Legal Bulletin No. 267

Issued 03 July 2026

Welcome to the two hundred and sixty-seventh 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.

Motor Accidents non-Presidential Member Decisions

Earl v Allianz Australia Insurance Limited [2026] NSWPIC 249

Motor Accident Injuries Act 2017; discretionary exemption application by claimant and insurer consented; basis not suitable; claim involves complex liability, fault and causation, factual issues and non-CTP parties; related proceedings in the District Court on foot; Civil Liability Act 2002; Workers Compensation Act 1987; proceedings for damages also claimed; claims to be heard together; single forum more suitable and cost effective; Personal Injury Commission Rules 2021; rule 99(3)(a),(b) and (d); Held – claim not suitable for assessment at the Personal Injury Commission pursuant to section 7.34 (1)(b); recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 4 May 2026| Member: Shana Radnan

AAI Limited t/as GIO v Redroff [2026] NSWPIC 362

Motor Accident Injuries Act 2017; settlement approval; claimant 24 year-old driver involved in a collision; injured her right wrist; required a splint; after physiotherapy treatment has made a good recovery; some residual discomfort; works in a sedentary position; whole person impairment assessed at 1%, entitled to past and future economic loss; Held – settlement approved in the sum of $107,503.30; settlement just, fair and reasonable and within the range of likely potential damages assessment is the claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.

Decision date: 17 June 2026| Member: Elyse White

Constantinou v AAI Limited t/as AAMI [2026] NSWPIC 326

Motor Accident Injuries Act 2017; procedural determination; insurer’s application for dismissal of proceedings; where insurer purported to give a direction under section 6.26(1); whether direction validly given; whether claimant failed to comply with direction; whether claimant taken to have withdrawn the claim; Wahhab v Insurance Australia Ltd referred to, Weston Application; Weston Application, Re; Employers Mutual Indemnity (Workers Compensation) Ltd v Omni Corp Pty Ltd applied; Held – the insurer’s direction was issued on a date within, not after, the period 2 years and 6 months since the accident; direction not given in compliance with section 6.26(1); insurer not entitled to give the direction; section 6.26(3) not engaged; the claim for damages is extant; insurer’s application for dismissal declined.

Decision date: 19 June 2026| Senior Member: Brett Williams

AAI Limited t/as GIO v Wallis-Baker [2026] NSWPIC 363

Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 24 January 2024; 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; Held – settlement approved in the amount of $437,500.00, consisting of $375,000.00 for non-economic loss and past economic loss of $47,500.00 and $15,000.00 future economic loss.

Decision date: 18 June 2026| Member: Philip Carr

AAI Limited t/as GIO v Collings [2026] NSWPIC 378

Motor Accident Injuries Act 2017; approval of $660,400.00 pursuant to section 6.23; 57 year-old claimant employed as an indoor sports stadium manager suffered severe orthopaedic injuries in a motor vehicle accident on 4 June 2025; injuries included left hip and ankle fractures, rotator cuff tear of the left shoulder and Grade 5 dislocation of the left acromioclavicular joint and general soft tissue injuries; claimant underwent total hip replacement internal fixation of the right ankle fractures;  hardware required removal; claimant mitigated his damage by dedicated application to rehabilitation, real risk of increasing symptoms and consequent restrictions in day to day activities and work as a result of degenerative change in the injured areas; non-economic loss in the sum of $400,000.00, past economic loss, $80,000 and future economic loss in the sum of $180,400.00 calculated on the loss of one day per week from work for the next four years and thereafter a loss of two days per week for five years, i.e., to retirement age; Held – total settlement figure of $660,400.00 approved as just, fair and reasonable.

Decision date: 24 June 2026| Member: Michael Inglis

Workers Compensation non-Presidential Member Decisions

Johnstone v Randstad Pty Ltd [2026] NSWPIC 339

Workers Compensation Act 1987; consideration of definition of suitable employment in section 32A; worker suffered psychological injury; liability accepted by insurer; contemporaneous medical evidence preferred as to capacity as applicant’s subsequent representations to independent medical specialists, Medical Assessor and Medical Panel was overall unreliable evidence; Held – applicant capable of full time suitable duties employment between 14 November 2023 to 3 October 2024 and fit for 12 hours of suitable employment between 4 October 2024 to 24 November 2025 due to deterioration in psychological condition.

Decision date: 10 June 2026| Member: Diana Benk

Salemi v Good Guy Baking Company Pty Ltd [2026] NSWPIC 364

Workers Compensation Act 1987; application for assessment by a Medical Assessor (MA) as to whether the worker’s degree of permanent impairment is more than 20%; section 39; applicant sought referral of accepted lumbar spine, endocrine system and scarring, cardiovascular system also to be referred for assessment by agreement, however cervical spine injury in dispute; Held – the cervical spine injury is to be included in a referral to  MA for assessment; lumbar spine, cervical spine, endocrine system, cardiovascular system and scarring (TEMSKI) remitted to the President for referral to MA for assessment as to whether the degree of permanent impairment is more than 20%.

