Legal Bulletin No. 266
This bulletin was issued on 26 June 2026
Issued 26 June 2026
Welcome to the two hundred and sixty-sixth 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 external site and will be available shortly, on Jade external site and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.
Presidential Member Decision
State of New South Wales (TAFE NSW) v Webster [2026] NSWPICPD 25 external site
Workers compensation; whether error on the part of the Member in determining that the proposed surgery was reasonably necessary; State of New South Wales v Culhana [2025] NSWCA 157 discussed and applied; Diab v NRMA Limited [2014] NSWWCCPD 72 discussed; Held – the name of the appellant (the respondent in the proceedings below), wherever it appears, is amended to “State of New South Wales (TAFE NSW)”; the Member’s Certificate of Determination dated 12 September 2025 is confirmed.
Decision date: 15 June 2026 | Before: Acting Deputy President Elizabeth Wood
Motor Accidents non-Presidential Member Decisions
AAI Limited t/as GIO v Fraser [2026] NSWPIC 32 external site
Motor Accident Injuries Act 2017; settlement approval; damages limited to past and future economic loss and superannuation, claimant sustained fracture of her left wrist and developed psychological injuries; after surgery and treatment, the claimant has made a good recovery and returned to full work capacity; Held – settlement approved under 6.23(2)(b) of the Act in the sum of $150,000 within the range of settlement expected by a Member in the Commission; insurer to receive a credit for payment of statutory benefits; parties acknowledge entitlement to future treatment and care for reasonable accident-related injuries.
Decision date: 22 January 2026| Member: Elyse White
Insurance Australia Limited t/as NRMA Insurance v BVR [2026] NSWPIC 338 external site
Motor Accident Injuries Act 2017; approval of settlement of claim for common law damages; section 6.23; proposed settlement comprised an allowance for past economic loss only; C6 vertebral compression fracture was longstanding and likely caused by a previous motor accident in 1989; soft tissue injuries to neck, head, left elbow and left knee caused by the accident; injuries to the head, left knee and left elbow have resolved; claimant’s psychological injury assessed at 1% WPI by the Personal Injury Commission; claimant was 64 years of age at the time of accident; proposed settlement represented full loss of wages from the date of accident to age 67; Held – proposed settlement of $187,012.80 is approved.
Decision date: 10 June 2026| Member: Maurice Castagnet
Spencer v AAI Limited t/as AAMI [2026] NSWPIC 342 external site
Motor Accident Injuries Act 2017; settlement approval; claimant 28 yrs old, riding his motor cycle when the insured driver hit him from behind; major injury to his left hand which continues to be aggravated by certain work activities, claimant employed with the ADF as an Army Aviation Technician, WPI assessed as not greater than 10%, damages limited to past and future economic loss; Held – settlement approved in the sum of $340,000; settlement is just, fair and reasonable and within the range of likely potential damages assessment if the claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.
Decision date: 11 June 2026| Member: Elyse White
AAI Limited t/as AAMI v Carroll [2026] NSWPIC 347 external site
Motor Accident Injuries Act 2017; settlement approval; claimant at the age of 17 years old was a passenger who knew the driver was intoxicated,; insurer alleged 30% contributory negligence; suffered serious internal injuries; claimant an apprentice hairdresser; employer unable to provide light duties; apprenticeship delayed due to injuries; completed apprenticeship and now working as a senior stylist; claimant may experience periods of incapacity in the future; damages for non-economic loss, past and future economic loss; Held – settlement approved in the sum of $504,700 after deduction for 30% contributory negligence; settlement just, fair and reasonable and within the range of likely potential damages assessment if the claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.
Decision date: 12 June 2026| Member: Elyse White
Smallman v AAI Limited t/as GIO [2026] NSWPIC 348 external site
Motor Accident Injuries Act 2017; claim for statutory benefits; whether claimant wholly or mostly at fault for the purposes of sections 3.11 and 3.28; claimant has no recollection of accident; claimant not seen by insured driver prior to accident; allegation of edge filtering contrary to the Road Rules 2014; AAI Ltd (t/as GIO) v Evic, Podrebersek v Australian Iron & Steel Pty Ltd, and Verryt v Schoupp considered and applied; in-person assessment conference with oral evidence from claimant and insured driver; Held – contributory negligence of claimant assessed at 60%; claimant not wholly or mostly at fault for the purposes of sections 3.11 and 3.28; costs allowed pursuant to sections 8.3(4) and 8.10(4).
