Legal Bulletin No. 235

Issued 31 October 2025

Welcome to the two hundred and thirty fifth 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 Decisions 

State of New South Wales (Sydney Local Health District) v BNV [2025] NSWPICPD 73

Workers compensation; psychological injury; whether the worker sustained primary psychological injury in the nature of an aggravation of her pre-existing psychological injury in the course of her employment and whether employment was the main contributing factor to the injury; no error by Member found; Held – the appeal is dismissed; the Member’s Certificate of Determination dated 12 February 2025 is confirmed; pursuant to Rule 132 of the Personal Injury Commission Rules 2021  de-identify the matter.

Decision date: 17 October 2025 | Before: Acting Deputy President Geoffrey Parker SC

Bunnings Group Limited v Harrison [2025] NSWPICPD 74

Workers compensation; approach to be taken in considering alleged errors of fact; State of New South Wales v Culhana [2025] NSWCA 157 applied; section 15 of the Workers Compensation Act 1987; deemed date of injury; Haddad v The GEO Group Australia Pty Ltd [2024] NSWCA 135 applied; section 261(6) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act); section 261(6) of the 1998 Act; awareness of injury not relevant when awareness of injury pre-dates the deemed date of injury; section 261(4) of the 1998 Act; whether delay in making the claim for compensation was occasioned by ignorance, mistake or other reasonable cause; Held – the name of the appellant (the respondent below) is amended wherever it appears to “Bunnings Group Limited”; leave to appeal the interlocutory decision dated 15 April 2025 pursuant to section 352(3A) of the Workplace Injury Management and Workers Compensation Act 1998 is granted; determination [3] of the Member’s Certificate of Determination dated 15 April 2025 is amended to read: “3. For the purpose of assessment and quantification of the applicant’s entitlement to payment of permanent impairment compensation pursuant to s 66 of the 1987 Act, the date of the applicant’s primary psychological injury is 6 April 2022.”; order [6] of the Member’s Certificate of Determination is amended to read: “6. The matter is remitted to the President for referral to a Medical Assessor for assessment as follows: Date of injury: 6 April 2022 (deemed). Body parts: psychological. Method: whole person impairment.”; the Member’s Certificate of Determination is otherwise confirmed.

Decision date: 21 October 2025 | Before: Deputy President Elizabeth Wood

Motor Accidents non-Presidential Member Decisions

Baram v Allianz Australia Insurance Limited [2025] NSWPIC 431

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 when he lost control, crossed onto the incorrect side of the road, and sustained injuries; claimant alleged he was forced to take evasive action because unidentified motorcyclists had suddenly crossed over onto his side of the road and rode towards him; determined the said motorcyclists were not on the incorrect side of the road; statements of an independent witness who was riding his motorcycle behind the claimant confirmed the claimant had lost control of his motorcycle; Held – motor accident was caused wholly or mostly by the fault of the claimant; claimant entitled to payment of reasonable and necessary legal costs beyond the regulated amount of legal costs.

Decision date: 10 October 2025 | Member: David Ford

Youi Pty Limited v Bacopanos [2025] NSWPIC 549

Motor Accident Injuries Act 2017; claim for damages; insurer’s application for exemption on basis claim not suitable for assessment; insurer alleges claimant has made false or misleading statements and there are elements of complexity in the assessment; claimant objects to exemption and provided explanation; insurer presses exemption; Held – claim not suitable for assessment due to serious nature of allegations made by insurer and the need for hearing involving strict application of the rules of evidence; court most appropriate forum to resolve the dispute; Allianz Australia Limited v Tarabay, Insurance Australia Limited t/as NRMA Insurance v Taylor, IAG Limited t/as NRMA Insurance v Abiad, Kelly v MAA & Anor, and Insurance Australia Limited v Banos referred to and followed; recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 25 September 2025 | Member: Belinda Cassidy

Mousawi v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 557

Motor Accident Injuries Act 2017; sections 1.4 and 1.9 causal and temporal issues considered; Part 5 no-fault provisions considered; the claimant was injured on 16 May 2021; Axiak v Ingram, Davis v Swift, Hossain v Mirdha, Whitefield v Melenewycz, Adlawan v Recochem Inc, and Lifetime Care and Support Authority of NSW v Foster considered and applied; Held – accident found not to engage no-fault provisions.

Decision date: 16 October 2025 | Member: Philip Carr

Cheng v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 566

Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether accident caused wholly or mostly by the fault of the claimant for the purposes of sections 3.11 and 3.28; claimant collided with rear of stationary vehicle on motorway; speed limit 110km/h; hazard lights on stationary vehicle not activated; Podrebersek v Australian Iron & Steel Pty Ltd (Podrebersek), Axiak v Ingram, Allianz Australia Insurance Limited v Shuk, and AAI Limited t/as GIO v Evic discussed; Held – the claimant’s ability to perceive stationary vehicle obscured by vehicle in front; vehicle in front changed lanes suddenly; claimant applied brakes; claimant did not fail to exercise reasonable care in the circumstances; accident not caused wholly or mostly by the fault of the claimant; relative culpability cannot be assessed in accordance with Podrebersek unless there are at least two culpable parties.