Decision date: 18 June 2026| Member: Fiona Seaton

Khoury v Anaconda Group Pty Ltd ATF Anaconda Unit Trust [2026] NSWPIC 365

Workers Compensation Act 1987; sleep condition; whether applicant suffered consequential obstructive sleep apnoea as a result of accepted shoulder and back injuries; Winmill v MWR Transport Pty Ltd, Bogdanovich v Farlow Concrete Pty Ltd, and Arch-Systems Fabrication Pty Ltd v McCann applied; Held – obstructive sleep apnoea may be assessable as a respiratory condition if, inter alia, it was brought about as a result of postural changes in sleeping position as a result of an accepted injury; totality of the lay and medical evidence establishes on balance of probabilities that the applicant suffers obstructive sleep apnoea and that it was caused by postural changes to his sleep patterns as he was unable to lay on his right side owing to pain and now sleeps in the supine position; applicant’s sleep condition is referred for medical assessment along with the accepted lumbar spine and right shoulder injuries.

Decision date: 19 June 2026| Member: Cameron Burge

Lyons v Target Australia Pty Ltd [2026] NSWPIC 366

Workers Compensation Act 1987; restoration of proceedings; whether applicant can restore proceedings to allow an appeal against a Medical Assessment Certificate (MAC) following lodgement of an Election to Discontinue in the former Workers Compensation Commission (Commission), such appeal being on the grounds of deterioration and/ or availability of additional information; transitional provisions; whether applicant had an unexercised right at the date of commencement of the Personal Injury Commission; applicant suffered an accepted lumbar spine injury in 2009; in 2010 applicant had a laminectomy; in 2015 a MAC was issued in the former Commission assessing her as suffering a 13% whole person impairment; before a Certificate of Determination could be issued by the former Commission, the applicant discontinued the proceedings; in 2017, separate proceedings were referred to a different assessor to determine whether the applicant had reached maximum medical improvement; applicant had not; applicant was then recommended by her treating surgeon for fusion surgery; respondent denied liability for that surgery by dispute notice dated 2 March 2021; in 2022 proceedings in relation to the proposed surgery were heard, and orders made for the respondent to pay the costs of and incidental to the surgery as it was reasonably necessary as a result of the injury; in late 2022, the applicant underwent the fusion surgery; in 2025, the applicant applied for the proceedings to be restored; respondent opposed that application, on the basis there were no proceedings to restore, because they had been discontinued as opposed to being concluded by a Certificate of Determination; respondent argued the Commission did not have jurisdiction to hear the matter, as there were no proceedings in existence; the question also arose as to whether the applicant had an unexercised right of appeal as at 1 March 2021, being the commencement date of the Personal Injury Commission; Held – the applicant had an unexercised right of appeal pursuant to sections 327(3)(a) and/or 327(3)(b) the 1998 Act as at 1 March 2021; the Personal Injury Commission has jurisdiction to restore the proceedings, as the rights under sections 327(3)(a) and (b) are not extinguished by the discontinuance, but rather pertain to the MAC, which remains binding on the parties; proceedings restored.

Decision date: 19 June 2026| Member: Cameron Burge

Diaz v Dnata Airport Services Pty Ltd [2026] NSWPIC 367

Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); section 57 of the Personal Injury Commission Act 2020 (PIC Act); sections 327 and 329 of the 1998 Act; reconsideration; new evidence; Samuel v Sebel Furniture Limited, Riverina Wines Pty Ltd v Registrar of the Workers Compensation Commission of NSW & Ors, Hilliger v Hilliger, and Papalia v Transom Services Pty Ltd t/as Transom Scaffolding considered and applied; Held – the Certificate of Determination dated 9 March 2023 is rescinded pursuant to section 57(1) of the PIC Act; matter is remitted to the President for a determination as to whether the applicant may be referred for a further assessment of permanent impairment by the original Medical Assessor, as an alternative, to an appeal pursuant to section 329(1) of the 1998 Act.

Decision date: 19 June 2026| Member: John Turner

Moslemi v State of New South Wales (Western Sydney Local Health District) & Ors [2026] NSWPIC 368

Workplace Injury Management and Workers Compensation Act 1998; whether a claim for the compensation sought had been made against the second respondent; applicant worked as a midwife for all three respondents; liability for injury disputed by other respondents; sections 289(1) and (3) of the Act considered; whether second respondent failed to determine the claim as and when required by the Act; Held – at no time prior to the commencement of the proceedings had adequate particulars of the claim been given to the second respondent; the Personal Injury Commission cannot hear or otherwise deal with the claim against the second respondent; proceedings against the second respondent dismissed; remaining proceedings listed for further preliminary conference.

Decision date: 19 June 2026| Senior Member: Rachel Homan

Hussein v City of Parramatta Council [2026] NSWPIC 369

Workplace Injury Management and Workers Compensation Act 1998; claim for digestive system impairment being caused by psychological injury; applicant required to clean remains from a suicide from his workplace in very hot conditions on Australia Day; whether subsequent surgery 10 days later was related to earlier obesity or worker’s reaction of persisting uncontrollable vomiting since his exposure; whether possible cause expressed by medical experts established probability on all the materials; Woolworths v Moriarty considered and applied; whether restrictions and impairments caused by the digestive system condition could be assessed in the psychiatric assessment; Stewart v NSW Police Service considered and applied; Held – digestive system condition found to be caused by accepted psychological injury; matter referred for assessments of the digestive system and psychological injury.

