Legal Bulletin No. 233

Issued 17 October 2025

Welcome to the two hundred and thirty second edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.

Presidential Member Decision

Payne v Mercy Hospitals NSW Ltd [2025] NSWPICPD 69

Workers compensation; where there is no foundation for the conclusion reached, there is error of law; Minister for Immigration and Citizenship v SZMDS [2010] HCA 16; Minister for Immigration & Multicultural Affairs v Al-Miahi [2001] FCA 744; Nicolia v Commissioner for Railways (NSW) (1970) 45 ALJR 465; Onesteel Reinforcing Pty Ltd v Sutton [2012] NSWCA 282 applied; where there is a failure to deal with a submission, the submission must be substantial and material to the outcome; Wang v State of New South Wales [2019] NSWCA 263; Day v SAS Trustee Corporation [2021] NSWCA 71 applied; Held – the name of the respondent, wherever necessary, is amended to “Mercy Hospitals NSW Ltd”; the Member’s Certificate of Determination dated 9 April 2025 is revoked; the matter is remitted to a different Member for re-determination.

Decision date: 8 October 2025 | Before: Deputy President Elizabeth Wood

Motor Accidents non-Presidential Member Decisions

AAI Limited t/as AAMI v Delamont [2025] NSWPIC 522

Motor Accident Injuries Act 2017; section 6.23; claimant self-represented; claimant sustained injury as a result of a motor vehicle accident including fracture at the base of the left big toe resulting in synovial thickening with increased vascularity in the first MTP joint; claimant off work for 17 weeks and return to normal duties; past economic loss $11,500.00 ongoing symptoms of pain and discomfort in the foot; claimant able to continue working until normal retirement; buffer for future economic loss $40,000.00; Held – settlement of $51,500.00 approved as just, fair and reasonable and within the range of likely outcomes.

Decision date: 1 October 2025 | Member: Michael Inglis

Singh v QBE Insurance (Australia) Limited [2025] NSWPIC 524

Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether accident caused wholly or mostly by the fault of the claimant for the purposes of section 3.11 and section 3.28; accident occurred when claimant proceeded through traffic lights and collided with the insured who was travelling in the opposite direction; AAI Limited t/as GIO v Evic discussed and followed; Sibley v Kais applied; insurer seeks an order pursuant to section 8.3(4) for its reasonable legal costs to be paid; claimant seeks an order that there are exceptional circumstances that ought ground an order that the insurer pay his reasonable costs pursuant to section 8.10(4)(b); AAI Ltd trading as GIO v Moon discussed and applied; Held – the claimant found to have entered the intersection contrary to a red traffic light and failed to keep a proper lookout; the insured failed to keep a proper lookout; the relative culpability was assessed 80% to the claimant and 20% to the insured; ‘exceptional circumstances’ found justifying an order that the insurer pay the reasonable costs of the claimant including counsel fees and expert fees pursuant to section 8.10(4)(b); the insurer in the circumstances is entitled to its reasonable costs from its client insurer pursuant to section 8.3(4); claimant found to be wholly or mostly at fault.

Decision date: 2 October 2025 | Member: Terrence Broomfield

Gray v QBE Insurance (Australia) Limited [2025] NSWPIC 528

Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether the motor accident was caused wholly or mostly by the fault of the claimant under sections 3.11 and 3.28; claimant was riding his motorcycle travelling behind the insured vehicle; claimant attempted to overtake the insured vehicle at the same time insured vehicle commenced to also change lanes; claimant took evasive action by applying his brakes suddenly resulting in a loss of control and collided with the kerb; claimant dislodged from his motorcycle and sustained serious injuries; fellow motorist operated a dashcam and the footage captured the entire incident; determined the claimant was not wholly or mostly at fault; the degree of the claimant’s contributory negligence assessed at 50%; Held – motor accident not caused wholly or mostly by the fault of the claimant; both the claimant and the insurer are entitled to payment of reasonable and necessary legal costs beyond the regulated amount of legal costs.