Decision date: 12 June 2026| Member: Bianca Montgomery-Hribar
Cupac v AAI Limited t/as GIO [2026] NSWPIC 349 external site
Motor Accident Injuries Act 2017; claims assessment dispute about the amount of damages to be paid to the claimant under section 7.36 (3) and 7.36 (4); claimant was driving his motor vehicle through an intersection when a collision occurred with the insured motor vehicle; insured driver failed to comply with red light traffic signal; insurer admitted liability; claimant sustained soft tissue injuries to neck, thoracic and lumbar spine, labral tear right shoulder and psychological injuries; at the time of the accident claimant was an air conditioning technician and electrical fitter; aged 39 years; since the accident claimant was unable to resume full duties at work; working reduced hours and light duties; insurer conceded non threshold injuries; no claim for non-economic loss; claim for damages for past and future economic loss; determined claimant entitled to damages for past economic loss; Held – claimant is entitled to damages for past and future economic loss.
Decision date: 12 June 2026| Member: David Ford
AAI Limited t/as GIO v Mather [2026] NSWPIC 350 external site
Motor Accident Injuries Act 2017; settlement approval; claimant 68 yr-old passenger in vehicle driven by her husband; insured driver swerved onto the incorrect side of the road causing a collision; claimant sustained rib and chest injuries; made a full recovery; was on long service leave and planned to retire three months post-accident; damages limited to fourteen weeks past economic loss amounting to $26,290.16; Held – settlement approved in the sum of $26,290.16; settlement just, fair and reasonable and within the range of likely potential damages assessment if the claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.
Decision date: 12 June 2026| Member: Elyse White
Insurance Australia Limited t/as NRMA Insurance v Bonda [2026] NSWPIC 355 external site
Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 22 February 2022; claimant was working at the time of the accident; claimant is aware no entitlement to future statutory benefits once settlement is approved; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines; settlement approved in the amount of $64,061.10, consisting of nil non-economic loss and past economic loss of $34,061.10 and $30,000.00 future economic loss.
Decision date: 15 June 2026 | Member: Philip Carr
Workers Compensation non-Presidential Member Decisions
Simmons v Stay Loaded Pty Ltd [2026] NSWPIC 59 external site
Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998; election to discontinue proceedings filed after Medical Assessment Certificate (MAC) issued in 2023 in relation to psychological injury assessed at 14% whole person impairment; in 2025 the applicant filed an application to appeal against the decision of the Medical Assessor (MA) on the basis that there had been a deterioration of his psychological condition including the fact that he had been scheduled under the Mental Health Act 2007 and forcibly restrained in hospital for a time since the MAC was issued; issue raised as to whether the Personal Injury Commission could use section 57 of the Personal Injury Commission Act 2020 (PIC Act) to reconsider the discontinuance of the proceedings; finding made that section 57 could not be used because sealing the Election to Discontinue did not amount to a decision of the Commission; finding made that the discontinuance of the application to resolve a dispute did not render the MAC a nullity; finding that section 327(3)(a) of the 1998 Act provides for an appeal of a MAC on the grounds of deterioration and contains no time limit governing when such an appeal can be filed; Pham v Quality Bakers Australia Pty Limited t/as Goodman Fielder, Cram Fluid Power Pty Ltd v Green, and Campbelltown City Council v Vegan considered; Lizdenis v Central Pty Ltd, and Meyers v Andrew Miedecke Motors Pty Ltd applied; Held – in accordance with the objects in section 3 of the PIC Act, the order is made that the proceedings be restored and the appeal be dealt with by the President’s Delegate to decide whether or not to refer the appeal to a Medical Appeal Panel.
Decision date: 30 January 2026| Member: Josephine Bamber
Nicholson v Essential Energy [2026] NSWPIC 337 external site
Workers Compensation Act 1987; accepted psychological injury and section 11A(1) dispute withdrawn; sole issue for determination was the applicant’s capacity for work and entitlement to weekly compensation in the period from 19 September 2024 to date and continuing; respondent disputed the applicant’s suffered an incapacity for work resulting from injury; Held – the applicant established that she suffered a partial incapacity for work resulting from the injury with entitlement to weekly compensation payable under sections 36 and section 37.
