Legal Bulletin No. 216
This bulletin was issued on 20 June 2025
Issued 20 June 2025
Welcome to the two hundred and sixteenth 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.
Motor Accidents non-Presidential Member Decisions
BVV v QBE Insurance (Australia) Limited [2025] NSWPIC 158
Motor Accident Injuries Act 2017; claim for statutory benefits; insurer’s denial of liability for ongoing benefits under sections 3.11 and 3.28; claimant’s application under Schedule 2(3)(d) and (e); claimant experienced hypoglycaemic episode while driving causing accident; insurer alleged claimant demonstrated symptoms before driving and that he knew or ought to have known dangers of driving while having these symptoms; claimant denied previous hypoglycaemic episodes; issues about where the accident happened, what the claimant had eaten, whether he was fasting and how long he had diabetes; Held – claimant not wholly or mostly at fault; claimant knew or ought to have known of relationship between food, blood sugar levels and risks of driving with diabetes; no contributory negligence due to absence of medical evidence about symptoms, disease management, diet, fasting, and warning signs; AAI Limited t/as Evic applied (approach to wholly or mostly dispute); Insurance Australia Limited t/as Richards followed (onus of proof); Australian Broadcasting Tribunal v Bond followed (drawing inferences).
Decision date: 17 April 2025 | Member: Belinda Cassidy
QBE Insurance (Australia) Limited v Hanang [2025] NSWPIC 226
Motor Accident Injuries Act 2017; settlement approval under section 6.23; claimant self-represented; claimant suffered an undisplaced fracture through the upper sternum without haematoma; claimant made a substantial recovery within a reasonably short period; insurer assessed past economic loss at $9,000.00 including superannuation; allowed $1,081.00 for Fox v Wood and $11,200.00 as a buffer for potential future economic loss although such loss seemed unlikely; total settlement in the sum of $21,881.00 proposed; Held – settlement approved as just, fair and reasonable and within the range of likely outcomes.
Decision date: 26 May 2025 | Member: Michael Inglis
Workers Compensation non-Presidential Member Decisions
Hawat v FLH NSW Pty Ltd [2025] NSWPIC 251
Workers Compensation Act 1987; sections 66 and 65A; claim for lump sum compensation for a primary psychological injury; accepted physical injury of severe tinnitus and secondary psychological injury; late onset of symptoms and diagnosis of post-traumatic stress disorder (PTSD); Patrech v State of New South Wales, and RSL (QLD) War Veterans’ Homes Ltd v Watkins considered and applied; Held – applicant sustained a primary psychological injury in the course of his employment with the respondent; matter remitted to the President for referral to a Medical Assessor for assessment of whole person impairment pursuant to section 66.
Decision date: 4 June 2025 | Member: Kathryn Camp
Shlimon v Steric Pty Ltd [2025] NSWPIC 252
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); relevant date of injury for lump sum claim where further disease injury in same employment; Haddad v The GEO Group Australia Pty Ltd, and Ozcan v Macarthur Disability Services Ltd considered; Held – where later injury augmented impairment resulting from initial injury monetary value of entitlement to compensation to be assessed on initial date of injury.
Decision date: 4 June 2025 | Member: Mitchell Strachan
Cowley v Builders Trade Centre (NSW) Pty Ltd [2025] NSWPIC 253
Workers Compensation Act 1987; section 11A(1) and section 33; psychological injury; whether injury sustained “wholly or predominantly” as a result of action by the respondent in respect to “performance appraisal” and/or “discipline”; whether the respondent’s actions were “reasonable”; whether the applicant had suffered incapacity as a result of the psychological injury; cases cited; Pirie v Franklins Ltd, Department of Education and Training v Sinclair, Fitzgerald JA in Manly Pacific International Hotel Pty Ltd v Doyle, Kooragang Cement Pty Ltd v Bates, Northern NSW Local Health Network v Heggie, Dunn v Department of Education and Training, Irwin v Director-General of Education, Ivanisevic v Laudet Pty Ltd, and Melder v Ausbowl Pty Ltd; Held – applicant has no current work capacity and has not had any current work capacity since the date from when weekly compensation is claimed; respondent has not satisfied its onus of establishing the defence under section 11A(1).
