Legal Bulletin No. 244
This bulletin was issued on 23 January 2026
Issued 23 January 2026
Welcome to the two hundred and forty forth 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
Ahmadi v Allianz Australia Insurance Limited [2026] NSWPIC 1
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; factual dispute about circumstances of accident; Held – claimant’s version of accident preferred in critical respects; insurer failed to make out its case; accident not caused wholly or mostly by the fault of the claimant; costs order sought under section 8.10(4) not made.
Decision date: 12 January 2026 | Senior Member: Brett Williams
Kojic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 13
Motor Accident Injuries Act 2017; claim for statutory benefits; insurer’s denial of liability for ongoing statutory benefits under section 3.28 on basis claimant “wholly at fault”; claimant pedestrian on major Sydney six lane road walked across three empty lanes and was hit by car travelling lawfully in bus lane; assessment undertaken on the papers; Held – claimant wholly or mostly at fault due to crossing a street in an unsafe place (less than 100m from lights) and in an unsafe manner (on mobile phone and not keeping a proper lookout); AAI Limited t/as GIO v Evic followed re approach to decision-making; Derrick v Cheung cited regarding foreseeability; Mamo v Surace cited regarding standard of care; Davis v Swift referred to in regards to degree of contributory negligence; costs allowed on the basis of section 8.10(4).
Decision date: 13 January 2026 | Member: Belinda Cassidy
AAI Limited t/as GIO v Nguyen [2026] NSWPIC 14
Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 17 December 2024; claimant working at the time of the accident; claimant is aware this approval resolves her common law damages claim; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); Held – settlement approved in the amount of $87,428.37 consisting of nil non-economic loss, past economic loss of $12,428.37, and $75,000.00 by way of a buffer for future economic loss.
Decision date: 13 January 2026 | Member: Philip Carr
AAI Limited t/as AAMI v Liros [2026] NSWPIC 15
Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 12 June 2025; claimant was working at the time of the accident; claimant is aware the approval resolves his common law damages claim; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); Held – settlement approved in the amount of $95,000 consisting of nil non-economic loss, past economic loss of $1,694.00, and $93,304.75 for future economic loss.
Decision date: 14 January 2026 | Member: Philip Carr
QBE Insurance (Australia) Limited v Bridge [2026] NSWPIC 16
Motor Accidents Compensation Act 1999; claims assessment dispute about the amount of damages to be paid to the claimant under section 94(5); claimant was stationary in his motor vehicle when the vehicle being driven by the insured driver collided with the rear of his vehicle; determined the claimant sustained soft tissue injuries to his neck and back which exacerbated underlying degenerative changes in the cervicothoracic and thoracolumbar spine; claimant is employed as a plant operator operating a bulldozer in the coal mining industry; determined after a period of four years post-accident there was no diminution in earning capacity causally related to the injuries suffered by him in the accident; insurer admitted liability and no allegation of contributory negligence; claim for past and future economic loss; Held – claimant is entitled to damages for past and future economic loss.
Decision date: 14 January 2026 | Member: David Ford
Workers Compensation non-Presidential Member Decisions
CJD v Workers Compensation Nominal Insurer (iCare) & Anor [2025] NSWPIC 362
Workers Compensation Act 1987; section 145(1) recovery from uninsured employer; dispute as to whether the applicant should reimburse the Nominal Insurer for compensation paid to the injured worker or a lesser amount; worker’s credibility questioned; Held – worker’s evidence accepted and payments of compensation reflected level of capacity; applicant liable to reimburse the Nominal Insurer in respect of compensation paid to or on behalf of the worker.
Decision date: 31 July 2025 | Senior Member: Elizabeth Beilby
Hickson v Collins Transport Group Pty Ltd [2026] NSWPIC 2
Workers Compensation Act 1987; claim for medical or related expenses arising from left ankle condition; whether the left ankle condition was a consequence of an altered gait caused by the applicant’s accepted lumbar spine injury; Held – the applicant sustained a consequential left ankle condition as a result of altered gait caused by his accepted lumbar spine injury; respondent to pay reasonably necessary medical or related expenses with respect to the applicant’s left ankle condition.
