Legal Bulletin No. 238
This bulletin was issued on 21 November 2025
Issued 21 November 2025
Welcome to the two hundred and thirty eighth edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.
Motor Accidents non-Presidential Member Decisions
Midha v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 595
Motor Accident Injuries Act 2017; assessment of damages pursuant to sections 7.36 (3) and 7.36(4); non-economic loss; injuries included multiple facial fractures, abrasions, left distal radius fracture, cervical spine C7/T1 fracture and disruption, chronic thoracic pain multiple surgeries, and dental injuries; psychological injuries; past economic loss; Held –claimant entitled to weekly loss as they are a high earner unable to return to work; future economic loss caused significant disadvantage on open labour market with ongoing restrictions; weekly loss to age 70 with deduction of vicissitudes of 40%; no allowance post age 70 for ongoing business enterprise.
Decision date: 7 November 2025 | Member: Shana Radnan
Cowper v AAI Limited t/as GIO [2025] NSWPIC 596
Motor Accident Injuries Act 2017; damages; liability admitted for accident; physical and psychological injuries; claim for past and future economic loss; joint medico-legal examination for traumatic brain injury, treating evidence, and lay evidence; history of high achievement and earning; tech start up; closed period of past loss; claimant earning more than statutory cap; claim for reduced earnings 12-years in the future and early retirement; application to rehabilitation; loss of partial use of upper and lower right extremity and continuing cognitive deficit; returned to work after accident, albeit with reduced physical abilities; claimant has reduced tolerance for high pressure; consideration and application of section 4.7 of likely prospects; possibilities of circumstances which would mitigate loss; Held – claimant and lay witness are witness of credit; preponderance of medical evidence supports prospect of reduced employment and early retirement; agreed past economic loss; future economic loss buffer for high earner; costs and disbursements assessed.
Decision date: 7 November 2025 | Member: Terence O'Riain
Raad v QBE Insurance (Australia) Limited [2025] NSWPIC 598
Motor Accident Injuries Act 2017; claim for statutory benefits under Part 3 dispute about whether claimant is wholly or mostly at fault; claimant driver of car entering Victoria Road from a side street at Gladesville; accident happened at night with visibility issues for both drivers; rear facing dashcam from another vehicle; joint expert’s report indicated claimant likely failed to give way; Held – claimant departed from the standard of care expected; insured found not culpable; claimant’s contributory negligence assessed at 80%; claimant wholly or mostly at fault; costs allowed for two disputes on the basis of the Motor Accident Injuries Regulation 2017; referred to AAI Limited t/as GIO v Evic re approach to decision making, Allianz Australia Insurance Limited v Shuk re relative culpability, Davis v Swift and Serrao (by his tutor Serrao) v Cornelius re assessment of contributory negligence where no other culpable party, and AAI Limited t/as GIO v Moon referred to as to costs.
Decision date: 7 November 2025 | Member: Belinda Cassidy
Heron v AAI Limited t/as AAMI [2025] NSWPIC 599
Motor Accident Injuries Act 2017; application for a late claim for an assessment and application for statutory benefits; application made nearly four years after the motor accident; sections 6.2, 6.14 and 7.33 referred to; whether a full and satisfactory explanation for delay in making the application; delay due to mistaken belief; solicitor contact initiated and claimant did not hear back; no further action taken by claimant; claimant’s belief could not make a claim as a passenger against driver; prompted to seek advice by friend nearly four years later; claimant’s explanation was his mistaken belief corrected by current solicitor only; Held – claimant’ s explanation neither full nor satisfactory; late claim leave not granted; insurer entitled to refuse statutory payments; Figliuzzi v Younan relied on by insurer; legal costs awarded to claimant.
Decision date: 10 November 2025 | Member: Shana Radnan
Arnott v Allianz Australia Insurance Limited [2025] NSWPIC 600
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 her motorcycle immediately behind the insured motor vehicle; claimant attempted to overtake the insured vehicle; claimant propelled over the roof of the insured vehicle and landed on the ground sustaining serious injuries; determined the insured driver did not look into his rearview mirrors prior to making the right hand turn and was driving in an erratic manner; driver did not activate his right hand turn indicator until the last second; determined the claimant was not wholly or mostly fault determined the degree of the claimant’s contributory negligence assessed at 15%; 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: 10 November 2025 | Member: David Ford
Abraham v Allianz Australia Insurance Limited [2025] NSWPIC 603
Motor Accident Injuries Act 2017; assessment of damages pursuant to sections 7.36 (3) and 7.36(4); non-economic loss; injuries included resolved physical injuries and ongoing psychological against a background of pre-existing psychological conditions; significant aggravation; Held – past and future economic loss; high earner unable to return to work; future economic loss no earning capacity; weekly loss to age 67 with deduction of vicissitudes of 25%.
