Legal Bulletin No. 241
This bulletin was issued on 12 December 2025
Issued 12 December 2025
Welcome to the two hundred and forty first 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 Decision
Tamworth Regional Council v Spicer [2025] NSWPICPD 82
Workers compensation; section 11A of the Workers Compensation Act 1987; Canterbury Bankstown Council v Gazi [2019] NSWWCCPD 14 considered and applied; consideration of the term “transfer”; Manly Pacific International Hotel Pty Ltd v Doyle [1999] NSWCA 465 discussed; Held – leave to appeal the Member’s Certificate of Determination of 12 May 2025 is granted; orders 1 and 2 of the Certificate of Determination dated 12 May 2025 are confirmed; orders 3 and 4 of the Certificate of Determination dated 12 May 2025 are revoked; the matter is remitted to Member Burge to be heard and determined in accordance with the reasons in this decision.
Decision date: 3 December 2025 | Before: Acting Deputy President Michael Perry
Motor Accidents non-Presidential Member Decisions
Insurance Australia Limited t/as NRMA Insurance v Bae [2025] NSWPIC 628
Motor Accident Injuries Act 2017; Personal Injury Commission Act 2020 (PIC Act); the claimant suffered injuries caused by a motor vehicle accident; the medical dispute related to whether the claimant sustained a non-threshold physical and/or psychiatric injuries; the claimant was assessed by the PIC as having a non-threshold lumbar spine injury and a non-threshold psychiatric injury; the insurer lodged a review application in respect to the non-threshold physical assessment; Review Panel raised that this application for review should be dismissed noting the unchallenged finding of the non-threshold psychiatric injury assessment; insurer had issued a revised statutory benefits liability notice accepting claimant had a non-threshold injury; insurer’s submission that it may seek a further application on the non-threshold finding of the psychiatric injury speculative and without evidentiary basis; allowing review to proceed contrary to objects of the PIC Act; no medical dispute about the existence of a non-threshold injury; Held – the application to review the medical assessment dismissed as frivolous or otherwise misconceived.
Decision date: 26 September 2025 | Principal Member: Marie Johns
Sim v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 629
Motor Accident Injuries Act 2017; claims made by pillion passenger for statutory benefits and damages; referral to Commission of miscellaneous claims assessment matter; lack of clarity about subject matter of proceedings; preliminary conference held; parties confirmed no issue of liability in statutory benefits claim and damages claim not ready to be assessed; Held – proceedings dismissed under section 54(b) of the Personal Injury Commission Act 2020 on the basis the proceedings were now lacking in substance.
Decision date: 9 October 2025 | Member: Belinda Cassidy
AAI Limited t/as GIO v Meyer [2025] NSWPIC 635
Motor Accident Injuries Act 2017; settlement approval; claimant was working at the time of the accident; claimant is aware no entitlement to future statutory benefits once settlement is approved; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); Held –settlement approved in the amount of $67,000.00; consisting of nil non-economic loss and past economic loss; future economic loss of $67,000.00.
Decision date: 28 November 2025 | Member: Philip Carr
Contarino v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 636
Motor Accident Injuries Act 2017; claimant suffered threshold injuries; claim for surgery outside 12-month period; claimant filed application for medical assessment of treatment dispute; insurer’s application to summarily dismiss application; insurer not liable to pay for the proposed treatment; section 3.28(1)(b); application for medical assessment frivolous; claimant asserted that medical assessment could assist in a non-threshold determination; medical assessment only relevant to dispute between the parties; Owen v Motor Accidents Authority; Held – application frivolous and an abuse or process; application summarily dismissed.
Decision date: 1 December 2025 | Principal Member: John Harris
Sayour v Allianz Australia Insurance Limited [2025] NSWPIC 644
Motor Accident Injuries Act 2017; miscellaneous claims assessment; insurer’s application for review of the amount of statutory benefits that are payable under Division 3.3; insurer does not accept the injury sustained by the claimant was as a result of a motor accident; claimant was a passenger in an Uber motor vehicle being driven by the insured driver who was intoxicated and allegedly driving the motor vehicle in a dangerous and frightening manner; the insured driver was subject to a random breath test which resulted in a BAC reading of 0.86; the claimant alleges he suffered psychological injuries; insurer asserted this was not a single event; claimant cited Galea v Bagtrans Pty Ltd; determined the one trip did not constitute a series of incidents with injury arising gradually; determined the claim does fall within the scope of the Act and the claimant is entitled to statutory payments; Held – decision of the insurer is set aside and determined the claimant is entitled to statutory benefits pursuant to section 3.1.
