Legal Bulletin No. 246

Issued 6 February 2026

Welcome to the two hundred and forty sixth edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.

Motor Accidents non-Presidential Member Decisions

Rapa v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 35

Motor Accident Injuries Act 2017; damages assessment; claimant rundown by a vehicle involved in criminal activity out the front of her home; sustained injuries to her neck, right shoulder, hand and wrist, lower back, right hip, and psychological injuries; worked in child care; able to return to pre-accident duties; claim for loss of promotion and increased earnings; entitlement to damages for non-economic loss; Held– damages assessed at non-economic loss of $350,000; past economic loss of $82,192 and future loss by way of a buffer considering the claimant’s young family and potential future opportunities for promotions $350,000; total assessment of $782,192.

Decision date: 22 January 2026 | Member: Elyse White

Fanosh-Fossa v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 47

Motor Accident Injuries Act 2017; claimant’s application for exemption under section 7.34(1)(b); claimant injured by unregistered forklift on a construction site; common law claim for damages against the nominal defendant; Supreme Court proceedings commenced by claimant against the occupier of the construction site; application not made under section 7.34(1)(a) for a mandatory exemption; the circumstances of the case satisfy the requirements of rule 99(3)(d) of the Personal Injury Commission Rules 2021 for the grant of a discretionary exemption under section 7.34(1)(b); Held – claim is not suitable for assessment by Commission; recommendation made that the claim be exempted; recommendation subsequently approved by Division Head, as the President’s delegate.

Decision date: 22 January 2026 | Member: Maurice Castagnet

AAI Limited t/as AAMI v Witschi [2026] NSWPIC 48

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident as passenger; claimant sustained right shoulder injuries and brief psychological condition; brief period off work; remainder pre-injury duties; medical evidence supports no deterioration; insurer accepted claimant’s offer; claimant educated and expressed himself as having agency to decide on accepting settlement; proposed settlement fair, just and reasonable; Held – proposed settlement approved.

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

Insurance Australia Limited t/as NRMA Insurance v Tamatoa [2026] NSWPIC 49

Motor Accident Injuries Act 2017; recommendation claim not suitable for assessment; insurer has alleged the claimant was riding his motorcycle and engaged in motor racing at the time of the accident; insurer has denied liability for the claim; collision occurred between the claimant’s motorcycle and the insured motor vehicle at an intersection; claimant sustained serious injuries; insurer has submitted the insured driver and a front seat passenger in the insured motor vehicle are uncooperative and it is not certain whether these individuals will attend an assessment conference in the Commission; submitted on behalf of the insurer the matter should be exempted on discretionary grounds; Held – the matter be exempted under section 7.34(1)(b) on the grounds the claim involves issues of liability, including contributory negligence, fault, or causation; rule 99(3)(b) of the Personal Injury Commission Rules 2021; recommendation subsequently approved by Division Head, as the President’s delegate.

Decision date: 10 December 2025 | Member: David Ford

Workers Compensation non-Presidential Member Decisions

State of New South Wales (NSW Police Force) v COU [2026] NSWPIC 22

Workers Compensation Act 1987; claim for psychological injury; claim for lump sum compensation pursuant to sections 66 and 67; respondent raises credit issues in relation to the applicant; respondent does not accept that the applicant sustained a psychological injury to which his employment was the main contributing factor; respondent otherwise also relies upon a defence to the applicant’s claim pursuant to section 11A; whether the applicant has sustained a psychological injury in accordance with section 4(b)(i); AV v AW, and Hancock v East Coast Timber Products Pty Ltd considered; whether the respondent can establish that any psychological injury of the applicant’s was wholly or predominantly caused by action taken or proposed to be taken by it with respect to discipline; Manly Pacific International Hotel Pty Limited v Doyle, Insurance Australia Group Services Pty Limited v Outram, Ponnan v George Weston Foods Limited, Hamad v Q Catering Limited, and Mason v Demasi considered; whether the respondent can establish the reasonableness of the actions taken or proposed to be taken by it with respect to discipline; Melder v Ausbowl Pty Limited, Buxton v Bi-Lo Pty Ltd, Ritchie v Department of Community Services, and Northern NSW Local Health Network v Heggie considered; Held – applicant has sustained a psychological injury in accordance with section 4(b)(i); respondent has failed in its onus to establish a defence in accordance with section 11A; the injury was wholly or predominately caused by reasonable action taken or proposed to be taken by it with respect to discipline; proceedings remitted for medical assessment; de-identification order made in accordance with rule 132 of the Personal Injury Commission Rules 2021; respondent ordered to pay applicant’s costs with a complexity uplift certified for both parties.

