Legal Bulletin No. 248

This bulletin was issued on 20 February 2026

Issued 20 February 2026

Welcome to the two hundred and forty 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 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

Glenn v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 145

Motor Accident Injuries Act 2017; discretionary exemption application by claimant; complex factual issues; contributory negligence 45% in issue; numerous proceedings in District Court; cost effective to be heard in single venue; length of trial and number of witnesses to be called; police and experts and non-CTP parties subpoena required to attend; both claimant and insurer consent to application; Held – claim not suitable for assessment at the Personal Injury Commission pursuant to section 7.34(1)(b); basis not suitable; claim involves complex liability, fault, and causation; reliance on rules 99(3)(a) and (b) of the Personal Injury Commission Rules 2021.

Decision date: 11 April 2025 | Member: Shana Radnan

Insurance Australia Limited t/as NRMA Insurance v Israel [2025] NSWPIC 361

Motor Accident Injuries Act 2017; assessment of damages; liability wholly admitted; insured elderly driver lost control at a roundabout crashing into the bedroom where the claimant was sleeping; claimant sustained an aggravation of chronic mental health symptoms; insurer conceded claimant entitled to damages for non-economic loss; claimant granted disability benefits; agreed no entitlement to damages for economic loss; Held – damages for non-economic assessed.

Decision date: 29 July 2025 | Member: Elyse White

Tu v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 468

Motor Accident Injuries Act 2017; damages assessment; pedestrian hit by car; contributory negligence; conflicting accounts of cause of accident; inadvertent tripping over median strip; Held – 40% contributory negligence; credibility of claimant relevant; lack of supporting documentation for claim for economic loss; working country to these restrictions; application for protection visa; allegation of multiple injuries; significant shoulder injury; 11% whole person impairment; uncertainty in respect to future employment circumstances; ongoing incapacity for employment; uncertain surrounding migration status; basis for calculation of future economic loss; buffer; future economic loss.

Decision date: 2 September 2025 | Member: Hugh Macken

Chmaisse v Allianz Australia Insurance Limited [2026] NSWPIC 66

Motor Accident Injuries Act 2017; miscellaneous assessment matter; claim for statutory benefits; whether claimant wholly or mostly at fault; claimant collided with a bus turning to the left in front of him; CCTV footage relied upon; no expert evidence; claimant acknowledged the bus had left-indicator flashing but did not believe the bus would turn left on the incorrect assumption the road was not suitable for the bus to turn left; claimant submitted bus driver breached Road Rule 2014 regulations 28(1), 148, 149 and 290; finding on review of CCTV footage no breach on part of insured bus driver; accident caused wholly by the claimant failing to keep a proper lookout; sections 3.11 and 3.28; Held – accident caused wholly by the fault of the injured person.

Decision date: 4 February 2026 | Member: Shana Radnan

BPX v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 69

Motor Accident Injuries Act 2017; assessment of damages; high speed head-on collision; liability admitted; significant physical and psychological injuries; claimant entitled to non-economic loss damages; school student at time of accident and university student at time of assessment; claim for past economic loss disputed; dispute about most likely future circumstances; dispute about quantification of future economic loss award; Held – non-economic loss award $530,000; past economic loss assessed as a buffer; $854,669 awarded for future economic loss including buffer of $100,000; total damages assessed $1,510,323.

Decision date: 5 February 2026 | Senior Member: Brett Williams

Tucker v Allianz Australia Insurance Limited [2026] NSWPIC 70

Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether injury sustained by the claimant resulted from a motor accident; section 1.9; claimant involved in a collision; after pulling to the side of the road and whilst standing beside her car the claimant fell and sustained injury; whether the claimant sustained a head strike in the accident resulting in dizziness which caused her to fall; pre-existing history of dizziness and falls; claimant provided inconsistent histories of events; Held – claimant did not sustain head strike; dizziness not caused by the accident; no injury sustained in collision; no injury as a result of the driving of the vehicle or caused during a collision; sections 1.9(a) and 1.9(b); fall not causally related to collision; injuries sustained in fall not as a result of dangerous situation causing by the driving of the vehicle or a collision; section 1.9(1)(d); injury sustained by the claimant did not result from a motor accident.

Decision date: 5 February 2026 | Senior Member: Susan McTegg

Flanagan v Allianz Australia Insurance Limited [2026] NSWPIC 79

Motor Accident Injuries Act 2017 (MAI Act); miscellaneous claims assessment; whether statutory benefits payable under section 3.37(2) following criminal proceedings; claimant charged with serious driving offences related to the accident; District Court entered special verdicts of “act proven but not criminally responsible” under the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 (NSW) on three charges; dismissed a fourth summary offence without conviction under section 10(1)(a) of the Crimes (Sentencing Procedure) Act 1999 (NSW); insurer denied benefits; outcomes did not amount to “acquittals” or “discontinuance” under section 3.37(2) of the MAI Act; claimant submitted the special verdicts and section 10 of the MAI Act; dismissal were exculpatory and reflected findings of no criminal responsibility; Personal Injury Commission held that section 3.37(2) of the MAI Act is to be construed in light of legal substance, not formal labels; special verdicts and dismissal without conviction on mental health grounds constituted acquittals for the purposes of section 3.37(2) of the MAI Act; Personal Injury Commission rejected narrow construction of “acquitted of the offence charged”; provision does not disentitle claimants who are found not criminally responsible by reason of mental illness; Held – statutory benefits payable; insurer not entitled to deny payment under section 3.37 of the MAI Act.