Decision date: 2 December 2025 | Member: David Ford
Allianz Australia Insurance Limited v Molnar [2025] NSWPIC 646
Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident on government bus; damages to be assessed under Chapter 5 of the Motor Accidents Compensation Act 1999; McTye v Ching Yu Chang by his tutor Leo Alexander Birch; left hand dominant claimant sustained a fracture of left little finger; brief period off work; subsequent return to pre-injury duties; reduced grip strength in left hand; small chance of degenerative changes developing; Held – proposed settlement approved.
Decision date: 2 December 2025 | Senior Member: Brett Williams
Workers Compensation non-Presidential Member Decisions
Valentine v The Royal Australasian College of Physicians [2025] NSWPIC 408
Workers Compensation Act 1987; claim for weekly benefits of compensation 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 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 performance appraisal/discipline; respondent discharged its onus with respect to section 11A; determination made; award for the respondent.
Decision date: 14 August 2025 | Member: Diana Benk
Collison v Genesis Plumbing NSW Pty Ltd [2025] NSWPIC 415
Workers Compensation Act 1987; claim for section 60 expenses; left shoulder surgery; consideration of injury and reasonable necessity of medical and treatment expenses; Diab v NRMA Limited, NSW Local Health District v Iles, South Western Sydney Area Health Services v Edmonds, Makita Australia Pty Ltd v Sprowles, Hancock v East Coast Timber Products Pty Ltd, Australian Conveyor Engineering v Mecha Engineering Pty Limited, Allianz Australia Workers Compensation (NSW) Limited v Qummou and others, Cant v Catholic Schools Office, Rail Services Australia v Dimovski, AV v AW, One Steel Reinforcing Pty Ltd v Sutton, Brambles Industries Limited v Bell, and Krstevska v Fast & Fluid Mgt Australia Pty Ltd considered; Held – applicant sustained an injury to his left shoulder pursuant to section 4(b)(ii); applicant’s employment was the main contributing factor to the applicant’s injury to his left shoulder; surgery is a reasonably necessary medical treatment as a result of the injury to the applicant.
Decision date: 18 August 2025 | Member: Anne Gracie
Clements v Woolworths Group Ltd [2025] NSWPIC 443
Workers Compensation Act 1987; claim for compensation pursuant to section 60 for costs associated with a proposed right knee surgery; whether worker sustained a work injury pursuant to sections 4 and 9A; delay in reporting work related cause for the injury; inconsistent mechanisms of injury described in the evidence; Mason v Demasi, Davis v Council of the City of Wagga Wagga, Watson v Foxman, and Onassis v Vergottis considered; Held – differing accounts as to how the knee injury occurred extremely difficult to reconcile; worker failed to discharge her onus; award for the respondent.
Decision date: 28 August 2025 | Member: Rachel Homan
Busuttil v Ses Mental Health [2025] NSWPIC 631
Workers Compensation Act 1987; work capacity dispute; consideration of definition of suitable employment in section 32A; worker injured when bitten by dog; suffered both a physical and psychological injury; worker had returned to work as an apprentice; whether role of call centre operator suitable employment; medical evidence supported physical capacity; insufficient medical evidence regarding psychological capacity; Held – work capacity decision upheld; interim payment direction declined.
Decision date: 26 November 2025 | Member: Diana Benk
Laphos v All-Scale Tree & Garden Services Pty Ltd [2025] NSWPIC 632
Workers Compensation Act 1987; claim for costs of and incidental to lumbar decompression surgery and therapy pursuant to section 60; accepted lumbar injury; whether pathology at lumbar spine sufficient to warrant surgical intervention; whether injury materially contributed to need for treatment of obstructive sleep apnoea; Held – applicant discharged onus of demonstrating that surgery is reasonably necessary; while congenital or pre-existing conditions were likely to be the predominant cause of the sleep apnoea the injury made the condition overt and severe thereby necessitating treatment.
