Legal Bulletin No. 268

Issued 10 July 2026

Welcome to the two hundred and sixty-eighth edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII 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

Edwards v Allianz Australia Insurance Limited [2026] NSWPIC 291

Motor Accident Injuries Act 2017 (MAI Act); Motor Accidents Compensation Act 1999 (MAC Act); recommendation claim not suitable for assessment; claimant was injured whilst travelling as a passenger on a bus on 15 August 2024; determined the matter is a public bus motor accident and therefore a public transport accident as defined in section 121 of the Transport Administration Act 1988, determined in the case of McTye v Ching Yu Chang by his tutor Leo Alexander Birch; claim for damages is for past and future medical expenses, past and future domestic care and assistance, as a lump sum award in accordance with the provisions of the MAC Act prima facie; the matter is governed by the provisions of the MAI Act, however, since the claim is to be determined pursuant to the provisions of the MAC Act; claimant is not entitled to claim statutory benefits pursuant to the provisions of MAI Act and claimant cannot obtain the benefit of future treatment from CTP care, if such treatment is determined to be reasonable and necessary; as there is no such provision for entitlement in MAC Act claimant seeks discretionary exemption on the basis there is an absence of settled authority which creates a genuine uncertainty for the parties and does give rise to complex legal questions that may not necessarily be suited to an award by the Personal Injury Commission;  rule 99(3)(a) of the Personal Injury Commission Rules 2021 (NSW); Held – the matter be exempted under section 7.34 (1)(b) of the MAI Act on the grounds that the claim involves complex legal or factual issues or complex issues in the assessment of the amount of the claim; recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 22 May 2026 | Member: David Ford

AAI Limited t/as GIO v Murdoch [2026] NSWPIC 382

Motor Accident Injuries Act 2017; approval of $325,000.00 pursuant to section 6.23(b); 76 year old claimant received severe orthopaedic injuries when knocked from his bicycle by a vehicle on 23 May 2023; the injuries included a left femur periprosthetic fracture and severe fracture in the right ankle, a sprain and aggravation of underlying degenerative changes, hip and total ankle replacement required; the claimant had ongoing symptoms of pain and stiffness but had returned to skiing, cycling and using a paddle board; claim for non-economic loss only; Held – $325,000.00 approved as just, fair and reasonable.

Decision date: 25 June 2026 | Member: Michael Inglis

Salman v Allianz Australia Insurance Limited [2026] NSWPIC 383

Motor Accident Injuries Act 2017; dispute about contributory negligence in statutory benefits claim under section 3.38 dispute resolved the day prior to hearing; applications made for costs orders under sections 8.3(4) and 8.10(4)(b); Wright v Insurance Australia Limited t/as NRMA Insurance applied; Held – exceptional circumstances for the purposes of section 8.10(4)(b) exist; insurer to pay the claimant’s reasonable and necessary legal costs as agreed or assessed; insurer permitted to pay its lawyers reasonable costs in connection with the proceedings.

Decision date: 26 June 2026| Senior Member: Brett Williams

Insurance Australia Limited t/as NRMA Insurance v Doyle [2026] NSWPIC 385

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident as motor bike rider; claimant sustained lower limb injuries and brief psychological condition; seven months off work; attempted return to work but employer would not pass him fit for previous duties; brought retirement forward by three years; medical evidence supports deterioration but currently permanent impairment is not greater than 10%; claimant accepted insurer’s initial offer; claimant told Member that past earnings based on years when claimant made extra super contributions; past and future economic loss recalculated; insurer revised offer; claimant accepted this; claimant demonstrated he had agency to decide on accepting settlement; proposed settlement fair, just and reasonable within the meaning of the Act; Held – proposed settlement approved.