Decision date: 9 June 2026| Member: David Cooper
Abrhaim v The CJ Labour Hire Company Pty Ltd (Deregistered) [2026] NSWPIC 340 external site
Workers Compensation Act 1987; application for domestic assistance for transportation of applicant’s three children to and from school, daycare, and after school activities; Hesami v Hong Australia Corporation Pty Ltd considered; Held – applicant has not established he is entitled to compensation pursuant to section 60AA(1) in respect of transportation of his children to and from school, daycare, and after school activities; award for the respondent.
Decision date: 10 June 2026| Member: Fiona Seaton
Hunter v Invocare Australia Pty Ltd [2026] NSWPIC 341 external site
Workers Compensation Act 1987; whether the applicant suffered right hip injury in the course of her employment on 26 September 2024; claim for section 60 expenses relating to right hip replacement surgery; lack of contemporaneous evidence linking hip symptoms to the incident; inconsistent reporting of injury and previous chronic yet spontaneous exacerbations of hip pain and other possible explanations for the applicant’s condition; Nguyen v Cosmopolitan Homes, AV v AW , Paric v John Holland, Davis v Council of the City of Wagga Wagga, and Fox v Percy considered and applied; Held – not satisfied that applicant discharged onus of proof with regards to injury; award for respondent with respect to claim for section 60 expenses.
Decision date: 10 June 2026| Member: Diana Benk
Sader v Formcrete Personnel Pty Ltd (in Liquidation) [2026] NSWPIC 343 external site
Workers Compensation Act 1987; applicant was injured in an accident at work; respondent accepted liability for injuries to the applicant’s cervical spine, right upper extremity and scarring/temski; respondent denied liability for any consequential sleep condition, submitting that a significant proportion of the applicant’s weight gain could not be attributed to the accident; Held – a proportion of the weight gain was attributable and that pain, leading to supine sleeping, and the use of respiratory suppressant medications were also consequential causative factors.
Decision date: 11 June 2026| Member: Lea Drake
Workers Compensation Act 1987; whether the applicant suffered consequential condition to the urinary and reproductive system (Kidney) as a result of accepted lumbar spine injury on 7 December 2017; applicant maintains high ingestion of NSAID medication resulted in kidney dysfunction ultimately requiring nephrectomy; gaps and inconsistencies in the medical evidence; value of contemporaneous evidence discussed which revealed the applicant had well advanced long term chronic renal disease prior to workplace injury and ingestion of NSAID; Nguyen v Cosmopolitan Homes, Kooragang Cement Pty Ltd v Bates (Constructions) Pty Ltd, and Kumar v Royal Comfort Bedding; Held – award for the respondent for consequential claims of the urinary and reproductive system (kidney); balance of accepted injuries including lumbar spine, scarring and gastric ulcer (upper digestive system) referred to a Medical Assessor to assess degree of whole person impairment.
Decision date: 11 June 2026| Member: Diana Benk
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim by uninsured employer pursuant to section 145(3) of the alleging that it is not liable in respect of compensation payments made by the first respondent to the second respondent; consideration of statement evidence, other factual evidence, financial evidence, medical reports and other treatment records, as well as claim correspondence; consideration of onus of proof; A1 Granny Flats v Workers Compensation Nominal Insurer, Nguyen v Cosmopolitan Homes, Drca v KAB Seating Systems Pty Ltd considered; consideration of whether the second respondent was a worker; Stevens v Brodribb Sawmilling Co Pty Limited, Digby v Hyspec Construction & Roofing Pty Limited, and Construction, Forestry, Maritime, Mining and Energy Union v Personnel Contracting Pty Limited considered; consideration of whether the second respondent sustained injury; Galluzzo v Commonwealth Bank of Australia, Trustees of the Society of St Vincent de Paul (NSW) v Maxwell James Kear as administrator of the estate of Anthony John Kear considered; extent of the second respondent’s work capacity and need for treatment considered; section 261 of the 1998 Act considered; Held – as at 28 September 2023, the second respondent was a worker in the employ of the applicant; the second respondent suffered injury to his lower back/coccyx on 28 September 2023 pursuant to sections 4 and 9A of the 1987 Act; applicant has discharged its onus of proving that the second respondent had no restrictions on his work capacity between 13 October 2024 and 16 December; applicant has failed to discharge its onus of proving that the second respondent had current work capacity between 17 December 2024 and 1 March 2025; applicant has failed to discharge its onus of proving that the second respondent’s medical consultations were not reasonably necessary; applicant cannot rely upon section 261(1) of the 1998 Act to prove that it had no liability to compensate the second respondent; applicant was not insured in respect of its liability to compensate the second respondent in accordance with the 1987 Act regarding his injury on 28 September 2023; amount of $20,661 has been paid by the first respondent to or on behalf of the second respondent with respect to his 28 September 2023 injury; of that amount, an amount of $10,056.43 was paid in weekly benefits compensation payments between 13 October 2024 and 16 December; applicant is not liable to reimburse this amount to the first respondent; the applicant is liable to reimburse to the first respondent the remainder of the amount paid by it ($10,604.57); as a result, the applicant’s request for an order from the Personal Injury Commission pursuant to section 145(3) of the 1987 Act, that it is not liable to reimburse the amount of $20,661 to the first respondent is upheld; applicant is instead found to be liable to reimburse the amount of $10,604.57 to the first respondent and is ordered to pay that amount.