Decision date: 21 October 2025 | Senior Member: Brett Williams

Papagelou v AAI Ltd t/as AAMI [2025] NSWPIC 567

Damages assessment; injuries exceed 10% whole person impairment (WPI); credibility and veracity of claimant; requirement for spinal fusion; psychological injury; post-traumatic stress disorder (PTSD); Held – claimant retains significant transferable skills; claimant able to continue in employment with some restrictions; scope for significant further improvement; overpayment by insurer; claimant not accepted in respect of payroll management assertions; claimant credibility; claimant able to pursue business and development opportunities; uncertainty as to calculations of past and future economic loss; requirement for buffer to reflect loss of earnings.

Decision date: 21 October 2025 | Member: Hugh Macken

Wakeling v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 569

Motor Accident Injuries Act 2017; common law damages claim; right front of claimant’s vehicle collided with left rear of insured’s vehicle; differing versions as to what lead up to the collision; both claimant and insured driver gave evidence and were cross-examined; reference to Road Rules 2014 (NSW); findings made on credit and reliability of evidence; evidence of insured driver preferred; finding that claimant failed to keep a proper lookout and insured driver failed to observe proximity of mini-bus behind and take necessary action to avoid collision; both drivers found equally at fault; insurer conceded entitlement to damages for non-economic loss; references to AAI Limited t/as GIO v Evic, Manley v Alexander, and Eskander v QBE Insurance (Australia) Limited; Held – award for $439,185.94 after adjusting for 50% contributory negligence.

Decision date: 22 October 2025 | Member: Gary Victor Patterson

Workers Compensation non-Presidential Member Decisions

CHC v Park Pty Ltd [2025] NSWPIC 474

Workplace Injury Management and Workers Compensation Act 1998; application for reconsideration seeking a revocation of a Certificate of Determination and a referral to another Medical Assessor (MA) pursuant to section 329; challenge to assessment of MA on basis of miscalculation of whole person impairment, deduction pursuant to section 323, lack of detailed reasons, and in the interests of justice; State of New South Wales (NSW Department of Education) v Kaur, Campbelltown City Council v Vegan, Ferguson v State of New South Wales, Marks v Secretary, Department of Communities and Justice (No 2), Cole v Wenaline Pty Limited, Howell v Stringvale Pty Ltd, and Samuel v Sebel Furniture Limited discussed and followed; Held – no merit in applicant’s application; application declined.

Decision date: 11 September 2025 | Principal Member: Glenn Capel

Humuer v Patent Formwork Pty Ltd [2025] NSWPIC 551

Workers Compensation Act 1987; claim pursuant to section 60 for the costs of proposed lumbar surgery; accepted lumbar injury following a fall at work; dispute as to nature of the injury and its ongoing effect; whether structural pathology or soft tissue injury; abnormal illness behaviour observed by respondent’s experts; Held – treating surgeon’s view as to the nature of the injury preferred; the proposed surgery is reasonably necessary as a result of injury; award for the applicant.

Decision date: 15 October 2025 | Member: Rachel Homan

Tika v Trucking Specialist Group Pty Ltd ATF [2025] NSWPIC 552

Workers Compensation Act 1987; undisputed workplace injury; claim for lump sum compensation; section 66 of the Act; medication prescribed for conditions accepted as caused by workplace injury; gastrointestinal condition; whether consequential to workplace injury as a consequence of using prescribed medication; conflicting opinion from independent medical examiners; delayed onset of condition considered; cigarette smoking considered as other possible cause; Held – prescribed medication most likely cause of gastrointestinal condition; accepted as consequential to workplace injury due to prescribed medication; referral to medical assessor for assessment of whole person impairment.

Decision date: 15 October 2025 | Member: Adam Halstead

Allsop v NCC Group Pty Ltd [2025] NSWPIC 553

Workers Compensation Act 1987; claim for lump sum compensation; section 66 of the Act; worker working from home; manager attended meeting with worker at home; worker held captive and repeatedly assaulted by manager; psychological injury claimed from assault; injury undisputed; employer contends incident outside scope of employment; section 4 of the Act; employer contends employment not a significant contributing factor; section 94 of the Act; relevance of reason for assault considered; Tarry v Warringah Shire Council, Humphrey Earl Ltd v Speechley, Rantino v Collins & Moss Pty Ltd, and Kelly v Secretary, Department of Family and Community Services considered; Held – assault occurred at work; worker injured in the course of employment; employment a significant contributing factor to injury; referred to Medical Assessor for assessment of whole person impairment.