Decision date: 15 January 2026 | Member: Gaius Whiffin

Griffiths v Secretary, Department of Communities and Justice [2026] NSWPIC 33

Workers Compensation Act 1987; whether the applicant suffered consequential conditions to his right knee and lumbar spine; accepted injury to the left knee; value of contemporaneous evidence; Nguyen v- Cosmopolitan Homes, Kooragang Cement Pty Ltd v Bates (Constructions) Pty Ltd, and Makita (Australia) Pty Ltd v Sprowles considered; assessment of expert evidence in the Commission; Held – applicant has consequential conditions to the right knee and lumbar spine resulting from the left knee injury; unbroken chain of causation was found; matter referred to a Medical Assessor for assessment of whole person impairment of left knee, right knee, and lumbar spine.

Decision date: 21 January 2026 | Member: Diana Benk

Berry v Cavanough Racing Pty Ltd [2026] NSWPIC 34

Workers Compensation Act 1987; undisputed workplace injury; claim for lump sum compensation; section 66; whether right knee, right hip, and lumbar spine conditions consequential to workplace injury to left knee due to altered weight bearing and gait; conflicting opinion from independent medical examiners; whether injury made a material contribution to claimed consequential conditions; clauses 44 and 46 of the Workers Compensation Regulation 2016 considered with respect to medical reports for referral to medical assessment; Pirie v State of New South Wales (New South Wales Police Force) considered; Held – workplace injury likely contributed to development of claimed conditions in a material way; right knee, right hip, and lumbar spine conditions accepted as consequential to workplace injury; referral to Medical Assessor for assessment of whole person impairment.

Decision date: 21 January 2026 | Member: Adam Halstead

Araghi v DAC Finance Pty Ltd t/as Opal Healthcare [2026] NSWPIC 38

Workers Compensation Act 1987; applicant suffered a direct injury to her right lower extremity (knee) when she fell; applicant also suffered a consequential injury to her left upper extremity (wrist) as a consequence of that injury; Held – respondent to pay for surgery proposed for the applicant’s left-sided carpel tunnel syndrome and knee replacement surgery.

Decision date: 22 January 2026 | Member: Lea Drake

Rodgers v Grid Electrical Services Pty Ltd [2026] NSWPIC 40

Workers Compensation Act 1987; claim for surgery to the left knee; dispute whether the treatment is reasonably necessary as a result of the accepted left knee injury particularly given pre-existing constitutional changes; Kooragang Cement Pty Ltd v Bates, Rose v Health Commission (NSW), Bartolo v Western Sydney Area Health Service Diab v NRMA Ltd discussed and applied; Held – surgery is reasonably necessary as a result of workplace injury which materially contributed to the need for surgery; pursuant to section 60 respondent is to pay the applicant’s reasonably necessary medical expenses with respect to left knee MPFL reconstruction and tibial tuberosity transfer and associated expenses.