Decision date: 11 November 2025 | Member: Shana Radnan
Workers Compensation non-Presidential Member Decisions
CYS v State of New South Wales (NSW Police Force) [2025] NSWPIC 575
Workers Compensation Act 1987; claim for psychological injury; whether the applicant sustained a psychological injury in accordance with section 4 as a result of exposure to traumatic employment events; AV v AW, Hancock v East Coast Timber Products Pty Limited, Paric v John Holland (Constructions) Pty Limited, and Paric v John Holland (Constructions) Pty Limited considered; whether the respondent can establish (pursuant to section 11A) that the applicant's psychological injury was wholly or predominantly caused by reasonable action taken or proposed to be taken by it with respect to performance appraisal and/or transfer; Pirie v Franklins Limited, Department of Education and Training v Sinclair, Manly Pacific International Hotel Pty Limited v Doyle, Insurance Australia Group Services Pty Limited v Outram, Ponnan v George Weston Foods Limited, Temelkov v Kemblawarra Portugese Sports and Social Club Limited, and Smith v Roads and Traffic Authority of NSW considered; Held – applicant sustained injury in the form of post-traumatic stress disorder (PTSD) (section 4); respondent has failed to establish its defence under section 11A; applicant is entitled to payment of his reasonably necessary expenses pursuant to section 60.
Decision date: 24 October 2025 | Member: Diana Benk
Peden v MoonShine Hotels [2025] NSWPIC 590
Workers Compensation Act 1987; claim for lump sum compensation as a result of primary psychological injury; whether primary or secondary psychological injury; Held – the applicant’s claim for permanent impairment arises from a secondary psychological injury so that no compensation is payable in respect of permanent impairment pursuant to section 65A; award for the respondent.
Decision date: 5 November 2025 | Member: Fiona Seaton
Workers Compensation Act 1987; claim for compensation for medical treatment pursuant to section 60; accepted work injuries to applicant’s left knee; applicant claimed compensation for cost of left knee arthroscopy, high tibial osteotomy and allograft, and plate fixation; whether the applicant had recovered from the effects of the accepted injury; whether the left knee arthroscopy, high tibial osteotomy and allograft, and plate fixation was reasonably necessary as a result of the accepted injury; Held – the applicant did not recover from the effects of the accepted injury; the left knee arthroscopy, high tibial osteotomy and allograft, and plate fixation was reasonably necessary as a result of the accepted injury.
Decision date: 5 November 2025 | Member: Karen Garner
Shack v Toll Group [2025] NSWPIC 592
Workers Compensation Act 1987; claim for weekly compensation in respect of accepted left shoulder injury previously assessed at 11% whole person impairment (WPI); applicant unable to return to pre-injury employment as a truck driver; whether the applicant is able to return to work in suitable employment; Held – applicant has capacity to work in sedentary roles; having regard to the nature of the applicant’s incapacity and his age, education, skills, and work experience there is no work for which the applicant is currently suited; at all relevant times the applicant had no current work capacity; award in favour of the applicant for weekly compensation.
Decision date: 5 November 2025 | Senior Member: Rachel Homan
The Well Skin Clinics Pty Ltd v Workers Compensation Nominal Insurer & Anor [2025] NSWPIC 593
Workers Compensation Act 1987; application in response to recovery sought by nominal insurer for workers compensation benefits paid to an injured worker; applicant concedes employment but otherwise disputes injury, incapacity, and payment of medical expenses; Held – worker sustained an injury to her lower back in the course of her employment with the applicant; worker had no current work capacity for the period in which recovery is sought by nominal insurer; medical expenses incurred by the worker were reasonably necessary as a result of her injury for the period in which recovery is sought by nominal insurer.