Decision date: 29 June 2026 | Member: Terence O'Riain

Workers Compensation non-Presidential Member Decisions

Greenhalgh v State of New South Wales (NSW Police Force) [2026] NSWPIC 361

Workers Compensation Act 1987; exempt worker; claim for weekly compensation for partial incapacity as a result of accepted physical injuries; supervening psychological injury resulted in total incapacity for work; where incapacity resulting from psychological injury later became partial; degree of incapacity caused by physical injuries; whether incapacity resulting from physical injuries was separate and distinct from incapacity caused by psychological injury; application of discretion to reduce any award of weekly compensation pursuant to the former section 40(1) of the Act; Held – incapacity resulting from accepted physical injuries was separate and distinct from incapacity resulting from psychological injury; award of weekly compensation as a result of physical injury prior to physical injury on the basis of partial incapacity; award of weekly compensation thereafter on the same basis, reduced to a nominal amount in the application of discretion; award of weekly compensation for partial incapacity resulting from physical injuries from the date when incapacity from psychological injury also became partial; reduction of 50% in the application of discretion.

Decision date: 3 July 2026 | Principal Member: Richard Perrignon

York v Hunter River Trees Pty Ltd [2026] NSWPIC 379

Workers Compensation Act 1987; claim for medical expenses for medicinal cannabis; accepted injury to the lumbar spine; dispute as to whether medicinal cannabis is reasonably necessary treatment as a result of accepted injury; whether applicant has a substance abuse disorder; whether medicinal cannabis is harmful; section 60; principles in Murphy v Allity Management Services Pty Ltd applied; Sutherland Shire Council v Baltica General Insurance Co Ltd, and Diab v NRMA Limited considered and applied; Held – applicant discharged onus of proof that the provision of medicinal cannabis is reasonably necessary as a result of the accepted injury, within the meaning of section 60 of the Act.

Decision date: 24 June 2026| Member: Kathryn Camp

Desmond v State of New South Wales (NSW Police Force) [2026] NSWPIC 380

Workers Compensation Act 1987; application for weekly compensation and the cost of surgery in 2024 as a result of injury to the right shoulder in 2016; whether injury materially contributed to surgery in 2024; whether injury consisted in a tear of the supraspinatus tendon; whether symptoms continued until surgery; whether need for surgery resulted from a fall away from work in 2024; Held – injury included a tear of the supraspinatus tendon, which enlarged over time in accordance with its natural progression and materially contributed to the need for surgery; awards of weekly compensation; order that the respondent pay the cost of surgery.

Decision date: 24 June 2026 | Principal Member: Richard Perrignon

Head v Bellambi Neighbourhood Centre [2026] NSWPIC 381

Workers Compensation Act 1987; lump sum compensation claim pursuant to section 66; accepted injury to the right knee on 11 November 2015; disputed claim of instability of the right knee causing the applicant to fall and suffer consequential injuries to her left knee and lumbar spine; absence of evidence regarding causation from treating orthopaedic specialist; finding made that applicant had not discharged her onus of proof applying Nguyen v Cosmopolitan Homes Pty Ltd, Nicholls v The Professional Pest Controllers Pty Ltd, and Estate of Clarke v State of New South Wales (Greystanes Disability Services); disputed claim of gastrointestinal conditions developing as a consequence of ingestion of medication; finding made in applicant’s favour after considering in detail the medication prescribed to her by her general practitioner; whether applicant’s medico-legal specialist has correctly assessed permanent impairment is a matter for the Medical Assessor (MA); Held –  award for the respondent in relation to the claims of consequential conditions to the left knee and lumbar spine as a result of instability in the right knee from the injury on 11 November 2015; award for the applicant for the claims of consequential conditions to the upper and lower gastrointestinal systems as a result of the applicant taking medication to treat her right knee injury sustained on 11 November 2015; lump sum claim is remitted to the President for referral to a MA to assess permanent impairment.

Decision date: 24 June 2026 | Member: Josephine Bamber

Bayato v The Ebenezer Foundation Ltd [2026] NSWPIC 384

Workers Compensation Act 1987; psychological injury; defence under section 11A; whether injury caused by reasonable actions of employer with respect to performance appraisal, discipline, or dismissal; applicant teacher at a small independent school; initially paid below award wage; drove school bus on a voluntary basis for up to three hours per day; interactions between applicant and principal; consideration of appropriate date of injury; Held – date of injury deemed to have occurred day after dismissal, not three years earlier; applicant’s injury not wholly or predominantly caused by reasonable actions of employer; award for lump sum compensation made.