Decision date: 23 January 2026 | Member: Diana Benk

Hardy v Young Shire Council & Anor [2026] NSWPIC 41

Workers Compensation Act 1987; claim for permanent impairment lump sum compensation pursuant to section 66; applicant sustained accepted injuries to his lumbar spine, right knee, and scarring; whether applicant also sustained injury to his thoracic spine pursuant to section 4(b)(ii); Held – applicant sustained injury to his thoracic spine pursuant to section 4(b)(ii); matter remitted to the President to be referred for a medical assessment of whole person impairment.

Decision date: 23 January 2026 | Member: Karen Garner

Whittaker v Manildra Energy Australia Pty Ltd & Ors [2026] NSWPIC 42

Workers Compensation Act 1987; death claim; determination dependency, apportionment and payment of death benefit and interest; TNT Group 4 Pty Limited v Halioris, Kaur v Thales Underwater Systems Pty Ltd, Wratten v Kirkpatrick & Ors, BFG v Polyfoam (Sydney) Pty Ltd & Ors, and Slater v Newman Bros (Sawmill) Pty Ltd discussed and applied; Held – death benefit apportioned and orders for payment to adult dependants and agreed interest; further submissions to be made regarding calculation of interest, orders for interest, and the management fee.

Decision date: 23 January 2026 | Principal Member: Glenn Capel

Self v Sydney Trains [2026] NSWPIC 43

Workers Compensation Act 1987;claim for permanent impairment lump sum compensation pursuant to section 66; consequential condition; material contribution; Moon v Conmah Pty Limited, Hunt & Hunt Lawyers v Mitchell Morgan Nominees Pty Limited, Murphy v Allity Management Services Pty Ltd, Gould v Vaggelas, Briginshaw v Briginshaw, State of New South Wales v Bishop, Trustees for the Roman Catholic Church for the Diocese of Bathurst v Hine, and Nagy v Arthur Tzaneros Discretionary Trust & Luke Webber Trust t/as Labour Power & Anor considered and applied; Held – accepted that the back injury materially contributed to the applicant experiencing an epileptic seizure; applicant sustained a consequential condition in the form of an aggravation of the pre-existing epileptic condition as a result of the pain caused by the accepted back injury; matter remitted to the President for referral to a Medical Assessor pursuant to section 321 of the Workplace Injury Management and Workers Compensation Act 1998 for assessment.

Decision date: 27 January 2026 | Member: John Turner

Gillespie v Plant Haul Pty Ltd & Ors [2026] NSWPIC 44

Workers Compensation Act 1987; the Workplace Injury Management and Workers Compensation Act 1998; death claim; determination of dependency, apportionment, and payment of death benefit, interest and management fee; TNT Group 4 Pty Limited v Halioris, Kaur v Thales Underwater Systems Pty Ltd, Wratten v Kirkpatrick & Ors discussed and applied; Held – death benefit apportioned and orders for payment of benefit, interest, and management fee.

Decision date: 23 January 2026 | Principal Member: Glenn Capel

Kumar v Campbelltown City Council [2026] NSWPIC 45

Workers Compensation Act 1987; claim for weekly compensation in respect of psychological injury due to bullying and harassment at work; where applicant subsequently incarcerated for assault and diagnosed with post-traumatic stress disorder; whether incapacity resulted from work injury; Kooragang Cement Pty Ltd v Bates applied; Held – applicant sustained a compensable psychological injury but was able to continue working in pre-injury duties until his arrest; causal relationship between the work injury and the assault not established; Commission not satisfied that incapacity had resulted from the work injury; award in favour of the respondent in respect of the claim for weekly compensation.