Decision date: 6 November 2025 | Member: John Isaksen
Piggott v MidCoast Council [2025] NSWPIC 601
Workers Compensation Act 1987; claim for weekly compensation and expenses for medical treatment; sections 33 and 60; undisputed workplace injury to both knees; arthroscopic treatment of injuries accepted by respondent employer; worker later required bilateral knee replacement surgery, disputed by employer as arising from workplace injuries; effect of workplace injuries contended by employer to have resolved after arthroscopic treatment; employer attributes knee replacement surgery to degenerative osteoarthritis; worker agrees osteoarthritis a factor but that injuries never resolved and materially contributed to the need for knee replacement surgery, disputed by employer; not in dispute that knee replacement surgeries reasonably necessary; Held – effects and symptoms of workplace injuries were not resolved by arthroscopies and persisted throughout entire relevant period to the time of knee replacement surgeries; worker incapacitated for work while recovering from knee replacement surgeries; employer to pay weekly compensation and treatment expenses.
Decision date: 10 November 2025 | Member: Adam Halstead
Lane v Aldi Stores (A Limited Partnership) [2025] NSWPIC 602
Workers Compensation Act 1987; causative link between shoulder flexion at work and shoulder dislocation; Held – previous history was a contusion, not a dislocation; respondent is directed to pay the applicant’s direct and incidental medical and related treatment expenses in respect of the left shoulder arthroscopy.
Decision date: 11 November 2025 | Member: Lea Drake
Motor Accidents Medical Review Panel Decisions
Kaur v QBE Insurance (Australia) Limited (No 2) [2025] NSWPICMP 862
Motor Accident Injuries Act 2017; review under section 7.26 of a threshold injury dispute; claimant alleged accident caused psychological injury (post-traumatic stress disorder) and bruxism secondary to that; claimant did not identify the particular tooth alleged to have been chipped or fractured; claimant re-examined by one Medical Assessor (MA) and whole of mouth examined; Held – evidence of bruxing found; no evidence of fractures of any teeth; evidence of small chips to two teeth; chips not caused by bruxing but by claimant’s habit and diet; no dental injuries caused by the accident; certificate of MA confirmed.
Decision date: 6 November 2025 | Panel Members: Member Belinda Cassidy, Dr Geoffrey (Paul) Curtin, and Dr Adrian Vertoudakis | Injury module: Dental Injury
Williams v QBE Insurance (Australia) Limited [2025] NSWPICMP 863
Motor Accident Injuries Act 2017; insured car struck claimant’s motor bike; upper and lower limb injuries with cervical spine soft tissue injury referred to assess permanent impairment and treatment; Medical Assessor certified not greater than 10% and treatment not reasonable and necessary; claimant applied for review; Review Panel re-examination; claimant consistent; accident was capable of causing all referred injuries; 11% permanent impairment; different clinical findings; Held – different permanent impairment findings to original assessment; treatment causally related to accident and reasonable and necessary; Review Panel revoked original certificates; permanent impairment greater than 10%.
Decision date: 6 November 2025 | Panel Members: Member Terence O’Riain, Dr Drew Dixon, and Dr Mohammed Assem | Injury module: Spine, Upper Limb, Lower Limb, and Skin; Treatment Type: Surgery
Insurance Australia Limited t/as NRMA Insurance v COT [2025] NSWPICMP 865
Motor Accident Injuries Act 2017; review of medical assessment under section 7.26; dispute about whether degree of permanent impairment resulting from psychological injury caused by the accident is greater than 10%; Medical Assessor certified post-traumatic stress disorder, major depressive disorder, and alcohol use disorder caused by the accident gave rise to impairment greater than 10%; Held – psychological injury caused by the accident gave rise to a 9% permanent impairment; certificate revoked; Review Panel certified the degree of permanent impairment not greater than 10%.
Decision date: 7 November 2025 | Panel Members: Senior Member Brett Williams, Dr Paul Friend, and Dr Surabhi Verma | Injury module: Mental and Behavioural
Walford v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 868
Motor Accident Compensation Act 1999; review of medical assessment; whole person impairment; post-traumatic stress disorder and persistent depressive disorder with a persistent major depressive episode; pre-accident workplace challenges; physical injuries; symptoms consistent with post-traumatic stress disorder and major depressive disorder; psychological symptoms persisting; impaired current functioning; psychiatric impairment; rating scale pre-accident; significant difficulty with social and recreational activities; concentration, persistence; significant difficult adaptation; Held – Review Panel assessed 16% whole person impairment (WPI).