Decision date: 10 February 2026 | Member: Bridie Nolan

Smith v AAI Limited t/as GIO [2026] NSWPIC 80

Motor Accident Injuries Act 2017; wholly or mostly at fault; motor vehicle accident; motorcycle accident; contributory negligence; speed; single vehicle accident; miscellaneous claims assessment; whether claimant wholly or mostly at fault; sections 3.11 and 3.28; claimant sustained injury riding motorcycle on bush trail when hit a partially submerged rock and thrown; insurer alleged claimant mostly at fault; alleged 80% contributory negligence; Held – claimant travelling 60 kph at time; speed was excessive in circumstances; claimant failed to take reasonable care; contributory negligence assessed at 50%; rock partially submerged and camouflaged by dirt and leaf litter not readily visible to motorcyclist; claimant not wholly or mostly at fault.

Decision date: 10 February 2026 | Senior Member: Susan McTegg

AAI Limited t/as GIO v Ellery [2026] NSWPIC 81

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident as driver; claimant sustained right shoulder injuries and psychological condition; not entitled to non-economic loss; long period off work; permanently restricted from pre-injury duties; medical evidence supports deterioration and early retirement; coexisting morbidities from non-accident related conditions; insurer accepted claimant’s offer; claimant commercially minded and expressed himself as having agency to decide on accepting settlement; proposed settlement fair, just and reasonable; Held – proposed settlement approved.

Decision date: 10 February 2026 | Member: Terence O'Riain

AAI Limited t/as GIO v Milich [2026] NSWPIC 83

Motor Accident Injuries Act 2017; settlement approval pursuant to section 6.23; self-represented claimant who suffered stomach haematoma, splenic laceration, left transverse process, L3 fracture, small pulmonary contusions, and a suspected urinary tract infection; good recovery from soft tissue injuries; orthopaedic evidence that the L3 transverse process had symptomatically healed with a minor scoliosis of no functional significance; threshold injury; psychiatric injury in the form of a phobia against driving; claimant unwilling to undergo further psychological treatment; Held – evidence established on balance that the claimant would eventually return to driving; threshold psychiatric injury; past economic loss assessed; allowance for future economic loss; settlement approved.

Decision date: 10 February 2026 | Member: Michael Inglis

AAI Limited t/as GIO v Tan [2026] NSWPIC 91

Motor Accident Injuries Act 2017 (MAI Act); Motor Accidents Compensation Act 1999 (MAC Act); Transport Administration Act 1988 (NSW); McTye v Chang applied; settlement approval; claimant was injured on a bus owned by Transport for NSW; claimant was not working at the time of the accident; claimant is aware no entitlement to future statutory benefits once settlement is approved; Held – settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines, version 9.3; settlement approved in the amount of $290,000.00 consisting of nil non-economic loss, past economic loss, future economic loss, past attendant care, and future attendant care; less statutory benefits paid by the insurer.

Decision date: 11 February 2026 | Member: Philip Carr

Allianz Australia Insurance Limited v Studman [2026] NSWPIC 92

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident as pedestrian; claimant sustained lower limb injuries; entitled to non-economic loss; long period off his feet and undergoing rehabilitation; no loss of earnings; permanently restricted from pre-injury duties and recreation; significant pain and suffering and loss of amenity of life; medical evidence supports continuing disability; claimant legally trained, commercially minded and demonstrated agency to decide on accepting settlement; proposed settlement fair, just and reasonable; Held – proposed settlement approved.

Decision date: 11 February 2026 | Member: Terence O'Riain

Njoroge v AAI Limited t/as AAMI [2026] NSWPIC 93

Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether insurer entitled to refuse weekly statutory benefits under section 6.13; claim lodged approximately 16-months after motor accident; claimant sought weekly benefits for first 26-weeks post-accident; insurer denied entitlement under section 6.13(2), which prohibits backdating of weekly payments where claim is made outside 28-days unless permitted by regulation; Motor Accidents Regulation (Regulation) 8A inapplicable; claimant submitted explanation for delay was full and satisfactory and that section 6.13(3) permitted the claim; Personal Injury Commission held section 6.13(3) permits a late claim to proceed but does not override the bar in section 6.13(2); Held – insurer entitled to refuse payment of weekly statutory benefits for the first 26-weeks; statutory prohibition in section 6.13(2) engaged; Regulation 8A not applicable.