Decision date: 7 October 2025 | Member: David Ford

Workers Compensation non-Presidential Member Decisions

Farkoosh v Commercial Skip Pty Ltd & Ors [2025] NSWPIC 523

Workers Compensation Act 1987; claim for weekly compensation and payment of medical expenses; issues of “worker”, injury, and incapacity; Held – applicant was a worker within the meaning of the Act; applicant had suffered injury to lower back with consequential condition of adjustment disorder; award for respondent in respect of other alleged injuries; award under section 37 for a closed period claim; general award under section 60.

Decision date: 1 October 2025 | Member: Michael Moore

Davis v MTEC Mechanical Services Pty Ltd [2025] NSWPIC 525

Workers Compensation Act 1987; claim for proposed spinal surgery; section 60 dispute; causation; factual issues considered; Kooragang Cement Ltd v Bates considered; Held – proposed surgery reasonably necessary as a result of subject injury.

Decision date: 3 October 2025 | Member: Michael Wright

Roustaei v Modern Glass Australia Pty Ltd [2025] NSWPIC 527

Workers Compensation Act 1987; application claimed costs of proposed sacroiliac arthrodesis (fusion); whether applicant sustained sacroiliac joint injury disputed; whether proposed surgery reasonably necessary disputed; Held – the applicant sustained a sacroiliac joint injury as the result of his employment with the respondent; proposed surgery reasonably necessary; respondent to pay the cost of proposed sacroiliac arthrodesis (fusion) at gazetted rates.

Decision date: 7 October 2025 | Member: Fiona Seaton

Motor Accidents Medical Review Panel Decisions

Insurance Australia Limited t/as NRMA Insurance v Awada [2025] NSWPICMP 754

Motor Accident Injuries Act 2017; Personal Injury Commission Rules 2021; review of decision of Medical Assessor (MA) who assessed the claimant as having 18% whole person impairment (WPI) and diagnosed a persistent depressive disorder and a social anxiety disorder; claimant involved in an accident; issue of whether the claimant’s psychiatric disability was affected by his physical injuries and disabilities; claimant examined by the Review Panel following which the insurer sought to rely upon a medical report without having previously sought the claimant’s consent and notifying the Review Panel that the claimant was being medically examined; Review Panel determined that it would not accept the late report in evidence; Review Panel assessed the claimant as having a 7% WPI and diagnosed a persistent depressive disorder with anxious distress; certificate of MA revoked.

Decision date: 5 September 2025 | Panel Members: Member Alexander Bolton, Dr Paul Friend, and Dr Alan Doris | Injury module: Mental and Behavioural

Jones v Allianz Australia Insurance Limited [2025] NSWPICMP 755

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury dispute; psychological injury; claimant passenger on bus; consideration of specific phobia, adjustment disorder, and post-traumatic stress disorder; significant medical history; claimant examined; Held – claimant meets the criteria for specific phobia, situation (bus travel) and adjustment disorder with anxiety; psychological injuries caused by the accident; specific phobia (bus travel) is not a threshold injury; MAC revoked.

Decision date: 5 September 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Paul Friend, and Dr Thomas Newlyn | Injury module: Mental and Behavioural

AAI Limited t/as GIO v Soliman [2025] NSWPICMP 686

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury dispute; psychological injury; issues of causation; claimant examined; Held – claimant meets the criteria for adjustment disorder with anxiety caused by the accident; claimant meets criteria for persistent depressive disorder but this is not caused by the accident; MAC revoked.

Decision date: 9 September 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Wayne Mason, and Dr Surabhi Verma | Injury module: Mental and Behavioural

CBS v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 750

Motor Accidents Compensation Act 1999; review of Medical Assessment Certificate (MAC); claimant was a child of just over 2-years when she was hit and run over by a utility while playing in a car park; her parents were removed by the NSW Department of Community Services and she has since had nine different foster parent placements; claimant had difficulty regulating her emotions in both school and home environments; claimant was diagnosed by original Medical Assessor as having a disruptive mood dysregulation disorder with a 9% whole person impairment (WPI); Review Panel re-examined the now 12-year-old claimant and noted  improvement with special schooling and claimant has more capacity to self-regulate; Review Panel took into account variations in lifestyle due to claimant’s age, schooling, and complex upbringing in accordance with clauses 1.220 of the Motor Accident Permanent Impairment Guidelines; Held – Review Panel diagnosed reactive attachment disorder and disruptive mood dysregulation disorder as a result of the motor accident; Review Panel assessed 17% whole person impairment (WPI) with 2% for treatment effect; MAC revoked; new certificate issued.