Decision date: 11 June 2026 | Member: Gaius Whiffin
Aulakh v CDC NSW Pty Ltd [2026] NSWPIC 346 external site
Workers Compensation Act1987; dispute as to injury to the applicant’s lumbar spine; closed period claim for weekly compensation; applicant a bus driver; conflicting medical evidence as to the cause of lumbar symptoms; applicant’s medical evidence preferred to that of respondent’s independent medical examiner due to inconsistencies and poor reasoning in his reports; Held – pursuant to section 4(b)(ii) the applicant sustained an injury to his lumbar spine with his employment with the respondent being the main contributing factor to the aggravation of the lumbar disease with the deemed date of injury of 15 February 2024; applicant has no current capacity for employment from 3 February 2025 to 2 September 2025; respondent is to pay the applicant weekly compensation under sections 36(1) and 37(1) from 3 February 2025 to 2 September 2025 based on the pre-injury average weekly earnings figure of $1,644.59 (as indexed); respondent is to have credit for payments made to the applicant in this period not including annual leave, sick leave, or long service leave.
Decision date: 11 June 2026| Member: Josephine Bamber
Turner v Iannelli Holdings Pty Ltd & Anor [2026] NSWPIC 351 external site
Workers Compensation Act1987; claim under section 25(1) for lump sum death benefit; deceased worker died in a truck crash while enroute to deliver produce for employer; whether injury arising out of or in the course of employment for the purposes of section 4(a); evidence that deceased worker’s wife was possibly driving the vehicle at the time of the accident; post-mortem toxicology results revealing high levels of illicit drugs; Workcover Authority of NSW v Walsh, Badawi v Nexon Asia Pacific Pty Limited trading as Commander Australia Pty Limited, and Tarry v Waringah Shire Council considered; Held – on the balance of probabilities the deceased worker was the driver; the ingestion of illicit drugs took the deceased worker outside the course of employment; section 14(1) not satisfied; nevertheless, injury arose out of employment; employment a substantial contributing factor to injury pursuant to section 9A; death resulted from an injury.
Decision date: 12 June 2026| Senior Member: Rachel Homan
BXY v BYP [2026] NSWPIC 352 external site
Workers Compensation Act1987; application for lump sum compensation based on psychological injury contracted by employment in 2020; applicant had significant illicit drug use which was not disclosed to various doctors until 2024; credibility of applicant; non-work stressors included illicit drug abuse, criminal charge and conviction, and partner’s health in the context of significant time off work; applicant’s submission that work caused illicit drug use rejected; discussion of non-work causes and issues of materiality of cause of psychological injury; Paric v John Holland Constructions Pty Ltd applied; discussion of fair climate of various medical opinion in the absence of comment of non-work factors; issues of proof of employment being the main contributory factor to the contraction of the disease; finding made there was a perception of bullying in the context of performance appraisal for late and non-attendances at work; other non-work causes for contraction of psychological injury; suggestion of reversal of onus; onus not established that employment was the main contributory factor to contracting the disease; Held – award in favour of respondent.