Decision date: 15 October 2025 | Member: Adam Halstead

Pilsworth v Campbelltown City Council [2025] NSWPIC 554

Workers Compensation Act 1987; claim for cost of proposed left total knee arthroplasty; whether the applicant sustained a consequential left knee condition as the result of the accepted right knee injury; Held – the applicant sustained a consequential left knee condition as the result of the accepted right knee injury; the proposed left total knee arthroplasty is reasonably necessary medical treatment; the respondent is to pay the costs of the proposed left total knee arthroplasty.

Decision date: 15 October 2025 | Member: Fiona Seaton

Page v NSW Trains [2025] NSWPIC 555

Workers Compensation Act 1987; claim for lump sum death benefit pursuant to section 25 and funeral expenses; liability to pay compensation accepted; identification of dependants; Held – orders for payment of compensation.

Decision date: 16 October 2025 | Member: Rachel Homan

Gardiner v Leigh Stoddart and Company [2025] NSWPIC 556

Workers Compensation Act 1987; worker sustained accepted injury to lumbar spine in 2020; claim for bariatric weight loss surgery for treatment of lumbar spine symptoms and for subsequent lumbar spine surgery; Diab v NRMA Ltd, and Rose v Health Commission (NSW) considered; Held – weight loss surgery reasonably necessary for treatment of lumbar spine injury; award for applicant.

Decision date: 16 October 2025 | Member: Michael Wright

Antoniak v The Star Entertainment Group Ltd [2025] NSWPIC 558

Workers Compensation Act 1987; claim for weekly payments; respondent sought dismissal of proceedings on the basis of Port of Melbourne Authority v Anshun Pty Ltd (Anshun) estoppel; Habib v Radio 2UE Sydney Pty Limited, and Clayton v Bant considered and applied; Held – respondent failed to establish that the rights subject to the estoppel claim correspond with the rights that should have been the subject of the first proceeding; respondent further failed to establish it was unreasonable for the applicant not have to have claimed weekly compensation in the earlier proceedings; applicant not estopped from bringing a claim for weekly benefits; respondent liable to pay weekly benefits pursuant to sections 36, 37(1), and 37(2).

Decision date: 16 October 2025 | Member: Diana Benk

Bradwell v Canley Heights RSL & Sporting Club Ltd [2025] NSWPIC 559

Workers Compensation Act 1987; weekly payments; whether injury has led to incapacity; whether effects of injury ongoing; time limits; whether claim statue barred; applicant suffered a lumbar spine injury however kept working for a further 15 months before eventually ceasing work after suffering a hip injury at home; investigations revealed the presence of a small hernia, and there is no issue that as a result of his physical conditions the applicant has developed a secondary psychological injury; Held – the effects of the lumbar injury are ongoing; the applicant’s hernia was caused by the nature and conditions of employment; as a result of his physical injuries the applicant has developed a secondary psychological injury; as a result of his injuries the applicant was and remains permanently incapacitated for employment; respondent to pay the applicant weekly compensation as claimed and the applicant’s section 60 expenses.

Decision date: 17 October 2025 | Member: Cameron Burge

Singh v HealthScope Operations Pty Ltd [2025] NSWPIC 560

Workers Compensation Act 1987; claim for proposed surgery; section 60 dispute; whether the surgery to the lumbar spine (namely L4-S1 anterior lumbar interbody fusion and T10 to Pelvis - posterior spinal fusion) is reasonably necessary; Rose v Health Commission (NSW), and Diab v NRMA Ltd considered; Held – proposed surgery reasonably necessary as a result of subject injury.

Decision date: 17 October 2025 | Member: Carolyn Rimmer

Formula One Container Service Pty Ltd v Workers Compensation Nominal Insurer (iCare) & Ors [2025] NSWPIC 561

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); application pursuant to section 145 (an uninsured employer) for a determination as to its liability to reimburse the nominal insurer for payments it made in respect of the injury to the second respondent; the parties agreed the only issues in dispute were whether the second respondent was a worker employed by the applicant and/or whether he was a deemed worker under Schedule 1.2 of the 1998 Act; principles in Malivanek v Ring Group Pty Ltd applied; Held – the order made pursuant to rule 62 of the Personal Injury Commission Rules 2021 joining the second respondent to the proceedings is revoked; the second respondent was a deemed worker under Schedule 1.2 of the 1998 Act employed by the applicant; the applicant concedes it did not have a policy of workers compensation insurance for injury occurring to the second respondent; the applicant is liable and ordered to reimburse the nominal insurer for the payments it has made.