Decision date: 26 November 2025 | Member: Rachel Homan
Workers Compensation Act 1987; claim for benefits in respect of the death of a worker; determination as to whether the worker left persons dependent for support on her; consideration of statement evidence, claim correspondence, and factual material; Held – no persons dependent for support on the worker at the date of her death; respondent liable to pay the amount of $834,200 in accordance with section 25(1)(a); amount to be paid to the applicant (as the legal personal representative of the worker) in accordance with section 32.
Decision date: 27 November 2025 | Member: Gaius Whiffin
Kobilarov v Kellogg (Aust) Pty Ltd [2025] NSWPIC 634
Workers Compensation Act 1987; work capacity decision regarding the applicant’s ability to perform suitable work followed by denial of liability on basis that the applicant did not satisfy criteria in section 38; vocational assessment and labour market analysis reports inconsistent with medical evidence; Mid North Coast Local Health District v De Boer, and Wollongong Nursing Home Pty Ltd v Dewar discussed and applied; Held – applicant had no current work capacity; award of weekly compensation.
Decision date: 28 November 2025 | Principal Member: Glenn Capel
Meyer v SMYC Pty Ltd [2025] NSWPIC 637
Workers Compensation Act 1987; section 60; reasonably necessary; Murphy v Allity Management Services Pty Ltd, Rose v Health Commission (NSW), Bartolo v Western Sydney Area Health Service, and Diab v NRMA Limited cited and applied; Held – the L4/5 and L5/S1 laminectomy, discectomy, and PLIF fusion (two level) surgery proposed is not within the meaning of section 60 as a result of the accepted injury; there is an award for the respondent in respect to the costs of and incidental to the L4/5 and L5/S1 laminectomy, discectomy, and PLIF fusion (two level) surgery proposed.
Decision date: 1 December 2025 | Member: John Turner
Basham v State of New South Wales (Nepean Blue Mountains Local Health District) [2025] NSWPIC 638
Workers Compensation Act 1987; whether proposed treatment results from accepted injury; section 60; Kooragang Cement Pty Ltd v Bates, and Murphy v Allity Management Services Pty Limited applied; whether proposed treatment reasonably necessary; Diab v NRMA Limited applied; Held – proposed surgery is reasonably necessary as a result of accepted injury.
Decision date: 1 December 2025 | Member: Mitchell Strachan
Bridge v J Hutchinson Pty Ltd [2025] NSWPIC 639
Workers Compensation Act 1987; claim for compensation for medical treatment pursuant to section 60; accepted work injuries to applicant’s lower back and left hip; applicant claimed compensation for cost of future stereotactic guided left L4/5 far lateral foraminotomy; whether the stereotactic guided left L4/5 far lateral foraminotomy was reasonably necessary as a result of the accepted injury; Held – the stereotactic guided left L4/5 far lateral foraminotomy was reasonably necessary as a result of the accepted injury.
Decision date: 1 December 2025 | Member: Karen Garner
Sohail v Serco Australia Pty Ltd [2025] NSWPIC 640
Workers Compensation Act 1987; weekly compensation; medical expenses; undisputed that applicant worker injured lumbar spine at work by way of aggravation to pre-existing disease; respondent employer contends injury has resolved; weekly compensation payments ceased; worker claims symptoms of injury continue and that she has no capacity for work; also claims consequential psychological condition from injury; all disputed by employer; Held – symptoms of lumbar spine injury continuing; no capacity for work due to injury; consequential psychological condition found to have arisen; respondent to pay weekly compensation; also to meet reasonably necessary treatment costs associated with consequential psychological condition.
Decision date: 1 December 2025 | Member: Adam Halstead
Ljubicic v State of New South Wales (Fire & Rescue NSW) [2025] NSWPIC 641
Workers Compensation Act 1987; claim for lump sum compensation for consequential gastrointestinal condition and scarring; whether the gastrointestinal condition was a consequence of treatment of the accepted colorectal injury; Held – the applicant sustained a gastrointestinal condition as a consequence of the right hemicolectomy required to treat the accepted colorectal injury; matter remitted to the President for referral to a Medical Assessor to assess whole person impairment.