Decision date: 12 January 2026 | Member: Fiona Seaton
Kacevski v Medina Property Services Pty Ltd [2026] NSWPIC 4
Workers Compensation Act 1987; claim for weekly compensation and treatment expenses in respect of accepted lumbar injury; applicant certified fit for pre-injury duties before he resigned and commenced employment in own business; flare of symptoms while attempting to lift a television in own business; applicant incapacitated thereafter; whether incapacity resulted from the accepted work injury; State Government Insurance Commission v Oakley (Oakley); Kooragang Cement Pty Ltd v Bates; Held – applicant continued to experience minor symptoms after resigning but they were not incapacitating; insufficient evidence to demonstrate that case fell within the first two categories of case described in Oakley; applicant did not discharge onus of demonstrating that incapacity resulted from the work injury; award for the applicant for treatment expenses subject to section 59A.
Decision date: 12 January 2026 | Senior Member: Rachel Homan
Little v D P J Coating Systems Pty Ltd [2026] NSWPIC 5
Workplace Injury Management and Workers Compensation Act 1998; consequential condition; applicant had accepted back injury; claimed that knee condition arose as a result of back injury due to limping; reference made to limp in clinical records; no explanation of how a back injury could lead to a consequential condition in the knee; insufficient to rely on “commonsense” test without medical explanation as to how it had occurred; Held – award for the respondent for consequential condition claim.
Decision date: 12 January 2026 | Member: Parnel McAdam
Kapoor v Westpac Banking Corporation [2026] NSWPIC 6
Workers Compensation Act 1987; claim for weekly benefits arising from a psychological injury; Held – section 11A defence not made out as the onus of “wholly or predominantly” not made out; consideration of section 46.
Decision date: 12 January 2026 | Senior Member: Elizabeth Beilby
Chdid v A New Image Rendering (NSW) Pty Ltd [2026] NSWPIC 8
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for compensation for industrial deafness; nature of the dispute between the parties; Held – referred to Medical Assessor under section 321(1) of the 1998 Act.
Decision date: 12 January 2026 | Member: Catherine McDonald
Ingram v Secretary, Department of Education [2026] NSWPIC 9
Workers Compensation Act 1987; claim for weekly compensation, medical expenses, and lump sum compensation in respect of psychological injury; dispute as to whether whole or predominant cause was reasonable action with respect to transfer pursuant to section 11A(1); where numerous staff nominated for transfer following a review which found the applicant’s school was overstaffed; where applicant was approached by many colleagues for support; whether only action with respect to transfer of “the worker” caught by section 11A(1); Held – broad approach to construction of section 11A(1) adopted; respondent’s medicolegal evidence did not consider the cumulative effect of stressors not appropriately characterised as “transfer”; respondent’s witness evidence did not address issues raised by the applicant going to reasonableness; awards in favour of the applicant for weekly compensation and treatment expenses; medical dispute remitted for referral to a Medical Assessor.
Decision date: 12 January 2026 | Senior Member: Rachel Homan
Mason v Secretary, Department of Planning, Housing and Infrastructure & Ors [2026] NSWPIC 10
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); death claim; determination of dependency, apportionment, and payment of death benefit and interest; TNT Group 4 Pty Limited v Halioris, Kaur v Thales Underwater Systems Pty Ltd, and Wratten v Kirkpatrick & Ors discussed and applied; Held – death benefit and agreed interest apportioned and orders for payment.
Decision date: 13 January 2026 | Principal Member: Glenn Capel
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); worker and independent contractor; whether applicant an employee of the first respondent or a contractor; whether applicant a deemed worker in any event; applicant was undertaking work in a tree felling operation when a branch fell and struck his head causing traumatic brain damage; applicant alleges his relationship with the first respondent was one of employer and employee; no issue the first respondent was uninsured at the date of injury, or that the applicant is totally incapacitated for employment as a result of his injury; Held – primary regard must be had to the terms of the agreement in determining the nature of the relationship between the applicant and first respondent; Construction, Forestry, Maritime, Mining and Energy Union v Personnel Contracting Pty Ltd, and ZG Operations Australia Pty Ltd v Jamsek followed; the evidence does not establish the agreement entered into amounts to a sham arrangement; the terms of the agreement establish on balance that the relationship between the applicant and first respondent was one of principal and contractor; the evidence also discloses the applicant falls within the definition of a deemed worker of the first respondent; the first respondent being uninsured, the second respondent as nominal insurer is to pay the applicant weekly compensation and reasonably necessary medical expenses.