Decision date: 19 June 2026| Member: John Wynyard

Nabytowicz v The Junction Works Limited & Ors [2026] NSWPIC 370

Workers Compensation Act 1987; deceased worker died on 7 February 2021; applicant made a claim for funeral expenses payable under section 26 and lump sum benefit payable under section 25(1)(a); the second, third and fourth respondents made a claim for lump sum benefit payable under section 25(1)(a); first respondent disputed the deceased worker died as a result of injury sustained in the course of his employment; Held – the deceased worker died as a result of injury sustained in the course of his employment; first respondent is to pay the applicant’s claim for funeral expenses; leave is granted to list these proceedings for further conference relevant to determination of the claims for lump sum benefit payable under the section 25(1)(a) of the 1987 Act made by the applicant, second respondent, third respondent and fourth respondent.

Decision date: 19 June 2026| Member: Jacqueline Snell

Meehan v State of New South Wales (NSW Police Force) [2026] NSWPIC 371

Workers Compensation Act 1987; section 40; two awards; partial incapacity; total incapacity; user pay shifts; overtime; estoppel; psychological injury; physical injury; two awards; former police officer paid weekly compensation in respect of accepted psychological injury from 6 September 2019 to date; claim for compensation under section 40 from 15 March 2012 in respect of accepted physical injuries to the right shoulder, cervical spine, lumbar spine, right hip and right knee; in receipt of consent award for physical injury from 8 December 2021; question of estoppel; Held – respondent not discharge onus to establish estoppel arising from 2021 consent award; applicant not establish inability to undertake overtime or user pay shifts between 15 March 2012 and ceasing work on 6 September 2019; partial incapacity for work due to physical injury but no reduction in earnings to establish award pursuant to section 40 in the period 15 March 2012 to 6 September 2019; totally incapacitated due to psychological injury until 24 November 2025 and thereafter partial incapacity; in accordance with principles in Cordina Chicken Farms Pty Ltd v Thoa Hong Le exercise of section 40 discretion to reduce applicant’s entitlement to weekly compensation for physical injury by 75% during period of total psychological incapacity; reduction by 50% during period partial psychological incapacity; section 40 award in favour of applicant in respect of physical injuries.

Decision date: 22 June 2026| Senior Member: Susan McTegg

Chen v Ettason Pty Ltd [2026] NSWPIC 372

Workers Compensation Act 1987; claim for lump sum compensation for permanent impairment resulting from right wrist injury and consequential obstructive sleep apnoea condition; sleep apnoea alleged to have resulted from weight gain and change in sleep positioning to more supine sleep; liability for sleep apnoea condition disputed; conflicting evidence regarding pre-injury weight and extent of any weight gain; Held – applicant has not demonstrated a material contribution from the wrist injury to his obstructive sleep apnoea; self-reported weight gain unreliable; objectively demonstrated 4 kg weight gain after diagnosis; causal relationship between weight gain and wrist injury not established; conflicting histories regarding whether applicant slept more in the supine position as a result of the injury; award for the respondent with respect to the consequential sleep apnoea condition; accepted right wrist injury referred to Medical Assessor for assessment of permanent impairment.

Decision date: 22 June 2026| Senior Member: Rachel Homan

Lincoln v Warren Shire Council [2026] NSWPIC 373

Workplace Injury Management and Workers Compensation Act 1998; applicant had two falls in the course of his employment; the first was on 27 April 2020 and the second was on 22 November 2021; claim made for compensation for permanent impairment; liability accepted for injury to the left upper extremity; in dispute was whether applicant suffered an injury to the right hip; the dispute centred on a November 2019 report of a fall to the right hip; the applicant’s pre-existing osteoarthritis in the right hip; whether the falls of 27 April 2020 and 22 November 2021 could have caused injury to the right hip; Held – applicant suffered an injury to his right hip in the course of his employment on 27 April 2020 and 22 November 2021; claim for permanent impairment is remitted to the President for referral to a Medical Assessor to determine permanent impairment.

Decision date: 22 June 2026| Member: Jeffrey Gabriel

Logan v State of New South Wales (NSW Police Force) [2026] NSWPIC 374

Workplace Injury Management and Workers Compensation Act 1998; application pursuant to section 57 of the Personal Injury Commission Act 2020 to reconsider and rescind a certificate of determination; application to appeal a medical assessment pursuant to section 327 lodged out of time; amended appeal lodged with an application to extend time; whilst pending registration, a certificate of determination was issued in respect of the medical certificate; Held – certificate of determination reconsidered and rescinded.