Decision date: 10 November 2025 | Panel Members: Member Hugh Macken, Dr Christopher Rikard-Bell, and Dr Alan Doris | Injury module: Mental and Behavioural
QBE Insurance (Australia) Limited v Codianni [2025] NSWPICMP 869
Motor Accident Injuries Act 2017; claimant was injured in a motor vehicle accident; Medical Assessor (MA) issued a certificate assessing 15% whole person impairment (WPI); a medical dispute arose as to total WPI; insurer sought a review of the medical assessment under section 7.26; Review Panel conducted an examination and considered the factors contributing to the injury according to section 6.6 of the Motor Accident Guidelines; MA’s determination was revoked; Review Panel substituted the determination that the claimant sustained 4% WPI.
Decision date: 10 November 2025 | Panel Members: Member Terence Stern OAM, Dr Shane Moloney, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb
Insurance Australia Limited t/as NRMA Insurance v CMO [2025] NSWPICMP 870
Motor Accident Injuries Act 2017;review of medical assessment under section 7.26; dispute about whether degree of permanent impairment resulted from psychological injury caused by the accident is greater than 10%; whether there was pre-existing and/or subsequent impairment; Medical Assessor found pre-existing impairment and certified accident caused impairment greater than 10%; Held – pre-existing psychological impairment but no subsequent impairment; accident caused impairment greater than 10%; certificate revoked due to different findings about diagnosis and degree of impairment.
Decision date: 10 November 2025 | Panel Members: Senior Member Brett Williams, Dr Alan Doris, and Dr Thomas Newlyn | Injury module: Mental and Behavioural
AAI Limited t/as GIO v Waite [2025] NSWPICMP 871
Motor Accident Compensation Act 1999;review of medical assessment of single Medical Assessor (MA); whether psychological injury suffered as a result of the motor accident gives rise to a whole person impairment (WPI) greater than 10%; assertions of pre-existing impairment; surveillance relied upon by insurer; surveillance allowed pursuant to rule 109 of the Personal Injury Commission Rules 2021; original MA assessed 17% WPI; Held – found 5% WPI due to persistent depressive disorder with anxious distress caused by the motor vehicle accident; original medical assessment revoked.
Decision date: 10 November 2025 | Panel Members: Member Elizabeth Medland, Dr Samson Roberts, and Dr Michael Hong | Injury module: Mental and Behavioural
AAI Limited t/as GIO v Mohammed [2025] NSWPICMP 872
Motor Accident Injuries Act 2017; motor accident; assessment of whether motor accident caused a non-threshold injury; rear-end collision; various body parts except left shoulder threshold injuries; left shoulder injury; contemporaneous complaint and limited abduction; initial left shoulder ultrasound did not show a tear; recent ultrasound showed a partial tear of the supraspinatus tendon; reading of ultrasound notoriously dependent on skills of the interpreter; negative ultrasound finding is not conclusive of absence of pathology; other examination findings consistent with left partial thickness tear of the supraspinatus tendon; Held – original assessment revoked; claimant assessed as sustaining injury to left shoulder which was not a threshold injury.
Decision date: 10 November 2025 | Panel Members: Principal Member John Harris, Dr Christopher Oates, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, and Lower Limb
Cha v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 873
Motor Accident Injuries Act 2017; assessment of whole person impairment (WPI); the claimant suffered injury in a motor vehicle accident; claimant had an earlier workplace injury; Medical Assessor found injuries referred for assessment were not caused by the accident; claimant sought review; Held – both major depressive disorder and alcohol use disorder present before the accident; deterioration in function; aggravation of major depressive disorder and alcohol use disorder caused by the accident; claimant sustained non-threshold injury; current permanent impairment of 22% plus additional 1% for the effect of treatment; pre-existing permanent impairment of 19% WPI; permanent impairment assessed at 4% as result of injury caused by the accident.
Decision date: 10 November 2025 | Panel Members: Senior Member Susan McTegg, Dr John Baker, and Dr Steven Yeates | Injury module: Mental and Behavioural
Harb v AAI Limited t/as AAMI [2025] NSWPICMP 874
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; Medical Assessor certified that the psychological injuries referred for assessment were not caused by the accident; whether psychological injuries caused by accident; determination of whether psychological injuries are threshold injuries and whether degree of permanent impairment that has resulted from psychological injuries caused by accident is greater than 10%; consideration of pre-existing injuries and impairment; Held – Review Panel satisfied claimant’s adjustment disorder was caused by the accident; determination of threshold injury; degree of permanent impairment resulting from claimant’s psychological injuries caused by the accident is 1%, which is not greater than 10%; MAC revoked.