Decision date: 27 January 2026 | Member: Rachel Homan

Motor Accidents Medical Review Panel Decisions

Fitzsimmons v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 37

Motor Accidents Compensation Act 1999; motor accident; claimant rear seat passenger of vehicle that collided with tree; assessment of whole person impairment for severe facial injuries; previous medical assessment of facial scarring at 7%; other medical assessment of 2% for left eye injury; present medical assessment by Medical Assessor assessed facial scarring at 5% and facial nerve injury at 2% resulting in combined impairment of 9%; whether facial scarring part of this medical dispute or as assessed in previous certificate; evidence relied upon in this medical assessment did not include an assessment of scarring; no application for a further assessment of facial scarring pursuant to section 62; written submissions in support of claim were for body parts not previously assessed; Mandoukos v Allianz Australia Insurance Limited applied; facial scarring not part of this medical assessment matter and not before Medical Review Panel; claimant developed hemifacial spasm caused by facial nerve palsy suffered in the motor accident; assessment of left facial nerve at 2% under Table 4 of the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th ed 1 March 2021, which coincides with assessment under review; Held – original assessment revoked; combined certificate issued greater than 10%.

Decision date: 22 January 2026 | Panel Members: Principal Member John Harris, Dr Malcolm Linsell, and Dr John Giles| Injury module: Facial Injury and Impairment

Ola v AAI Limited t/as GIO [2026] NSWPICMP 38

Motor Accident Injuries Act 2017; whole person impairment (WPI); treatment and care disputes; claimant’s vehicle was rear-ended by the insured vehicle which in turn was impacted by another vehicle behind it; claimant says that she suffered injuries to cervical spine, lumbar spine, both shoulders, chest, buttocks, and both legs; claimant says that she suffers from a number of consequential disabilities and impairments as a result of that (close) accident; claimant was involved in a second motor accident in 2021; claimant says that symptoms in her neck were worsened by the second accident; claimant’s treating neurosurgeon recommended multi-level cervical disc replacements after conservative treatment failed; insurer declined; insurer says claimant was involved in a later third motor accident of which no details are given; insurer raised causation issue and submitted that diagnostic investigations showed only degenerative changes; Medical Assessor (MA) assessed 5% WPI for cervical spine injury; MA found that total disc replacements at C4/C5 and C5/C6 related to the first accident but not the second accident; MA not satisfied that proposed surgery was reasonable and necessary as a result of first accident, nor likely to improve claimant’s condition; claimant’s review application; claimant reassessed by theMedical Review Panel; parties resolved WPI dispute; Held – Medical Review Panel satisfied that proposed surgery related to subject first accident; was reasonable and necessary and likely to improve claimant’s condition; causation certificates confirmed; other certificates revoked.

Decision date: 22 January 2026 | Panel Members: Member Gary Victor Patterson, Dr Drew Dixon, and Dr Shane Moloney| Injury module: Spine, Upper Limb, and Lower Limb; Treatment Type: Surgery

Insurance Australia Limited t/as NRMA Insurance v Halabi [2026] NSWPICMP 39

Motor Accident Injuries Act 2017; impairment; review; insurer disputed causation and permanent impairment; alleging psychological injuries before accident; Commission referred psychiatric condition to assess permanent impairment; medical certificate assessed 22% permanent impairment; referred for review; re-examination; claimant was cooperative but inconsistent; no finding on credit; accident was capable of causing referred injury being major depressive disorder; pre-existing permanent impairment deducted from permanent impairment caused by the accident;  Held – different clinical findings to original assessment; Medical Review Panel revoked original Medical Assessment Certificate; 11% permanent impairment with different clinical findings; permanent impairment greater than 10%.

Decision date: 22 January 2026 | Panel Members: Member Terence O'Riain, Dr John Baker, and Dr Ankur Gupta| Injury module: Mental and Behavioural

Rodriguez v Allianz Australia Insurance Limited [2026] NSWPICMP 45

Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident when her vehicle was hit from behind; Medical Assessor (MA) determined that all of the injuries referred to him were caused by the accident and were threshold injuries with the exception of the injury to the right hand which was a non-threshold injury for the purposes of the Act; insurer sought a review of the medical assessment; Medical Review Panel conducted its own examination; Held – Medical Review Panel confirmed the determination by the MA with the exception of the right hand, which it certified was a threshold injury; determined that the injury to the left knee was not caused by the accident.