Decision date: 4 February 2026 | Member: Bridie Nolan

Workers Compensation non-Presidential Member Decisions

Chinchilla v UGL Rail Services Pty Ltd [2025] NSWPIC 594

Workers Compensation Act 1987; claim for lump sum compensation in respect of bilateral hip and shoulder injuries as a result of the nature and conditions of employment; dispute as to the dates of injury pleaded and as to whether the injuries to the left hip, right hip, and right and left shoulders could be aggregated; parties agreed that the deemed date of injury for the bilateral hips was 18 October 2018; satisfied that applicant was incapacitated as a result of the shoulder injury on 14 October 2021 and that the date of injury for the bilateral shoulder injury is 14 October 2021, that being the date of incapacity, and not 22 October 2024, that being the date was made; Haddad v The GEO Group Australia Pty Limited considered; in respect of question of aggregation, not satisfied that the impairments arose out of the same incident; Department of Ageing, Disability and Home Care v Findlay distinguishable; Held – matter remitted to the President for referral to a Medical Assessor for medical assessment of whole person impairment of left lower extremity (hip), right lower extremity (hip) deemed to have occurred on 18 October 2019 and the upper left extremity (shoulder), and right upper extremity (shoulder) deemed to have occurred on 14 October 2021.

Decision date: 6 November 2025 | Member: Carolyn Rimmer

Marsh v L & P Adams Pty Ltd [2025] NSWPIC 607

Workers Compensation Act 1987; claim for compensation for medical treatment pursuant to section 60; accepted work injuries to applicant’s lumbar spine and right shoulder; applicant claimed compensation for cost of future radiofrequency neurotomy of the cervical spine; whether the applicant sustained a cervical spine consequential condition; whether the future radiofrequency neurotomy of the cervical spine was reasonably necessary as a result of the lumbar spine injury; Held – applicant did sustain a cervical spine consequential condition; the future radiofrequency neurotomy of the cervical spine was reasonably necessary as a result of the lumbar spine injury.

Decision date: 13 November 2025 | Member: Karen Garner

Erkekaslan v Collisioncare Pty Ltd [2025] NSWPIC 654

Workers Compensation Act 1987; applicant was found to have suffered erectile dysfunction as a result of an original injury and subsequent lumbar surgeries; coccydynia was also found to be causally related the original injury and subsequent surgeries; Held – respondent to pay the applicant’s medical expenses incurred to date for treatment for applicant’s erectile dysfunction; respondent to pay for medical expenses incurred to date for treatment and surgery for applicant’s coccydynia.

Decision date: 4 December 2025 | Member: Lea Drake

Nelson v Kennards Hire Pty Ltd [2026] NSWPIC 67

Workers Compensation Act 1987; causal relationship between accident and left knee symptoms; need for surgery considered; Held – found a causal connection; surgery necessary and reasonable.

Decision date: 4 February 2026 | Member: Lea Drake

Handsaker v Coles Group Limited t/as Liquorland (Australia) Pty Limited & Ors [2026] NSWPIC 68

Workers Compensation Act 1987; claim for payment of death benefit; whether accepted injury to deceased worker in 2016 materially contributed to the condition which led to her death in 2021; consequential condition; test of causation; whether an actual persuasion of an asserted fact has been established; when claim is said to have been duly made for the purposes of calculation of interest payable; deceased worker suffered an accepted back injury in 2016; underwent a great deal of treatment over the ensuing years; late 2021, the deceased suffered a deep vein thrombosis (DVT) and ensuing pulmonary emboli and died on 29 December 2021; the deceased’s husband brings proceedings for the payment of the death benefit and funeral expenses, together with interest; in issue the question of causation of the DVT and subsequent emboli; Held – evidence discloses the deceased’s injury and the treatment of it by heavy doses of medication gave rise to a condition of hypomobility in the lead up to her death; evidence also establishes the hypomobility caused by the injury made a material contribution to the onset of the DVT; there was an unbroken chain of causation between the accepted back injury and the consequential DVT condition and emboli; deceased also suffered from colitis; first respondent is ordered to pay the death benefit and funeral expenses to the applicant and second to fourth respondents in accordance with the orders made in relation to apportionment; order the first respondent pay interest on the sums claimed from 17 March 2025 to date.

Decision date: 4 February 2026 | Member: Cameron Burge

Attenborough v Mantra Hospitality Admin Pty Ltd [2026] NSWPIC 73

Workers Compensation Act 1987; claim for weekly compensation and a declaration and orders that proposed cervical surgery was reasonable necessary; whether alternatives of personal injury or disease injury had been proven; whether accurate histories had been taken; Qannadian v Bartter Enterprises Pty Limited, and Mason v Demasi considered; Nguyen v Cosmopolitan Homes considered regarding onus of proof; Held – claimant failed to establish that she had injured her neck in the subject accident or that she suffered from neck pain thereafter until fresh injury two years later; observations on use of contemporaneous medical notes; insufficient evidence presented to establish that employment had been main contributing factor to the disease nature and conditions injury; award for the respondent.