Decision date: 22 June 2026| Member: Elizabeth Medland

Gooding v Workers Compensation Nominal Insurer (iCare) & Anor [2026] NSWPIC 375

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for weekly compensation payments pursuant to the 1987 Act; whether the applicant was a worker pursuant to section 4 of the 1998 Act or a deemed worker pursuant to section 5 of the 1998 Act and clause 2 of Schedule 1 to the 1998 Act; ZG Operations Australia v Jamsek, On Call Interpreters and Translators Agency Pty Ltd v Commissioner of Taxation, Stevens v Brodribb Sawmilling Company Pty Ltd, and Pasqua v Morelli Constructions Pty Ltd considered; Held – applicant not a worker or deemed worker; award for the respondent.

Decision date: 22 June 2026| Member: Diana Benk

Hall v Navigator Consulting & Research Pty Ltd t/as Navigator Consulting Trust [2026] NSWPIC 346

Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for a closed period of weekly benefits in respect of a disputed psychological injury; deficient and inconsistent evidence; reliability of statement evidence and assertions recorded in medical histories; whether expert opinions were provided in a fair climate; competing causes of a psychological condition; main contributing factor; Nguyen v Cosmopolitan Homes, Paric v John Holland Constructions Pty Ltd, Cellarit Pty Ltd v Cawarrah Holdings Pty Ltd, AV v AW considered and applied; Held – aspects of the applicant’s evidence was unreliable and affected the weight to be attached to opinions in expert evidence founded on that evidence; evidence of competing causes of injury not properly considered; applicant failed to discharge onus of proof on balance of probabilities that he sustained a disease injury; award for the respondent.

Decision date: 23 June 2026| Member: Kathryn Camp

Yendle v Australian Urban Tree Services Pty Ltd [2026] NSWPIC 347

Workers Compensation Act 1987; applicant was injured in a work accident on 12 August 2019; subsequently, the applicant has suffered from constant pain in his left leg and lumbar spine, sleep disturbance caused by pain and frequent falls from left leg weakness; applicant uses aids including crutches and a walking stick; applicant sought the trial of a mobility scooter; respondent then denied further exercise physiology; it also rejected the trial of the mobility scooter; the Personal Injury Commission found that the applicants pain induced insomnia treatment; Held – continued exercise physiology and the trial of a mobility scooter were reasonably necessary.

Decision date: 23 June 2026| Member: Lea Drake

Motor Accidents Medical Review Panel Decisions

Insurance Australia Limited t/as NRMA Insurance v Brownlow [2026] NSWPICMP 421

Motor Accident Injuries Act 2017; procedural decision; review of medical; Review Panel determined re-examination required; insurer’s application for re-examination to be postponed because claimant failed to attend medico-legal assessment; discussion of Review Panel’s functions by reference to Wingfoot Australia Partners Pty Ltd v Kocak, Jarvis v Allianz Australia Insurance Limited, Allianz Australia Insurance Limited trading as Allianz v Susak, Allianz Australia Insurance Limited v Bell, AAI Limited trading as GIO v Amos; Held – given its function, the Review Panel is not satisfied the insurer will be denied procedural fairness if the re-examination proceeds; given the legal context in which the review is conducted, the Review Panel is not satisfied postponing the re-examination would facilitate the just, quick and cost effective resolution of the real issues in the proceedings; Review Panel declined to postpone the re-examination.

Decision date: 12 June 2026| Panel Members: Senior Member Brett Williams, Dr John Lam-Po-Tang, and Dr John Baker| Injury module: Mental and Behavioural

AAI Limited t/as GIO v Lee [2026] NSWPICMP 422

Motor Accident Injuries Act 2017; determination by original Medical Assessor (MA) claimant’s cervical spine injury was not a threshold injury; insurer’s application for review under section 7.26; claimant had five previous incidents or accidents resulting in radiculopathic symptoms in the cervical spine and right upper limb; claimant’s current accident was collision with car proceeding straight through an intersection with the claimant turning; claimant had cervical spine surgery after the current accident; insurer’s primary argument was claimant had radiculopathy before the accident and radiculopathy after the accident and that there was no “new” or “distinct” injury but an aggravation of pre-existing pathology and that an aggravation injury was a threshold injury; claimant referred “cervical spine radiculopathy” for assessment and later clarified injury alleged to C5 and C6; the claimant was examined by a MA; onus of proof lay with the claimant; Lynch v AAI Limited followed; accident could have, and did cause an injury to the cervical spine; Briggs v IAG Limited t/as NRMA Insurance applied; extensive discussion about nerve and nerve root injuries and radiculopathy; Morrison v QBE Insurance (Australia) Limited followed in terms of whether positive sciatic nerve root tension signs applied to cervical radiculopathy; Review Panel satisfied claimant had a nerve root condition manifesting at times, but not consistently, in radicular symptoms and signs of radiculopathy before the car accident; Review Panel also satisfied that currently the claimant satisfied the criteria for a nerve root condition manifesting in two signs of radiculopathy; Review Panel determined an aggravation or exacerbation of a pre-accident condition is an injury consistent with common law principles; Angileri v Allianz Australia Insurance Limited applied; Review Panel also determined an aggravation or exacerbation injury to a pre-existing non-threshold condition is a non-threshold injury; Todev v AAI Limited t/as GIO, and AAMI t/as GIO v Hoblos applied; Held – claimant’s cervical spine C6 nerve root injury was a non-threshold injury; certificate confirmed.

