Legal Bulletin No. 270

Issued 24 July 2026

Welcome to the two hundred and seventieth 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

Al Saidawi v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 400

Motor Accident Injuries Act 2017; damages assessment; liability denied; evidence from claimant and insured they drove through a green light in an intersection causing a collision; evidence supported claimant was distracted following a vehicle through the intersection; claimant had different version of events leading up to the collision; claimant must have been mistaken she proceeded through the intersection with a green light; Held – claimant wholly at fault for the accident; damages assessed in the sum of $0 and costs and disbursements assessed in the amount of $17,573.59.

Decision date: 12 June 2026| Member: Elyse White

Insurance Australia Limited t/as NRMA Insurance v Tanuja Banu [2026] NSWPIC 357

Motor Accident Injuries Act 2017; insurer’s application for exemption from assessment; opposed by claimant; where claimant’s employer at time of accident (a company of which her husband was a director) failed to produce documents in response to a direction for production; reliability issues; significant award sought; Insurance Australia Limited t/as NRMA Insurance v Banos, IAG Limited t/a NRMA Insurance v Khaled & Ors, and Secretary of the Department of Planning, Industry and Environment v Blacktown City Council applied; Held – insurer should be in a position to obtain records that are “apparently relevant” to the issues in dispute and will likely add, in some way or another, to the relevant evidence in the case;  that cannot occur in the Personal Injury Commission (Commission) in circumstances where a third-party failed to comply with a direction for production and where the Commission does not have the power to enforce the direction; claim not suitable for assessment by the Commission; recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 16 June 2026| Senior Member: Brett Williams

AAI Limited t/as GIO v Mason [2026] NSWPIC 402

Motor Accident Injuries Act 2017; settlement approval; claimant learner rider accelerated to avoid a collision and in doing so, the bike hit the kerb causing him to slide on the roadway before colliding with a power pole; inexperience contributed to the collision; allegation of 50% contributory negligence; insurer’s medico-legal assessed a whole person impairment at 14%; claimant off work for 7 months before returning part time and to full capacity; buffer allowance for future economic loss with the possibility of a knee replacement in 20 - 30 years; Held – settlement approved in the sum of $372,500; allegation of 50% contributory negligence just and equitable having considered the circumstances of the events; 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: 8 July 2026| Member: Elyse White

Khammi v AAI Limited t/as GIO [2026] NSWPIC 408

Motor Accident Injuries Act 2017; miscellaneous claims assessment; statutory benefits; whether accident caused wholly or mostly by claimant’s fault under sections 3.11 and 3.28; collision at signal-controlled intersection between northbound through vehicle and vehicle turning right from motorway off-ramp; insurer alleged claimant entered against red traffic signal; contemporaneous accounts of both drivers consistent but irreconcilable; police conclusion and infringement based substantially on hearsay account of unidentified independent witness; absence of CCTV, event-level signal data or other objective evidence; engineering evidence unable to determine signal phase but supported absence of avoidable opportunity once turning vehicle entered claimant’s path; insurer bore onus of establishing statutory disentitling fact and failed to establish, to the requisite degree of persuasion, that the claimant entered against a red signal or was otherwise at fault; Held – accident not caused wholly or mostly by the fault of the claimant.

Decision date: 13 July 2026 | Member: Bridie Nolan

Allianz Australia Insurance Limited v Speers [2026] NSWPIC 410

Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 12 July 2024; claimant was working at the time of the accident; claimant is aware this approval resolves his common law damages claim; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines; Held – settlement approved in the amount of $21,322.00, consisting of nil non-economic loss, past economic loss of $1,322.00 and $20,000.00 for future economic loss.