Decision date: 6 February 2026 | Member: John Wynyard

Papadopoulos v The Parish Church of St James [2026] NSWPIC 75

Workers Compensation Act 1987; applicant fell through a floor in the course of employment; whether applicant sustained a cervical spine injury in the fall; whether applicant entitled to payment of medical expenses including two cervical spine surgeries; Held – the applicant sustained a cervical spine injury pursuant to sections 4(a) and 9A; respondent to pay the reasonably necessary medical treatment expenses as a result of the cervical spine injury including two surgeries pursuant to section 60.

Decision date: 9 February 2026 | Member: Fiona Seaton

Fisher v Bega Cheese Limited [2026] NSWPIC 76

Workers Compensation Act 1987; permanent impairment claim; applicant suffered accepted injury to his right elbow; accepted consequential condition to his right shoulder in the nature of adhesive capsulitis; applicant also claimed to have suffered frank injury to his right wrist and thumb in the injurious event which is disputed by the respondent; Chanaa v Zarour applied; Held – totality of the evidence discloses the applicant suffered injury to both his right wrist and thumb in the incident at issue; corroboration is unnecessary in a civil case; clinical records of the applicant’s treating practitioners reveal complaints concerning the disputed body systems soon after the incident at issue; matter remitted to the President for referral of all claimed body systems to a Medical Assessor to determine the applicant’s permanent impairment.

Decision date: 9 February 2026 | Member: Cameron Burge

Lambkin v State of New South Wales (Fire & Rescue NSW) [2026] NSWPIC 77

Workers Compensation Act 1987; death claim; liability accepted; determination of dependency; payment of death benefit and interest; TNT Group 4 Pty Limited v Halioris, and Richardson v Turfco Australia Pty Ltd discussed and applied; Held – applicant was the sole dependant; whole of the death benefit is payable to the applicant; orders for payment to the applicant under section 85A; orders as to costs.

Decision date: 9 February 2026 | Senior Member: Rachel Homan

Petronaitis (Nee Riley) v Life Without Barriers [2026] NSWPIC 78

Workers Compensation Act 1987; whether the applicant suffered consequential conditions to the right knee, lymphoedema, and lumbar spine as a result of an accepted left knee injury; gaps and inconsistencies in the medical evidence; value of contemporaneous evidence; Nguyen v Cosmopolitan Homes applied; Kooragang Cement Pty Ltd v Bates (Constructions) Pty Ltd considered; Held – award for the respondent for consequential claims of the right knee and lumbar spine; applicant developed a consequential condition of lymphoedema in the left lower extremity resulting from left knee injury and surgery undertaken in the course of rehabilitation; matter referred to a Medical Assessor for assessment of whole person impairment of the left lower extremity, including the (knee and lymphoedema) and sleep disorder; respondent to pay reasonable section 60 expenses relating to left knee, sleep disorder, and lymphoedema.

Decision date: 9 February 2026 | Member: Diana Benk

Rodgers v Show Support Pty Ltd [2026] NSWPIC 84

Workplace Injury Management and Workers Compensation Act 1998; application for referral to a Medical Assessor (MA) in respect of section 39; threshold injury dispute; dispute as to right hip injury in fall from a ladder; factual considerations; Held – applicant suffered injury to right hip in fall from ladder; referral to MA.

Decision date: 10 February 2026 | Member: Michael Wright

Leavy v ZNX Pty Ltd [2026] NSWPIC 85

Workers Compensation Act 1987; claim for weekly benefits; factual; medical dispute as to bilateral knee conditions; frank incident; nature and conditions; subsequent secondary condition right arm and shoulder following fall; resulted in left knee giving way; Held – applicant sustained aggravation of knee conditions resulting from nature and conditions; secondary condition resulting from knee injury; award for applicant for weekly benefits.

Decision date: 10 February 2026 | Member: Michael Wright

Fenton v Busways North West Pty Ltd [2026] NSWPIC 86

Workers Compensation Act 1987; medical expenses; applicant assaulted at work; suffered injury to his face, head, and mouth; claim for replacement of artificial teeth; two teeth directly damaged in blow; applicant claiming replacement of five teeth; whether full replacement reasonably necessary; Diab v NRMA Ltd applied; alternative treatment available but low potential effectiveness; cost was higher compared with alternative; Held – medical expenses reasonably necessary; respondent ordered to pay for replacement of five teeth.

Decision date: 10 February 2026 | Member: Parnel McAdam

Gao v Australian Fervent Sky Group Pty Ltd (Deregistered) [2026] NSWPIC 87

Workers Compensation Act 1987; application for right shoulder surgery; accepted injury; applicant had undergone two previous shoulder surgeries; cause of relationship of treatment to injury not in issue; whether proposed surgery reasonably necessary; Diab v NRMA Ltd applied; Held – treating surgeon’s report equivocal as to prospects of further surgery; respondent’s qualified reports raised applicant’s poor responses to prior surgeries and suggested poor outcome from further surgery; updated MRI scan showed pathology amenable to surgery; opinion of pathology and need for surgery limited to applicant’s qualified doctor; finding made that shoulder tear likely to deteriorate in absence of further surgery; findings made that surgery reasonably necessary despite less than favourable prospects; respondent ordered to pay costs of and associated with proposed surgery pursuant to section 60(5).