Decision date: 13 January 2026 | Member: Cameron Burge
Newson v Inloop Pty Ltd [2026] NSWPIC 12
Workers Compensation Act 1987; section 11A(1); provision of employment benefits; reasonable action; Pirie v Franklins Ltd, Department of Education and Training v Sinclair, ACR v Grace Worldwide Pty Ltd, Rock Logistics Pty Ltd v Chelin, Sweet Art Special Events Pty Ltd v Workers Compensation Nominal Insurer (iCare) & Ors, Hall v Aware Super Services Pty Ltd, Northern NSW Local Health Network v Heggie, Irwin v Director-General of Education, Ivanisevic v Laudet Pty Ltd, Department of Education and Training v Sinclair, and Van Vliet v Landscape Enterprises Pty Ltd considered and applied; Held – the respondent’s decision to refuse to provide alternate or modified work duties to the applicant to accommodate the restrictions caused by her jaw condition was action in respect to the “provision of employment benefits” for the purposes of section 11A(1); for the purposes of section 11A(1) the action taken by the respondent in respect to “provision of employment benefits” was not reasonable; the respondent has not discharged its onus in making out a defence under section 11A(1); the respondent to pay the applicant pursuant to section 37; the respondent is to pay the applicant’s reasonably necessary medical and treatment expenses for psychological injury pursuant to section 60.
Decision date: 13 January 2026 | Member: John Turner
Motor Accidents Medical Review Panel Decisions
CIC Allianz Insurance Limited v Hamka [2026] NSWPICMP 10
Motor Accidents Compensation Act 1999; review of Medical Assessment Certificate (MAC); t-bone collision with claimant’s leg being trapped in the vehicle requiring extrication by emergency services; claimant assessed by original Medical Assessor (MA) as having 26% whole person impairment (WPI) for psychiatric injuries; preliminary issues relating to allocation to MA under section 60 cannot be considered by the Panel now constituted; referral of dispute as “psychiatric injury” broad enough for Panel to explore an array of psychiatric diagnoses contained in the documentation relied upon by the parties; Mandoukos v Allianz Australia Insurance Limited considered; Held – Panel diagnosed accident-related chronic post-traumatic stress disorder and alcohol use disorder and assessed 7% WPI; psychological symptoms from previous motor accident in 2007 no longer present at time of subject motor accident in 2017; no deduction for pre-existing impairment required; MAC revoked; new certificate issued.
Decision date: 13 January 2026 | Panel Members: Member Jeremy Lum, Dr Ankur Gupta, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural
Hamed v Youi Pty Limited [2026] NSWPICMP 11
Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident when her vehicle was struck by another car; a dispute arose as to the claimant’s whole person impairment (WPI); Medical Assessor (MA) determined the claimant’s WPI was 9%; claimant made an application under section 7.26 for referral of assessment to the Review Panel; Review Panel conducted its own examination and found that WPI as a result of injuries sustained in the accident totalled 6%; certificate of MA was revoked.
Decision date: 14 January 2026 | Panel Members: Member Terence Stern OAM, Dr Margaret Gibson, and Dr Sophia Lahz | Injury module: Spine, Upper Limb, Lower Limb, Brain Injury, and Digestive System
QBE Insurance (Australia) Limited v Issa [2026] NSWPICMP 12
Motor Accident Injuries Act 2017; threshold injury dispute; claimant was the rear-seated passenger in a motor vehicle driven by her daughter; the insured vehicle collided with the rear of the vehicle in which the claimant was travelling; claimant developed pain in her neck, shoulders, and back; claimant attended physiotherapy which was not of much benefit; claimant has seen a specialist for her neck and back; claimant has been referred to a psychiatrist; Medical Assessor (MA) certified that claimant suffered a major depressive disorder with anxious distress which is not a threshold injury; insurer’s review application granted on basis that MA did not reveal a clear path of reasoning particularly on causation; claimant re-examined; Held – Review Panel satisfied that claimant’s psychiatric injury caused by the accident; that injury was a major depressive disorder which is not a threshold injury; certificate confirmed.
Decision date: 14 January 2026 | Panel Members: Member Gary Victor Patterson, Dr Gerald Chew, and Dr Himanshu Singh | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Northcote [2026] NSWPICMP 13
Motor Accidents Compensation Act 1999; review of Medical Assessment Certificate (MAC); claimant hit as a pedestrian by four-wheel drive in what was claimed to be an intentional hit by the claimant’s ex-partner’s partner; claimant assessed by original Medical Assessor as having 17% whole person impairment (WPI) for psychiatric injuries; Held – Review Panel diagnosed post-traumatic stress disorder and intermittent episodes of major depression and assessed 22% WPI; some pre-existing mental health problems noted however no active pre-existing psychiatric diagnosis and therefore no apportionment required; change in diagnosis and impairment value required MAC to be revoked; new certificate issued.