Decision date: 26 June 2026| Member: Parnel McAdam

Ramsay v Anglican Care [2026] NSWPIC 386

Workers Compensation Act 1987; accepted lumbar spine injury sustained by the applicant in the course of employment with the respondent on 14 January 2025; disputed claims for the costs of three surgeries with the issue whether those surgeries were reasonably necessary treatment as a result of the agreed injury as required by section 60; Diab v NRMA Ltd applied; Held – pursuant to section 60 of the Act, the anterior and posterior spinal fusions at L5/S1 on 6 and 13 March 2026, and ancillary expenses, are reasonably necessary treatment as a result of the agreed injury in the course of the applicant’s employment with the respondent on 14 January 2025; pursuant to section 60, the proposed posterior fusion surgery to T12 to L2 is reasonably necessary treatment as a result of the agreed injury in the course of her employment with the respondent on 14 January 2025; the respondent is to pay the costs of all three surgeries, and ancillary expenses, upon production of accounts, receipts, and/or Medicare Notice of Charge at the rates in the applicable SIRA fees order.

Decision date: 29 June 2026 | Member: Josephine Bamber

Smith v Ashcon Asphalting Pty Limited (In Liquidation) [2026] NSWPIC 387

Workers Compensation Act 1987; injury to cervical spine; delay in recording of symptoms; onus of proof; standard of proof; NOM v DPP, and Drca v KAB Seating Systems Pty Ltd considered and applied; Held – award for the applicant on injury to the cervical spine; matter referred to Medical Assessor to determine permanent impairment.

Decision date: 29 June 2026| Member: Mitchell Strachan

Moriera v CNN Property Services Pty Ltd [2026] NSWPIC 388

Workers Compensation Act 1987; injury to left shoulder on 27 June 2022 not in dispute, right shoulder injury disputed, entitlement to ongoing weekly compensation under section 38(2) and cost of proposed right shoulder surgery disputed; Held – the applicant sustained a right shoulder injury on 27 June 2022, she has no current work capacity from 10 January 2025 which is likely to continue indefinitely pursuant to section 38(2); the proposed right shoulder cuff repair surgery is reasonably necessary medical treatment pursuant to section 60.

Decision date: 30 June 2026| Member: Fiona Seaton

Motor Accidents Medical Review Panel Decisions

Transport Accident Commission v Braidwood [2026] NSWPICMP 445

Motor Accident Injuries Act 2017; motor accident on 31 August 2019; claimant was a front seat passenger where the driver of that vehicle caused the accident; assessment of whole person impairment for psychological injuries; claimant served medical legal report as part of tender bundle before Review Panel; three months after service and 7 days prior to medical examination, insurer sought adjournment to obtain report in reply; no satisfactory explanation for delay; report admitted and adjournment declined; claimant had significant history of pain and pain resulting from subject motor accident; application of clause 6.214 and 6.215 of the Motor Accident Guidelines; no assessment of pre-existing impairment despite probable symptoms; assessment otherwise raised no issues of principal; Held – claimant assessed at 7% whole person impairment; original assessment revoked; certificate issued for psychological injury not greater than 10%.

Decision date: 25 June 2026| Panel Members: Principal Member John Harris, Dr Melissa Barrett, and Dr Paul Friend| Injury module: Mental and Behavioural

Abagi v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 447

Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) dated 16 December 2025; the MA assessed an 8% whole person impairment but found that the development of an inflammatory arthritis was not caused by the accident; claimant involved in a motor vehicle accident on 21 May 2020 suffering physical injuries to his foot, arm, toes, right-hand, right knee, cervical spine and thoracic spine and then developed inflammatory arthritis in approximately August 2021; claimant relied on several medical journal articles to the effect that psoriatic arthritis is a development following trauma but insurer refuted this on the basis the claimant was not suffering from psoriasis; on examination the Medical Examiners noted signs of psoriasis on the claimant’s heels and accepted this as being indicative that he had suffered psoriasis at some stage; claimant carries an HLA-B27 gene leaving him with a genetic predisposition to the development of psoriasis; submissions made by both parties about the medical journal articles relied upon by the claimant; Held – Review Panel was satisfied that the development of psoriatic arthritis did follow the trauma of the motor vehicle accident however the Review Panel was not satisfied that the claimant’s impairment had stabilised and considered that he required treatment and that he should be reassessed in 12 months’ time.