Decision date: 11 November 2025 | Panel Members: Member Bianca Montgomery-Hribar, Dr Gerald Chew, and Dr Matthew Jones | Injury module: Mental and Behavioural
Insurance Australia Limited t/as NRMA Insurance v Tamplin [2025] NSWPICMP 875
Motor Accident Injuries Act 2017; assessment of whole person impairment (WPI); claimant suffered injury in a motor vehicle accident; Medical Assessor certified the claimant had sustained 11% WPI as a result of post-traumatic stress disorder caused by the accident; pre-existing condition; insurer sought review; Held – claimant had pre-existing generalised anxiety disorder; post-traumatic stress disorder caused by the accident; current permanent impairment of 7%; pre-existing permanent impairment of 0% WPI; permanent impairment assessed at 7% as result of injury caused by the accident.
Decision date: 11 November 2025 | Panel Members: Senior Member Susan McTegg, Dr John Baker, and Dr Steven Yeates | Injury module: Mental and Behavioural
Insurance Australia Limited t/as NRMA Insurance v Abdel-Ghani [2025] NSWPICMP 876
Motor Accident Injuries Act 2017; review of medical assessment of single Medical Assessor (MA); whether psychological injuries caused by the motor accident give rise to a whole person impairment (WPI) which is greater than 10%; claimant witnessed his father being struck by a vehicle; original MA diagnosed persistent depressive disorder giving rise to a 14% WPI; issues of correct diagnosis and level of functioning; claimant went on to study at university and work part time; Held – Review Panel found 5% WPI due to a post-traumatic stress disorder caused by the motor accident; certificate of medical assessor revoked.
Decision date: 11 November 2025 | Panel Members: Member Elizabeth Medland, Dr Steven Yeates, and Dr Alan Doris | Injury module: Mental and Behavioural
Roxanas v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 884
Motor Accident Injuries Act 2017; review of medical assessment of single Medical Assessor; whether injuries caused by the motor accident give rise to a whole person impairment (WPI) that is greater than 10%; physical injuries from motor accident; mild traumatic brain injury, along with injuries to the cervical spine, lumbar spine, and right shoulder; injuries to left shoulder, hands, left foot, and toes determined to not be caused by the motor accident; no evidence of cognitive impairment was detected; WPI assessment of 0% for brain injury in accordance with clinical dementia rating (CDR); inconsistency in shoulder movements; Held – total 2% WPI; certificate of medical assessor revoked.
Decision date: 12 November 2025 | Panel Members: Member Elizabeth Medland, Dr Tai-Tak Wan, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, Lower Limb, and Brain Injury
Moretti v Allianz Australia Insurance Limited [2025] NSWPICMP 885
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 WPI at 0%; claimant sought a review of the assessment under section 7.26; Review Panel re-examined the claimant; Held – Review Panel revoked the certificate of the MA; substituted determination of 7% WPI.
Decision date: 12 November 2025 | Panel Members: Member Terence Stern OAM, Dr Christopher Canaris, and Dr John Baker | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
BUW v B & L Linings Pty Ltd [2025] NSWPICMP 858
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from 11% whole person impairment (WPI) for a psychological injury; whether Medical Assessor had given adequate reasons regarding his classification in all categories but social and recreational activities; Held – reasons not adequate; Wingfoot Australia Partners Pty Ltd v Kocak, and Campbelltown City Council v Vegan considered; claimant re-examined; MAC revoked.
Decision date: 5 November 2025 | Panel Members: Member John Wynyard, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Paterick v Coalcore Pty Ltd ATF Paterick Family Trust [2025] NSWPICMP 859
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); medical appeal; deduction pursuant to section 323; Medical Assessor made deduction of one-third due to surgery being required for chronic pathology rather than frank incident; Cole v Wenaline Pty Limited, Elcheikh v Diamond Formwork (NSW) Pty Ltd (in Liq), and Ryder v Sundance Bakehouse discussed; previous condition identified but was asymptomatic; insufficient evidence to displace the assumption in section 323(2); Held – MAC revoked; deduction of one-tenth made.