Decision date: 4 June 2025 | Member: John Turner
Mirsad Transport Pty Ltd v Singh & Ors [2025] NSWPIC 254
Workers Compensation Act 1987; claim for benefits in respect of the death of a worker; apportionment of lump sum payable under section 25(1)(a); consideration of respondents’ (dependants’) statutory declarations and other statutory declarations/statement evidence, claim correspondence, and factual material; consideration of who was dependent for support on the worker at the date of his death; consideration of appropriateness of apportionment agreed between the parties; Held – no other persons but the first and second respondents were dependent for support on the worker at the date of his death; the third respondent was not dependent for support on the worker at the date of his death; apportionment of the lump sum under section 25(1)(a) as agreed between the parties approved; awards entered in relation to the first and second respondents.
Decision date: 4 June 2025 | Member: Gaius Whiffin
Cadden v Prestige Racehorse Transport Pty Ltd [2025] NSWPIC 255
Permanent impairment compensation; whether applicant suffered injury to his sciatic nerve in addition to accepted work-related injuries to his right upper and right lower extremities; whether applicant also suffered complex regional pain syndrome (CRPS); whether an injury to the applicant’s right sciatic nerve forms part of the injury to the right lower extremity; Held – applicant suffered injury to his right sciatic nerve which will therefore form part of the referral for medical assessment of the right lower extremity; (by consent) the question of whether the applicant meets the criteria for CRPS is properly a matter for a Medical Assessor (MA) to consider; matter remitted to the President for referral to a MA to determine the permanent impairment of the applicant’s right lower extremity and right upper extremity.
Decision date: 5 June 2025 | Member: Cameron Burge
Briggs v HammondCare [2025] NSWPIC 256
Workers Compensation Act 1987; claim for lump sum compensation in respect of a psychological injury; injury in the nature of an aggravation of a disease accepted; worker dismissed during probationary period following performance management; whether injury wholly or predominantly due to reasonable action with respect to discipline, performance appraisal and/or discipline pursuant to section 11A(1); meaning of “discipline” and “performance appraisal”; Held – respondent discharged its onus pursuant to section 11A(1); award for the respondent.
Decision date: 6 June 2025 | Member: Rachel Homan
Akbawy v Hays Specialist Recruitment (Australia) Pty Ltd [2025] NSWPIC 257
Workers Compensation Act 1987; claim for weekly payments including disputed consequential conditions and capacity; Moon v Conmah Pty Limited, Kumar v Royal Comfort Bedding Pty Ltd, Kooragang Cement Pty Limited v Bates considered; Held – two of three claimed consequential conditions resulted from undisputed injury; third not established; award in favour of applicant for claimed weekly compensation.
Decision date: 10 June 2025 | Member: Michael Wright
White v Patrick Stevedores Holdings Pty Ltd [2025] NSWPIC 258
Workplace Injury Management and Workers Compensation Act 1998; section 4; whether applicant a ‘worker’; employment disputed by respondent; sufficiency of evidence; whether employment established; whether respondent was employer; Held – evidence not sufficient to establish the respondent was employer; not established applicant was employed by the respondent; award for the respondent.
Decision date: 10 June 2025 | Member: Adam Halstead
Motor Accidents Medical Review Panel Decisions
Gordian RunOff Ltd v Alabasinis [2025] NSWPICMP 308
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); degree of permanent impairment dispute; claimant developed psychological symptoms following the subject accident; claimant had an extensive pre-accident history including significant musculo-skeletal complaints arising from previous work injuries; Medical Assessor (MA) certified 11% whole person impairment (WPI) for various musculo-ligamentous and musculo-skeletal injuries after allowing for pre-existing impairments; Review Panel gave close and detailed consideration to the claimant’s presentation upon examination and all of the medical evidence; Review Panel explains why its findings differ to those of the MA and the claimant’s IMEs; Held – Review Panel finds 7% WPI; no matters of principle; MAC revoked.
Decision date: 6 May 2025 | Panel Members: Member Gary Victor Patterson, Dr Michael Couch, and Dr Mohammed Assem | Injury module: Spine, Upper Limb, and Lower Limb
AAI Limited t/as AAMI v Tassone [2025] NSWPICMP 397
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant was injured in a motor vehicle accident; Medical Assessor (MA) issued a certificate assessing 12% whole person impairment (WPI); a medical dispute arose as to total WPI; insurer sought a review of the MAC under section 7.26; Review Panel conducted an examination and considered the factors contributing to the injury according to clause 6.6 of the Motor Accident Guidelines; MAC revoked; Review Panel substituted the determination that the claimant sustained WPI of 11%.