Decision date: 12 June 2026| Principal Member: John Harris
EAY v FFC [2026] NSWPIC 354 external site
Workers Compensation Act 1987; claim for psychological injury; injury not in dispute; 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 discipline; Poonan v George Weston Foods, Hamad v Q Catering, Northern NSW Local Health Network v Heggie, and Irwin v Director General of School Education considered; Held – applicant sustained injury in the form of adjustment disorder under section 4; respondent has failed to establish its defence under section 11A due to flawed and delayed disciplinary process and continuation of disciplinary process despite internal investigations revealing that claims made in relation to the applicant’s conduct could not be verified; applicant is entitled to payment of reasonably necessary expenses pursuant to section 60 and award of weekly compensation from 11 March 2025.
Decision date: 12 June 2026| Member: Diana Benk
Rose v Catholic Healthcare Ltd [2026] NSWPIC 356 external site
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); sections 37 and 60 of the 1987 Act; sections 260 and 389 of the 1998 Act; claim; consequential condition; incapacity; reasonably necessary as the result of an injury; material contribution; State of New South Wales v Bishop, Kooragang Cement Pty Ltd v Bates, Moon v Conmah Pty Limited, Hunt & Hunt Lawyers v Mitchell Morgan Nominees Pty Limited, Murphy v Allity Management Services Pty Ltd, and Gould v Vaggelas considered and applied; Held – a claim has been made in respect to bilateral carpal tunnel syndrome and in respect to bilateral carpal tunnel release surgeries; that the bilateral carpal tunnel release surgery was reasonably necessary as the result of the accepted injury to the left knee; that the applicant has sustained consequential conditions of the right wrist and left wrist as the result of the accepted injury to the left knee on 19 September 2023; Held – respondent is to pay the applicant pursuant to section 37 of the 1987 Act; $474.73 from 6 October 2025 to 12 October 2025; $609.66 from 13 October 2025 to 19 October 2025, and $374.62 from 20 October 2025 to 3 January 2026; an award for the respondent in respect to the claim for weekly compensation for the periods from 14 July 2025 to 5 October 2025, and from 4 January 2026 to 26 February 2026; respondent is to pay the costs of and incidental to the bilateral carpal tunnel release surgery pursuant to and in accordance with section 60 of the 1987 Act.
Decision date: 15 June 2026 | Member: John Turner
Finlay Screening & Crushing Systems Pty Ltd v Pearce [2026] NSWPIC 359 external site
Workers Compensation Act 1987; claim for lump sum death benefit; liability to pay compensation accepted; identification of dependants who were wholly or partly dependent for support; findings made that parents and sister of deceased were not dependent and did not wish to claim a portion of the death benefit; whether the respondent was the deceased worker’s de facto partner; Held – while the evidence established that the respondent and deceased worker had a ‘relationship as a couple’, the Personal Injury Commission was not satisfied that they were ‘living together’ for the purposes of section 21C of the Interpretation Act 1987; respondent was the deceased worker’s legal personal representative; orders for payment of the death benefit and discretionary interest to the respondent in her capacity as legal personal representative.
Decision date: 16 June 2026| Senior Member: Rachel Homan
Moore v Freedom Enterprises Australia Pty Ltd [2026] NSWPIC 360 external site
Workers Compensation Act 1987; weekly benefits under section 38; whether the applicant is totally incapacitated and likely to remain so; work capacity decision; whether the applicant’s condition since the making of the decision has deteriorated; consequential conditions; whether applicant suffered DVT, pulmonary emboli, respiratory issues and a secondary psychological condition as a result of the accepted injury; Held – applicant has discharged the onus of proof in establishing the presence of the consequential conditions; applicant is totally incapacitated for employment and is likely to remain so permanently; respondent ordered to pay weekly compensation per section 38 as claimed by the applicant.
Decision date: 16 June 2026| Member: Cameron Burge
Motor Accidents Medical Review Panel Decisions
Insurance Australia Limited t/as NRMA Insurance v Waters [2025] NSWPICMP 287 external site
Motor Accident Injuries Act 2017; review of medical assessment by Review Panel; assessment of whole person impairment (WPI); alleged injuries to the left ankle, lumbar spine, left wrist and pelvis caused by motor accident occurring on 2 December 2020; issues of causation; lumbar spine injury found to be caused by the accident as a secondary injury due to altered gait from left lower extremity injury; mechanism of injury found to be consistent with left wrist injury, however, injury now resolved; Review Panel found no injury to pelvis, however, an injury to the hip, which was not referred for assessment; Held – Medical Assessment Certificate (MAC) revoked; WPI for the injuries assessed at 7%; new combined MAC issued certifying WPI of 11% (4% scarring in separate MAC) is greater than 10%.