Decision date: 6 November 2025 | Panel Members: Member Parnel McAdam, Dr Drew Dixon, and Dr Margaret Gibson | Body system: Right Upper Extremity, and Scarring
Cognetta v Independent Pipe Fabrication Pty Ltd [2025] NSWPICMP 860
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) applied correct criteria to rate the appellant’s impairment in social and recreational activities; whether the MA’s rating of the appellant’s impairment in social and recreational activities involved error; whether MA had regard to irrelevant consideration when rating the appellant’s impairment in social functioning; whether MA had regard to a report of the appellant’s medical expert; Held – MA applied correct criteria, his ratings in the challenged psychiatric impairment rating scale (PIRS) involved no error, and that he had regard to the substance of the appellant’s medical expert’s report; MAC confirmed.
Decision date: 6 November 2025 | Panel Members: Member Marshal Douglas, Dr Michael Hong, and Dr Graham Blom | Body system: Psychological/Psychiatric
Cormie v Able Futures Pty Ltd [2025] NSWPICMP 861
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 two of the psychiatric impairment rating scale (PIRS) categories (social functioning and employability); Held – Appeal Panel considered that the Medical Assessor’s path of reasoning was inadequate, and it was not clearly discernible from the reasons given in the MAC that the assessments under the contested PIRS categories were based upon the correct criteria; a re-examination was considered necessary in the circumstances of a finding of error; MAC confirmed.
Decision date: 6 November 2025 | Panel Members: Member Jane Peacock, Professor Nicholas Glozier, and Dr Michael Hong | Body system: Psychological/Psychiatric
Gourlay v Enterprise and Training Company Ltd [2025] NSWPICMP 866
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from 9% assessment for psychological injury claim; whether Medical Assessor (MA) erred in finding a class 2 rating for concentration, persistence and pace; whether MA erred in failing to give an uplift for the effects of treatment; Held – claimant mistook MA’s reporting of her symptoms as acceptance of the same; Wingfoot Australia Partners Pty Ltd v Kocak referred to; the effects of treatment were not demonstrated to have shown a substantial or total elimination of claimant’s permanent impairment; Zoric v Secretary, Department of Education & Ors considered; MAC confirmed.
Decision date: 7 November 2025 | Panel Members: Member John Wynyard, Dr Michael Hong, and Dr John Baker | Body system: Psychological/Psychiatric
Dunn v Bradley Dunn Pty Ltd [2025] NSWPICMP 867
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether demonstrable error or incorrect application of criteria arising from failure to consider alternative methods for evaluating impairment at the left lower extremity (knee) and selecting the method giving the highest impairment rating; where worker had undergone tibial tubercle transfer; where parties’ independent experts both applied Table 17.33 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5); Held – Medical Assessor erred in allocating 0% whole person impairment (WPI) after considering range of movement only; the surgery was analogous to a proximal tibial osteotomy; applying paragraph 1.23 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines) the left knee ought to be assessed at 10% WPI in accordance with Table 17.33 of AMA 5; MAC revoked.
Decision date: 10 November 2025 | Panel Members: Senior Member Rachel Homan, Dr Roger Pillemer, and Dr Andrew Porteous | Body system: Left Lower Extremity, Right Lower Extremity, Lumbar Spine, and Scarring (TEMSKI)
Gerrish v Office of the Director of Public Prosecutions [2025] NSWPICMP 877
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); complex fresh evidence issue; dispute between doctors regarding the accuracy of their reports; fresh evidence rejected; challenge to three psychiatric impairment rating scale (PIRS) categories; Held – no error in the Medical Assessor’s assessments; MAC confirmed.
Decision date: 11 November 2025 | Panel Members: Member Deborah Moore, Dr Michael Hong, and Dr John Lam Po Tang | Body system: Psychological/Psychiatric
Neader v TS 14 Plus Australia Pty Ltd ATF Vestito Unit Trust [2025] NSWPICMP 878
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal against the one-third section 323 deduction made by the Medical Assessor (MA) for pre-existing osteoarthritis in the medial and patellofomoral compartments of the left knee; Appeal Panel found that MA erred in failing to adequately consider all of the evidence and failed to give adequate reasons; Appeal Panel made a deduction pursuant to section 323(2); Held – MAC revoked.