Decision date: 14 July 2026| Member: Philip Carr

Workers Compensation non-Presidential Member Decisions

Zaki v Total Logistic Solutions Group Pty Ltd [2026] NSWPIC 397

Workers Compensation Act 1987; sections 32A, 33, 37, 38, and 60; incapacity for work results from an injury; pre-existing condition; incarceration; Kooragang Cement Pty Ltd v Bates, Briginshaw v Briginshaw, Calman v Commissioner of Police, and McCarthy v Department of Corrective Services considered and applied; Held – that the applicant’s incapacity for work results from the work injury on 12 August 2022; that the applicant has been totally incapacitated for any work since 13 July 2024 and remains totally incapacitated for work as a result of the injury sustained on 12 August 2022; the respondent is to pay the applicant weekly compensation pursuant to section 37 on the basis of total incapacity; payment is based on pre-injury average weekly earnings indexed as at 13 July 2024 of $2,570, from 13 July 2024 subject to indexation until an aggregate period of 117 weeks of compensation have been paid pursuant to section 37 following which the respondent is to pay the applicant weekly compensation pursuant to section 38 to date and continuing on the basis of total incapacity and subject to indexation; respondent is to pay the applicant’s reasonably necessary medical and treatment expenses pursuant to section 60.

Decision date: 6 July 2026 | Member: John Turner

Mollah v Allsite Australia Pty Ltd [2026] NSWPIC 403

Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998; applicant tripped over forklift tynes and fell, injuring his right shoulder in the course of his employment on 13 December 2021; it was also pleaded that he sustained a consequential left shoulder injury to his left shoulder as a result of favouring same to avoid injury to the right shoulder; applicant also claimed to have suffered sleep apnoea and chronic insomnia consequential to his orthopaedic injuries; the dispute centred on whether the applicant suffered the consequential left shoulder, a consequential sleep disorder injury, and whether there is a medical dispute with respect to the sleep disorder injury and permanent impairment attributable to same; application of Moon v Conmah Pty Limited; discussion of recent authorities pertaining to the assessment of permanent impairment for insomnia caused by chronic pain including Bogdanovic v Farlow Concrete Pty Ltd, Arch-Systems Fabrication Pty Ltd v McCann and Carrasco v RKDOIG Pty Ltd; Held – the  applicant suffered an injury to his left shoulder consequential to the right shoulder injury sustained on 13 December 2021; he applicant suffers from insomnia as a result of his orthopaedic injuries; the claim for permanent impairment for the shoulders and for the central and peripheral nervous system (insomnia) is remitted to the President for referral to a Medical Assessor to determine permanent impairment.

Decision date: 8 July 2026 | Member: Jeffrey Gabriel

Buddee v COGS Services Pty Ltd [2026] NSWPIC 404

Workers Compensation Act 1987; claim pursuant to section 66;  in relation to the applicant’s right upper extremity (wrist and shoulder) and left upper extremity (wrist and shoulder); the respondent accepted that bilateral wrist injuries were sustained by the applicant in the course of her employment with the respondent; the respondent disputes the applicant’s allegation that she sustained consequential conditions in both of her shoulders as a result of her wrist injuries; in the alternative, the applicant alleged she sustained injury to both of her wrists in the course of employment with the respondent; Nguyen v Cosmopolitan Homes Pty Ltd applied; Held – finding made that the applicant that did not discharge her onus of proof in relation to establishing injury to the wrists and /or consequential conditions in the shoulders as a result of her accepted wrist injuries.

Decision date: 8 July 2026 | Member: Josephine Bamber

Blicharski v Masterwall NSW Pty Ltd [2026] NSWPIC 405

Workplace Injury Management and Workers Compensation Act 1998; interlocutory issue; whether respondent on notice of claim across multiple dates of injury; whether applicant can proceed on both dates of injury; sections 254, 260, 261; representation of respondent’s insurer; Elphick v Westfield Shopping Centre considered and applied; date of injury with respect to lump sum claim; State Government Insurance Commission (Western Australia) v Oakley, and Shlimon v Steric Pty Ltd referred; Held – the applicant can proceed against the respondent with respect to an injury sequence involving incidents on 30 June 2021 and 3 December 2021; matter listed for further arbitration hearing with respect to the remaining issues in dispute.