Decision date: 10 February 2026 | Principal Member: John Harris

Bartolo v Catholic Schools Parramatta Diocese Ltd [2026] NSWPIC 89

Workers Compensation Act 1987; claim for medical treatment expenses and lump sum compensation; section 17; hearing loss of gradual process; section 60; claim for the cost of treatment; bilateral hearing aids; whether reasonably necessary as a result of undisputed noise induced hearing loss; respondent contends no hearing loss during employment in excess of that at start of employment; pre-employment hearing test conducted; independent medical examiner hearing testing; differing results of audiograms and medical opinion relied upon by the applicant and respondent; whether worker’s hearing worsened during employment; Held – employment related hearing loss; respondent liable for the provision of bilateral hearing aids; reasonably necessary due to work related noise exposure; referred for medical assessment in relation to whole person impairment for hearing loss.

Decision date: 10 February 2026 | Member: Adam Halstead

Zhang v Pengda Pty Ltd [2026] NSWPIC 90

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); claim for permanent impairment compensation under section 66 of the 1987 Act; applicant fell from a work truck; accepted multiple rib fractures and right elbow injury; disputed thoracic spine and left knee injuries; value of contemporaneous evidence; medical histories in clinical records; expert evidence in a fair climate; the terms “personal injury” and “disease” are not mutually exclusive categories; Mason v Demasi, Davis v Council of the City of Wagga Wagga, Watson v Foxman, Onassis v Vergottis, Hancock v East Coast Timbers Products Pty Ltd, Paric v John Holland (Constructions) Pty Ltd, and Zickar v MGH Plastic Industries Pty Ltd considered; Held – applicant did not suffer injury to his thoracic spine arising out of or in the course of his employment; applicant suffered injuries to the ribs, right elbow, and left knee arising out of or in the course of his employment with the respondent; matter remitted to the President for referral to a Medical Assessor under section 321 of the 1998 Act for the assessment of whole person impairment in respect of the right upper extremity (elbow) and left lower extremity (knee).

Decision date: 10 February 2026 | Member: Anthony Scarcella

Motor Accidents Medical Review Panel Decisions

Ali v Allianz Australia Insurance Limited [2025] NSWPICMP 588

Motor Accident Injuries Act 2017; review of medical assessment; Held – determination confirmed; injuries caused by the motor accident with threshold injuries; rear end collision; claimant continued to work; claimant relied on walking stick; neurological examination normal; no signs of radiculopathy; multiple soft tissue injuries.

Decision date: 8 August 2025 | Panel Members: Member Hugh Macken, Dr Mohammed Assem, and Dr Shane Maloney | Injury module: Spine, Upper Limb, and Lower Limb

Carulli v Allianz Australia Insurance Limited [2025] NSWPICMP 640

Motor Accidents Compensation Act 1999; review of medical assessment; application to resolve a treatment dispute; whether physiotherapy treatment arises from the accident and is reasonable and necessary; prior motor vehicle claim; prior lumbar spinal injury; multiple surgical procedures post-accident; over 200 sessions with physiotherapist; no reason for proposed treatment nor any clinical outcome identified; claimant indicated that physiotherapy treatment had provided no sustained relief from symptoms; alternative treatments likely to provide better recovery; physiotherapy is not providing any sustained improvement; no clinical rationale for recommendation of ongoing physiotherapy; Held – treatment not considered reasonable and necessary; medical certificate confirmed.

Decision date: 26 August 2025 | Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Shane Moloney | Treatment Type: Physiotherapy Treatment

Lai v QBE Insurance (Australia) Limited [2025] NSWPICMP 673

Motor Accidents Compensation Act 1999; review of medical assessment; threshold injury; graze and abrasion near left eye; passenger in motor vehicle; graze to left side of face; nil bony tenderness; complaints of fine line in upper eyelid; no visible scarring or deformity near the left eye; no evidence of altered or lost sensation in skin; facial movements normal and symmetrical; injury appears to have resolved; no evidence of any nerve involvement; Held – threshold injury; medical certificate confirmed.

Decision date: 5 September 2025 | Panel Members: Member Hugh Macken, Dr John Giles, and Dr Paul Curtin | Injury module: Facial Injury and Impairment

Insurance Australia Limited t/as NRMA Insurance v Elmir [2025] NSWPICMP 685

Motor Accident Injuries Act 2017; review of medical assessment; gastro-oesophageal reflux disease analgesic gastropathy; medication-induced gastrointestinal motility disorder; whole person impairment (WPI); no direct impact to chest or abdomen; chronic pain in neck, shoulders, elbow, pelvis, and left knee; visceral hypersensitivity of the gastrointestinal tract; constitutional condition unrelated to and completely independent of the motor vehicle accident; gastrointestinal symptoms have not arisen from the motor vehicle accident; Held – no rating for WPI is applicable; medical certificate revoked.