Decision date: 2 December 2025 | Member: Fiona Seaton
Berry v Allianz Australia Services Pty Ltd [2025] NSWPIC 642
Workers Compensation Act 1987; claim for weekly compensation and treatment expenses in respect of primary psychological injury; whether employment was the main contributing factor to the injury; whether the injury was wholly or predominantly caused by reasonable action with respect to performance appraisal pursuant to section 11A(1); applicant had a serious, non-work related medical condition requiring time off work; applicant claimed to have an unreasonable or excessive workload on her return to work; performance issues raised; Held – respondent’s expert opinion that the psychological condition was due to stress related to the applicant’s physical illness was not consistent with the contemporaneous treating evidence; while the applicant’s perception of her workload differed from that of her manager, there were real events that were perceived as hostile; the respondent’s expert opinion failed to weigh the contribution of action with respect to performance appraisal; Hamad v Q Catering Ltd applied; awards in favour of applicant.
Decision date: 2 December 2025 | Senior Member: Rachel Homan
Pritchard v Nianah Pty Ltd [2025] NSWPIC 643
Workers Compensation Act 1987; claim for compensation pursuant to section 60 for future medicinal cannabis treatment; accepted injury to the right foot and accepted consequential conditions to the bilateral hips; query past psychosis; risk of the proposed treatment activating psychosis; dispute as to whether the proposed treatment is reasonably necessary as a result of accepted injury; principles in Diab v NRMA Limited, Rose v Health Commission (NSW), Kooragang Cement Pty Ltd v Bates, and Murphy v Allity Management Services Pty Ltd considered and applied; Held – the five-stage cannabinoid treatment proposed is reasonably necessary treatment as a result of the injuries sustained by the applicant in the course of his employment with the respondent within the meaning of section 60; the respondent is to pay for the cost of and ancillary to the five-stage cannabinoid treatment of four months duration proposed.
Decision date: 2 December 2025 | Member: Anthony Scarcella
Motor Accidents Medical Review Panel Decisions
BZI v QBE Insurance (Australia) Limited [2025] NSWPICMP 833
Motor Accident Injuries Act 2017; claimant was injured in a motor vehicle accident; Medical Assessor (MA) certified that the claimant’s injuries to the left hip and left thigh were threshold injuries; a medical dispute arose as to whether the physical injuries sustained were threshold injuries; the claimant sought a review of the medical assessment under section 7.26; the Review Panel conducted an examination and considered the factors contributing to the injury according to section 6.6 of the Motor Accidents Guidelines; Held – MA’s determinations were revoked; the Review Panel determined that the injuries to the claimant’s left hip and left thigh were non-threshold injuries.
Decision date: 29 October 2025 | Panel Members: Member Terence Stern OAM, Dr Drew Dixon, and Dr Tai-Tak Wan | Injury module: Lower Limb
AAI Limited t/as GIO v Zreika [2025] NSWPICMP 936
Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident; a dispute arose as to whether the claimant suffered threshold injuries; Medical Assessor (MA) issued a certificate and determined the mild wedge compression of T11 and T10 showing reduced height and fibromyalgia were caused by the accident; the fibromyalgia was a threshold injury for the purposes of the Act; the wedge compression was a non-threshold injury for the purposes of the Act; the Medical Review Panel conducted its own examination; Held – the Panel determined that the fibromyalgia and mild wedge compression of T11 and T10 showing reduced height were caused by the accident but are threshold injuries; the certificate of the MA was revoked.
Decision date: 27 November 2025 | Panel Members: Member Terence Stern OAM, Dr Les Barnsley, and Dr Sophia Lahz | Injury module: Spine
BQL v Allianz Australia Insurance Limited [2025] NSWPICMP 937
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; threshold injury dispute; psychological injury; claimant passenger in vehicle; claimant child at time of accident; claimant examined; Held – claimant meets the DSM-5-TR criteria for adjustment disorder with mixed anxiety and depressed mood; Review Panel satisfied adjustment disorder caused by the accident; adjustment disorder is defined as a threshold injury for the purposes of the Act; MAC revoked due to different findings about diagnosis however no change to outcome.
Decision date: 27 November 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Thomas Newlyn, and Dr Paul Friend | Injury module: Mental and Behavioural
Murgoska v QBE Insurance (Australia) Limited [2025] NSWPICMP 939
Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) determined the claimant’s whole person impairment (WPI) as a result of the accident was 2%; claimant made an application under section 7.26 of the Act for referral of assessment to the Review Panel; Held – the Review Panel conducted its own examination and found that WPI as a result of injuries sustained in the accident totalled 19%; certificate of MA was revoked.
