstances; Bindah v Carter Holt Harvey Woodproducts Australia Pty Ltd applied; MAC confirmed.

Decision date: 9 September 2025 | Panel Members: Member John Wynyard, Dr Drew Dixon, and Dr Margaret Gibson | Body system: Right Upper Extremity, Right Lower Extremity, Lumbar Spine, and Cervical Spine

Musgrave v State of New South Wales (NSW Police Force) [2025] NSWPICMP 693

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the ratings the Medical Assessor (MA) made of the appellant’s impairment in all psychiatric impairment rating scale (PIRS) categories accorded with the evidence and whether the Medical Assessor (MA) had focused on sufficient matters regarding the appellant’s function so as to be able to rate the appellant’s function in all domains; Held – the MA obtained a sufficient history to be able to rate the appellant’s impairment and had regard to the relevant evidence; there was no demonstrable error in the MAC and the MA made his assessment based on the correct criteria; MAC confirmed.

Decision date: 10 September 2025 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Dr Ash Takyar | Body system: Psychological/Psychiatric

Ajaka v APG & Co Pty Ltd ATF Beaujolais Unit Trust [2025] NSWPICMP 694

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); injury to cervical spine, thoracic spine, right upper extremity, left upper extremity, and skin (scarring); claim for permanent impairment; Medical Assessor (MA) certified that worker had not reached maximum medical improvement (MMI) because of possible further treatment; worker appealed; Held – error found because MA failed to identify what the possible further treatment was and there was no evidence that the worker was having any more than physiotherapy, hydrotherapy, and muscle manipulation; re-examination considered necessary in the circumstances of error; MAC revoked.

Decision date: 10 September 2025 | Panel Members: Member Jane Peacock, Dr James Bodel, and Dr Timothy Anderson | Body system: Cervical Spine, Thoracic Spine, Left Upper Extremity, and Right Upper Extremity

Camilleri v All Castle Homes Pty Ltd [2025] NSWPICMP 695

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); injury to right and left extremities; claim for permanent impairment; Medical Assessor (MA) assessed fair result for knee replacements at 20% whole person impairment (WPI) for each lower extremity about which there was no complaint on appeal; MA deducted two-thirds under section 323 which was the subject of the appeal by the worker; MA exercised his clinical judgment in making a deduction of two-thirds to account for the contribution of the pre-existing conditions, injury, or abnormality of the knees to the overall level of permanent impairment assessed (based on a fair result for the knee replacements); path of reasoning can clearly be followed and is consistent with the available evidence; Held – Appeal Panel could discern no error; MAC confirmed.

Decision date: 10 September 2025 | Panel Members: Member Jane Peacock, Dr James Bodel, and Dr Tommasino Mastroianni | Body system: Left Lower Extremity, and Right Lower Extremity

Amcha v Roads and Maritime Services [2025] NSWPICMP 696

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under four of the psychiatric impairment rating scale (PIRS) categories (self-care and personal hygiene, social and recreational activities, travel, concentration, persistence and pace, and employability); Held – Appeal Panel considered that the Medical Assessor’s (MA) path of reasoning was inadequate; it was not clearly discernible from the reasons given in the MAC that the assessments under the contested PIRS categories were based upon the correct criteria and whether the MA had discounted impairment on the basis of a physical disorder and/or medication side effects; re-examination was considered necessary in the circumstances of a finding of error; MAC revoked.

Decision date: 11 September 2025 | Panel Members: Member Jane Peacock, Professor Nicholas Glozier, and Dr Douglas Andrews | Body system: Psychological/Psychiatric

Burcher v CVA Construction & Carpentry Pty Ltd [2025] NSWPICMP 704

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of permanent impairment as a result of laceration with circular saw; referred to Medical Assessor (MA) by consent; MA stated that the incident was inconsistent with the injury and declined to assess whole person impairment (WPI) necessitating re-examination; re-examination findings adopted; Coca- Cola Europacific Partners v Pombinho considered; Held – MAC revoked.

Decision date: 12 September 2025 | Panel Members: Member Catherine McDonald, Dr Tim Anderson, and Dr Drew Dixon | Body system: Left Upper Extremity, and Scarring

Motor Accidents Merit Review Decision

Rasul v Allianz Australia Insurance Limited [2025] NSWPICMR 26

Motor Accident Injuries Act 2017; statutory benefits claim; merit review; costs dispute; other costs and expenses; costs arising from medical assessment matter; occupational therapist report; report alleged to have been obtained solely for medical assessment matter; dispute about whether report reasonable or necessary; costs of report significantly exceeded treatment and care subject of medical assessment matter; proportionality considered; Allianz Australia Insurance Limited v Rymer considered; section 8.10 considered and applied; AAI Limited v Moon considered and applied; Held –costs of report reasonable and necessary however significant portion of report addressed issues outside scope of medical assessment; claimant entitled to recover partial costs of report from insurer under section 8.10.

Decision date: 16 July 2025 | Merit Reviewer: Biana 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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