Legal Bulletin No. 227
This bulletin was issued on 5 September 2025
Issued 5 September 2025
Welcome to the two hundred and twenty seventh 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
Mahroei v QBE Insurance (Australia) Limited [2025] NSWSC 976
Administrative law; Personal injury tribunal; Personal injury; Hearing Rule; Disclosure; Potential adverse findings; Adequacy of reasons; Held – the plaintiff’s summons filed 21 August 2024 is dismissed; the plaintiff is to pay the first defendant’s costs.
Decision date: 28 August 2025 | Before: Harrison AsJ
Motor Accidents non-Presidential Member Decisions
AAI Limited t/as GIO v CXA [2025] NSWPIC 265
Motor Accident Injuries Act 2017; section 6.23; claimant self-represented; claimant sustained serious injuries as a result of a motor accident including a pulmonary laceration, right pneumothorax, displaced manubrium fracture, rib fractures, intra-abdominal free fluid, small bowel injury, left comminuted displaced olecranon fracture, left displaced humeral fracture, left proximal phalanx fracture first toe, T-12/L1 fracture, grade 1 splenic laceration, and atrial flutter; claimant had made a substantial recovery enabling her to return to golf at 80 years of age; residual symptoms included some psychological disturbance pain in and around the abdominal area and intermittent pain but with a constant dull ache in the left arm; liability admitted; Held – settlement of $180,000.00 representing non-economic loss only approved as just, fair, and reasonable and within the range of likely outcomes.
Decision date: 13 June 2025 | Member: Michael Inglis
AAI Limited t/as AAMI v Herft [2025] NSWPIC 432
Motor Accident Injuries Act 2017; settlement approval; claimant was injured in a motor vehicle accident; claimant was not working at the time of the accident and in receipt of the aged pension; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); Held –settlement approved in the amount of $325,000; consisting of non-economic loss; nil past economic loss and future economic loss.
Decision date: 27 August 2025 | Member: Philip Carr
Choi v QBE Insurance (Australia) Limited [2025] NSWPIC 433
Motor Accident Injuries Act 2017; claimant was injured in a motor vehicle accident; claim for removalist expenses; referred as a miscellaneous claims dispute under Schedule 2, clause 3(n) to determine whether there is any liability for the services in dispute on the basis they meet the definition of “treatment and care”; Held – removalist expenses do not constitute everyday tasks; insurer’s liability for statutory benefits does not extend to the claim for removalist expenses where it does not constitute treatment and care within section 1.4.
Decision date: 27 August 2025 | Senior Member: Susan McTegg
Workers Compensation non-Presidential Member Decisions
Hackett v Chatswood RSL Club [2025] NSWPIC 421
Workers Compensation Act 1987; application to set aside work capacity decision; not satisfied that applicant had capacity to work 30 hours a week when struggling to work 25 hours in current employment; not satisfied that applicant’s secondary psychological condition was taken into account; found that applicant could not work in management role; Held – work capacity decision is set aside.
Decision date: 20 August 2025 | Member: Carolyn Rimmer
Westhorpe v Eastern Australia Airlines Pty Ltd t/as QantasLink [2025] NSWPIC 423
Workers Compensation Act 1987; claim for bilateral hearing aids; whether applicant sustained noise induced hearing loss; whether employment caused a loss of hearing pursuant to section 17; Held – applicant’s expert evidence preferred; compensable injury pursuant to section 17; treatment reasonably necessary pursuant to section 60; award for the costs of supplying and fitting binaural digital hearing aids in accordance with the current Workers Compensation (Hearing Aid Fees) Order.