Decision date: 17 October 2025 | Member: Josephine Bamber

Sinclair v State of New South Wales (Fire & Rescue NSW) [2025] NSWPIC 562

Workers Compensation Act 1987; matter remitted by Presidential Unit for re-determination; claim for permanent impairment compensation, compensation for pain and suffering, and section 60 expenses as result of prostate cancer; applicant is a firefighter but not entitled to benefit of presumptive legislation due to length of service; respondent disputed that the applicant had sustained injury, and that employment was a substantial contributing factor to injury; oral evidence from epidemiologist and applicant’s independent medical examiner; application by applicant to lodge supplementary statement with written submissions in reply to respondent’s submissions refused; application by applicant for determination of permanent impairment without referral to Medical Assessor refused; Murray v Shillingsworth, Seltsam Pty Limited v McGuiness, EMI (Australia) Ltd v Bes, Badawi v Nexon Asia Pacific Pty Limited trading as Commander Australia Pty Limited, Inspector General in Bankruptcy v Bradshaw, Etherton v ISS Properties Services Pty Ltd, Thompson v Bernipave Pty Ltd, and Boga v Carpet Call (Vic) Pty Ltd t/as Carpet Call considered; Held – applicant sustained injury arising out of or in the course of employment; employment was a substantial contributing factor to injury; matter remitted to President for referral to Medical Assessor; general order for section 60 expenses; respondent to pay applicant’s costs.

Decision date: 20 October 2025 | Senior Member: Kerry Haddock

Williams v Medi-Rent Pty Ltd [2025] NSWPIC 563

Workers Compensation Act 1987; claim for cost of dental treatment plan for acid erosion of teeth; the application of crowns on affected teeth disputed; alternative proposal of resin restorations; Held – the dental treatment proposed by the doctors including the application of crowns to the applicant’s affected teeth is reasonably necessary medical or related treatment as the result of the accepted injury pursuant to section 60.

Decision date: 21 October 2025 | Member: Fiona Seaton

Gamlin v State of New South Wales (NSW Police Force) [2025] NSWPIC 564

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act);claim for permanent impairment compensation pursuant to section 66 of the 1987 Act; whether the applicant sustained injury to his cervical spine and right shoulder pursuant to section 4(b)(ii) of the 1987 Act; whether compensation is precluded by operation of sections 254 and/or 261 of the 1998 Act; the extent and quantification of the applicant’s entitlement to payment of permanent impairment compensation pursuant to section 66 of the 1987 Act; Held – applicant sustained injury to his cervical spine and right shoulder pursuant to section 4(b)(ii) of the 1987 Act; compensation is not precluded by operation of sections 254 and 261 of the 1998 Act; the matter be remitted to the President to be referred to a Medical Assessor for assessment of the degree of whole person impairment.

Decision date: 21 October 2025 | Member: Karen Garner

Motor Accidents Medical Review Panel Decisions

AAI Limited t/as AAMI v CAK [2025] NSWPICMP 698

Motor Accident Injuries Act 2017; accident 8 July 2023; treatment dispute; Medical Assessor’s (MA) certificate found causal nexus between the accident and treatment which was reasonable and necessary except for one aspect; insurer sought review on grounds that MA did not engage with insurer’s argument that forces in the accident were insufficient to cause referred injuries and the claimant was inconsistent in versions of the accident he provided to various treatment providers; insurer relied on biomechanical engineer’s expert report; claimant refused to attend re-examination; Review Panel considered treating doctors and MA’s opinions regarding nexus with accident; clinical judgment was that accident mechanism could cause referred injuries; evidence supported it being probable; appropriate treatment; section 3.24; Held – accident caused referred injuries and treatment reasonable and necessary; original certificate confirmed.

Decision date: 11 September 2025 | Panel Members: Member Terence O’Riain, Dr Ian Cameron, and Dr Michael Couch | Injury module: Treatment Type: Radiological Investigations, Surgery, Medical Specialist Consultation, and Other

CAK v AAI Limited t/as AAMI [2025] NSWPICMP 727

Motor Accident Injuries Act 2017; accident 8 July 2023; claimant incurred gradual hearing loss; dispute related to causation; original certificate did not accept link with hearing loss and accident; claimant’s review application; whether accident as it is alleged to have happened could cause gradual hearing loss; medical opinions were that forceful head injury with significant loss of consciousness was necessary prerequisite to condition having a traumatic aetiology; no evidence supporting necessary trauma occurring; claimant refused to be re-examined; on the papers; Held – accident did not cause hearing loss; original assessment confirmed.

Decision date: 19 September 2025 | Panel Members: Member Terence O’Riain, Dr Brian Williams, and Dr Thandavan Raj |           Treatment Type: Equipment

Allianz Australia Insurance Limited v Kit [2025] NSWPICMP 791

Motor Accident Injuries Act 2017; review of medical assessment of single medical assessor by review panel; whether psychological injury caused by the motor accident is a threshold injury; claimant injured in a motor accident in 2022 when waiting at a bus stop; prior motor accident in 2015 with associated psychological injury; original Medical Assessor diagnosed an exacerbation of major depressive disorder and therefore not a threshold injury; Held – Review Panel found the claimant suffers a somatic symptom disorder according to DSM-5 and therefore not a threshold injury; medical certificate revoked due to differing diagnosis; new certificate issued.