Decision date: 5 June 2025 | Panel Members: Member Terence Stern OAM, Dr Shane Moloney, and Dr Mohammed Assem | Injury module: Upper Limb, Lower Limb, and Minor Skin
AAI Limited t/as AAMI v BTG [2025] NSWPICMP 399
Motor Accident Injuries Act 2017; insurer’s review of Medical Assessment Certificate (MAC) under section 7.26; threshold injury dispute; psychiatric injury; claimant wished to withdraw from proceedings and did not want to pursue claim; insurer wished to proceed; assessment undertaken on the papers; Held – claimant sustained an adjustment disorder and did not satisfy criteria for other possible diagnoses raised by health practitioners (post-traumatic stress disorder (PTSD), somatic symptom disorder, major depressive disorder); adjustment disorder is a threshold injury; MAC revoked.
Decision date: 5 June 2025 | Panel Members: Member Belinda Cassidy, Dr Wayne Mason, and Dr Alan Doris | Injury module: Mental and Behavioural
Kwarteng v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 404
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); degree of permanent impairment dispute; claimant’s IME found 21% whole person impairment (WPI) (although not stabilised); insurer’s IME found that the claimant’s minor injuries were transient, there was no assessable impairment, and that the claimant was motivated by financial gain; Medical Assessor (MA) found 5% WPI for the right shoulder assessed by analogy due to inconsistencies; the Review Panel thought it appropriate to assess by range of motion method as satisfied that claimant was making her best efforts; Held – Review Panel found 12% WPI for right upper extremity; no assessable impairment found in uninjured left shoulder; MAC revoked.
Decision date: 6 June 2025 | Panel Members: Member Gary Victor Patterson, Dr Christopher Oates, and Dr Michael Couch | Injury module: Spine, and Upper Limb
Allianz Australia Insurance Limited v Theobald [2025] NSWPICMP 412
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); permanent impairment dispute; claimant was a pedestrian in a parking lot when she was hit by a car and her left foot was trapped under the car tyre; Medical Assessor assessed 11% whole person impairment (WPI) comprising of left ankle fusion, left hindfoot fusion, and left fourth and fifth toe fractures and surgical scarring; Held – Review Panel found 5% WPI to the lumbar spine due to dysmetria, left hindfoot arthrodesis 4% WPI, stiffness in lesser toes 2% WPI and surgical scarring 1% WPI; Review Panel found the left ankle fusion to be related to an old fracture which was not aggravated by the motor accident; total WPI was 12%; MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Thomas Rosenthal | Injury module: Spine, and Lower Limb
QBE Insurance (Australia) Limited v Tregear [2025] NSWPICMP 413
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury; lumbar spinal injury; cervical spine; C5/6 septa infusion; radiological scans identify cervical disc bulge; ongoing imaging; radiculopathy; disc protrusion at C5/6 level with irritation on the right C6 nerve root; significance of examination history; radiological imaging support claimant contention; vocal spinal discectomy and fusion; reasonable and necessary; non-threshold injury; Held – MAC confirmed.
Decision date: 11 June 2025 | Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Drew Dixon | Injury module: Spine, Upper Limb, and Lower Limb; Treatment Type: Surgery and Medical Specialist Consultation
QBE Insurance (Australia) Limited v Tregear (No 2) [2025] NSWPICMP 414
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); cervical spinal injury; C5/disc bulge with some thecal sac; ongoing pain and discomfort; mild to moderate degenerative changes in cervical spine; neurogenic headaches; persistent headache attributed to whiplash; need for specific targeted therapy; Held – neurosurgical review reasonable and necessary; MAC confirmed.
Decision date: 11 June 2025 | Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Drew Dixon | Injury module: Spine, Upper Limb, and Lower Limb; Treatment Type: Surgery and Medical Specialist Consultation
Workers Compensation Medical Appeal Panel Decisions
BTN v Secretary, Department of Education [2025] NSWPICMP 315
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 one of the psychiatric impairment rating scale (PIRS) categories (travel) as well as error in applying a deduction under section 323 of two-tenths; Held – Appeal Panel found error in respect of the assessment of travel; Appeal Panel found error in the making of a deduction of two-tenths and found it should have been limited to one-tenth as the impairment from the pre-existing condition was too difficult to assess; MAC revoked.
Decision date: 6 May 2025 | Panel Members: Member Jane Peacock, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Mazan v State of New South Wales (NSW Police Force) [2025] NSWPICMP 393
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appellant submits that the Medical Assessor erred in his whole person impairment (WPI) assessment of two of the categories of the psychiatric impairment rating scale (PIRS) namely social and recreational activities and employability; Held – no error with the assessment for social and recreational activities; error regarding employability; no need to revoke the MAC as the WPI remains the same.