Decision date: 11 November 2025 | Panel Members: Member Carolyn Rimmer, Dr Margaret Gibson, and Dr Roger Pillemer | Body system: Left Lower Extremity, and Skin/Scarring
Joyce v State of New South Wales (Ambulance Service of New South Wales) [2025] NSWPICMP 879
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 (self-care and personal hygiene, social and recreational activities, social functioning, and concentration, persistence and pace); Held – Appeal Panel considered that the Medical Assessor’s path of reasoning was adequate, and it was clearly discernible from the reasons given in the MAC that the assessments under the contested PIRS categories were based upon the correct criteria; MAC confirmed.
Decision date: 11 November 2025 | Panel Members: Member Jane Peacock, Dr John Po-Lam-Tang, and Dr Michael Hong | Body system: Psychological/Psychiatric
Messina v PT Oakwell Pty Ltd ATF Oakwell Employee Unit Trust [2025] NSWPICMP 880
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal against 8% assessment for psychological injury; whether computation error; whether error in making one-tenth deduction; whether adequate reasons given; Held – computation error conceded; result would be 15% whole person impairment (WPI) reduced to 14% by one-tenth deduction; Medical Assessor applied and discussed Chapter 11.10 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5) in making one-tenth deduction; conflicting authority of Marks v Secretary, Department of Communities and Justice (No 2), Camden Council v Harle, and Matheson v Baptistcare NSW & ACT considered and discussed; observations made as to difficulties in interpretation of Chapter 11.10 and section 323; MAC revoked to correct computation error.
Decision date: 11 November 2025 | Panel Members: Member John Wynyard, Dr Graham Blom, and Dr Douglas Andrews | Body system: Psychological/Psychiatric
Wetere v Coles Supermarkets Australia Pty Ltd [2025] NSWPICMP 881
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); worker sustained physical injuries to wrists; primary psychological injury arising from events following allocation of suitable duties referred for assessment; whether Medical Assessor (MA) erred by diagnosing a secondary psychological injury; no agreement between the parties or determination by a Commission member that the worker had sustained a secondary psychological injury and none mentioned in the referral; first Appeal Panel decision set aside by Supreme Court; Held – MAC affected by demonstrable error; MA was required to undertake his assessment of the primary psychological injury separately from a consideration of any impairment that had resulted from the physical injuries; re-examination required; MAC revoked.
Decision date: 11 November 2025 | Panel Members: Senior Member Rachel Homan, Dr Douglas Andrews, and Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric
Australian Unity Ltd v Jordanoska [2025] NSWPICMP 882
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) provided adequate reasons for assessment of respondent’s impairment due to a total knee replacement; whether MA measured the respondent’s extension lag and flexion contracture; whether MA provided adequate reasons for the assessment of the respondent’s impairment due to scarring; Held – MA adequately explained his assessment of the respondent’s impairment relating to her knee replacement and measured the respondent’s extension lag and flexion contracture in order to do so; MA did not adequately explain his reasons for his assessment of the respondent’s impairment due to scarring and that was an error; respondent re-examined; MAC revoked.
Decision date: 11 November 2025 | Panel Members: Member Marshal Douglas, Dr Todd Gothelf, and Dr Tommasino Mastroianni | Body system: Left Lower Extremity, and Scarring
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 (self-care and personal hygiene, social and recreational activities, travel and social functioning); Held – Appeal Panel considered that the Medical Assessor’s path of reasoning was adequate, and it was clearly discernible from the reasons given in the MAC that the assessments under the contested PIRS categories were based upon the correct criteria; MAC confirmed.
Decision date: 11 November 2025 | Panel Members: Member Jane Peacock, Dr John Baker, and Dr Michael Hong | Body system: Psychological/Psychiatric
Motor Accidents Merit Review Decision
Chowdhury v AAI Limited t/as GIO [2025] NSWPICMR 33
Motor Accident Injuries Act 2017; merit review; dispute about payment of weekly benefits under Division 3.3; pre-accident weekly earnings (PAWE); meaning of PAWE; Schedule 1, clause 4(1); onus of proof; incomplete evidence; outstanding documents; compliance with directions; where evidence of earnings not reconcilable with tax return; GST; business expenses; Held – the reviewable decision is confirmed.
Decision date: 10 November 2025 | Merit Reviewer: Katherine Ruschen
This publication is for information only. The publication is not legal advice. The information provided is not a substitute for reading the decisions. The Commission does not accept liability for the information in this publication or for way the information is used.
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