Decision date: 21 August 2025 | Member: Diana Benk
Taylor v John Thompson Racing [2025] NSWPIC 424
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for lump sum compensation pursuant to section 66 of the 1987 Act; whether bilateral knee and left shoulder injuries arose from the nature and conditions of employment with the respondent employer; late notice of injury; section 254 of the 1998 Act considered on special circumstances; late claim for compensation made more than three years after injury; section 261 of the 1998 Act considered on whether serious and permanent disablement in relation to knees; Held – special circumstances for late claim established; insufficient medical evidence to support finding of serious and permanent disablement for knee injury; also insufficient medical evidence to support claim for knee injury; claim for left shoulder impairment below greater than 10% threshold; no basis for referral to medical assessor for left shoulder; award for the respondent.
Decision date: 21 August 2025 | Member: Adam Halstead
Jradi v Securecorp Protective Services Pty Ltd [2025] NSWPIC 425
Workplace Injury Management and Workers Compensation Act 1998; applicant seeking lump sum compensation for psychological injury; respondent conceded injury but contested liability on the basis that the applicant had not made a claim for compensation within 6-months of the date of injury (section 261); Held – applicant’s explanation that he misunderstood advice from solicitors as to the need to make a claim was credible and was either ignorance, mistake or other reasonable excuse; respondent’s defence to claim unsuccessful; matter remitted to President for referral to Medical Assessor.
Decision date: 21 August 2025 | Member: Michael Moore
Hasselman v Katoomba Scenic Skyway Pty Ltd [2025] NSWPIC 426
Workers Compensation Act 1987; lump sum claim pursuant to section 66; respondent disputes applicant’s entitlement to lump sum compensation as she already had an assessment of permanent impairment for workplace psychological injury from deemed date of injury of 17 February 2017; applicant asserts she is suffering from a separate psychological injury as a result of being retrenched with a deemed date of injury of 11 July 2018; respondent disputes this is a second injury; Held – applicant has not discharged her onus of proof to establish the claimed injury in absence of evidence from her treating psychologist and treating psychiatrist; award for the respondent.
Decision date: 25 August 2025 | Member: Josephine Bamber
Nicholls v The Professional Pest Controllers Pty Ltd [2025] NSWPIC 427
Workers Compensation Act 1987 (1987 Act);Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for lump sum compensation pursuant to section 66 of the 1987 Act; cervical spine injury undisputed; degree of whole person impairment agreed; late notice of injury; section 254 of the 1998 Act; notice where worker is also director of employer company; knowledge of worker as director relevant to notice; notice requirements and special circumstances provisions considered; late claim for compensation made more than three years after injury; section 261 of the 1998 Act; serious and permanent disablement agreed; whether ignorance or other reasonable cause for late claim; Held – special circumstances for late notice present; exception to claim within six-month time limit not established; failure to claim within that period a bar to recovery; award for the respondent.
Decision date: 25 August 2025 | Member: Adam Halstead
Webber v Charles Sturt University [2025] NSWPIC 428
Workers Compensation Act 1987; claim for lump sum compensation for noise induced hearing loss; whether the respondent was the applicant’s last noisy employer; Held – the applicant has sustained noise induced hearing loss; the respondent was the last noisy employer pursuant to section 17; matter remitted to the President for referral to a Medical Assessor to assess the degree of permanent impairment; applicant entitled to payment of reasonably necessary medical expenses.
Decision date: 25 August 2025 | Member: Fiona Seaton
Motor Accidents Medical Review Panel Decisions
Allianz Australia Insurance Limited v Pate [2025] NSWPICMP 368
Motor Accident Injuries Act 2017; review of single medical assessment; whether injuries caused by the motor accident give rise to a whole person impairment (WPI) greater than 10%; evidence suggests presence of pre-existing shoulder issues; delay in reporting shoulder symptoms after the accident; re-examination took place; no inconsistencies noted; claimant explained delay in reporting symptoms of shoulder due to taking of analgesics; Held – found 7% WPI for right shoulder, 2% scarring, and 0% cervical spine (DRE category I); 9% total WPI; certificate revoked and new certificate issued.