Decision date: 30 September 2025 | Panel Members: Member Jeremy Lum, Dr Paul Friend, and Dr Neil Jeyasingam | Injury module: Mental and Behavioural

El Dirany v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 759

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant involved in a head on collision when vehicle in opposite direction veered into his lane; alleged psychiatric injuries as a result of motor accident; original Medical Assessor assessed of 7% whole person impairment (WPI) for persistent depressive disorder with anxious distress with 1% WPI for treatment effect; Review Panel noted pre-existing symptoms from death of brother and unwell mother one year before accident caused increased susceptibility of suffering psychiatric injury but no recognisable diagnosis; motor accident caused persistent depressive disorder; post-traumatic stress disorder no longer present due to passage of time; Held – Review Panel found 5% WPI with 1% WPI for treatment effect; MAC revoked; new certificate issued.

Decision date: 2 October 2025 | Panel Members: Member Jeremy Lum, Dr Gerald Chew, and Dr Ronald Gill | Injury module: Mental and Behavioural

Kaur v QBE Insurance (Australia) Limited [2025] NSWPICMP 761

Motor Accident Injuries Act 2017; insurer’s review of Medical Assessment Certificate (MAC) under section 7.26; threshold injury dispute; injuries to neck, lower back, right shoulder, and left knee in dispute; claimant had previous neck and lower back complaints; claimant alleged disc protrusions in cervical and lumbar spine and nerve root injuries were caused by the accident; claimant alleged bursitis in right shoulder was not a threshold injury and that undisclosed left knee injury was not a threshold injury; Held – Review Panel not satisfied left knee was injured in the accident; Review Panel found no rupture of tissue in right shoulder and bursitis is a threshold injury; Review Panel found no evidence of radiculopathy at time of re-examination or in the records; Review Panel found disc protrusions in cervical and lumbar spine were not caused by the accident; MAC revoked due to different determination concerning knee injury; no change to the outcome all injuries were threshold injuries.

Decision date: 3 October 2025 | Panel Members: Member Belinda Cassidy, Dr David Gorman, and Dr Shane Moloney | Injury module: Spine, Upper Limb, and Lower Limb

Insurance Australia Limited t/as NRMA Insurance v Li [2025] NSWPICMP 762

Motor Accident Injuries Act 2017; review of decision of Medical Assessor (MA) who assessed the claimant as having 17% whole person impairment (WPI) and diagnosed a post-traumatic stress disorder; claimant involved in an accident on 22 November 2021; insurer disputed psychiatric impairment rating scale (PIRS) assessments; claimants post-accident recovery complicated by over use of traditional Chinese medicine in combination with excessive alcohol intake; claimant had demonstrated pre-accident anxiety and panic attacks but not evident for some time before the accident; claimant had also used excess alcohol pre-accident but Review Panel satisfied that post accident she used this in excess to self-medicate; Held – Review Panel assessed the claimant as having a 22% WPI and diagnosed a post-traumatic stress disorder and alcohol use disorder in remission; certificate of MA revoked.

Decision date: 3 October 2025 | Panel Members: Member Alexander Bolton, Dr Himanshu Singh, and Dr Christopher Canaris | Injury module: Mental and Behavioural

AAI Limited t/as AAMI v Noun [2025] NSWPICMP 763

Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) diagnosing the claimant with a post-traumatic stress disorder which was a non-threshold injury; claimant injured on 23 March 2023 suffering physical and psychiatric disabilities; claimant not being treated at the time of the accident for any psychiatric disability; Review Panel not satisfied that on the day of examination the claimant demonstrated all of the criterion for post-traumatic stress disorder; Held – Review Panel satisfied that the claimant was suffering a persistent depressive disorder; certificate of MA revoked; Review Panel determined the claimant was suffering a non-threshold injury.