Decision date: 8 July 2026 | Member: Mitchell Strachan

Zouri v Underwood Smash (N.S.W) Pty Ltd [2026] NSWPIC 409

Workers Compensation Act 1987; claim for weekly payments of compensation for disease injury to both upper limbs and/or conditions affecting both upper limbs as a consequence of laceration injury to left hand; both causes of incapacity disputed by respondent; Held – award for the respondent for both causes of incapacity claimed by the worker.

Decision date: 13 July 2026 | Member: John Isaksen

Brandon v West Tamworth League Club Ltd [2026] NSWPIC 411

Workers Compensation Act 1987; claim pursuant to section 60in relation proposed right L5/S1 dorsal root ganglion stimulator, and ancillary expenses as a result of injury on 8 September 2022 to the applicant’s right ankle sustained in the course of employment with the respondent; Diab v NRMA Ltd applied; Held – finding made proposed treatment is reasonably necessary as a result of the workplace injury.

Decision date: 14 July 2026 | Member:  Josephine Bamber

Motor Accidents Medical Review Panel Decisions

Insurance Australia Limited t/as NRMA Insurance v BZW [2026] NSWPICMP 485

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); section 7.26; dispute about whole person impairment (WPI) including causation; Medical Assessor certified accident caused depression and post-traumatic stress disorder (PTSD) gave rise to a WPI assessed at 15%; Norrington v QBE Insurance (Australia) Ltd, and AAI Ltd Tas GIO v McGiffen applied; Held – PTSD and the aggravation of pre-existing stimulant use disorder caused by the accident gave rise to a WPI assessed at 19%; MAC revoked.

Decision date: 9 July 2026| Panel Members: Senior Member Brett Williams, Dr John Baker, and Dr John Lam-Po-Tang| Injury module: Mental and behavioural

Allianz Australia Insurance Limited v Chesworth [2026] NSWPICMP 488

Motor Accident Injuries Act 2017; Medical Review Panel; assessment of whole person impairment (WPI); dispute concerning classification of complex pelvic ring injury under American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4^th ed (AMA 4) section 3.4; causation of left shoulder injury and pre-existing impairment; early radiology described non-displaced fractures but operative findings established pelvic instability requiring sacroiliac screw fixation and supra-acetabular external fixation; Held –  pelvic injury to be assessed as a single mechanically unstable pelvic ring injury rather than separate sacral and pelvic fractures; contemporaneous AC joint tenderness and subsequent MRI established accident-caused acromioclavicular joint sprain notwithstanding absence of early shoulder fracture; no deduction for pre-existing shoulder impairment; Held – healed pelvic ring injury involving the left sacroiliac joint assessed at 10% WPI under the AMA 4, section 3.4(f); left shoulder assessed at 3% WPI; combined permanent impairment assessed at 13% WPI, exceeding the 10% threshold.

Decision date: 10 July 2026| Panel Members: Member Bridie Nolan, Dr Drew Dixon, and Dr Shane Moloney| Injury module: Spine, Upper Limb, Lower Limb, and Skin

Insurance Australia Limited t/as NRMA Insurance v Nassou [2026] NSWPICMP 489

Motor Accident Injuries Act 2017; section 1.6(3); whole person impairment (WPI); persistent depressive disorder; consistency of presentation; assessment of whole person impairment (WPI); claimant suffered injury in a motor vehicle accident on 25 March 2020; Medical Assessor (MA) assessed a WPI at 15% as a result of persistent depressive disorder with anxious distress and somatic symptom disorder with predominant pain caused by accident; insurer sought review; Held – certificate of MA revoked; condition deteriorated over time; persistent depressive disorder caused by the accident; WPI assessed at 19%.