Decision date: 9 September 2025 | Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Siddarth Sethi | Injury module: Digestive System

Insurance Australia Limited t/as NRMA Insurance v Park [2025] NSWPICMP 896

Motor Accidents Injuries Act 2017; threshold injury disputes; the claimant was with his grandmother, aunt and cousin in the carpark at Macquarie Hospital; insured vehicle ran over the claimant’s cousin without the driver realising what had happened; claimant’s aunt and grandmother tried to free the claimant’s young cousin from under the car; an ambulance arrived; claimant’s aunt and grandmother were emotionally traumatised; Medical Assessor certified that the claimant suffered from accident-related parasomnia which is not a threshold injury; Review Panel made a differential diagnosis of post-traumatic stress disorder; Held – certificate revoked because of different diagnosis.

Decision date: 18 November 2025 | Panel Members: Member Gary Victor Patterson, Dr Thomas Newlyn, and Dr Neil Jeyasingam | Injury module: Mental and Behavioural

Gilbey v QBE Insurance (Australia) Limited [2026] NSWPICMP 85

Motor Accidents Injuries Act 2017; review of medical assessment; assessment of threshold injury; post-traumatic stress disorder; pre-accident difficulties with behaviour at school; cognitive skills intact and in keeping with her estimated previous level of ability; difficulty with attention; difficulty with some aspects of memory; in the first six months after the motor accident claimant reached the criterion for the diagnosis of post-traumatic stress disorder; disturbance present for more than one month; clinically significant distress; iron impairment in social and occupational functioning; Held – non-threshold injury; medical certificate confirmed.

Decision date: 5 February 2026 | Panel Members: Member Hugh Macken, Dr Paul Friend, and Dr Thomas Newlyn | Injury module: Mental and Behavioural

CIC Allianz Insurance Limited v Masri [2026] NSWPICMP 88

Motor Accidents Compensation Act 1999; motor accident; rear-end collision; assessment of whole person impairment (WPI) for psychological injury; original medical assessment of 19%; claimant suffered various physical injuries to neck and back with ongoing complaints of pain; effects disregarded for purposes of assessment of functioning restricted by pain; application of clause 1.214 and 1.215 of the Motor Accident Permanent Impairment Guidelines; claimant continued to practice as sole practitioner in legal practice on reduced hours; assessment of concentration partly based on examination; Georges v Musico applied; Held – original assessment revoked; certificate issued; WPI not greater than 10%.

Decision date: 6 February 2026 | Principal Member John Harris, Dr John Baker, and Dr Matthew Jones | Injury module: Mental and Behavioural

Gheshlaghi v AAI Limited t/as GIO [2026] NSWPICMP 89

Motor Accident Compensation Act 1999; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor vehicle accident when the vehicle he was driving was hit from behind; claimant sustained physical injury as a result; dispute arose as to the claimant’s WPI; MA determined the claimant’s permanent impairment as a result of spinal and shoulder injuries at 7%; claimant sought a review of the assessment under section 63; Review Panel re-examined the claimant; Held – Review Panel confirmed MA’s certificate of 7% WPI.

Decision date: 6 February 2026 | Panel Members: Member Terence Stern, Dr David Gorman, and Dr Mohammed Assem | Injury module: Spine, and Upper Limb

Wang v AAI Limited t/as GIO [2026] NSWPICMP 90

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant assessed by original Medical Assessor (MA) as having 13% whole person impairment (WPI) for persistent depressive disorder; claimant’s vehicle was in a multi-vehicle pileup and was stationary when hit from behind by another vehicle; claimant sustained chest and ribs pain with psychological symptoms developing soon afterwards; Review Panel re-examined the claimant and essentially agreed with the original MA’s diagnosis of persistent depressive disorder; impairment rating was slightly different at 15% WPI; Held – claimant had a WPI greater than 10%; MAC revoked; new certificate issued.

Decision date: 6 February 2026 | Panel Members: Member Jeremy Lum, Dr Wayne Mason, and Dr Graham Blom | Injury module: Mental and Behavioural

Bryson v AAI Limited t/as GIO [2026] NSWPICMP 91

Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor accident; vehicle she was driving was hit from behind; claimant sustained injury dispute arose as to the claimant’s WPI; MA determined the claimant’s permanent impairment as a result of spinal injury at 19%; insurer sought a review of the assessment under section 7.26; Review Panel re-examined the claimant; Held – Review Panel confirmed certificate of MA.

Decision date: 6 February 2026 | Panel Members: Member Terence Stern, Dr Sophia Lahz, and Dr Les Barnsley | Injury module: Spine

Bryson v AAI Limited t/as GIO (No 2) [2026] NSWPICMP 92

Motor Accidents Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor accident; vehicle she was driving was hit from behind; claimant sustained injury; dispute arose as to the claimant’s WPI; MA determined the claimant’s permanent impairment as a result of the visual impairment sustained at 5%; insurer sought a review of the assessment under section 7.26; Review Panel re-examined the claimant; Held – Review Panel confirmed MA’s certificate.