Decision date: 3 October 2025 | Panel Members: Member Alexander Bolton, Dr Himanshu Singh, and Dr Christopher Canaris | Injury module: Mental and Behavioural

Waldron v Allianz Australia Insurance Limited [2025] NSWPICMP 764

Motor Accident Injuries Act 2017; assessment of threshold psychological injury under section 1.6(3); claimant suffered injury as a bus passenger; psychological condition existing since accident; Medical Assessor found the accident caused adjustment disorder; claimant sought review; Held – claimant had experienced psychological symptoms for more than six months; sustained phobia from accident; certificate revoked; not a threshold injury.

Decision date: 3 October 2025 | Panel Members: Member Terence O'Riain, Dr Christopher Canaris, and Dr Himanshu Singh | Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Bell [2025] NSWPICMP 770

Motor Accident Injuries Act 2017; review of medical assessment; threshold injuries; median nerve injury; prior scooter accident; injury to right shoulder; cervical spine injury; ongoing neck pain; variable pain distribution; right carpal tunnel syndrome; definition of non-threshold injury; cervical spine non-verifiable radiculopathy; carpal tunnel syndrome coincidental finding; Held – no evidence of direct injury to right hand/wrist; threshold injury; certificate revoked.

Decision date: 7 October 2025 | Panel Members: Member Hugh Macken, Dr Michael Couch, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb

Insurance Australia Limited t/as NRMA Insurance v McBride [2025] NSWPICMP 772

Motor Accident Injuries Act 2017; permanent impairment; review; insurer disputed causation and permanent impairment; alleging psychological injuries before accident; Commission referred psychiatric condition to assess permanent impairment; Medical Assessor (MA) certificate assessed 19% permanent impairment; referred for review; re-examination; claimant was cooperative and consistent; accident was capable of causing referred injuries; 19% permanent impairment with different clinical findings; Held – different clinical findings to original assessment; Review Panel revoked original medical assessment certificate; permanent impairment greater than 10%.

Decision date: 7 October 2025 | Panel Members: Member Terence O’Riain, Dr John Baker, and Dr Himanshu Singh | Injury module: Mental and Behavioural

Yun v QBE Insurance (Australia) Limited [2025] NSWPICMP 773

Motor Accident Injuries Act 2017; assessment of threshold psychological injury under section 1.6(3); claimant suffered injury as passenger in an accident; psychological condition existing since accident; Medical Assessor found the accident caused adjustment disorder; claimant sought review; Held – claimant had experienced psychological symptoms for more than six months; sustained persistent depressive disorder (dysthymia) from accident; certificate revoked; not a threshold injury.

Decision date: 8 October 2025 | Panel Members: Member Terence O’Riain, Dr Christopher Canaris, and Dr Ankur Gupta | Injury module: Mental and Behavioural

Wilson v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 774

Motor Accident Injuries Act 2017; assessment of whole person impairment (WPI) for facial injuries; claimant front seat passenger in vehicle T-boned in high-speed collision; claimant sustained left mandibular fracture and other injuries; on examination claimant had a minor degree of malocclusion giving rise to TMJ symptoms; claimant suffers from ongoing pain when attempting to chew hard foods; Table 6 of American Medical Association Guides to the Evaluation of Permanent Impairment, 4th ed (AMA 4) when read with the Motor Accident Guidelines (the Guidelines) provides a range of between 1 and 19% WPI; intermittent jaw locking and discomfort with heavy mastication with mild TMJ crepitus; provides basis for assessment at 7%; effective loss of molar teeth due to unrelated condition did not reduce mastication efficiency; no basis for deduction due to prior or subsequent condition (clause 6.31 and 6.34 of the Guidelines); claimant had undergone no treatment subsequent to motor accident other than immediate post-operative surgery; despite suggestions of recommended treatment there were no plans; absence of past treatment and lack of plans indicated that it was extremely unlikely further dental treatment will occur; impairment assessed as permanent; Held – claimant’s degree of permanent impairment for fractured jaw assessed at 7%; original assessment revoked; separate Review Panel determining other injuries.