Decision date: 10 July 2026 | Panel Members: Senior Member Susan McTegg, Dr Melissa Barrett, and Dr Paul Friend | Injury module: Mental and behavioural

Insurance Australia Limited t/as NRMA Insurance v Atwal [2026] NSWPICMP 490

Motor Accident Injuries Act 2017; Medical Review Panel; assessment of whole person impairment (WPI); dispute concerning cervical spine, thoracic spine and right shoulder injuries following motor vehicle accident; claimant alleged cervical C6 radiculopathy and thoracic impairment; Review Panel held objective clinical findings and imaging did not establish assessable cervical radiculopathy or thoracic impairment, with both spinal injuries assessed as Diagnosis-Related Estimates (DRE) Category I; right shoulder surgery, including posterior labral repair, biceps tenodesis, acromioplasty and distal clavicle excision, found causally related to the accident; no separate impairment assessed for distal clavicle excision to avoid duplication under the Motor Accident Guidelines; no deduction for pre-existing impairment despite earlier motor accident, as evidence did not permit reliable assessment of ratable impairment immediately before the subject accident; Held – cervical spine assessed at 0% WPI, thoracic spine assessed at 0% WPI, right shoulder assessed at 9% WPI; combined impairment assessed at 9% WPI, not exceeding the 10% threshold.

Decision date: 10 July 2026| Panel Members: Member Bridie Nolan, Dr Margaret Gibson, and Dr Drew Dixon| Injury module: Spine, Upper Limb, and Skin

Erceg v Allianz Australia Insurance Limited [2026] NSWPICMP 494

Motor Accident Injuries Act 2017; whole person impairment (WPI) dispute; claimant was travelling through a roundabout when the car in front of her stopped suddenly; the vehicle she was driving subsequently was rear-ended by the insured vehicle; claimant recalls being jolted forward onto the steering wheel, being in shock and experiencing generalised pain in her back, neck and shoulders; insurer maintained that circumstances of accident not sufficiently severe to cause extent of psychological injury claimed; insurer relied upon biomechanical engineering evidence; Medical Assessor (MA) found major depressive disorder and panic disorder caused by the accident; MA calculated 47% WPI utilising the psychiatric impairment rating scale; MA added 1% WPI for treatment effects; insurer’s review application allowed on basis that the MA did not use the correct test for causation; claimant re-examined by both Review Panel MAs; Review Panel satisfied that subject accident caused the claimant to suffer major depressive disorder with anxious distress; claimant’s evidence preferred to that of insurer’s civil engineer; Review Panel assessed at 15% WPI with no adjustment for pre-existing impairment nor treatment effects; Review Panel considered but rejected diagnosis of somatic symptom disorder; Held – certificate revoked.

Decision date: 13 July 2026| Panel Members: Member Gary Victor Patterson, Dr Christopher Canaris, and Dr Michael Hong| Injury module: Mental and behavioural

Allianz Australia Insurance Limited v Lombardo [2026] NSWPICMP 495

Motor Accident Injuries Act 2017; assessment of whole person impairment (WPI); claimant was 5 years of age when she came from the Philippines; claimant worked as a registered nurse before the accident; claimant’s pre-accident history is marked by a long-standing diagnosis of generalised anxiety disorder (GAD); despite the symptoms with psychological sequelae, the claimant could maintain her responsibilities as a healthcare professional, and manage her household independently; claimant was stationary at a red light, when a truck, travelling at speed, collided with the rear of the claimant’s car, causing it to be forcefully pushed into the car in front of it; claimant developed neck pain and left arm symptoms; claimant was involved in two further motor vehicle accidents, causing her to cease work; Medical Assessor (MA) certified 14% WPI for Major Depressive Disorder of moderate to severe intensity, and Exacerbation of GAD, with features of somatisation and traumatisation; insurer’s review application allowed on basis of MA’s alleged failure to assess pre-existing impairment in accordance with the Motor Accident Guidelines; claimant re-examined by both MAs who diagnosed persistent depressive disorder (dysthymia) with a major depressive episode and anxious distress; MA assessed a WPI at 8% including a 1% uplift for treatment effects; MA explain why adjustment for impairment arising from subsequent motor accident(s) is not appropriate; Held –  certificate revoked.