Decision date: 27 May 2025 | Panel Members: Member Elizabeth Medland, Dr David Gorman, and Dr Thomas Rosenthal | Injury module: Spine, and Upper Limb
Kim v Youi Pty Limited [2025] NSWPICMP 628
Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor vehicle accident; MA determined the claimant’s permanent impairment at 10%; the claimant sought a review of the assessment under section 7.26; the Review Panel re-examined the claimant; Review Panel revoked certificate of MA; substituted determination of 12% whole person impairment.
Decision date: 21 August 2025 | Panel Members: Member Terence Stern OAM, Dr Matthew Jones, and Dr Ronald Gill | Injury module: Mental and Behavioural
Nicolaou v Allianz Australia Insurance Limited [2025] NSWPICMP 633
Motor Accident Injuries Act 2017; medical review of certificate of Medical Assessor (MA); claimant suffered injury in an accident; the dispute related to the assessment of whole person impairment (WPI) of ear, nose, throat and related structures (hearing impairment and equilibrium vestibular impairment); MA found no hearing loss caused by the accident; accident did cause tinnitus but not assessable in absence of hearing loss caused by accident; no objective findings of vestibular impairment; MA assessed 0% WPI; Held – hearing loss not caused by accident; tinnitus caused by accident; no evidence of vestibular dysfunction; claimant suffers from vestibular migraine; certificate of MA affirmed.
Decision date: 22 August 2025 | Panel Members: Senior Member Susan McTegg, Dr Thandavan Raj, and Dr Sophia Lahz | Injury module: Ear, Nose, Throat and Related Structures
Kewin v AAI Limited t/as AAMI & Anor [2025] NSWPICMP 635
Motor Accident Injuries Act 2017; threshold injury dispute; claimant was driving a work vehicle as a courier on the date of injury; Medical Assessor (MA) certified that referred injuries to cervical spine, lumbar spine, left wrist and hand, and right elbow are threshold injuries caused by the subject accident; MA found that injuries to both shoulders were not caused by the accident; bio-mechanical engineering evidence as to mechanism of accident and causation of injuries; Held –Review Panel did not accept claimant’s evidence as to circumstances of accident and mechanism of right elbow injury; Review Panel found accident-related injuries to cervical spine, left wrist and hand are threshold injuries; Review Panel found injuries to the lumbar spine, both shoulders, and right elbow were not caused by subject accident; symptoms likely caused by underlying degenerative conditions; all are otherwise threshold injuries; certificate revoked.
Decision date: 22 August 2025 | Panel Members: Member Gary Victor Patterson, Dr Michael Couch, and Dr Les Barnsley | Injury module: Spine, and Upper Limb
Kairouz v Allianz Australia Insurance Limited [2025] NSWPICMP 641
Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor vehicle accident; MA determined the claimant’s permanent impairment at 5%; the claimant sought a review of the assessment under section 7.26; the claimant was re-examined; Held – Review Panel revoked certificate of MA; substituted determination of 7% whole person impairment.
Decision date: 26 August 2025 | Panel Members: Member Terence Stern OAM, Dr Gerald Chew, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural
Webb v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 642
Motor Accident Injuries Act 2017; whether the claimant’s psychiatric injuries arising out of a motor accident were threshold injuries; review of certificate and reasons of Medical Assessor (MA); MA diagnosed the claimant as having a threshold injury of an adjustment disorder with anxiety and depressed mood after being referred assessment of post-traumatic stress disorder; the Review Panel considered several possible diagnoses and a submission by the insurer that the claimant had not made submissions alleging a specific phobia; Held – the Review Panel concluded that it must examine the claimant and while a diagnosis of post-traumatic stress disorder had been referred it determined that the claimant had suffered a specific phobia of driving which was evidenced in clinical notes and other medical assessments which is a non-threshold injury; certificate and reasons of the MA revoked.