Decision date: 26 June 2026 | Panel Members: Member Alexander Bolton, Dr Leslie Barnsley, and Dr Ian Cameron| Injury module: Spine, Upper Limb and Lower Limb

Petchell v QBE Insurance (Australia) Limited [2026] NSWPICMP 448

Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; where claimant was impacted by vehicle as a pedestrian; injuries to cervical spine, thoracic spine,  lumbar spine and right ankle; where the original Medical Assessor (MA) assessed a whole person impairment (WPI) of 7% for the right ankle injury (fracture of the talus) and assessed a 0% WPI for the soft tissue thoracic spine injury; where the original MA found that soft tissue injuries to the cervical and lumbar spines had resolved at the time of his assessment; re-examination by the Review Panel; where the Review Panel found that soft tissue injuries to the cervical spine, thoracic spine and lumbar spine caused by the accident had not resolved at the time of the re-assessment; right ankle injury assessed at 7% WPI; lumbar spine injury assessed at 5% WPI; thoracic spine injury assessed at 0% WPI and the cervical spine injury assessed at 0% WPI; Held – original Medical Assessment Certificate (MAC) revoked; permanent impairment assessed at 12%; new MAC issued.

Decision date: 26 June 2026| Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr Margaret Gibson| Injury module: Spine, and Lower Limb

Allianz Australia Insurance Limited v Lin [2026] NSWPICMP 449

Motor Accident Injuries Act 2017; insurer’s application for review of medical assessment of Medical Assessor (MA) under section 7.26; whole person impairment (WPI) dispute; where the claimant was impacted by vehicle as a pedestrian; where the MA found that a traumatic brain injury, a T9 fracture of the thoracic spine, a fracture of the left  clavicle and soft tissue injuries to the cervical spine, right shoulder and left knee caused by the motor accident gave rise to a WPI assessed at 21%; re-examination by the Review Panel; where the Review Panel found that the motor accident caused a traumatic brain injury, a T9 fracture of the thoracic spine, a fracture of the left clavicle and a soft tissue to the left knee but did not cause any injuries to the cervical spine and the right shoulder; WPI assessed at 15%; Held – the Medical Assessment Certificate (MAC) of assessment of the MA is revoked; new MAC issued.

Decision date: 26 June 2026| Panel Members: Member Maurice Castagnet, Dr Sophia Lahz, and Dr Christopher Oates| Injury module: Spine, Upper Limb, and Lower Limb

AAI Limited t/as AAMI v Kumari [2026] NSWPICMP 450

Motor Accident Injuries Act 2017; review of medical assessment by Review Panel; threshold injury dispute and treatment and care dispute; tears of the knees and shoulder; found that on balance of probabilities the tears were not caused by the motor accident; treatment including MRI referrals and further physiotherapy sessions found to be related to the injuries caused by the motor accident but not reasonable and necessary;  no radiculopathy found and no meniscus tear of the knees, or tear to the shoulder caused by the accident; injuries are threshold injuries for the purposes of the Act; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 26 June 2026| Panel Members: Member Elizabeth Medland, Dr Mohammed Assem, and Dr Shane Maloney | Injury module: Spine, Upper Limb, and Lower Limb; Treatment Type: Radiological Investigations, and Physiotherapy Treatment

Esho v QBE Insurance (Australia) Limited [2026] NSWPICMP 451

Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) dated 4 November 2025; claimant injured in a pedestrian versus car motor vehicle accident in a car park on 13 December 2022 with a collision to her right hip causing her to fall on her left side; claimant was admitted to hospital for two months followed by a further one month in hospital for rehabilitation; no complaint made in this time by the claimant of a left shoulder injury; first complaint of left shoulder injury was in August 2023; Review Panel not satisfied that the injury to the claimant’s left shoulder was caused by the accident; Held – certificate and reasons of the MA confirmed with assessment of a 9% whole person impairment.