Decision date: 13 July 2026 | Panel Members: Member Gary Victor Patterson, Dr Christopher Canaris, and Dr Surabhi Verma | Injury module: Mental and behavioural

Wannous v QBE Insurance (Australia) Limited [2026] NSWPICMP 496

Motor Accident Injuries Act 2017; assessment of threshold injury; claimant was on his way to work driving towards the M5 and came to a halt just before a roundabout; insured vehicle collided with the rear of the claimant’s vehicle which was shunted into the Ute in front of it; claimant was conveyed to hospital; claimant complained of pain in the back of his head, neck and lower back with psychological sequelae; claimant denies any history of psychiatric illness; Medical Assessor certified the motor accident caused claimant to suffer an adjustment disorder with mixed anxiety and depressed mood, which is a threshold injury; claimant’s review application allowed by President’s delegate for failure to put inconsistencies to claimant; both Review Panel Medical Assessors re-examined and diagnosed a threshold injury, being an adjustment disorder with anxiety; Held – Review Panel revoked certificate because diagnosed injury has a different diagnostic code, despite same result.

Decision date: 13 July 2026| Panel Members: Member Gary Victor Patterson, Dr Paul Friend, and Dr Melissa Barrett| Injury module: Mental and behavioural

Powe v QBE Insurance (Australia) Limited [2026] NSWPICMP 497

Motor Accident Injuries Act 2017; Medical Review Panel; assessment of whole person impairment; claimant dragged by moving courtesy bus while alighting; dispute concerning lumbar spine impairment, bilateral knee impairment and scarring; Review Panel held lumbar soft tissue injury did not satisfy Diagnosis-Related Estimates (DRE) Lumbosacral Category II, with current findings consistent only with DRE Category I; bilateral knee soft tissue injuries accepted on background of pre-existing tricompartmental osteoarthritis, but no deduction for pre-existing impairment in the absence of evidence of ratable symptomatic permanent impairment before the accident; right knee assessed by patellofemoral crepitus, left knee by range of motion, without impermissible combination of alternative methods under the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4^th ed; healed rib fractures and knee scarring attracted no assessable impairment; Held – chest/ribs assessed at 0% WPI, lumbar spine assessed at 0% WPI, right knee assessed at 2% WPI, left knee assessed at 4% WPI, scarring assessed at 0% WPI; combined impairment assessed at 6% WPI, not exceeding the 10% threshold.

Decision date: 13 July 2026| Panel Members: Member Bridie Nolan, Dr Margaret Gibson, and Dr Ian Cameron| Injury module: Spine, Upper Limb, Lower Limb, and Skin

Patterson v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 499

Motor Accidents Injuries Act 2017; psychological injury; threshold injury dispute; claimant sustained injuries to his neck and back when his stationary car was hit from behind by another car; claimant later developed psychological injuries; original Medical Assessment Certificate (MAC) diagnosed accident related adjustment disorder as DSM-5-TR criteria for post-traumatic stress disorder (PTSD) and major depressive disorder not met; Review Panel re-examined claimant and found the accident as described did not conform to a criterion A event as required under the DSM-5-TR criteria for a diagnosis of PTSD; Review Panel found claimant’s presentation to be consistent with persistent depressive disorder; Review Panel set out how each of the criterion A-H were met for a diagnosis of persistent depressive disorder; pre-accident stressors in police career contributed to vulnerability however claimant largely coped with them and without becoming depressed or anxious; Review Panel noted persistent depressive disorder was not strictly raised as a psychological injury to be assessed however as two and a half years have passed, Review Panel determined the major depressive episodes are now better characterised as a persistent depressive disorder and was within the purview of the Review Panel; Held – persistent depressive disorder is not a threshold injury; MAC revoked; new MAC issued.