Decision date: 17 June 2026| Panel Members: Member Belinda Cassidy, Dr Drew Dixon, and Dr Sophia Lahz| Injury module: Spine

Insurance Australia Limited t/as NRMA Insurance v Jovicic [2026] NSWPICMP 423

Motor Accident Injuries Act 2017; review of medical assessment by Review Panel; whether recommended arthroscopy and debridement of right knee is causally related to the motor accident and reasonable and necessary; whether degenerative changes present prior to the motor accident; causation as to whether accident capable of giving rise to a meniscal tear, and whether the tear was caused by the accident and/or worsened; test of balance of probabilities; Review Panel found accident capable of giving rise to pathology due to torsional forces through knee that was likely extended at time of accident; no evidence of symptomatic condition in knee prior to accident; likely that degenerative changes present bilaterally but accident caused a worsening rendering symptomatic and accelerating degenerative process; surgery proposed the standard accepted treatment; conservative measures not assisted to any significant degree; surgery cost effective and will alleviate some symptoms; clause 4.81 of the Motor Accident Guidelines not relevant to medical assessments, as submitted by insurer; Held – certificate confirmed.

Decision date: 17 June 2026| Panel Members: Member Elizabeth Medland, Dr Drew Dixon, and Margaret Gibson| Treatment Type: Surgery

Bournes v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 424

Motor Accident Injuries Act 2017; threshold injury dispute; permanent impairment dispute; claimant was driving his car when a 4WD with a front bull bar turned into him causing a collision with the driver’s side door; claimant was later cut out by emergency services; original Medical Assessment Certificate (MAC) found a 7% whole person impairment (WPI) due to sciatica nerve entrapment and a right hip labral injury; Review Panel did not find sciatica nerve entrapment as the radiating pain to the right buttock and leg were more likely to be from the lumbar spine rather than due to compression of the sciatic nerve through the piriformis muscle; right hip labral tear consistent with mechanism of accident with driver’s door pushed into right hip and immediate complaints of right hip pain; Held – right hip labral tear is not a threshold injury; right hip loss of range of motion assessed at 2% WPI; lumbar spine non-verifiable radicular complaints assessed at 5% WPI; total combined WPI assessed at 7%; change in description of injuries results in MAC being revoked; new MAC issued.

Decision date: 17 June 2026 | Panel Members: Member Jeremy Lum, Dr David Gorman, and Dr Tai-Tak Wan | Injury module: Spine, and Lower Limb

Avila v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 425

Motor Accident Injuries Act 2017; review of medical assessment; revocation of certificate; threshold injury; post-traumatic stress disorder (PTSD) and major depressive disorder; aged pensioner at date of accident; pre-accident disability support pension; rear and collision; pre-accident medication; unreliable history and conflicting explanations; no psychiatric diagnosis or disorder; no symptoms consistent with PTSD; motor vehicle accident not a criterion A event; no clinical psychiatric disorder developed postaccident; treatment and care not caused by or related to subject motor accident; Held – threshold injury; certificate revoked; new certificate issued.

Decision date: 17 June 2026| Panel Members: Member Hugh Macken, Dr Thomas Newlyn, and Dr Paul Friend| Injury module: Mental and Behavioural; Treatment Type: Psychological Treatment, and Domestic Assistance

Allianz Australia Insurance Limited v Todd [2026] NSWPICMP 429

Motor Accident Injuries Act 2017; medical assessment of amount of care (domestic assistance) and insurer’s application for review under section 7.26; claimant injured back, neck and alleged psychological injuries in an accident on 15 May 2021; claimant found to have accident-related need for ongoing domestic assistance by Medical Assessor (MA) Rosenthal whose certificate was not challenged; MA Castle-Burton assessed two hours of domestic assistance was reasonable and necessary in the circumstances; dispute limited to period from when insurer ceased paying for domestic assistance on 1 June 2023 and fifth anniversary of motor accident when it appeared Lifetime Care and Support Authority started paying for care; Member held teleconference with parties in an attempt to resolve the dispute but dispute did not settle; claimant examined by both MAs by audio-visual meeting; determined 2.5 hours of domestic assistance was reasonable and necessary in the circumstances. Held – certificate revoked; no issue of principle.

Decision date: 18 June 2026| Panel Members: Member Belinda Cassidy, Dr Dawn Piebanga, and Dr Lauren Alach| Treatment Type: Domestic Assistance

Bolam v AAI Limited t/as GIO [2026] NSWPICMP 430

Motor Accident Injuries Act 2017; medical review panel; whole person impairment (WPI); post-traumatic-stress disorder (PTSD); alcohol use disorder; self-care and personal hygiene; social and recreational activities; travel; social functioning; concentration, persistence and pace; adaption; pre-existing condition; assessment of WPI; claimant was injured in a motor vehicle accident on 11 February 2023; Medical Assessor (MA) certified the claimant had sustained a 0% WPI as a result of exacerbation of PTSD and alcohol use disorder caused by the accident after making a deduction for pre-existing impairment by incorrectly applying principles in State Government Insurance Commission v Oakley; claimant sought review; Held – claimant had PTSD, major depressive disorder and alcohol use disorder caused by the accident; current permanent impairment assessed at 9% WPI; reduction for pre-existing condition sustained as a result of service with the NSW Police Force of 1% WPI; final assessment of 8% WPI; certificate of MA revoked; new certificate issued.