Decision date: 28 November 2025 | Panel Members: Member Terence Stern OAM, Dr Christopher Canaris, and Dr John Baker | Injury module: Mental and Behavioural
Tyerman v Insurance Australia Limited t/as NRMA Insurance (No 2) [2025] NSWPICMP 940
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant assessed by original Medical Assessor as having 6% whole person impairment (WPI) for major depressive disorder; Held – Review Panel re-examined and arrived at a similar diagnosis of mild major depressive disorder and a WPI of 8%; MAC revoked; new certificate issued.
Decision date: 28 November 2025 | Panel Members: Member Jeremy Lum, Dr Christopher Rikard-Bell, and Dr Himanshu Singh | Injury module: Mental and Behavioural
AAI Limited t/as AAMI v Ahmed [2025] NSWPICMP 941
Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) certified soft tissue injury to lumbar spine was a threshold injury; injury to the right foot and the left foot was not caused by the accident; radial tear of the medial meniscus of the right knee was a non-threshold injury caused by the accident; insurer sought review; Held – test for causation as per Briggs v IAG Limited Trading as NRMA Insurance considered; certificate MA revoked; soft tissue injury to lumbar spine and to both feet (resolved) were threshold injuries; radial tear of the medial meniscus of the right knee was caused by the accident and is a non-threshold injury.
Decision date: 1 December 2025 | Panel Members: Senior Member Susan McTegg, Dr Mohammed Assem, and Dr Shane Moloney | Injury module: Spine, and Lower Limb
Kurt v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 944
Motor Accident Injuries Act 2017; threshold injury dispute; review of Medical Assessment Certificate (MAC); pre-existing history of persistent depressive disorder; original Medical Assessor found psychological injury not caused by the motor accident because there was no new psychiatric diagnosis; Held – Review Panel found aggravation of pre-existing psychological condition caused by the motor accident; Todev v AAI Limited t/as GIO applied; MAC revoked.
Decision date: 4 December 2025 | Panel Members: Member Jeremy Lum, Dr Ronald Gill, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
Waud v BCS Infrastructure Support Pty Ltd [2025] NSWPICMP 560
Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred when assessing the degree of the appellant’s permanent impairment from an injury of hearing loss by excluding the appellant’s hearing loss in his left ear to the extent it exceeded his hearing loss in his right ear; whether MA correct to make a deduction under section 323(1) for damage to appellant’s cochleas that occurred during approximately 4 years of employment in Queensland in the midst of a period of 42-years employment in NSW; whether MA correct to find that appellant did not have severe tinnitus; Held – MA made no error by excluding the appellant’s hearing loss in his left ear to the extent it exceeded his hearing loss in his right ear and by finding the appellant did not have severe tinnitus; the MA erred by making a deduction under section 323(1); MAC revoked.
Decision date: 30 July 2025 | Panel Members: Member Marshal Douglas, Dr Robert Payten, and Dr Henley Harrison | Body system: Hearing Loss
Bellette v Hercules Towing & Salvage Co [2025] NSWPICMP 581
Workplace Injury Management and Workers Compensation Act 1998; appeal from Medical Assessment Certificate (MAC); assessment under the Table of Disabilities; where loss of efficient use of each leg at or above the knee was referred for assessment; whether Medical Assessor erred in failing to take account of restriction in motion and sensory symptoms; Held – error in failing to take account of both; worker examined and assessed by Appeal Panel; MAC revoked and replaced.
Decision date: 7 August 2025 | Panel Members: Member Richard Perrignon, Dr Robert Kuru, and Dr Roger Pillemer | Body system: Back, Right Leg, and Left Leg
Aliprad v Abbey Manufacturing Group Pty Ltd [2025] NSWPICMP 712
Workplace Injury Management and Workers Compensation Act 1998; appeal by worker in relation to Medical Assessor’s (MA) Medical Assessment Certificate (MAC) on the basis of deterioration; the MA has assessed permanent impairment of the lumbar spine and right lower extremity (ankle) totaling 8%; the worker underwent fusion surgery from T10 to S1; Principal Member found a deterioration had occurred and rescinded the certificate of determination that had been issued and finding the appeal was limited to an assessment for threshold purposes of the degree of permanent impairment of the lumbar spine and right lower extremity; Held – Appeal Panel found it could not assess permanent impairment arising from scarring or the thoracic spine as those body systems had not been referred and had not been considered by the original MA; the Appeal Panel revoked the MAC and issued a fresh MAC having assessed the worker as having 29% permanent impairment.