Decision date: 6 February 2026 | Panel Members: Member Terence Stern, Dr Kerrie Meades, and Dr Michael Steiner | Injury module: Eyes

Cahill v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 94

Motor Accidents Injuries Act 2017; threshold injury; whole person impairment (WPI) dispute; Medical Assessor (MA) found all injuries threshold; no need to assess WPI; claimant applied for review of both decisions in single medical review proceedings; claimant alleged back, neck, right leg, right arm, and right shoulder injuries; issue of causation due to “minor” nature of accident; claimant had pre-existing relapsing remitting multiple sclerosis (RRMS); claimant examined by both MAs; Held – test of causation of threshold injury is same as test of causation for impairment; Kinchela v NRMA, and Briggs v NRMA followed; Review Panel satisfied claimant had a vulnerable spine due to his RRMS and accident could have caused injury; Review Panel satisfied that claimant did sustain injury to neck and lower back; Panel not satisfied claimant injured shoulder, arm, or leg; cervical spine injury did not completely or partially rupture any tissue and no radiculopathy; lumbar spine injury did not completely or partially rupture any tissue and while two signs of radiculopathy not currently present; Review Panel satisfied that a treating doctor had found two signs of radiculopathy in an examination after the accident; David v Allianz applied; WPI assessed at 11%; medical certificate revoked.

Decision date: 9 February 2026 | Panel Members: Member Belinda Cassidy, Dr Shane Moloney, and Dr Sophia Lahz | Injury module: Spine, Lower Limb, and Upper Limb

Karacayli v Allianz Australia Insurance Limited [2026] NSWPICMP 98

Motor Accidents Injuries Act 2017; review of medical assessment; threshold injury; excellent general health before the subject motor accident; T-bone collision whilst riding motorcycle; left shoulder labral tear; mild subacromial, sub deltoid bursitis; bony contusion of the anterior aspect of the humoral head and neck; clinical diagnosis by treating orthopaedic surgeon preferred; confirmation of history and mechanism of injury more likely to correctly identify and diagnose injury; mild but definite restriction of left shoulder elevation due to anterior joint pain; non-threshold injury; Held – medical certificate confirmed.

Decision date: 10 February 2026 | Panel Members: Member Hugh Macken, Dr Sophia Lahz, and Dr Margaret Gibson | Injury module: Brain Injury, Spine, Upper Limb, and Lower Limb

Carter v Allianz Australia Insurance Limited [2026] NSWPICMP 99

Motor Accident Injuries Act 2017; motor accident; rear end collision; issue of threshold injury; back pain with left sided symptoms; post motor accident right sided lower back and right leg symptoms; claimant established that the motor accident caused injury to the L3/4 disc causing referred pain in the L4 nerve root; finding made based on clinical and history; intervertebral disc is cartilaginous tissue; motor accident caused tearing of disc resulting in referred pain; Held – original assessment confirmed.

Decision date: 10 February 2026 | Panel Members: Principal Member John Harris, Dr Drew Dixon, and Dr Mohammed Assem | Injury module: Spine

Fayad v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 100

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); assessment of permanent impairment for psychiatric injuries; claimant’s vehicle was stationary and hit from behind by another vehicle; original Medical Assessor (MA) diagnosed post-traumatic stress disorder resulting in 17% whole person impairment (WPI); Held – Review Panel diagnosed major depressive disorder with anxious distress resulting in 7% WPI; psychiatric impairment rating scale; Review Panel assessed class 3 as opposed to class 2 in categories of social functioning, concentration persistence and pace, and adaptation; MAC revoked; new certificate issued.

Decision date: 10 February 2026 | Panel Members: Member Jeremy Lum, Dr John Baker, and Dr Christopher Rikard-Bell | Injury module: Spine, and Lower Limb

Allianz Australia Insurance Limited v Buestami [2026] NSWPICMP 105

Motor Accidents Compensation Act 1999; motor accident; rear-end collision; assessment of whole person impairment (WPI) for psychological injury; original medical assessment of 19%; Supreme Court revoked previous Review Panel determination; Buestami v Allianz Australia Ltd applied; deterioration in functioning over past three years; relevance of subsequent incidents and clause 1.34 of the Motor Accident Permanent Impairment Guidelines; Slade v Insurance Australia Ltd applied; isolation directly attributable to motor accident; no objective evidence of incident resulting in permanent impairment; Held – original assessment revoked due to change in diagnosis; higher assessment; certificate issued; WPI greater than 10%.

Decision date: 11 February 2026 | Panel Members: Principal Member John Harris, Dr Sharon Reutens, and Dr Melissa Barrett | Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decisions

State of New South Wales (Ambulance Service of NSW) v Mali [2026] NSWPICMP 81

Workplace Injury Management and Workers Compensation Act 1998; appeal by employer from 15% assessment for psychiatric injury; whether Medical Assessor (MA) erred in psychiatric impairment rating scale categories of travel, and concentration, persistence and pace; whether continued casual employment as a flight attendant not adequately explained; Held – reasons in travel category failed to consider travel over vast area including Fiji 80 hours per month; explanation that such travel was in a controlled environment inadequate; class 2 rating reduced to class 1; MA did not consider duties of a flight attendant at all in giving class 3 for concentration, persistence and pace; Medical Assessment Certificate revoked.