Decision date: 13 July 2026 | Panel Members: Member Jeremy Lum, Dr Christopher Canaris, and Dr Gerald Chew| Injury module: Mental and behavioural

AAI Limited t/as GIO v Levar [2026] NSWPICMP 500

Motor Accidents Injuries Act 2017; Medical Review Panel; assessment of permanent impairment;  claimant sustained cervical spine, lumbar spine, left thumb and shoulder complaints following multi-impact collision; dispute as to causation of right hip condition and whether left shoulder restriction was assessable in the absence of intrinsic shoulder pathology; application of Nguyen v Motor Accidents Authority of New South Wales; Review Panel held left shoulder restriction was a direct consequence of the cervical spine injury and assessable notwithstanding the absence of a discrete glenohumeral injury; right hip trochanteric bursitis and iliotibial band tendinopathy not caused by the accident; Held – cervical spine assessed at 5% WPI, lumbar spine assessed at 5% WPI, consequential left shoulder impairment assessed at 4% WPI; combined permanent impairment assessed at 14% WPI, exceeding the 10% threshold.

Decision date: 13 July 2026| Panel Members: Member Bridie Nolan, Dr Mohammed Assem, and Dr Shane Moloney | Injury module: Spine, Upper Limb, and Lower Limb

QBE Insurance (Australia) Limited v Wong [2026] NSWPICMP 501

Motor Accidents Injuries Act 2017; threshold injury review of certificate and reasons of Medical Assessor (MA) dated 20 November 2025; claimant involved in forceful rear end collision on 19 April 2024; claimant initially made complaints of pain in his right shoulder and right hip within days of the accident but subsequent x-rays, ultrasound and MRI scans not immediately performed and then minor tears identified in September 2024; insurer alleged the tears were pre-existing but there was no medical evidence about this and no prior complaints of disability by the claimant; Review Panel satisfied that on the balance of probabilities the jolting collision caused a right labral tear of the right hip due to transmission of forces by the lap sash seatbelt with a whipping action; the claimant’s foot was on the brake so there would have been a transmission of forces along the femur directly to the hip capable of tearing tissues; Review Panel also satisfied that given early complaint of right shoulder pain and circumstances of the accident with seatbelt passing over the anterior right shoulder and then a sudden jolt it was probable that the accident caused a small subscapularis tear; Review Panel satisfied that as a result of the accident the claimant suffered non-threshold injuries; Held – certificate of MA affirmed.

Decision date: 14 July 2026| Panel Members: Member Alexander Bolton, Dr Drew Dixon, and Dr Sophia Lahz| Injury module: Nervous System (Neurological), Upper Limb, and Lower Limb

AAI Limited t/as GIO v Gee [2026] NSWPICMP 502

Motor Accidents Injuries Act 2017; threshold injury; insurer applied for review of Medical Assessor (MA) certificate dated 27 October 2025 finding the accident caused non-threshold injuries after low force vehicle impact; Review Panel assessed whether the accident caused diagnosed heel fracture; heel injury present after accident; insurer submits it was due to existing condition; credible claimant on history before accident; no history of lower limb or foot fracture before accident despite frequent records of lower limb and foot conditions relating to neuropathy; due to osteoporosis collision capable of causing injuries including “insufficiency fracture”; Review Panel considered Civil Liability Act 2002, and Briggs v IAG Limited t/a NRMA Insurance on causation; Held – referred heel fracture injury is not a threshold injury under the Act; MA’s certificate affirmed.