Decision date: 28 April 2025| Panel Members: Member Elizabeth Medland, Dr Drew Dixon, and Dr Shane Maloney| Injury module: Spine, Upper Limb, and Lower Limb
Insurance Australia Limited t/as NRMA Insurance v Yu [2026] NSWPICMP 407 external site
Motor Accident Injuries Act 2017; review of medical assessment; assessment of treatment and care-causation; right shoulder arthroscopy; rear seat passenger; minimally displaced rib fracture; superior labral anterior to posterior tear; conservative measures have not resolved the shoulder issues; delay in report of symptoms; reasonable explanation for delay; surgical intervention is appropriate noting ongoing symptoms; right shoulder arthroscopy relates to the injury caused by the motor accident; Held – request for right shoulder arthroscopy is reasonable and necessary in the circumstances.
Decision date: 26 May 2026| Panel Members: Member Hugh Macken, Dr David Gorman, and Dr Drew Dixon| Treatment Type: Surgery
AAI Limited t/as GIO v Naderi [2026] NSWPICMP 410 external site
Motor Accident Injuries Act 2017; review of the medical assessment certificate of a Medical Assessor; dispute about whether an injury to teeth was caused by the motor accident; whether the injury was a threshold injury; whether the claimant hit her face on impact; no evidence of reporting of injury in the days and weeks following the accident; claimant re-examined; where the review panel found that the motor accident did not cause any injury to teeth; Held – original Medical Assessment Certificate revoked.
Decision date: 11 June 2026| Panel Members: Member Maurice Castagnet, Dr Geoffrey Paul Curtin, and Dr Michael Couch| Injury module: Dental
Loke v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 412 external site
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); whole person impairment (WPI) dispute; alleged injuries to right hip, neck and lower back; original Medical Assessor found asymmetrical range of motion in the neck assessed at a 5% WPI and loss of range of motion in the right hip assessed at a 4% WPI; Review Panel re-examined and found cervical myelopathy and radiculopathy; complex causation issue; claimant had similar neck symptoms five years before the motor accident; radiology showed longstanding degenerative change with no acute traumatic markers; no cervical spine complaints for some four months after motor accident despite multiple consultations with treatment providers; Held – cervical myelopathy and radiculopathy considered a natural progression of a pre-existing degenerative condition; no material aggravation caused by the motor accident; causation provisions in clause 6.6 of the Motor Accident Guidelines referred to; other injuries accepted as causally related; lumbar spine assessed at 5% WPI; right hip assessed at 2%; MAC revoked; new certificate issued.
Decision date: 12 June 2026| Panel Members: Member Jeremy Lum, Dr Mohammed Assem, and Dr Margaret Gibson| Injury module: Spine, and Lower Limb
AAI Limited t/as GIO v Williams [2026] NSWPICMP 414 external site
Motor Accident Injuries Act 2017; application by insurer to issue a direction for production of documents from a Bank for the claimant’s credit card and banking records; claimant to be assessed for psychological injuries; application of principles discussed the Court of Appeal in Secretary of the Department of Planning, Industry and Environment v Blacktown City Council; examination of whole person impairment of psychological injury; application of psychological impairment rating scale (PIRS) categories; documents apparently relevant to a number of PIRS categories including self-care; travel and social and recreational activities; observations that practice objecting to third party directions are often based on a lack of meritorious submissions; Held – leave to insurer to issue direction.