Decision date: 16 October 2025 | Panel Members: Member Elizabeth Medland, Dr Surabhi Verma, and Dr Gerald Chew | Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Bhaskar [2025] NSWPICMP 792

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 11%; insurer made an application under section 7.26 for referral of assessment to the Review Panel; Held – Review Panel conducted its own examination and found that WPI as a result of injuries sustained in the accident totalled 11%; certificate of MA was confirmed.

Decision date: 16 October 2025 | Panel Members: Member Terence Stern OAM, Dr Margaret Gibson, and Dr Shane Moloney | Injury module: Lower Limb, and Skin

Sam v QBE Insurance (Australia) Limited [2025] NSWPICMP 795

Motor Accident Injuries Act 2017; threshold injury disputes; claimant was facing a red traffic light; insured vehicle drove onto the wrong side of the road and collided head-on with the claimant’s vehicle; claimant was trapped in his car for two hours and had to be cut out of the vehicle; Medical Assessor certified claimant suffered accident-related adjustment disorder with depressed mood and mixed anxiety; Held – Review Panel found exacerbation of chronic adjustment disorder secondary to chronic pain with anxiety and depression; certificate revoked.

Decision date: 16 October 2025 | Panel Members: Member Gary Victor Patterson, Dr Ronald Gill, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural

Jabarian v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 796

Motor Accident Injuries Act 2017; assessment of degree of permanent impairment dispute; claimant was driving to work when the insured vehicle ran a red light and collided with the passenger’s side of the claimant’s vehicle; ambulance attended and conveyed the claimant to Bankstown Hospital; claimant says she sustained head, cervical spine, thoracic spine, lumbar spine injury, left shoulder, right shoulder, left wrist, right wrist, hip, right leg, right foot, and right knee injuries as a result of the accident; insurer disputes the duration and extent of those alleged injuries and impairments; Medical Assessor found all injuries caused by motor accident and assessed 2% whole person impairment (WPI) for left shoulder by analogy; Held – Review Panel found 5% WPI for cervical spine (persistent dysmetria) and 2% WPI for each shoulder (by analogy); total 9% WPI; certificate revoked.

Decision date: 16 October 2025 | Panel Members: Member Gary Victor Patterson, Dr Christopher Oates, and Dr Sophia Lahz | Injury module: Spine, Brain Injury, Upper Limb, and Lower Limb

QBE Insurance (Australia) Limited v Ye [2025] NSWPICMP 797

Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) psychiatric by Medical Assessor (MA); claimant injured in motor vehicle accident; MA determined the claimant’s permanent impairment was 15%; the insurer sought a review of the assessment under section 7.26; the Review Panel re-examined the claimant; Held – Review Panel revoked certificate of MA; substituted determination of 5% WPI.

Decision date: 16 October 2025 | Panel Members: Member Terence Stern OAM, Dr Steven Yeates, and Dr Alan Doris | Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Halteh [2025] NSWPICMP 798

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant was a motorcycle rider injured in the subject accident in 2018 and again in 2020; both accidents involved serious fractures to his upper and lower limbs requiring internal fixation and nails; claimant assessed by original Medical Assessor (MA) as having 10% whole person impairment (WPI) for the musculoskeletal injuries; no reference made to subsequent accident in 2020; the claimant’s peripheral nerve injuries were assessed by another MA as 7% whole person impairment (WPI); insurer’s review application on the peripheral nerve assessment was declined by the Delegate; Review Panel re-examined and found 6% WPI for the musculoskeletal injuries related to the subject accident; Review Panel expressed an opinion that the causation decision regarding the peripheral nerve injuries was likely to be correct; Held – Review Panel combined its assessment with the peripheral nerve injury assessment to find 13% WPI which is greater than 10%; MAC revoked; new certificate and combined certificate issued.

Decision date: 17 October 2025 | Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Shane Moloney | Injury module: Lower Limb, Upper Limb, Skin

CIE v AAI Limited t/as GIO [2025] NSWPICMP 799

Motor Accidents Compensation Act 1999; motor accident; assessment of whole person impairment for psychiatric impairment; claimant presented with significant pre-existing psychiatric conditions, chronic pain, and history of drug and alcohol abuses; claimant’s history to Medical Assessors of pre-exiting condition inconsistent with records; chronic history of drug and alcohol abuse; criminal history; Review Panel did not accept claimant’s account unless corroborated; acceptance of aggravation dependent upon acceptance of claimant; Whisprun Pty Ltd v Dixon applied; chronic history of pre-accident physical symptoms; post-accident criminal behaviour; delay on seeking treatment post-accident; Review Panel not satisfied that motor accident caused an aggravation of pre-existing psychiatric condition; no assessment of permanent impairment required; Held – original assessment revoked.