Decision date: 19 June 2026| Panel Members: Senior Member Susan McTegg, Dr Christopher Canaris, and Dr John Lam-Po-Tang| Injury module: Mental and Behavioural

AAI Limited t/as GIO v Rouda [2026] NSWPICMP 431

Motor Accident Injuries Act 2017; threshold injury dispute; psychiatric injury; claimant was seat-belted driver of a Toyota HiAce van when he was rear-ended by the sedan; claimant alleged neck and lower back injuries with the onset of accident-related anxiety disorder, depression and post-traumatic stress disorder (PTSD); original Medical Assessment Certificate (MAC) diagnosed PTSD with Criterion A being satisfied because the claimant was considered to be involved in a serious motor accident where he feared serious injury; Review Panel noted that “depression” is not a recognised psychiatric illness or disorder under the DSM-5-TR and cannot be assessed as such;  diagnosis of PTSD was not mentioned in any of the documents and was specifically denied by the claimant when seen by his treating psychologist; the claimant made no mention of PTSD symptoms in the history given to the Review Panel; there was no contemporaneous complaint relating to increased anxiety, with subsequent anxiety symptoms related to driving anxiety only, yet the claimant continued to drive and drive on the same road as where the accident occurred; Review Panel found that anxiety symptoms were better accounted for in the diagnosis of adjustment disorder with anxiety; Review Panel also noted that the claimant increased his smoking of tobacco after the accident and related this to stress and anxiety; Review Panel found an accident-related exacerbation of a tobacco use disorder however excluded this diagnosis from assessment as it was not an injury referred for assessment and was not the subject of any submissions from the parties; Held – adjustment disorder with anxiety, persistent is a threshold injury; MAC revoked; new MAC issued.

Decision date: 19 June 2026| Panel Members: Member Jeremy Lum, Dr Thomas Newlyn, and Dr Himanshu Singh| Injury module: Mental and Behavioural

AAI Limited t/as GIO v Gibson [2026] NSWPICMP 432

Motor Accidents Compensation Act 1999; whole person impairment (WPI); review of further medical assessment certificate (MAC); injuries of left hip and left knee referred for further medical assessment; whether causation established; examination of pre-existing left knee injuries; whether accident sufficient to cause injuries alleged to left hip and left knee and requirement for subsequent surgery; Briggs v IAG Limited t/as NRMA Insurance considered and applied; Review Panel satisfied that the accident could have and did cause the left knee and left hip injuries; Held – claimant assessed at 16% WPI after deduction for pre-existing impairment; MAC confirmed.

Decision date: 22 June 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr Drew Dixon, and Dr Shane Moloney| Injury module: Lower Limb

Insurance Australia Limited t/as NRMA Insurance v Yu [2026] NSWPICMP 434

Motor Accident Injuries Act 2017; threshold physical injury dispute; a car collided with the right-side rear of the car the claimant was driving; alleged injuries to lumbar spine with referred pain into left lower extremities; delay of one month before seeing a general practitioner; whether MRI showing L5/S1 annular fissure and disc protrusion was caused by the motor accident; Review Panel decision in Tran v AAI Limited t/as AAMI distinguished; factors weighing in favour of disc pathology being caused by the motor accident includes: claimant’s age, the lack of pre-accident complaints, the entire clinical picture including back pain while sitting or standing, the persistence of non-verifiable radicular complaints, the presence of not only an annular fissure but a disc protrusion at the same level; Held – annular fissure and disc protrusion at L5/S1 were caused by the motor accident and is an injury to cartilage which is not a threshold injury; Medical Assessment Certificate confirmed.

Decision date: 23 June 2026| Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Shane Moloney| Injury module: Spine, Upper Limb, and Lower Limb

Khan v AAI Limited t/as GIO [2026] NSWPICMP 435

Motor Accident Injuries Act 2017; motor accident on 26 February 2023; insured vehicle collided with claimant’s bicycle; determination of whether the claimant suffered a non-threshold psychological injury; claimant travelled overseas on two occasions and completed courses; inconsistency with treating opinions that claimant had an intense fear of leaving home; functioning inconsistent with assertion of major depressive disorder; allegation of memory impairment inconsistent with clinical examination and diagnosis of major depressive disorder; Review Panel not limited to specific psychiatric diagnosis referred for dispute; observation that unfortunate practice had developed of referring a specific psychiatric diagnosis when determining the threshold injury issue; Held – claimant assessed at sustaining an adjustment disorder with mixed anxiety and depression which is a threshold injury; original Medical Assessment Certificate confirmed.