Decision date: 23 January 2026 | Panel Members: Member Terence Stern OAM, Dr Christopher Oates, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, Lower Limb, Brain Injury, and Digestive System

Insurance Australia Limited t/as NRMA Insurance v Uzelac [2026] NSWPICMP 50

Motor Accidents Compensation Act 1999; review of a medical assessment under section 63; dispute about permanent impairment; where Medical Assessor certified that accident caused psychological injury that gave rise to an impairment greater than 10%; Held – pre-existing psychological condition but no pre-existing impairment; permanent impairment as a result accident caused psychological injury not greater than 10%; medical assessment certificate revoked.

Decision date: 27 January 2026 | Panel Members: Senior Member Brett Williams, Dr Wayne Mason, and Dr Alan Doris| Injury module: Mental and Behavioural

Ruiz-Diaz v QBE Insurance (Australia) Limited [2026] NSWPICMP 51

Motor Accident Injuries Act 2017; degree of permanent impairment; threshold injury disputes; claimant was involved in a motor vehicle accident; claimant was referred for physiotherapy and chiropractic treatment sessions for injuries to his neck, lower back, right elbow and right little finger; imaging studies of his cervical spine, right elbow, lumbar spine and right hand were performed; claimant was referred to a sports physician; claimant returned to work on restricted light duties approximately three months after his accident; gradual onset of psychological symptoms; claimant relied upon contrary biomechanical engineering; discussion of principles applicable to such evidence; Medical Assessor (MA) did not assess whole person impairment (WPI) for reasons not stated; claimant consented to the MA assessing WPI; insurer objected; Medical Review Panel declined to publish MA’s findings on WPI; MA certified that claimant suffered accident-related persistent depressive disorder, which is a non-threshold injury; insurer’s review application; claimant re-examined; Makita v Sprowles, and Bugat v Fox considered; Allianz v Sekar distinguished; Elammar v AAI Limited considered and applied; Held – medical certificate confirmed.

Decision date: 27 January 2026 | Panel Members: Member Gary Victor Patterson, Dr Christopher Rikard-Bell, and Dr Ronald Gill| Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v BLP [2026] NSWPICMP 52

Motor Accidents Compensation Act 1999; review of a medical assessment under section 63; dispute about whether impairment as a result of psychological injury greater than 10%; Medical Assessor did not assess impairment having determined the injuries referred for assessment were secondary to a somatic symptom disorder; Held – claimant had a psychological injury diagnosed as persistent depressive disorder with anxious distress; impairment as a result of that injury was greater than 10%; medical assessment revoked.

Decision date: 27 January 2026 | Panel Members: Senior Member Brett Williams, Dr Christopher Canaris, and Dr Paul Friend | Injury module: Mental and Behavioural

Jabro v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 53

Motor Accidents Compensation Act 1999; motor accident; claimant riding motorcycle when the insured vehicle turned in front resulting in a T-bone collision; assessment of whole person impairment for various injuries; claimant suffered left shoulder dislocation resulting in further dislocations; assessment of the left shoulder/upper extremity is “mild” under Table 23 of American Medical Association Guides to the Evaluation of Permanent Impairment, 4th ed 1 March 2021 (AMA 4), as the ongoing dislocations can be reduced manually; subsequent dislocations are not “unrelated” within the meaning of clause 6.34 of AMA 4; State Government Insurance Commission v Oakley applied; assessment of various scars under TEMSKI scale at 2%; assessment of right foot ankle at 3% based on loss of range of motion consistent with various metatarsal fractures; Held – original assessments confirmed; combined medical assessment certificate issued greater than 10%.