Decision date: 26 June 2026| Panel Members: Member Alexander Bolton, Dr Drew Dixon, and Dr Mohammed Assem| Injury module: Spine, Upper Limb and Lower Limb

Insurance Australia Limited t/as NRMA v Toma [2026] NSWPICMP 454

Motor Accident Injuries Act 2017; review of medical assessment; threshold injury; aggravation of pre-existing cervical spine condition; muscular ligamentous strain of the thoracic spine; lumbar spine L5 radiculopathy with impingement of the L5 nerve root is a non-threshold injury; prior right shoulder injury; significant limitation in day-to-day activities; radiological material reports right paracentral disc protrusion indenting the thecal sac; wasting of the right calf; positive right sided sciatic stretch test; non-threshold injury; Held – Medical Assessment Certificate confirmed.

Decision date: 29 June 2026| Panel Members: Member Hugh Macken, Dr Les Barnsley, and Dr Margaret Gibson| Injury module: Spine, and Upper Limb

White v QBE Insurance (Australia) Limited [2026] NSWPICMP 455

Motor Accident Injuries Act 2017; Review Panel of medical assessment; assessment of whole person impairment (WPI); original Medical Assessor found inconsistencies in presentation meant no assessable WPI; Review Panel noted objective evidence of fracture to left thumb that must give rise to WPI, in addition to scarring; shoulder surgery by way of distal clavicular resection that automatically attracts assessable WPI; no inconsistency of presentation at re-examination; surveillance considered; issues of causation considered; right shoulder not related, left shoulder is; no deduction as no objective evidence of pre-existing symptomatic impairment; found a WPI assessed at 14%; Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 29 June 2026| Panel Members: Member Elizabeth Medland, Dr David Gorman, and Dr Margaret Gibson| Injury module: Spine, Upper Limb, Lower Limb, and Minor Skin

AAI Limited t/as GIO v Li [2026] NSWPICMP 456

Motor Accident Injuries Act 2017; insurer’s application for review under section 7.26 following the original assessment for whole person impairment assessed at 15%; claimant injured in rear end collision sustained injuries to neck and back determined by a Medical Assessor (MA) to be soft tissue threshold injuries; claimant had pre-accident history of neck and lower back injuries and psychological symptoms being treated in the year before the accident; claimant was a difficult historian; examined by two MAs; first re-examination abandoned when claimant was overseas and in a coffee shop at the time; second re-examination occurred in solicitor’s office; causation established; diagnoses of adjustment disorder and somatoform disorder; current WPI assessed at 5%; pre-existing impairment assessed at 1%; adjustment for treatment effect of 1%: Held – claimant’s WPI not greater than 10%; original Medical Assessment Certificate (MAC) revoked; no issue of principle; new MAC issued.

Decision date: 29 June 2026| Panel Members: Member Belinda Cassidy, Dr Wayne Mason, and Dr Abhishek Nagesh| Injury module: Mental and Behavioural

QBE Insurance (Australia) Limited v Au [2026] NSWPICMP 459

Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) dated 24 June 2025 who assessed a whole person impairment (WPI) of 5% and a diagnosis of post-traumatic stress disorder (PTSD); claimant involved in a car versus pedestrian accident which occurred on 4 July 2023; claimant’s psychiatric disability commenced almost immediately; his physical injuries caused ongoing pain and inconvenience;  consideration of whether the claimant’s working ability affected by his psychiatric condition or by his physical conditions and limitations; Review Panel assessed the claimant as having a diagnosis of PTSD and a WPI assessed at 7%; Held – Medical Assessment Certificate of the MA is revoked.