Decision date: 17 October 2025 | Panel Members: Principal Member John Harris, Dr Matthew Jones, and Dr Himanshu Singh | Injury module: Mental and Behavioural

Navarro v Allianz Australia Insurance Limited [2025] NSWPICMP 800

Motor Accident Injuries Act 2017; review of medical assessment; whole person impairment (WPI); soft tissue injury to lumbar sacral spine with aggravation of asymptomatic pre-existing chronic degenerative disease; soft tissue whiplash injury to the cervical spine with referred pain above shoulders; requirement to address WPI; diagnostic scans showed no clear abnormality; no muscle wasting and negative nerve stretching; no wasting and negative sciatic stretch testing; no evidence of radiculopathy nor any partial or complete rupture of ligaments; Held – the motor accident could not have caused the annular tears; they are degenerative in association with degenerative changes; pressure injury; restricted range of motion left shoulder; WPI 1%; medical assessment confirmed.

Decision date: 17 October 2025 | Panel Members: Member Hugh Macken, Dr Drew Dixon, and Dr David Gorman | Injury module: Spine, and Upper Limb

Ka'akah v QBE Insurance (Australia) Limited [2025] NSWPICMP 801

Motor Accident Injuries Act 2017; review of decision of Medical Assessor (MA) who assessed the claimant as having 7% whole person impairment (WPI) and diagnosed a post-traumatic stress disorder with a major depressive disorder; claimant involved in an accident; insurer relied on video surveillance footage but Review Panel concluded this revealed nothing contradicting the claimant’s claimed disabilities; claimant had limited post-accident claims of psychiatric disability but explained by not having access to Medicare and insurer not willing to fund treatment; Held – Review Panel not satisfied the claimant had post-traumatic stress disorder as he did not experience a life threatening event in the accident; Review Panel assessed the claimant as having a 7% WPI and diagnosed a major depressive disorder; certificate of MA revoked.

Decision date: 20 October 2025 | Panel Members: Member Alexander Bolton, Dr John Baker, and Dr Steven Yeates| Injury module: Mental and Behavioural

Ozun v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 807

Motor Accident Injuries Act 2017; Medical Review Panel; assessment under section 7.23; whether aggravation and exacerbation of multilevel degenerative spinal conditions constitute “injuries” within the meaning of section 1.4; claimant with longstanding, symptomatic cervical, and lumbar spondylosis reported increased pain following low-speed collision; pre-and post-accident imaging showed no structural change; clinical signs did not meet criteria for radiculopathy under clause 5.8 of the Motor Accident Guidelines; no new physiological disturbance or evidence of rupture, inflammation, or nerve involvement; Review Panel held post-accident symptom amplification without identifiable structural change did not satisfy statutory definition of “injury”; Held – alleged aggravations were not “injuries” under section 1.4.

Decision date: 20 October 2025 | Panel Members: Member Bridie Nolan, Dr Margaret Gibson, and Dr David McGrath | Injury module: Spine

Allianz Australia Insurance Limited v Angus [2025] NSWPICMP 808

Motor Accident Injuries Act 2017; review of medical assessment by Review Panel; whether psychological injury caused by the motor accident gives rise to a whole person impairment (WPI) that is greater than 10%; claimant suffered psychological injury from previous motor accident; Held – Review Panel found the claimant suffered an adjustment disorder prior to the motor accident; subject motor accident caused post-traumatic stress disorder WPI assessed at 4% (8% current, 4% pre-existing WPI); certificate revoked; new certificate issued.

Decision date: 20 October 2025 | Panel Members: Member Elizabeth Medland, Dr Gerald Chew, and Dr Steven Yeates | Injury module: Cervical Spine, Right Upper Extremity

AAI Limited t/as AAMI v Chamtieh [2025] NSWPICMP 809

Motor Accident Injuries Act 2017; threshold injury dispute; whether partial tears of the right shoulder rotator cuff are causally related to the motor accident; delay in obtaining radiological investigations; whether pathology is acute or chronic; Held – causation established on the balance of probabilities; right shoulder rotator cuff tears found to be caused by the motor accident; original medical assessment confirmed.