Decision date: 27 January 2026 | Panel Members: Principal Member John Harris, Dr Michael McGlynn, and Dr Christopher Oates| Injury module: Spine, Upper Limb, Lower Limb, and Skin

Workers Compensation Medical Appeal Panel Decisions

Central Tablelands Water v Lutherborrow [2026] NSWPICMP 35

Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Workers Compensation Act 1987 (1987 Act); appeal by employer against finding of 28% regarding two injuries which was apportioned fifty-fifty; whether the Medical Assessor (MA) conflated concepts of deduction and apportionment; whether MA erred in finding no pre-existing condition; claimant suffered violent injury to head; no investigations performed for 3-years; function of MA discussed; Wingfoot Australia Pty Ltd v Kocak applied; section 22 of the 1987 Act applied; Held – finding of no pre-existing condition open; Medical Assessment Certificate confirmed.

Decision date: 21 January 2026 | Panel Members: Member John Wynyard, Dr Margaret Gibson, and Dr James Bodel | Body system: Cervical Spine

Summerell v Cabneemm Pty Ltd [2026] NSWPICMP 36

Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor (MA) erred in respect of the deduction he made pursuant to section 323; Held – Appeal Panel agreed; MA’s deduction was excessive in part due to a flawed history; Medical Assessment Certificate revoked.

Decision date: 21 January 2026 | Panel Members: Member Deborah Moore, Dr Alan Home, and Dr Drew Dixon | Body system: Right Lower Extremity, and Left Lower Extremity

Cowling v Transport for NSW [2026] NSWPICMP 41

Workplace Injury Management and Workers Compensation Act 1998; claim for permanent impairment; assessment of permanent impairment of the cervical spine as DRE II challenged on appeal by the worker; Held – Appeal Panel found error as cervical spine was not assessed on the basis of correct criteria in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment,4^th ed 1 March 2021 (the Guidelines); Paragraph 4.37 of the Guidelines provides for assessment as DRE III when decompression surgery has been undertaken as was the case here; Medical Assessment Certificate revoked.

Decision date: 22 January 2026 | Panel Members: Member Jane Peacock, Dr Michael Davis, and Dr Todd Gothelf | Body system: Cervical Spine, and Scarring

Nwaigwe v Mackillop Family Services Ltd [2026] NSWPICMP 42

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) had regard to all relevant evidence with respect to his ratings of the appellant’s impairment in social and recreational activities, concentration persistence and pace, and employability; whether the MA erred regarding his ratings of the appellant’s impairment in those psychiatric impairment rating scale categories; Held – MA had regard to all relevant evidence and did not err with respect to his ratings of the appellant’s impairment in social and recreational activities and employability; MA did err with respect to his rating of the appellant’s impairment in concentration persistence and pace; Medical Assessment Certificate revoked.

Decision date: 22 January 2026 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric

Hardman v State of NSW (NSW Police Force) [2026] NSWPICMP 43

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; claim for permanent impairment; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under four of the psychiatric impairment rating scale categories; self-care and personal hygiene, social and recreational activities, travel, and employability; Held – re-examination was considered necessary in the circumstances of a finding of error; Medical Assessment Certificate revoked.

Decision date: 22 January 2026 | Panel Members: Member Jane Peacock, Dr Graham Blom, and Dr Ash Takyar | Body system: Psychological/Psychiatric

State of New South Wales (NSW Police Force) v Sadat [2026] NSWPICMP 46

Workplace Injury Management and Workers Compensation Act 1998; assessment of psychiatric disorder; appeal on grounds of demonstrable error and the assessment made on the basis of incorrect criteria in relation to the psychiatric impairment rating scales of self-care and personal hygiene, social and recreational activities, and employability; Medical Appeal Panel found no error in assessment of self-care and personal hygiene, social and recreational activities; Medical Appeal Panel found error in assessment of employability; Held – Medical Assessment Certificate revoked.