Decision date: 23 June 2026| Panel Members: Principal Member John Harris, Dr Melissa Barrett, and Dr Himanshu Singh| Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Slack [2026] NSWPICMP 436

Motor Accident Injuries Act 2017; review of medical assessment; assessment of threshold injury; no history of any physical ailments pre-accident; rear end collision; laceration to the scalp; no post-traumatic amnesia detected; diagnosis of post-traumatic stress disorder and major depression; physical and cognitive difficulties with auto mechanical work; no verifiable brain imaging abnormalities; diagnosis soft tissue injuries of the cervical thoracic and lumbar spine; soft tissue injury of the head with resultant scalp laceration; threshold injury; Held – Review Panel revokes certificate.

Decision date: 23 June 2026| Panel Members: Member Hugh Macken, Dr David Mcgrath, and Dr Sophia Lahz| Injury module: Brain Injury, and Spine

Eshak v AAI Limited t/as GIO [2026] NSWPICMP 438

Motor Accident Injuries Act 2017; whole person impairment dispute; claimant was involved in a motor vehicle accident on 13 January 2022; claimant was the seat-belted driver; claimant was proceeding straight through the roundabout, and was almost into the exit on the other side intending to go straight ahead on Brenan Street;  insured vehicle entered the intersection from the claimant’s left, striking his vehicle at the level of the “B” pillar; force of the impact pushed the claimant’s vehicle through the intersection, coming to rest on a concrete island; claimant’s vehicle was badly damaged; claimant recalls having investigations; no fractures were identified; claimant had a cervical neck injury in 2001 when he was pulling a pallet at work; he has had chronic pain and remained off work since that incident; Medical Assessor (MA) certified a 13% WPI arising from accident-related injuries to cervical spine, both shoulders, lumbar spine, right elbow and right middle finger; insurer’s review application allowed on basis that MA failed to apply paragraph 6.31 of the Motor Accident Guidelines correctly and failed to provide adequate reasons regarding the deduction made to the assessment of claimant’s WPI; claimant re-examined by both Review Panel MAs; injuries to right shoulder and right elbow found not caused; other injuries accepted and assessed at 7% WPI; Held – certificate revoked.

Decision date: 24 June 2026 | Panel Members: Member Gary Victor Patterson, Dr Margaret Gibson, and Dr Les Barnsley | Injury module: Spine, and Upper Limb

Marahby v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 439

Motor Accident Injuries Act 2017; Medical Review Panel; assessment of whole person impairment (WPI); rear-end collision; dispute concerning cervical spine, lumbar spine, bilateral shoulders and alleged radiculopathy; claimant relied on multilevel cervical degenerative pathology and right upper limb symptoms; Review Panel accepted cervical soft tissue injury with symptomatic aggravation of pre-existing cervical degeneration and non-verifiable radicular complaints, lumbar soft tissue injury, and right shoulder soft tissue injury; no clinically verifiable radiculopathy established; lumbar injury found resolved without assessable impairment; alleged left shoulder injury not caused by the accident; impairment assessed at 5% WPI for the cervical spine and 3% WPI for the right shoulder;  Held – total WPI assessed at 8%; threshold of greater than 10% WPI not reached; Medical Assessor’s certificate revoked; new certificate issued.

Decision date: 24 June 2026 | Panel Members: Member Bridie Nolan, Dr Drew Dixon, and Dr David Gorman | Injury module: Spine, and Upper Limb

AAI Limited t/as GIO v Cross [2026] NSWPICMP 440

Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident in January 2023; Medical Assessor (MA) assessed injuries to the cervical spine and lumbar spine; MA assessed lumbar spine as consistent with radiculopathy with increased medial hamstring jerks and a positive sciatic nerve root stretch test consistent with right L5 radiculopathy; Review Panel found a different result in its examination; Review Panel accepted the findings of the MA with respect to the lumbar spine; Review Panel determined that the injury to the lumbar spine was non-threshold; principles set out in David v Allianz Australia Insurance Limited, and Ali v AAI Ltd [2016] NSWCA 110 applied; Held – certificate confirmed.

Decision date: 24 June 2026| Panel Members: Member Terence Stern OAM, Dr Les Barnsley, and Dr David Gorman| Injury module: Spine

Karekal v AAI Limited t/as GIO [2026] NSWPICMP 441

Motor Accident Injuries Act 2017; assessment of threshold injury; claimant was driving to work behind an armoured truck on the M1 Freeway near Wollongong; transmission bar fell from beneath the truck which the claimant’s vehicle ran over whilst travelling at 110 km/ph; claimant struggled to control his vehicle which began to turn and lose power; claimant says he was aware of immediate pain in his neck with headaches and pain into his left arm; claimant tried returning to work as an academic which aggravated his pain; Medical Assessor (MA) certified that subject accident caused threshold injury to cervical spine and left elbow; injury to cervical spine-radiculopathy-found not caused; claimant’s review application allowed on basis that MA failed to provide adequate reasons why subsequent left-sided C6/C7 disc protrusion was not caused by motor accident; claimant re-examined by another MA on behalf of the Review Panel; both Review Panel MAs accept that all referred injuries were caused by the accident and are non-threshold injuries; Held – certificate revoked.