Decision date: 15 June 2026| Panel Member: Principal Member John Harris| Injury module: Spine, Upper Limb, and Lower Limb
Allianz Australia Insurance Limited v Gyimah [2026] NSWPICMP 415 external site
Motor Accident Injuries Act 2017; degree of whole person impairment (WPI) dispute; claimant was involved in a motor vehicle accident while travelling on a government bus; claimant was sitting when the bus driver suddenly braked for reasons unknown; claimant was propelled into the seat in front of her and onto the floor; claimant suffered an injury to her neck, shoulders, back and right ankle; scans were done but no fracture was identified; claimant’s MRI scans of the neck and lower part of the back showed some degenerative change; shoulders also showed some rotator cuff pathology in the region of the right shoulder; ultrasound of the right ankle showed a mild lateral ligament injury; Medical Assessor (MA) certified that the motor accident caused all of the referred injuries to the cervical spine, both shoulders, lumbar spine and right ankle; he found 17% WPI; an MA re-assessed claimant on behalf of the Review Panel; Held – Review Panel MAs agreed that all referred injuries were caused by the motor accident; MA agreed with an assessment of a 9% WPI; Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 15 June 2026| Panel Members: Member Gary Victor Patterson, Dr Drew Dixon, and Dr David Gorman| Injury module: Spine, Upper Limb, and Lower Limb
Transport Accident Commission v Gallo [2026] NSWPICMP 417 external site
Motor Accident Injuries Act 2017; review of medical assessment; assessment of degree of whole person impairment (WPI); right tempomandibular joint; prior bilateral TMJ disc repositioning surgery; persistent/facial pain since accident; no chronic bruxism history or dental factors precipitating in a TMJ issue; pre-existing condition; right side TMJ pain noted two years pre-accident; subject accident did not cause any deterioration; noted there is no dietary restriction; Held – WPI assessed at 0% in any event.
Decision date: 16 June 2026| Panel Members: Member Hugh Macken, Dr Rohan Krishnan, and Dr Adrian Vertoudakis| Injury module: Dental Injury
Transport Accident Commission v Gallo [2026] NSWPICMP 418 external site
Motor Accident Injuries Act 2017; review of medical assessment; assessment of degree of whole person impairment (WPI); soft tissue injury cervical spine; soft tissue injury left knee; accident did not cause or contribute to a worsening of a lumbar spine condition; ambulance records relevant; hospital records did not mention low back injury; first reference to lower back pain eight months post-accident; reproducible asymmetric loss of active range of motion of cervical spine; Held – WPI assessed at 5%.
Decision date: 16 June 2026| Panel Members: Member Hugh Macken, Dr Christopher Oates, and Dr Sophia Lahz| Injury module: Spine, and Lower Limb
Transport Accident Commission v Gallo [2026] NSWPICMP 419 external site
Motor Accident Injuries Act 2017; review of medical assessment; assessment of degree of permanent impairment; head (brain) injury; post traumatic headaches with right temporal sensory neurapraxia/trigeminal nerve bruising to right temporal area; CT scan of brain showed no lesion; tempomandibular joint discomfort; no medically verified post-traumatic amnesia; no cognitive abnormalities evident during the examination; no abnormal post injury Glasgow scale score; head soft tissue injury associated with right trigeminal nerve injury; mild numbness and pain; area of diminished sensation over part of the distribution of the first division of the right trigeminal nerve; degree of permanent impairment consequence on the trigeminal nerve injury is 3%; Medical Assessment Certificate confirmed.
Decision date: 16 June 2026| Panel Members: Member Hugh Macken, Dr Christopher Oates, and Dr Sophia Lahz| Injury module: Brain Injury
Workers Compensation Medical Appeal Panel Decisions
Malone v Yenda Prods Irrigation Pty Ltd [2026] NSWPICMP 409 external site
Workplace Injury Management and Workers Compensation Act 1998; psychological Injury; lump sum claim; appellant worker challenged assessment in one of the six psychological impairment rating scale categories; social and recreational activities; error found and re-examination considered necessary; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 9 June 2026| Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr John Lam-Po-Tang| Injury module: Psychiatric/psychological
Singh v T2 Transport Pty Ltd [2026] NSWPICMP 411 external site
Workplace Injury Management and Workers Compensation Act 1998; appeal from an assessment of a 9% whole person impairment (WPI) for an ankle/ foot injury; whether Medical Assessor (MA) had erred in not finding same ROM as claimant’s expert; whether MA had failed to assess hindfoot and midfoot; whether MA inadequately considered MRI scan concerning neurological denervation; whether claimant’s expert had been unreasonably rejected; whether MA had replicated respondent expert’s findings without independent analysis; Held – claimant’s submissions misconceived and made with an eye too keenly attuned to the perception of error, Medical Assessment Certificate confirmed.