Decision date: 8 October 2025 | Panel Members: Principal Member John Harris, Dr Geoffrey (Paul) Curtin, and Dr Adrian Vertoudakis | Injury module: Dental Injury

Saco v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 775

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant was on a motorcycle when a parked car pulled out in front of him and there was a T-bone collision; psychological injuries assessed by the original Medical Assessor who found post-traumatic stress disorder amounting to 8% whole person impairment (WPI); Review Panel noted pre-accident clinical notes which indicated some anxiety and substance use and that this may have been in part an adjustment to the COVID-19 period; no treatment or psychiatric diagnosis before the motor accident therefore no apportionment required; Held – Review Panel diagnosed persistent depressive disorder and assessment of WPI under the psychiatric impairment rating scale (PIRS) was 7%; treatment of psychiatric medication and seeing a psychiatrist was considered a mild (1%) treatment effect; total psychiatric impairment as a result of the motor accident was 8% WPI; MAC revoked as the Review Panel made a different diagnosis; new certificate issued.

Decision date: 8 October 2025 | Panel Members: Member Jeremy Lum, Dr Gerald Chew, and Dr Matthew Jones | Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decisions

BMY v Mullungeen Pty Ltd [2025] NSWPICMP 736

Workplace Injury Management and Workers Compensation Act 1998; appellant appealed from the Medical Assessment Certificate (MAC) which determined the MAC should be confirmed; the first Appeal Panel’s determination was the subject of judicial review proceedings in the Supreme Court; by consent the first Appeal Panel’s determination was set aside and the matter was remitted to the Commission for referral to a differently constituted Appeal Panel; with acceptance at preliminary review by the Appeal Panel that the Medical Assessor had not taken the proper approach required to be taken to a secondary psychological injury, the Appeal Panel determined the appellant should undergo re-examination; the Appeal Panel accepted assessment of the appellant at 8% whole person impairment (WPI); Held – MAC revoked; although the Appeal Panel’s resultant WPI is the same as in the MAC this is purely coincidental and has arisen through very different approaches.

Decision date: 23 September 2025 | Panel Members: Member Jacqueline Snell, Professor Nicholas Glozier, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric

Folan v APS Group (Girraween) Pty Ltd; APS Group (Girraween) Pty Ltd v Folan [2025] NSWPICMP 756

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeals against 7% whole person impairment (WPI) finding for cervical spine injury; the worker appealed the MAC and raised whether the Medical Assessor (MA) failed to consider whether radiculopathy present, or to adequately explain his decision regarding radiculopathy; the appellant employer appealed the MAC and raised whether the MA had erred in not making any deduction pursuant to section 323; Held – demonstrable error established in failure to explain why the imaging studies were not consistent with a clinical sign; Chapter 4.27 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5) considered; claimant re-examined and imaging study held to be inconsistent; MAC confirmed; no utility in the appellant employer’s appeal as claimant not entitled to compensation in any event; MAC confirmed.

Decision date: 1 October 2025 | Panel Members: Member John Wynyard, Dr Todd Gothelf, and Dr Sophia Lahz | Body system: Cervical Spine

Fisher v Able Roadwork Traffic Analysis Pty Ltd [2025] NSWPICMP 757

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from assessment pursuant to the Table of Disabilities; whether adequate reasons given for findings; Held – Medical Assessor’s reasoning difficult to comprehend; claimant re-examined; MAC revoked.

Decision date: 1 October 2025 | Panel Members: Member John Wynyard, Dr Chris Oates, and Dr Roger Pillemer | Body system: Neck and Back, Right Arm, and Left Arm

Roode v Endeavour Group Ltd [2025] NSWPICMP 758

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of scarring under Chapter 14 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021 (the Guidelines) and Table for the assessment of minor skin impairments as a result of lumbar spine surgery; paragraph 14.6 of the Guidelines; Held – MAC confirmed.