Decision date: 14 July 2026 | Panel Members: Member Terence O’Riain, Dr Margaret Gibson, and Dr Shane Moloney| Injury module: Lower Limb

De La Fuente v AAI Limited t/as AAMI [2026] NSWPICMP 503

Motor Accident Injuries Act 2017; assessment of threshold injury; claimant was driving to an open home; he was stationary, about to turn right at an intersection when he was rear-ended by the at-fault vehicle; he left the accident scene and drove to the open home; claimant after the subject accident says he is suffering significant physical and psychological injuries; claimant was involved in a previous motor vehicle accident in 2021; claimant suffered neck, lower back and left shoulder pain; claimant recalls a long period of physical therapy; claimant states that, before the subject accident, he made a full recovery and had recommenced gymnasium based exercise; claimant says he was disappointed that his physical condition regressed; claimant says that he began to have mental health difficulties after the subject accident; Medical Assessor (MA) certified that the subject accident caused an adjustment disorder with mixed disturbance of mood which is a threshold injury; claimant’s review application allowed on basis of alleged failure to properly apply the Motor Accident Guidelines and provide a proper pathway of reasoning; claimant re-examined by both Review Panel MAs who diagnosed an Adjustment disorder with mixed anxiety and depressed mood; Held – certificate revoked as the wording used by Medical Assessor is not in DSM-5-TR.

Decision date: 15 July 2026| Panel Members: Member Gary Victor Patterson, Dr John Baker, and Dr Surabhi Verma| Injury module: Mental and behavioural

MQP v Allianz Australia Insurance Limited [2026] NSWPICMP 504

Motor Accident Injuries Act 2017; review of medical assessment certificate (MAC); threshold injury determination; issue regarding causation; Allianz Australia Insurance Limited v Bell, and AAI Limited v SIRA (formerly MAA) considered and applied; whether single causative event; whether psychological injury caused by accident; Held – DSM-5-TR criterion A for post-traumatic stress disorder not satisfied; major depressive disorder caused by accident, being a non-threshold injury; Held – MAC revoked due to different diagnosis.

Decision date: 15 July 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr John Baker, and Dr Nagesh Abhishek| Injury module: Mental and behavioural

Workers Compensation Medical Appeal Panel Decisions

Ryan v Kumar Motors (Bankstown) Pty Ltd [2026] NSWPICMP 483

Workplace Injury Management and Workers Compensation Act 1998; in summary, the appellant submits that the Medical Assessor erred in his whole person impairment (WPI) assessment of two of the categories of the psychiatric impairment rating scale (PIRS); namely social and recreational activities and social functioning; Appeal Panel found no errors; the appellant relied on old evidence in support of her appeal; Held – Medical Assessment Certificate confirmed.

Decision date: 8 July 2026 | Panel Members:  Member Deborah Moore, Dr John Baker, and Dr Graham Blom | Injury module:  Psychiatric/psychological

Singh v Diebold Nixdorf Australia Pty Limited [2026] NSWPICMP 484

Workplace Injury Management and Workers Compensation Act 1998; appeal concerning the assessment of a cauda equina injury (sexual and urological systems) only on the grounds of demonstrable error and assessment being made on the basis of incorrect criteria; appellant submitted that the Medical Assessor (MA) impermissibly found there was no cauda equina injury contrary to the findings made by the Commission; Appeal Panel accepted that the MA exceeded his statutory task; Appeal Panel assessed 5% WPI in respect of the urological system and 5% WPI in respect of the sexual system; Held – Medical Assessment Certificate revoked.

Decision date: 8 July 2026 | Panel Members:  Member Carolyn Rimmer, Dr Edward Korbel, and Dr Ross Mellick | Injury module:  Lumbar spine, Cauda Equina Urological system, and Cauda Equina Sexual system

Morphett v St Vincent's Private Hospital [2026] NSWPICMP 486

Workplace Injury Management and Workers Compensation Act 1998; multiple physical injuries; appeal on lumbar spine based on deterioration following fusion surgery subsequent to Medical Assessment Certificate (MAC) and incorrect application of section 323; Riverina Wines Pty Ltd v Workers Compensation Commission of NSW applied; dietary restriction previously claimed but not assessed in original assessments: demonstrable error in failing to assess totality of claim; Skates v Hills Industries Ltd applied; appellant re-examined by the Medical Assessors separately due to different body systems; prior lumbar spine injury and discectomy; significant pre-existing degenerative condition and asymmetric disc collapse at time of injury; extent of deduction a finding of fact and previous decisions do not create legal precedent; Edwards v Noble applied; pre-existing condition at odds with one-tenth deduction; finding made of one-third deduction for lumbar spine impairment; Held – claimant re-assessed at 21% whole person impairment for various systems; original MAC revoked.