Decision date: 25 June 2026| Panel Members: Member Gary Victor Patterson, Dr Margaret Gibson, and Dr David Gorman| Injury module: Spine, and Upper Limb

Workers Compensation Medical Appeal Panel Decisions

Murphy v Woolworths Group Ltd [2026] NSWPICMP 426

Workplace Injury Management and Workers Compensation Act 1998; medical appeal; claim for deterioration; admission of fresh evidence under section 328(3); evidence of increase in fracture height leading to increase in DRE category; appellant also suggested Medical Assessor (MA) erred in application for section 323; error grounds not relied on in appeal; submitted that assessment of their assessor should be adopted, which included a lesser assessment in the lumbar spine; both doctors agreed thoracic spine had deteriorated; Held – deterioration in thoracic spine; appellant unable to raise error grounds in an appeal limited to deterioration; in any event section 323 arguments not accepted; likewise not open for respondent to challenge lumbar spine assessment; Medical Assessment Certificate revoked due to deterioration in thoracic spine; section 323 deduction and lumbar spine assessment confirmed.

Decision date: 17 June 2026| Panel Members: Member Parnel McAdam, Dr Drew Dixon, and Dr David Crocker| Injury module: Thoracic Spine, and Lumbar Spine

Johnson v Catholic Schools Parramatta Diocese Limited [2026] NSWPICMP 427

Workplace Injury Management and Workers Compensation Act 1998; appeal against the assessment of a 9% whole person impairment for psychological injury; whether Medical Assessor (MA) erred in his rating for every psychiatric impairment rating scale category except employability; whether MA had failed to mention relevant evidence; whether MA applied facts to the incorrect category; whether modifier for effects of treatment was incorrect; ; Wingfoot Australia Partners Pty Ltd v Kocak considered and applied; interpretation of Ballas v Department of Education (State of NSW) by the claimant was incorrect; Stolzenberg v Workers Compensation Nominal Insurer, Lancaster v Foxtel Management Pty Ltd, Botha v Secretary, NSW Department of Customer Service, and Diaz v Sydney International Container Terminals Pty Ltd considered and applied; Held – factual arguments no more than mere disagreement; MA not arbitrator or judge; not obliged to mention all the evidence; Medical Assessment Certificate confirmed.

Decision date: 17 June 2026| Panel Members: Member John Wynyard, Dr Graham Blom, and Dr Douglas Andrews | Injury module: Psychiatric/psychological

Visy Board Proprietary Ltd v Shaw [2026] NSWPICMP 428

Workplace Injury Management and Workers Compensation Act 1998; medical appeal; carpal tunnel syndrome; whether range of motion can be combined with sensory loss; clause 2.9 of the Workers Compensation Guidelines; whether worker’s impairment resulted solely from a peripheral nerve injury; whether the Medical Assessor applied section 323 correctly; whether the Medical Assessor (MA) provided adequate reasons; Held – carpal tunnel syndrome is solely a peripheral nerve injury; no error in section 323; Medical Assessment Certificate revoked.

Decision date: 17 June 2026| Panel Members: Member Parnel McAdam, Dr Rob Kuru, and Dr Alan Home| Injury module: Left Upper Extremity, Right Upper Extremity, and Scarring (TEMSKI)

King v Mr Bump Smash Repairs Pty Ltd [2026] NSWPICMP 433

Workplace Injury Management and Workers Compensation Act 1998; appeal from decision of Medical Assessor; sufficiency of reasons; Wingfoot Australia Partners Pty Ltd v Kocak applied; facial disfigurement; loss of supporting structures; skin disorder; Held – Medical Assessment Certificate (MAC) revoked; new reassessment; new MAC issued.

Decision date: 22 June 2026| Panel Members: Member Mitchell Strachan, Dr Geoffrey Curtin, and Dr Malcolm Linsell | Injury module: Facial Disfigurement, and Skin

Bhurra v Better Sets Pty Ltd [2026] NSWPICMP 437

Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor erred in his whole person impairment assessments of two of the categories of the PIRS, namely social and recreational activities and concentration, persistence and pace; re-examination required; Appeal Panel found error in the category of social and recreational activities; no error in the category of concentration, persistence and pace; Held – Medical Assessment Certificate revoked.

Decision date: 23 June 2026| Panel Members: Member Deborah Moore, Professor Nicholas Glozier, and Dr Douglas Andrews| Injury module: Psychiatric/psychological

Motor Accidents Merit Review Decisions

Lee v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMR 28

Motor Accident Injuries Act 2017; miscellaneous claims dispute as to entitlement to legal costs for unregulated merit review matter; claim for ‘exceptional costs’ under section 8.10 of the Act and exercise of discretion to award costs in favour of insurer pursuant to section 8.3; matter found to be exceptional in that it was out of the ordinary and unusual, however, declined to exercise the discretion under section 8.10 in favour of the claimant as the merit review application lacked merit and was based upon unreliable evidence; discretion exercised to award costs in favour of insurer’s legal representatives pursuant to section 8.3.

Decision date: 18 June 2026 | Merit Reviewer: Elizabeth Medland

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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