Decision date: 2 October 2025 | Panel Members: Member Catherine McDonald, Dr Tim Anderson, and Dr James Bodel | Body system: Lumbar Spine, and Scarring (TEMSKI)

Lachlan Shire Council v Stanley [2025] NSWPICMP 765

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appellant appealed against medical assessments of two Medical Assessor’s (MA); one assessment relates to the respondent’s upper and lower gastrointestinal tact and the other to the impairment the respondent has due to a respiratory-sleep disorder from his injury; whether MA correctly classified the respondent’s impairment of his upper gastrointestinal tract by reference to the criteria of Table 6-3 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5); whether MA erred by assessing the respondent had a permanent impairment due to symptoms in his lower gastrointestinal tract; whether the respondent’s sleep disorder was a primary sleep disorder following neurological injury and if not whether the MA erred by assessing the respondent had a permanent impairment from the consequential sleep disorder he had from his injury; Held – the MA’s rating of the respondent’s permanent impairment of his upper gastrointestinal tract was correctly done by reference to the criteria of Table 6-3 of AMA 5 and involved no error; the MA erred by assessing the respondent had permanent impairment due his lower gastrointestinal tract; the respondent’s injury was in part a neurological injury; the respondent’s sleep disorder is not a primary consequence of his neurological injury but rather is secondary to the pain he suffers from his neurological injury and cannot be rated for impairment under Table 13.4 of AMA 5; MAC revoked.

Decision date: 3 October 2025 | Panel Members: Member Marshal Douglas, Dr John Garvey, and Dr Christopher Grainge | Body system: Respiratory (Sleep Disorder), Lumbar Spine, and Digestive System

Manera v Diversey Australia Pty Ltd [2025] NSWPICMP 766

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); review of assessment of permanent impairment following total knee replacement; previous meniscectomy followed by several years of strenuous work; deterioration following a change in work duties; Medical Assessor allowed four-tenths deduction under section 323 which was excessive; Cole v Wenaline Pty Ltd, Ryder v Sundance Bakehouse, and Southwell v Qantas Airways Limited considered; section 323(2) applied; Held – MAC revoked.

Decision date: 3 October 2025 | Panel Members: Member Catherine McDonald, Dr James Bodel, and Dr Christopher Oates | Body system: Left Lower Extremity, and Scarring (TEMSKI)

Mitchell v State of New South Wales (NSW Police Force) [2025] NSWPICMP 767

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); the appellant submits that the Medical Assessor erred in respect of his assessment of “loss of efficient use” of the left hand/wrist under the Table of Disabilities by failing to apply the correct test; the Appeal Panel agreed; evidence of ongoing symptoms justifying assessment; Held – MAC revoked.

Decision date: 3 October 2025 | Panel Members: Member Deborah Moore, Dr James Bodel, and Dr Tommasino Mastroianni | Body system: Right Leg, and Left Hand

Spyrou v State of New South Wales (Fire & Rescue NSW) [2025] NSWPICMP 768

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 (travel, social functioning, concentration, persistence and pace, and employability); Held – Appeal Panel found there to be no error in each of the challenged assessments; MAC confirmed.

Decision date: 7 October 2025 | Panel Members: Member Jane Peacock, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric

Pawlutschenko v Marr Contracting Pty Ltd [2025] NSWPICMP 769

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of permanent impairment arising from crush injury to foot resulting in amputation of four toes; examinations by orthopaedic surgeon and plastic surgeon; plastic surgeon allowed 0% whole person impairment (WPI); re-examination limited to scarring; Held – MAC revoked.

Decision date: 7 October 2025 | Panel Members: Member Catherine McDonald, Dr Malcolm Linsell, and Dr Tommasino Mastroianni | Body system: Right Lower Extremity, and Skin

Motor Accidents Merit Review Decision

Elkhoury v QBE Insurance (Australia) Limited [2025] NSWPICMR 30

Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about treatment; $400 taxi fare; referred to Merit Reviewer to clarify whether dispute involved medical issue about whether transport services needed and reasonable and necessary or whether dispute about reasonable cost of treatment; preliminary conference held with legal representatives and further information provided; Held – no dispute about transport to and from shopping centre but taxi driver’s involvement in 3.5 hours of “assistance” while claimant at shopping centre disputed; dispute involves medical issue; medical dispute referred for assessment at same time as another medical dispute.

Decision date: 2 October 2025 | Merit Reviewer: Belinda Cassidy

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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