Decision date: 11 June 2026| Panel Members: Member John Wynyard, Dr Todd Gothelf, and Dr Christopher Oates| Injury module: Right Lower Extremity
Workers Compensation Act 1987; psychological injury; applicant suffered from ongoing pain caused by work accident; common ground that effects of pain were to be disregarded; application of observations of Basten AJA in Matheson v Baptistcare NSW & ACT; grounds of appeal by worker alleged error in three psychiatric impairment rating scale (PIRS) categories; error found in two categories; self-care and employability; Medical Assessor only considered effects of pain and did not consider effects from primary psychological injury; Appellant re-examined on two PIRS classes; findings made that pain also causing loss of function in those categories and the effects were disregarded; Held – claimant re-assessed at 13% permanent impairment; original Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 12 June 2026| Panel Members: Principal Member John Harris, Dr Michael Hong, and Dr Ash Takyar| Injury module: Psychiatric/psychological
Secretary, Department of Education v Conolly [2026] NSWPICMP 416 external site
Workplace Injury Management and Workers Compensation Act 1998; psychological injury; lump sum claim; appellant employer did not challenge the overall whole person impairment assessment; appellant complained on appeal that a deduction should have been made under section 323; no error found; Held – Medical Assessment Certificate confirmed.
Decision date: 15 June 2026| Panel Members: Member Jane Peacock, Dr Douglas Andrews, and Dr John Lam-Po-Tang| Injury module: Psychiatric/psychological
Pearson v Secretary (Department of Education) [2026] NSWPICMP 420 external site
Workplace Injury Management and Workers Compensation Act 1998; psychological Injury; lump sum claim; appellant worker challenged the assessments in two of the six psychiatric impairment rating scale categories; social and recreational activities and concentration, persistence and pace; error found and re-examination considered necessary; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 16 June 2026| Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr Ash Takyar| Injury module: Psychiatric/psychological
Motor Accidents Merit Review Decisions
Nguyen v Youi Pty Limited [2026] NSWPICMR 25 external site
Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about calculation of pre-accident weekly earnings (PAWE); whether evidence is consistent and reliable; inconsistencies as to pre-accident earnings, inconsistencies between payslips, tax records and accountant evidence, significant discrepancies between documents; inconsistent statements; failure to disclose source documents; absence of primary evidence; whether payments by a trust to a Visa card used by the claimant can be characterised as earnings; Allianz Insurance Australia Limited v Shahmiri, Kipkorir v Insurance Australia Ltd t/as NRMA, Alzate v Insurance Australia Ltd t/as NRMA, BAH v QBE Insurance (Australia) Ltd, Zou v QBE Insurance (Australia) Ltd, and Kozlov v Insurance Australia Ltd t/as NRMA considered and applied; Held – the reviewable decision is affirmed.
Decision date: 10 June 2026| Merit Reviewer: Katherine Ruschen
Beniwal v Youi Pty Limited [2026] NSWPICMR 26 external site
Motor Accident Injuries Act 2017; merit review; dispute about the amount of weekly payments of statutory benefits that are payable under Division 3.3 of the Act; Schedule 2(1)(a); pre-accident weekly earnings (PAWE); PAWE calculation; earnings as an earner; claimant is an earner, but claimant did not receive income during relevant 12 months before the accident; earnings reinvested in business; entitlement to statutory weekly benefits under the Act is not tied to the common law concept of compensation for loss of earning capacity; no costs; Held – insurer’s final reviewable decision affirmed
Decision date: 11 June 2026| Merit Reviewer: Terence O'Riain
Motor Accident Injuries Act 2017; schedule 1 clause 2(b); statutory weekly payments; earner; claimant was injured in a motor vehicle accident on 2 December 2024; claimant was on a pathway to employment at date of accident in that he had demonstrated his intention to obtain work as a security officer; claimant had notified Centrelink; paid the course fees and completed the First Aid course before the accident; claimant completed the requisite security course between 9 and 24 December 2024; claimant applied for his security licence on 27 December 2024; claimant’s security licence was issued on 26 February 2025; claimant entered into discussion with Wilson Security on 28 January 2025; insurer’s reviewable decision was that the claimant was not an earner; Held: claimant had not entered into an arrangement with an employer or other person to undertake employment before the accident; Held – reviewable decision affirmed.
Decision date: 11 June 2026| Merit Reviewer: Senior Member Susan McTegg
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