Decision date: 26 August 2025 | Panel Members: Member Alexander Bolton, Dr Paul Friend, and Dr Alan Doris | Injury module: Mental and Behavioural; Treatment Type: Psychological Treatment
Workers Compensation Medical Appeal Panel Decisions
BPM v Co As It Italian Association of Assistance [2025] NSWPICMP 505
Workplace Injury Management and Workers Compensation Act 1998; assessment of primary psychological injury by Medical Assessor (MA); appeal against assessment of two psychiatric impairment rating scale (PIRS) categories (social functioning and employability); Appeal Panel accepted that the MA took an irrelevant consideration into account in assessing social functioning; assessment of social functioning remains the same after considering other descriptors; MA did not adequately explain how he assessed capacity for work; assessment of employability reviewed and assessed as Class 5; Held – Medical Assessment Certificate revoked.
Decision date: 14 July 2025 | Panel Members: Member Carolyn Rimmer, Dr Michael Hong, and Dr Ash Takyar | Body system: Psychological/Psychiatric
Workplace Injury Management and Workers Compensation Act 1998; appeals by both worker and employer against Medical Assessor’s (MA) assessment of impairment in relation to psychiatric and psychological disorders; the MA erred in his assessment of the worker with regard to the psychiatric impairment rating scale (PIRS) categories of ‘self-care and personal hygiene’ and ‘social and recreational activities’; fresh evidence not admitted and worker’s appeal ground based on the availability of additional relevant information failed; Petrovic v BC Serv No 14 Pty Limited & Ors considered; otherwise MA’s assessment found to contain no error as his actual path of reasoning was revealed and his assessment was based on his clinical judgement; Pitsonis v Registrar of the Workers Compensation Commission & Anor, Ferguson v State of New South Wales, Parker v Select Civil Pty Limited, Jenkins v Ambulance Service of New South Wales, Bojko v ICM Property Service Pty Ltd & Ors, Vitaz v Westform (NSW) Pty Ltd, Western Sydney Local Health District v Chan, and Wingfoot Australia Partners Pty Ltd v Kocak; Held – Medical Assessment Certificate confirmed.
Decision date: 21 August 2025 | Panel Members: Member Gaius Whiffin, Dr John Baker, and Dr Ash Takyar | Body system: Psychological/Psychiatric
Daley v State of New South Wales (NSW Police Force) [2025] NSWPICMP 630
Workplace Injury Management and Workers Compensation Act 1998; appeal against Medical Assessor’s (MA) assessment of permanent impairment of the lumbar spine and the left lower extremity (hip); the MA erred in assessing permanent impairment when the appellant was scheduled to have hip replacement surgery in the imminent future; demonstrable error; application of incorrect criteria as the MA did not defer the medical assessment (in accordance with cls 1.15 and 1.16 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); re-assessment required once appellant’s condition had stabilised; re-assessment to consider permanent impairment of the left lower extremity (hip), permanent impairment of the lumbar spine, and any deduction to the assessed impairment findings necessary pursuant to section 323; New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales, Queanbeyan Racing Club Ltd v Burton, Merza v Registrar of the Workers Compensation Commission and Anor, Cole v Wenaline Pty Limited, and Ryder v Sundance Bakehouse considered; Held – Medical Assessment Certificate (MAC) revoked; new MAC unable to be issued at this time pending the stabilisation of the appellant’s condition.
Decision date: 21 August 2025 | Panel Members: Member Gaius Whiffin, Dr Robert Kuru, and Dr Tommasino Mastroianni | Body system: Lumbar Spine, and Left Lower Extremity
JB Hi-Fi Group Pty Ltd v Brewer [2025] NSWPICMP 631
Workplace Injury Management and Workers Compensation Act 1998; whether ratings the Medical Assessor (MA) made of the respondent’s impairment in the psychiatric impairment rating scale (PIRS) categories of self-care and personal hygiene, travel, and social functioning are correct; whether MA based his assessment on correct criteria; Held – MA’s rating of respondent’s impairment in self-care and personal hygiene involved error because the MA had regard to a hypothetical situation rather than the respondent’s function in this domain at the time of assessment; Appeal Panel found no error in the MA’s ratings of the respondent’s impairment in travel and in social functioning; Appeal Panel found MA based his assessment on incorrect criteria; Medical Assessment Certificate revoked.