Decision date: 9 July 2026 | Panel Members:  Principal Member John Harris, Dr Robert Kuru, and Dr Michael Bowler | Injury module:  Lumbar spine, Skin, Ear, Nose and throat, Lower digestive system, and Upper digestive system

KYA v JKS [2026] NSWPICMP 487

Workplace Injury Management and Workers Compensation Act 1998; Medical Appeal Panel; legislation section 327(3) demonstrable error, incorrect criteria, concentration, persistence and pace, and reasoning; Jenkins v Ambulance Service of New South Wales, Ferguson v State of New South Wales, and Wingfoot Australia Partners Pty Ltd v Kocak considered and applied; Held – Medical Assessment Certificate revoked.

Decision date: 9 July 2026 | Panel Members: Member John Turner, Dr John Baker, and Dr Ash Takyar| Injury module: Psychiatric/psychological

Naiebzada v Sydney Waterproofers Pty Ltd [2026] NSWPICMP 491

Workers Compensation Act 1987; assessment of “insomnia” under the neurological chapter caused by lumbar spine injury; appellant’s submission accepted that he sustained a neurological injury to the S1 nerve root; Military Rehabilitation and Compensation Commission v May applied; meaning of primary sleep disorder following neurological injury in clause 5.10 of the Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th edition, 1 March 2021 primary sleep disorder is caused by impairment of cellular neurological structures or function subserving the capacity for normal sleep; interpretation consistent with observations in Arch-Systems Fabrications Pty Limited v McCann ; determination consistent with finding by Appeal Panel in Lachlan Shire Council v Stanley that radiculopathy causing insomnia was a secondary sleep disorder; criticism of suggestion that insomnia can cause neurological condition; comments by a Medical Assessor in Carrasco v RKDOIG Pty Ltd approved; application to assess respiratory system in reply submissions; parties agreed before Member that the applicant did not suffer from sleep disorder due to respiratory condition; respiratory system not part of medical dispute; Skates v Hills Industries Ltd and Scone Race Club Ltd v Cottom applied; Held – parties agreed that lumbar spine and skin assessed at 27%; no assessable impairment under the neurological chapter for primary sleep disorder.

Decision date: 10 July 2026 | Panel Members: Principal Member John Harris, Dr Ross Mellick, and Dr David Crocker | Injury module:  Neurological

Sunnyfield Disability Services v French [2026] NSWPICMP 492

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; worker assessed as suffering from 15% whole person impairment; Medical Assessor (MA) made no deduction pursuant to section 323; whether MA failed to consider relevant considerations; whether MA erred in failing to make a deduction for pre-existing psychological symptoms or comorbid condition; Held – MA did not fail to consider relevant consideration; no error in declining to make a deduction; Medical Assessment Certificate confirmed.

Decision date: 10 July 2026 | Panel Members: Member Parnel McAdam, Dr Ash Takyar, and Dr Michael Hong | Injury module: Psychiatric/psychological

Dimovski v Sargents Pty Ltd [2026] NSWPICMP 493

Workplace Injury Management and Workers Compensation Act 1998; hearing loss; inclusion of frequencies; whether losses below 3 Kilohertz should be included; worker had extensive non-work-related losses; whether the Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th edition, allow for exclusion of certain frequencies; consideration of competing medical opinions; whether worker denied an opportunity to respond to what frequencies are assessable; whether Medical Assessor provided adequate reasons; Held - Medical Assessment Certificate confirmed.

Decision date: 10 July 2026 | Panel Members: Member Parnel McAdam, Dr Paul Niall, and Dr Robert Payten | Injury module: Hearing

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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