Decision date: 20 October 2025 | Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Thomas Rosenthal | Injury module: Spine, and Upper Limb

Wilson v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 810

Motor Accident Injuries Act 2017; motor accident; assessment of whole person impairment (WPI) for orthopaedic injuries and scarring; claimant front seat passenger in vehicle T-boned in high-speed collision; facial scarring assessed separately from body scarring (clause 6.191 of the Motor Accident Guidelines); assessments of impairment of left knee (fractured patella) and left hip (posterior dislocation); Review Panel’s assessments similar to original assessment; claimant assessed at 9% for orthopaedic and skin injuries; Held – claimant’s degree of permanent impairment for fractured jaw (mastication) assessed by another Review Panel at 7%; combined certificate greater than 10%.

Decision date: 21 October 2025 | Panel Members: Principal Member John Harris, Dr Christopher Oates, and Dr David Gorman | Injury module: Dental Injury

Idris v AAI Limited t/as AAMI [2025] NSWPICMP 811

Motor Accident Injuries Act 2017; motor accident; assessment of whole person impairment (WPI) for psychiatric impairment; partial amputation of finger; symptom validity testing not definitive; claimant appeared consistent in his complaints and admitted to a variety of activities; suggesting of malingering rejected; claimant’s assessed at 9% for impairment of psychological condition; no issues of principles; Held – original assessment revoked; claimant assessed at not greater than 10%.

Decision date: 22 October 2025 | Panel Members: Principal Member John Harris, Dr Gerald Chew, and Dr Alan Doris | Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Jubian [2025] NSWPICMP 815

Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) determined the claimant’s disputed treatment was related to the injuries caused by the accident and was reasonable and necessary in the circumstances; dispute about treatment; Held – Review Panel conducted its own examination and confirmed that the proposed referral was not causally related to the motor accident, and was not reasonable and necessary in the circumstances; Briggs v IAG Limited Trading as NRMA Insurance; the certificate of MA was revoked.

Decision date: 22 October 2025 | Panel Members: Member Terence Stern OAM, Dr Shane Moloney, and Dr Margaret Gibson | Injury module: Spine

Munjas v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 816

Motor Accident Injuries Act 2017; review of medical assessment of single medical assessor by Review Panel; whether the injuries caused by the motor accident is greater than 10% whole person impairment (WPI); claimant’s right foot and ankle ran over by a motor vehicle; consideration as to impairment related to metatarsal fractures; fractures not displaced on viewing of plain x-rays therefore no WPI; question of whether correct table (48 of American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA 4)) referred to; Held – found that the correct table referred to noting clause 6.106 of the Motor Accident Guidelines; also found that clinical diagnosis required to determine functional weakness and cannot occur on imaging alone; original medical assessment certifying 7% WPI confirmed.

Decision date: 22 October 2025 | Panel Members: Member Elizabeth Medland, Dr Shane Maloney, and Dr Mohammed Assem | Injury module: Lower Limb, and Minor Skin

Workers Compensation Medical Appeal Panel Decisions

Tregeagle v Mowbray Farm t/as ACMII Australia 2 Pty Ltd [2025] NSWPICMP 793

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment by Medical Assessor (MA) of 8% whole person impairment (WPI) for primary psychiatric condition; appeal under section 327(3)(c) and (d) on the basis that the MA did not correctly apply the psychiatric impairment rating scale (PIRS); the application of the PIRS in the scale of self care and personal hygiene was inconsistent with the evidence; Appeal Panel satisfied that MA took an irrelevant matter into consideration; which amounted to a demonstrable error; worker re-examined; Held – MAC revoked.

Decision date: 15 October 2025 | Panel Members: Member Carolyn Rimmer, Dr Michael Hong, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric

Crawley v Wagga Recruitment Pty Ltd [2025] NSWPICMP 794

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); claim in respect of bilateral sensorineural loss of hearing resulting from exposure to loud noise in his employment; Medical Assessor (MA) assessed 13% whole person impairment (WPI) and deducted 7% on a pro rata basis pursuant to section 323; Appeal Panel found that the MA erred in making a pro rata deduction as there was insufficient evidence to conclude that the appellant had been exposed to an unacceptable noise level for a sufficient length of time; Appeal Panel called for audiograms; worker re-examined in order to obtain a detailed history of noise exposure in his various employments; Appeal panel found appellant’s first employment in NSW with the tendencies, incidents, and characteristics to be capable of causing noise induced hearing loss on the balance of probabilities is October 2015 after he moved back to NSW from Queensland; Appeal Panel therefore found that the appellant has a pre-existing injury, condition, or abnormality of 8% WPI and an exact section 323 deduction can be made; Held – MAC revoked.

Decision date: 16 October 2025 | Panel Members: Member Carolyn Rimmer, Dr Robert Payten, and Dr Brian Williams | Body system: Hearing Loss

Windgap Foundation Ltd v Sonia [2025] NSWPICMP 802

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appellant submits that the Medical Assessor erred in failing to either examine the uninjured left ankle in order to provide a baseline comparison or (if he did conduct such examination) failed to document his findings in the MAC; Held – the Appeal Panel agreed; re-examination required; MAC revoked.