Decision date: 22 August 2025 | Panel Members: Member Marshal Douglas, Professor Nicholas Glozier, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Hardy Pastoral Company Pty Ltd v Wall [2025] NSWPICMP 636
Workplace Injury Management and Workers Compensation Act 1998; claim for lump sum for binaural hearing loss assessed under Table of Disabilities; appellant asserted assessment made on basis of incorrect criteria and Medical Assessment Certificate (MAC) contained demonstrable error; Medical Assessor applied incorrect deduction for presbycusis; failed to provide workings; Held – error found; re-assessed by Appeal Panel using Medical Assessor’s audiogram; MAC revoked and new MAC issued.
Decision date: 25 August 2025 | Panel Members: Senior Member Kerry Haddock, Dr Henley Harrison, and Dr Thandavan Raj | Body system: Hearing Loss
Rice v ACT Steelworks Administration Pty Ltd [2025] NSWPICMP 637
Workplace Injury Management and Workers Compensation Act 1998; 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 namely self-care and personal hygiene, social functioning, concentration, persistence and pace, and employability; Held – Appeal Panel found error in two domains namely social functioning and concentration, persistence and pace; a re-examination was not considered necessary as there was sufficient material before the Appeal Panel to enable a determination to be made; Medical Assessment Certificate revoked.
Decision date: 25 August 2025 | Panel Members: Member Jane Peacock, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Chesher v Chemico Holdings Pty Ltd [2025] NSWPICMP 638
Workplace Injury Management and Workers Compensation Act 1998; assessment of primary psychiatric injury; appeal against assessment of the psychiatric impairment rating scale (PIRS) classes in respect of self care and personal hygiene, social and recreational activities, and concentration, persistence and pace; Appeal Panel found error in the assessment of self care and personal hygiene, social and recreational activities, and concentration, persistence and pace; worker re-examined; Held – Medical Assessment Certificate revoked.
Decision date: 26 August 2025 | Panel Members: Member Carolyn Rimmer, Dr Michael Hong, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric
Deegan v Central Coast Council [2025] NSWPICMP 639
Workplace Injury Management and Workers Compensation Act 1998; assessment of primary psychiatric injury; appeal against assessment of the psychiatric impairment rating scale (PIRS) classes in respect of social and recreational activities, travel, social functioning and concentration, persistence and pace; Appeal Panel found error in the assessment of social and recreational activities, travel, social functioning and concentration, and persistence and pace; worker re-examined; review and re-examination did not lead to a different result and should not be interfered with (Robinson v Riley); Held – Medical Assessment Certificate confirmed.
Decision date: 26 August 2025 | Panel Members: Member Carolyn Rimmer, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric
Motor Accidents Merit Review Decisions
Schutz v AAI Limited t/as GIO [2025] NSWPICMR 22
Motor Accident Injuries Act 2017; merit review; dispute regarding amount of weekly payments of statutory benefits under section 3.7; claimant self-employed small business owner; late claim; weekly payments limited to second entitlement period; statutory interpretation of section 3.7, AB (a pseudonym) v Independent Broad-Based Anti-Corruption Commission considered and applied; whether calculation of post-accident earnings for the purposes of section 3.7(2) should consider entire financial year; Held – section 3.7(2) requires post-accident earnings to be calculated by reference to earnings after the first entitlement period; there is no basis upon which to base the calculation under section 3.7(2) on the full financial year if that period is not after the first entitlement period; claimant’s entitlement to be calculated accordingly; reviewable decision set aside.
Decision date: 25 August 2025 | Merit Reviewer: Bianca Montgomery-Hribar
This publication is for information only. The publication is not legal advice. The information provided is not a substitute for reading the decisions. The Commission does not accept liability for the information in this publication or for way the information is used.
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