Decision date: 30 June 2026| Panel Members: Member Alexander Bolton, Dr Melissa Barrett, and Dr Himanshu Singh| Injury module: Mental and Behavioural

You v QBE Insurance (Australia) Limited [2026] NSWPICMP 460

Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) dated 12 November 2025; threshold injury assessment arising out of an accident on 1 April 2023; claimant alleged injuries to her thoracic and lumbar spines; rear end collision with minimal damage to both vehicles; claimant alleged that she suffered annular tears to thoracic and lumbar spines; no record of injury to thoracic spine by the claimant’s GP following the accident; Review Panel not accepting of diagnosis of radiculopathy by treating practitioners as the Review Panel was not satisfied about the nature of clinical examination; Review Panel found no radiculopathy on examination and was not satisfied that the claimant has suffered an annular tear as a result of the accident; Held – certificate of MA affirmed.

Decision date: 30 June 2026| Panel Members: Member Alexander Bolton, Dr Leslie Barnsley, and Dr David Gorman| Injury module: Spine

QBE Insurance (Australia) Limited v Omeissah [2026] NSWPICMP 461

Motor Accident Injuries Act 2017; threshold injury dispute; claimant involved in a front on collision with a turning car; right knee injury from foot “slamming on brake” and impact; post-accident MRI showed a low grade medial collateral ligament injury with possible chondral fissuring and degenerative changes; issue of whether the chondral fissuring is related to the motor accident; original Medical Assessment Certificate (MAC) noted the presence of the fissure but did not provide reasons on why it was considered causally related to the motor accident; Review Panel re-examined and found the claimant’s right knee was asymptomatic; Review Panel noted that had the chondral fissure been acute, the claimant would unlikely have been better and asymptomatic; the more likely cause of the injury was a medial collateral strain which inflamed the surrounding tissue within the vicinity of the chondral fissure but without any structural change to the fissure itself; Held – right knee soft tissue injury caused by the motor accident which is a threshold injury; MAC revoked; new MAC issued.

Decision date: 30 June 2026| Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr David Gorman| Injury module: Spine, and Lower Limb

Taylor v AAI Limited t/as AAMI [2026] NSWPICMP 462

Motor Accident Injuries Act 2017; assessment of degree of permanent impairment; claimant was riding her motorcycle at a speed of about 25 km/h behind the insured Isuzu D-Max utility vehicle which was carrying an improperly secured load; a part of the load became dislodged and landed in the claimant’s path; while attempting to avoid the object, the claimant lost control of her motorcycle and fell, coming down hard on the road surface; claimant was shocked but did not lose consciousness; claimant could not stand up because of a foot injury; Medical Assessor (MA) found all injuries referred for assessment (cervical spine, thoracic spine and lumber spine, both hips, left foot and left ankle) were not caused by the motor accident; accordingly whole person impairment was not assessed; claimant’s review application allowed on basis that inconsistencies were not put to claimant; those inconsistencies mainly arose from social media posts depicting the claimant undertaking physical activities inconsistent with alleged impairments; claimant re-examined by another MA; Review Panel found injuries to cervical spine and thoracic spine not caused; Review Panel found injuries to lumbar spine, both hips and left foot caused by motor accident; injury to left ankle consequential to left foot injury; Held – Review Panel assessed a 11% WPI; Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 1 July 2026| Panel Members: Member Gary Victor Patterson, Dr Michael Couch, and Dr Shane Moloney| Injury module: Spine, and Lower Limb

Allianz Australia Insurance Limited v Pereira [2026] NSWPICMP 463

Motor Accident Injuries Act 2017; Medical Review Panel; review of Medical Assessment Certificate (MAC) regarding permanent impairment (physical); lumbar spine, cervical spine, right shoulder; issue of causation; consideration of asymptomatic pre-existing degenerative changes; short delay in seeking medical attention following accident; subsequent surgery caused by accident; use of diagnosis related estimate method (DRE) for evaluating impairment of the spine; claimant examined; AAI Limited t/as AAMI v Phillips, and Bath v Allianz Australia Insurance Limited considered and applied; Held – claimant’s lumbar spine and cervical spine injuries caused by accident; claimants right shoulder injury not caused by accident; claimant’s injuries caused by the accident assessed at 5% WPI; original MAC revoked; new MAC issued.