Decision date: 14 January 2026 | Panel Members: Member Jeremy Lum, Dr John Baker, and Dr Matthew Jones | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Schiemer [2026] NSWPICMP 14
Motor Accident Injuries Act 2017; degree of permanent impairment dispute; claimant was riding his motorbike; the motorbike front tyre struck an oil patch causing the motorbike to lose traction resulting in a loss of control; claimant fell with the motorbike landing heavily on his right leg and foot; claimant’s motorbike was extensively damaged; there was no cervical tenderness; a CT scan of the right shoulder showed mild degenerative changes; an MRI scan of the right shoulder revealed a partial thickness tear of the supraspinatus tendon, intra-articular biceps tendinopathy, suspected pectoralis major tendon tear, severe AC joint arthrosis, and soft tissue oedema; claimant underwent a right subscapularis and labrum repair; Medical Assessor (MA) found 14% whole person impairment (WPI) (5% cervical spine, 5% right upper extremity and chest, 3% right ankle, and 1% scarring); MA found injury to lumbar spine not caused by the motor accident; insurer’s review application; insurer submitted MA failed to address pre-existing Young Onset Parkinson’s Disease; failed to deduct pre-existing impairment for cervical spine and right ankle; insurer provided no IME reports; claimant re-examined; Review Panel made similar findings to MA except for the lumbar spine which the Panel found was not caused by the motor accident; Panel assessed 12% WPI after adjusting for pre-existing impairments for the right shoulder; Panel found no pre-existing impairment in the cervical spine; Held – certificate revoked.
Decision date: 14 January 2026 | Panel Members: Member Gary Victor Patterson, Dr Michael Couch, and Dr Christopher Oates | Injury module: Spine, Upper Limb, Lower Limb, and Minor Skin
Workers Compensation Medical Appeal Panel Decisions
Labourforce Impex Personnel Pty Ltd v Hababag [2026] NSWPICMP 2
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); respondent worker suffered accepted primary and secondary psychological injuries whilst in the employ of the appellant employer; Medical Assessor (MA) specifically requested to apportion between the primary and secondary injuries; no issue the MA neither considered nor referred to the secondary psychological condition; the matter was referred to the Appeal Panel for determination which determined the worker needed to be re-examined; question is not one of apportionment so much as determining any impairments arising from each of the injuries and disregarding any impairment arising from the secondary injury; Matheson v Baptistcare NSW & ACT followed; Appeal Panel determined the worker’s whole person impairment (WPI) attributable to the primary injury at 7%; original MAC is therefore revoked.
Decision date: 12 January 2026 | Panel Members: Member Cameron Burge, Professor Nicholas Glozier, and Dr John Baker | Body system: Psychological/Psychiatric
Brown v Trinity Retail Pty Ltd [2026] NSWPICMP 3
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of left upper extremity and cervical spine made in reconsideration MAC in which original assessment was maintained including no assessment for restriction in activities of daily living (ADLs) from the cervical spine injury; whether Medical Assessor (MA) erred in not making an assessment for restrictions in ADLs; Appeal Panel found that the MA erred in failing to provide adequate reasons for concluding that the cervical spine injury caused no restriction in ADLs; Held – MAC revoked.
Decision date: 12 January 2026 | Panel Members: Member Carolyn Rimmer, Dr Drew Dixon, and Dr Tommasino Mastroianni | Body system: Cervical Spine, and Left Upper Extremity
Holden v State of NSW (NSW Police Force) [2026] NSWPICMP 4
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal relates to section 323 deduction for a pre-existing condition; Medical Assessor deducted one-third; Held – Appeal Panel can find no evidence of any pre-existing condition to ground the relevant deduction; MAC revoked.
Decision date: 12 January 2026 | Panel Members: Senior Member Elizabeth Beilby, Dr Drew Dixon, and Dr Gregory McGroder | Body system: Cervical Spine
Ventia Australia Pty Ltd v Melgar [2026] NSWPICMP 5
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); consideration of deduction for a pre-existing condition; Medical Assessor failed to refer, consider, or take into account pre-existing treatment and radiology; Held – Appeal Panel determined that a one-tenth deduction pursuant to section 323 was appropriate.