Decision date: 15 September 2025 | Panel Members: Member Josephine Bamber, Dr Alan Home, and Dr Roger Pillemer | Body system: Lumbar Spine, and Right Lower Extremity
Brereton v Care'n GO Incorporated (In Liquidation) [2025] NSWPICMP 829
Workplace Injury Management and Workers Compensation Act 1998; appeal by claimant from 7% assessment for psychological injury; whether Medical Assessor (MA) had applied incorrect criteria in applying section 323; whether whole of the assessment compromised; Held – MA recognised pre-existing ADHD condition but incorporated it in his baseline assessment of concentration, persistence and pace; Coca Cola Europacific Partners API Pty Ltd v Pombinho considered and applied; claimant re-examined; MAC revoked.
Decision date: 28 October 2025 | Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr John Baker | Body system: Psychological/Psychiatric
Davy v State of New South Wales (Ambulance Service of NSW) [2025] NSWPICMP 931
Workplace Injury Management and Workers Compensation Act 1998; appeal from finding that maximum medical improvement not achieved; whether Medical Assessor (MA) failed to consider Chapter 1.16 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4thed 1 March 2021 (the Guidelines); whether deduction remarks erroneous; whether adequate reasons given; Held – MA erred in not applying the tests in Chapter 1.16 and 1.17 of the Guidelines; further error in failing to explain his finding in the light of unanimous expert opinion; El Masri v Woolworths Ltd, and Wingfoot Australia Partners Pty Ltd v Kocak applied; deduction remarks irrelevant and not binding; Cole v Wenaline Pty Ltd applied; appellant re-examined by Appeal Panel; Medical Assessment Certificate revoked.
Decision date: 18 November 2025 | Panel Members: Member John Wynyard, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric
Herd v Qantas Airways Ltd [2025] NSWPICMP 932
Workplace Injury Management and Workers Compensation Act 1998; medical appeal; visual system impairment; worker exposed to toxin on flight; consideration of clause 10.4 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4thed
1 March 2021; need to wear spectacles; whether worker needed to wear spectacles due to injury; consideration of worker’s latent hypermetropia; consideration of dry eyes; impairment in visual system combined with assessments of nervous system and skin; Held – Medical Assessment Certificate revoked.
Decision date: 26 November 2025 | Panel Members: Member Parnel McAdam, Dr Ian Wechsler, and Dr Kerrie Meades | Body system: Visual System, Nervous System, and Skin
State of New South Wales (Mid North Coast Local Area Health District) v Shaw [2025] NSWPICMP 933
Workplace Injury Management and Workers Compensation Act 1998; assessment of the lumbar spine and right lower extremity (hip) with the Medical Assessor (MA) making a deduction of one-tenth pursuant to section 323; appeal on the basis that a deduction of one-tenth was at odds with the evidence and a greater deduction should have been made consistent with the evidence; Appeal Panel satisfied that the MA made a deduction that was consistent with the evidence; Appeal Panel satisfied that the MA provided a path of reasoning that was adequate; Appeal Panel satisfied that the assessment was made on the basis of correct criteria and the Medical Assessment Certificate (MAC) did not contain a demonstrable error; Held – MAC confirmed.
Decision date: 26 November 2025 | Panel Members: Member Carolyn Rimmer, Dr James Bodel, and Dr Alan Home | Body system: Lumbar Spine, and Right Lower Extremity
Kasali v Francies Marine Service Pty Ltd [2025] NSWPICMP 934
Workplace Injury Management and Workers Compensation Act 1998; appeal pursuant to sections 327(3)(c) and (d); assessment of lumbar spine as DRE Lumbar category II on basis that appellant sustained a subsequent injury with the same employer and the surgery was carried out for the subsequent injury; this finding was inconsistent with an assessment of 1% for scarring from the surgery; Appeal Panel satisfied that the inconsistency amounted to a demonstrable error and there was a failure to provide adequate reasons; Appeal Panel obtained worker’s consent for Panel to access online the radiological films; Appeal Panel satisfied that the worker injured both L4/5 and L5/S1 discs in the subject injury and is satisfied that the subsequent injury would not have occurred if the worker had not been in the physical condition caused by the subject injury and any further damage was caused by the subject injury; Appeal Panel assessed DRE Lumbar category III; Held – Medical Assessment Certificate revoked.