Decision date: 1 July 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr Ian Cameron, and Dr Les Barnsley| Injury module: Spine, and Upper Limb

Workers Compensation Medical Appeal Panel Decisions

Med-X Pty Ltd v Lamena [2026] NSWPICMP 442

Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Workers Compensation Act 1987 (1987 Act); appeal by employer against 22% whole person impairment assessment for psychological injury; whether provisions of section 65A complied with; whether provisions of section 319 of the 1998 Act not complied with; whether opinion from employer’s expert sufficient to constitute a medical dispute; whether medical dispute created by correspondence; whether reasons inadequate; Mercy Connect Limited v Kiely, Matheson v BaptistCare NSW and ACT, and Skates v Hills Industries Ltd considered and distinguished; Held – section 319 of the 1998 Act definitional, not procedural, and not relevant; provisions of section 65A of the 1987 Act not applicable; the correspondence was an offer which was rejected and not relevant; no claim made for secondary psychological injury, and no agreement that secondary psychological injury be assessed; Medical Assessment Certificate confirmed.

Decision date: 24 June 2026| Panel Members: Member John Wynyard, Dr Michael Hong, and Dr Douglas Andrews| Injury module: Psychiatric/psychological

Lancaster v SGS Australia Pty Ltd [2026] NSWPICMP 443

Workplace Injury Management and Workers Compensation Act 1998; sections 327(3) and 326; Medical Appeal Panel; demonstrable error, previous injury, pre-existing condition or abnormality, absence of symptoms; Pereira v Siemens Ltd considered and applied; Held – Medical Assessment Certificate issued on 26 February 2026 confirmed.

Decision date: 24 June 2026| Panel Members: Member John Turner, Dr Robert Payten, and Dr Paul Niall| Injury module: Hearing Loss

Woodward v Samaritans Enhanced Living Options Hunter Mid North Coast Pty Limited [2026] NSWPICMP 444

Workplace Injury Management and Workers Compensation Act 1998; assessment of the upper extremities following injury deemed to have occurred on 6 January 2020; Medical Assessor (MA) applied three-fourth deduction in respect of the assessment of the right upper extremity; appeal against deduction on grounds of demonstrable error and the assessment being made on the basis of incorrect criteria; Appeal Panel satisfied that deduction in respect of peripheral nerve disorder (median nerve) was appropriate but deduction made in respect of range of motion of the right wrist was inconsistent with the evidence; MA failed to provide adequate reasons for the three-fourth deduction in respect of the right wrist; Held – Medical Assessment Certificate revoked.

Decision date: 24 June 2026| Panel Members: Member Carolyn Rimmer, Dr James Bodel, and Dr Margaret Gibson| Injury module: Left Upper Extremity, and Right Upper Extremity

Keremelevska v Qantas Airways Ltd [2026] NSWPICMP 446

Workplace Injury Management and Workers Compensation Act 1998; Medical Appeal Panel; section 323; demonstrable error; deduction on account of pre-existing excess weight; no evidence that such condition gave rise to any condition in the lower extremities; evidence of pre-existing condition in one knee; one-tenth deduction maintained for left lower extremity; no deduction for right lower extremity; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 25 June 2026| Panel Members: Member Elizabeth Medland, Dr Doron Sher, and Dr Mohammed Assem | Injury module: Right Upper Extremity, Right Lower Extremity, and Left Lower Extremity

Intereach Ltd v Day [2026] NSWPICMP 452

Workplace Injury Management and Workers Compensation Act 1998; section 327(3); Medical Appeal Panel; demonstrable error, incorrect criteria, rounding, Activities of Daily Living; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 26 June 2026| Panel Members: Member John Turner, Dr David Gorman, and Dr Robert Kuru| Injury module: Lumber Spine, Left Upper Extremity, and Left Lower Extremity

Loau v HME Services [2026] NSWPICMP 453

Workplace Injury Management and Workers Compensation Act 1998; assessment of impairment of the nervous system following head injury; whether demonstrable error or application of incorrect criteria; whether Medical Assessor applied an incorrect standard of proof when he stated he could “convince” himself of any organic abnormality in his neurological examination; whether there was a failure to provide adequate reasons in support of the finding that appellant’s diplopia was not caused by sixth nerve palsy to due injury; whether adequate reasons for finding that lesion demonstrated on MRI not traumatic; Held – reading the Medical Assessment Certificate (MAC) as a whole, no error disclosed; Medical Assessment Certificate confirmed.