Decision date: 12 January 2026 | Panel Members: Senior Member Elizabeth Beilby, Dr Drew Dixon, and Dr Christopher Oates | Body system: Lumbar Spine, and Scarring (TEMSKI)
Huzairan v Pharmacare Operations No. 2 Pty Ltd [2026] NSWPICMP 6
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appellant submitted that the Medical Assessor erred in failing to provide sufficient reasons for why he gave 1% whole person impairment (WPI) for activities of daily living (ADLs) for the cervical spine injury, and that he erred in failing to give at least 2% WPI for ADLs for the cervical spine injury; Held – Appeal Panel found no error; assessment was consistent with all of the evidence; MAC confirmed.
Decision date: 12 January 2026 | Panel Members: Member Deborah Moore, Dr James Bodel, and Dr Margaret Gibson | Body system: Cervical Spine
Kelly v Secretary, Department of Communities and Justice [2026] NSWPICMP 7
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the ratings the Medical Assessor (MA) made of the appellant’s impairment in the psychiatric impairment rating scale (PIRS) domains of self care and personal hygiene, social and recreational activities, and travel involved error; Held – MA’s ratings did not involve error; MAC confirmed.
Decision date: 13 January 2026 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric
Workman v Secretary, Department of Education [2026] NSWPICMP 8
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the Medical Assessor (MA) ought to have assessed the appellant’s impairment from the appellant’s injury to his knees by reference to Table 17-31 of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5), that is arthritis, rather than Table 17-33, that is a diagnosis based estimate; Held – MA did not err by assessing the appellant’s impairment by reference to Table 17-33, and meticulously explained why he did so; the MA applied the correct criteria to assess the appellant’s permanent impairment from his injury; MAC confirmed.
Decision date: 13 January 2026 | Panel Members: Member Marshal Douglas, Dr Alan Home, and Dr James Bodel | Body system: Left Lower Extremity, Right Lower Extremity, and Scarring (TEMSKI)
Standard Distributors Pty Ltd v Guler [2026] NSWPICMP 9
Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred by not limiting assessment of the respondent’s permanent impairment to the impairment she had of her respiratory system; whether MA erred by assessing the appellant’s impairment due to a sleep disorder by reference to the criteria of Chapter 5 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (the Guidelines); Held – MA erred and did not apply correct criteria to assess the respondent’s permanent impairment by assessing it by reference to Chapter 5 of the Guidelines in the circumstance where the respondent did not have a primary sleep disorder following a neurological injury; the respondent did not have sleep apnoea and so could not be rated for impairment by reference to the criteria of paragraphs 8.8 - 8.10 of the Guidelines; MAC revoked.
Decision date: 13 January 2026 | Panel Members: Member Marshal Douglas, Dr David Gorman, and Dr Peter Honeyman | Body system: Cervical Spine, Lumbar Spine, Left Upper Extremity, Right Upper Extremity, and Respiratory System
Motor Accidents Merit Review Decisions
Yan v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMR 39
Motor Accident Injuries Act 2017; merit review of insurer’s pre-accident weekly earnings (PAWE); decision made under Schedule 1, clause 4; insurer determined PAWE at $270.31 which was the weekly average of the gross earnings received by the claimant during the 12 months before the day of the motor accident under Schedule 1, clause 4(1); Merit Reviewer noted that the claimant did not have any earnings for much of the 12 months before the motor accident; claimant started her own business in the months before the motor accident and was earning more on a weekly basis; Merit Reviewer satisfied there was a “change of circumstances” within the meaning of subclause (3) of Schedule 1, clause 4; GST component subtracted from earnings; Held – Merit Reviewer found claimant could reasonably have expected to receive a PAWE of $1,085 but for the injury; the reviewable decision was set aside.
Decision date: 13 June 2025 | Merit Reviewer: Jeremy Lum
AAI Limited t/as AAMI v Mohit [2025] NSWPICMR 38
Motor Accident Injuries Act 2017; merit review; dispute under section 6.24; whether a request for unredacted bank statements and monthly Uber taxation summaries for post-accident periods is reasonable and whether the claimant has a reasonable excuse for failing to comply; inconsistencies in the evidence; incomplete evidence; unreliable evidence; credit issues; potential non-disclosure; insurer seeks further documents to determine the claimant’s post-accident loss of earnings for the purpose of payment of weekly benefits under Division 3.3 and to determine the validity of the claim and whether any part of the claim may be fraudulent; Held – the insurer’s request for further documents is reasonable and the claimant does not have a reasonable excuse for their failure to comply.
Decision date: 15 December 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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