Decision date: 26 November 2025 | Panel Members: Member Carolyn Rimmer, Dr Michael Davies, and Dr Tommasino Mastroianni | Body system: Lumbar Spine, and Scarring
Tooth v Kurri Kurri Community Services Ltd [2025] NSWPICMP 935
Workplace Injury Management and Workers Compensation Act 1998; the appellant submits that the Medical Assessor erred in finding that the appellant had reached maximum medical improvement (MMI); appellant had several hospital admissions this year and was an inpatient at the time of the assessment; having been admitted, acutely unwell, only one day previously; appellant has “intense suicidal thoughts”; as a matter of procedural fairness it is appropriate that she be re-examined when MMI is achieved; Held – Medical Assessment Certificate revoked; it is not appropriate to issue a new Medical Assessment Certificate at this time.
Decision date: 27 November 2025 | Panel Members: Member Deborah Moore, Dr Michael Hong, and Dr Graham Blom | Body system: Psychological/Psychiatric
Secretary, Department of Education v Uzunovska [2025] NSWPICMP 942
Workplace Injury Management and Workers Compensation Act 1998; assessment of impairment resulting from psychiatric injury; appeal by employer against the failure of the Medical Assessor (MA) to make a deduction pursuant to section 323 and the assessments in the psychiatric impairment rating scale (PIRS) scales of social and recreational activities and travel; Appeal Panel held that the MA’s determination not to make a deduction pursuant to section 323 was not at odds with the evidence and he did not fail to consider relevant information; Appeal Panel held that there was an error in the assessments of the PIRS scales of social and recreational activities and travel as the MA failed to take into account overseas travel; respondent worker re-examined; the assessment of total permanent impairment by the Appeal Panel was the same as that made by the MA; Held – Medical Assessment Certificate confirmed.
Decision date: 1 December 2025 | Panel Members: Member Carolyn Rimmer, Dr Graham Blom, and Dr Ash Takyar | Body system: Psychological/Psychiatric
Denshire v Goodwood Constructions NSW Pty Ltd [2025] NSWPICMP 943
Workplace Injury Management and Workers Compensation Act 1998; appellant suffered a rupture of his right knee ACL on three separate occasions while at work with the respondent; appellant described his injury as being a personal injury to his right knee having occurred on the first and last of those occasions; referral to Medical Assessor (MA) detailed the date of the last occasion as the date of injury; MA made a deduction of 50% under section 323(1) for the proportion of the appellant’s permanent impairment that was due to the ACL rupture the appellant suffered on the first occasion; whether the MA erred by doing so; whether the pathology of the injury the appellant suffered on each occasion was the same; whether section 322(2) required the MA to assess the appellant’s impairment from the injury he suffered on each occasion together; Held – Appeal Panel held the MA erred and should have assessed the appellant’s impairment arising from each incident together in accordance with section 322(2) because the pathology of the injury was the same, being a rupture of the ACL of his right knee.
Decision date: 1 December 2025 | Panel Members: Member Marshal Douglas, Dr Doron Sher, and Dr Tommasino Mastroianni | Body system: Right Lower Extremity, and Scarring
Motor Accidents Merit Review Decisions
Sheikh v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMR 35
Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about calculation of post-accident earnings for purpose of weekly payments under section 3.7 (second entitlement period); whether post-accident earnings equal or exceed pre-accident weekly earnings (PAWE); whether average weekly post-accident earnings amount can be adopted for the purpose of section 3.7; post-accident earning capacity dispute; jurisdiction of a merit review; medical assessment jurisdiction; Schedule 2(1)(a) and Schedule 2(2)(d); Held – the reviewable decision is remitted back to the insurer.
Decision date: 1 December 2025 | Merit Reviewer: Katherine Ruschen
Davoudi v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMR 36
Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about calculation of pre-accident weekly earnings (PAWE); clause 4(1); cash earnings; burden of proof; evidentiary burden; Held – the reviewable decision is set aside.
Decision date: 3 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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