Decision date: 26 June 2026 | Panel Members: Senior Member Rachel Homan, Dr Michael Davies, and Dr Sophia Lahz| Injury module: Nervous system

Ressler v State of New South Wales (South Eastern Sydney Local Health District) [2026] NSWPICMP 457

Workplace Injury Management and Workers Compensation Act 1998; there were two grounds of Appeal; appellant submitted that the Medical Assessor (MA) has used both incorrect criteria and made a demonstrable error in assessing a psychiatric impairment rating scale (PIRS) category of class 1 in respect of self-care and personal hygiene; Appeal Panel did not find that there has been any error in relation to a PIRS assessment of class 1 which was in line with the appellants history she provided to the MA on the day of the assessment; appellant submitted the MA made no adjustment for the effects of treatment as permissible under clause 1.31 to 1.33 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed, in line with Zoric v Secretary, Department of Education; Held – Appeal Panel could find no error in the MA’s approach.

Decision date: 29 June 2026| Panel Members: Senior Member Elizabeth Beilby, Dr Graham Blom, and Dr Douglas Andrews| Injury module: Psychiatric/psychological

Bains Liquor Pty Ltd v Sabharwal [2026] NSWPICMP 458

Workplace Injury Management and Workers Compensation Act 1998; appellant employer submits that Medical Assessment Certificate (MAC) contained demonstrable error and/or the application of incorrect criteria in assessment of whole person impairment (WPI) for the upper and lower digestive systems; whether there are signs and symptoms for assessment of WPI of those body systems; whether the Medical Assessor departed from properly applying the relevant parts of American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed, and the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed; Held – there was a demonstrable error and the application of incorrect criteria in the assessment of WPI for both the upper digestive system and lower digestive system; MAC revoked; new consolidated MAC issued which included agreed assessment of WPI of the lumbar spine.

Decision date: 29 June 2026 | Panel Members: Member John Isaksen, Dr John Garvey, and Dr Siddarth Sethi | Injury module: Lumbar Spine, Upper Digestive System, and Lower Digestive System

Motor Accidents Merit Review Decisions

KLT v Youi Pty Limited [2026] NSWPICMR 29

Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about the amount of statutory benefits payable for funeral expenses under section 3.4; merit review jurisdiction; schedule 2 clause 1(a); miscellaneous claims assessment jurisdiction; schedule 2 clause 3(b); cause of death not established; requirement for cause of death before determining whether death resulted from a motor accident; section 3(1) Transport Accident Act 1986 (Vic); RBK v Montague considered and applied; Held –  the reviewable decision is affirmed.

Decision date: 23 June 2026 | Merit Reviewer: Katherine Ruschen

Jaggi v AAI Limited t/as AAMI [2026] NSWPICMR 30

Motor Accident Injuries Act 2017; merit review; entitlement to weekly payments for statutory benefits; second entitlement period; application of section 3.7; Workers Compensation Act 1987 claim for same period made in relation to different injuries; claimant certified to have total incapacity arising from work place injuries; claimant unemployed during relevant period for reasons unrelated to motor vehicle accident; rule against double recovery; McMillan Investment Holdings Pty Ltd v Mangos (No 3), Anderson v Canaccord Genuity Financial (No 2), and Baxter v Obacelo Pty Ltd considered and applied; Held – claimant did not satisfy criteria in section 3.7; rule against double recovery would prevent compensation in any event; reviewable decision affirmed.

Decision date: 25 June 2026 | Merit Reviewer: Bianca Montgomery-Hribar

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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