Decision date: 4 June 2025 | Panel Members: Member Deborah Moore, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Pang v IBM Australia Ltd [2025] NSWPICMP 394
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of primary psychological injury; worker appealed assessments in the scales of concentration, persistence and pace and employability; Held – no error in assessment of concentration, persistence and pace; Medical Assessor erred in assessment of employability; MAC revoked.
Decision date: 4 June 2025 | Panel Members: Member Carolyn Rimmer, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) correctly applied the guidelines to determine whether respondent had radiculopathy; whether MA erred by finding the respondent had radiculopathy; Held – Appeal Panel found the MA made no error in finding the respondent had radiculopathy; MAC confirmed.
Decision date: 5 June 2025 | Panel Members: Member Marshal Douglas, Dr Roger Pillemer, and Dr Tim Anderson | Body system: Cervical Spine, and Left Upper Extremity
Leahey v Breona Residential Services Inc [2025] NSWPICMP 396
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); medical appeal; worker employed as a support worker; MAC certified worker as not having reached maximum medical improvement (MMI); further MAC assessed impairment; challenge to assessment made under the psychiatric impairment rating scales (PIRS); social and recreational activities, travel, and employability challenged; Held – MAC confirmed.
Decision date: 5 June 2025 | Panel Members: Member Parnel McAdam, Dr Michael Hong, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Corbett v Anglicare NSW South, NSW West & ACT [2025] NSWPICMP 405
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; need for mental state examination in MAC; re-examination; Held – MAC revoked.
Decision date: 6 June 2025 | Panel Members: Member Catherine McDonald, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric
Sydney Trains v Williams [2025] NSWPICMP 406
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by not making a deduction under section 323(1); what was the nature of the injury the subject of the medical dispute; what is the relevant date at which a pre-existing condition must exist; Held – Appeal Panel found MA erred by not engaging section 323(1); MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member Marshal Douglas, Dr Drew Dixon, and Dr Tommasino Mastroianni | Body system: Cervical Spine
Windley v Dowpac Pty Ltd [2025] NSWPICMP 407
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of bilateral elbow fractures; reference to opinions of other examiners; State of New South Wales v Kaur considered; Held – MAC confirmed.
Decision date: 10 June 2025 | Panel Members: Member Catherine McDonald, Dr Todd Gothelf, and Dr Christopher Oates | Body system: Right Upper Extremity, Left Upper Extremity, and Scarring (TEMSKI)
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; worker claims demonstrable errors in assessment of four of the psychiatric impairment rating scale (PIRS) categories (self care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace); employer claims demonstrable error in category of employability; reference to Ferguson v State of NSW, and Jenkins v Ambulance Service of NSW; Held – demonstrable error in assessment of travel; demonstrable error in assessment of employability; MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member John Isaksen, Dr Michael Hong, and Dr John Baker | Body system: Psychological/Psychiatric
Smith v Brambles Industries Ltd [2025] NSWPICMP 409
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of the neck and left arm; worker appealed in respect of the deduction under section 323; Held – error found in respect of the left arm as the Medical Assessor deducted the prior award for the subject injury; error found in respect of the deduction made in respect of the neck as no clinical or radiological history to support a condition that pre-existed the subject injury; MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member Jane Peacock, Dr Roger Pillemer, and Dr David Crocker | Body system: Neck, and Left Arm (Shoulder)
Toong v Pegasus Print Group Pty Ltd [2025] NSWPICMP 410
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); Medical Assessor (MA) found no sensory loss in left wrist due to subject injury and attributed cause of sensory loss to an unrelated injury; Appeal Panel considered that MA failed to adequately document the sensory changes and take into account clinical notes of general practitioner and applicant’s evidence; Appeal Panel found that the reasoning process was not adequately made out; worker re-examined; Held – MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member Carolyn Rimmer, Dr Drew Dixon, and Dr Margaret Gibson | Body system: Upper Left Extremity, and Scarring (TEMSKI)
Carter v Kids Academy Springfield [2025] NSWPICMP 411
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 three of the psychiatric impairment rating scale (PIRS) categories namely self care and personal hygiene, social and recreational activities, and social functioning; Held – Appeal Panel found error in the category of self care and personal hygiene; MAC revoked.
Decision date: 10 June 2025 | Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr John Lam Po Tang | Body system: Psychological/Psychiatric
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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