Decision date: 23 January 2026 | Panel Members: Member Carolyn Rimmer, Dr Douglas Andrews, and Professor Nicholas Glozier | Body system: Psychological/Psychiatric

Pennie v Bay Construction & Development Pty Ltd [2026] NSWPICMP 47

Workplace Injury Management and Workers Compensation Act 1998; injury to pelvis and left ankle assessed by Medical Assessor; proceedings and first appeal discontinued; second appeal filed after proceedings restored limited to deterioration; additional relevant information as a result of complex regional pain syndrome; re-examination; requirements for assessment of complex regional pain syndrome (CRPS); Elsworthy v Forgacs Engineering Pty Ltd; criteria for CRPS not made out; Held – Medical Assessment Certificate confirmed.

Decision date: 23 January 2026 | Panel Members: Member Catherine McDonald, Dr Drew Dixon, and Dr Christopher Oates | Body system: Pelvis, Left Lower Extremity, and Scaring (TEMSKI)

Quinlan v Coffs Harbour Aboriginal Land Council [2026] NSWPICMP 48

Workplace Injury Management and Workers Compensation Act 1998; appeal against assessment of psychiatric injury on the basis of demonstrable error and the application of incorrect criteria; Medical Assessor (MA) correct to apply no increase for effects of treatment; error in assessment of self-care and personal hygiene as Class 2; no error in assessment of social functioning; no error in assessment of travel; error in section 323 deduction made on basis of assessment of psychiatric impairment rating scale pre-injury as matters identified by the MA related largely to the existence of the condition or to ideation and not to the functioning; Held – Medical Assessment Certificate revoked.

Decision date: 23 January 2026 | Panel Members: Member Carolyn Rimmer, Dr Graham Blom, and Dr Ash Takyar | Body system: Psychological/Psychiatric

Cooke v AHG Newcastle Pty Ltd [2026] NSWPICMP 49

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) wrongly characterised appellant playing games, puzzles, and going mountain biking as being social and recreational activity because these activities did not involve interaction with others; Held – MA made no error to consider the appellant’s participation in these activities when evaluating the appellant’s impairment in social and recreational activities.

Decision date: 23 January 2026 | Panel Members: Member Marshal Douglas, Professor Nicholas Glozier, and Dr Douglas Andrews | Body system: Psychological/Psychiatric

Ventia Australia Pty Ltd v Melgar [2026] NSWPICMP 54

Workplace Injury Management and Workers Compensation Act 1998; consideration of deduction for a pre-existing condition; Medical Assessor failed to refer to, consider, or take in to account pre-existing treatment and radiology; Held – Medical Appeal Panel determined that a one-tenth deduction pursuant to section 323 of the Act was appropriate.

Decision date: 27 January 2026 | Panel Members: Senior Member Elizabeth Beilby, Dr Drew Dixon, and Dr Christopher Oates | Body system: Lumbar Spine, and Scarring (TEMSKI)

Qantas Airways Ltd v Huntley [2026] NSWPICMP 55

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 injury to the liver and laryngeal hypersensitivity by two separate Medical Assessors; Ferguson v State of New South Wales considered; Held – there was a demonstrable error in the assessment of WPI for the liver; demonstrable error and the application of incorrect criteria in the assessment of WPI for laryngeal hypersensitivity; re-examination required for assessment of laryngeal hypersensitivity; MAC revoked; new consolidated MAC issued.

Decision date: 27 January 2026 | Panel Members: Member John Isaksen, Dr John Garvey, and Dr David Gorman | Body system: Digestive System, and Respiratory System

Motor Accidents Merit Review Decision

Chowdhury v AAI Limited t/as GIO [2026] NSWPICMR 2

Motor Accident Injuries Act 2017; statutory benefits claim; merit review; application for costs pursuant to section 8.3(4); non-regulated merit review matter; whether insurer’s legal representatives should be entitled to recover legal costs; no application for exceptional costs; no application for costs by claimant; Held – significant work undertaken by insurer’s legal representatives in merit review matter; insurer’s legal representatives permitted to recover legal costs pursuant to section 8.3(4) in the amount sought, being 16 monetary units.

Decision date: 23 January 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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