Decision date: 17 October 2025 | Panel Members: Member Deborah Moore, Dr James Bodel, and Dr David Lewington | Body system: Lower Right Extremity, and Scarring (TEMSKI)

Lozare v Group Homes Australia Pty Ltd [2025] NSWPICMP 803

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of psychological injury under the psychiatric impairment rating scale (PIRS); appeal with respect to all tables except employability; re-examination; Coca-Cola Europacific Partners API Pty Ltd v Pombinho; Held – MAC revoked.

Decision date: 17 October 2025 | Panel Members: Member Catherine McDonald, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric

Tran v Beak & Johnston Pty Ltd & Ors [2025] NSWPICMP 804

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by not assessing the appellant had permanent impairment relating to his shoulders, thoracic spine, and right hip; Held – the findings of the MA from his examination of the appellant were such that the appellant did not have any rateable impairment of his right hip and thoracic spine and so consequently MA did not err by assessing the appellant had 0% whole person impairment (WPI) relating to those body parts; the MA’s assessment that the appellant had 0% WPI relating to his shoulders was based on the MA finding the appellant did not suffer an injury to his shoulders, in the circumstance where there was no dispute between the parties that he had; MA erred in that regard; appellant re-examined; MAC revoked.

Decision date: 17 October 2025 | Panel Members: Member Marshal Douglas, Dr Todd Gothelf, and Dr Tommasino Mastroianni | Body system: Lumbar Spine, Thoracic Spine, Lower Right Extremity, Left Upper Extremity, and Right Lower Extremity

Hazelton v Royal Freemasons Benevolent Institution [2025] NSWPICMP 805

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; consideration of the psychiatric impairment rating scales (PIRS) of social function and concentration, persistence and pace; application of section 323; worker looks after grandson; plays games for up to four hours per day; no error identified in assessment under the PIRS; deduction of one-tenth made for pre-existing history of depression; no error in application of section 323; Held – MAC confirmed.

Decision date: 17 October 2025 | Panel Members: Member Parnel McAdam, Dr Graham Blom, and Dr Michael Hong | Body system: Psychological/Psychiatric

Murr v Koudsy Body Works Pty Ltd atf Koudsy Body Works [2025] NSWPICMP 806

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); deterioration, incorrect criteria, and demonstrable error relied upon; assessment of the cervical spine and both knees; deterioration requires evidence of increase in degree of permanent impairment; Riverina Wines v Workers Compensation Commission of New South Wales relied upon; worker assessed with full range of motion in both knees; impairment of cervical spine consistent with all other assessors with no evidence of radiculopathy; grounds of appeal not made out; Held – MAC confirmed.

Decision date: 20 October 2025 | Panel Members: Member Parnel McAdam, Dr Drew Dixon, and Dr Tommasino Mastroianni | Body system: Lumbar Spine, Right Lower Extremity, Left Lower Extremity

Cox v Secretary, Department of Education [2025] NSWPICMP 812

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 an assessment under one of the psychiatric impairment rating scale (PIRS) categories (namely travel, social and recreational activities); Held – Appeal Panel could discern no error; MAC confirmed.

Decision date: 21 October 2025 | Panel Members: Member Jane Peacock, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric

PG Motors Pty Ltd t/as Lismore Nissan Kia v Easton [2025] NSWPICMP 813

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal by respondent employer in respect of a calculation error in assessment of whole person impairment (WPI) of right shoulder and in respect of a failure by Medical Assessor (MA) to make a section 323 deduction in respect to the cervical spine; appeal by applicant worker in respect of a failure to provide any and/or an adequate reasons to assert there was no evidence of radiculopathy of the cervical spine; applicant worker conceded that there was a calculation error in relation to assessment of the right shoulder; Appeal Panel satisfied that MA erred in his assessment in relation to a deduction under section 323 and failed to provide sufficient reasons for his conclusion that the applicant worker had no radiculopathy; applicant worker re-examined; Held –MAC revoked.

Decision date: 21 October 2025 | Panel Members: Member Carolyn Rimmer, Dr James Bodel, and Dr Margaret Gibson| Body system: Cervical Spine, Right Upper Extremity

Rezayee v P&M Quality Smallgoods Pty Ltd [2025] NSWPICMP 814

Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of permanent impairment arising from Lisfranc fracture in the right foot; Medical Assessor assessed by reference to gait derangement and declined to assess scarring; prohibitions in American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5)and the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021 (the Guidelines) against use of gait derangement other than as last resort; difference between skin loss in AMA 5 Table 17-36 and scarring; re-examination; Held – MAC revoked.

Decision date: 21 October 2025 | Panel Members: Member Catherine McDonald, Dr James Bodel, and Dr Tommasino Mastroianni | Body system: Right Lower Extremity, Scarring (TEMSKI)

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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