Decision date: 4 February 2026 | Panel Members: Member John Wynyard, Dr Graham Blom, and Dr Michael Hong | Body system: Psychological/Psychiatric

Atherton v State of New South Wales (Fire and Rescue) [2026] NSWPICMP 82

Workplace Injury Management and Workers Compensation Act 1998; appeal by claimant against 7% whole person impairment (WPI) assessment for psychological injury; whether errors made in four of the six categories of the psychiatric impairment rating scale; whether Medial Assessor (MA) had failed to give rating appropriate to the facts he found; whether MA had given adequate reasons; Ferguson v State of New South Wales, and Jenkins v Ambulance Service of New South Wales considered; Wingfoot Australia Partners Pty Ltd v Kocak, and Campbelltown City Council v Vegan considered; Held – submissions no more than mere disagreement; reasons adequate; observations as to submissions containing unsupported allegations of fact; Medical Assessment Certificate confirmed.

Decision date: 4 February 2026 | Panel Members: Member John Wynyard, Dr Michael Hong, and Dr Ash Takyar | Body system: Psychological/Psychiatric

Parkinson v EIRE Constructions Pty Ltd [2026] NSWPICMP 83

Workplace Injury Management and Workers Compensation Act 1998; appeal against 8% whole person impairment assessment for psychological injury; whether Medical Assessor (MA) erred in psychiatric impairment rating scale categories of self-care and personal hygiene, and concentration, persistence and pace; whether ratings appropriate; whether adequate reasons given;Ferguson v State of New South Wales, Jenkins v Ambulance Service of New South Wales applied; Wingfoot Australia Partners Pty Ltd v Kocak, and Campbelltown City Council v Vegan considered; concentration, persistence and pace submissions concerned with MA noting length of interview with claimant; Held – self-care submissions no more than disagreement about which rational minds might differ; reasons adequate; Abdal v Insurance Australia Limited t/as NRMA Insurance applied and error confirmed; reasons given adequate to confirm rating in any event; Medical Assessment Certificate confirmed.

Decision date: 4 February 2026 | Panel Members: Member John Wynyard, Dr Ash Takyar, and Dr Michael Hong | Body system: Psychological/Psychiatric

Bogdanovic v Farlow Concrete Pty Ltd [2026] NSWPICMP 84

Workplace Injury Management and Workers Compensation Act 1998; sleep and arousal disorders; Table 13-4 American Medical Association Guides to the Evaluation of Permanent Impairment, 5^thed (AMA 5); positional obstructive sleep apnoea resulting from injury; nature of referral; Skates v Hills Industries Ltd applied; jurisdiction of Medical Assessor; Bindah v Carter Holt Harvey Woodproducts Australia Pty Ltd applied; assessment of sleep apnoea; consideration of Epworth Sleepiness Score in 13.3c of AMA 5; by virtue of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed (the Guidelines) Table 13-4 must be applied; 13.3c of AMA 5 provides guidance but not binding; insomnia is not a neurological injury nor did it follow a neurological injury; to assess under Table 13-4 of the Guidelines for both obstructive sleep apnoea and insomnia would involve double dipping; Held – Medical Assessment Certificate revoked; assessment of positional obstructive sleep apnoea appropriate.

Decision date: 4 February 2026 | Panel Members: Member Parnel McAdam, Dr David Gorman, and Dr David Crocker | Body system: Left Upper Extremity, Right Upper Extremity, Lumbar Spine, Right Lower Extremity, and Sleep and Arousal Disorder

Flanagan v Secretary, Department of Communities and Justice [2026] NSWPICMP 87

Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor (MA) erred in his assessment of five of the psychiatric impairment rating scale categories; MA’s findings were inconsistent with some of his assessments; re-examination required; Appeal Panel found no errors; much of the evidence was more relevant to other categories; Held – Medical Assessment Certificate revoked.

Decision date: 5 February 2026 | Panel Members: Member Deborah Moore, Dr Michael Hong, and Dr John Baker | Body system: Psychological/Psychiatric

Chand v Bunnings Group Limited [2026] NSWPICMP 93

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred by engaging section 323(1); whether, in the event the MA did not err by engaging section 323(1), MA erred by not assuming in accordance with section 323(2) that the deductible proportion is 10%; Held – MA was correct to engage section 323(1) because the appellant had a pre-existing condition that formed a proportion of his permanent impairment from his injury; MA erred by not assuming in accordance with section 323(2) the deductible proportion is 10%; it was difficult to determine the proportion and making that assumption was not at odds with the evidence; Medical Assessment Certificate revoked.

Decision date: 6 February 2026 | Panel Members: Member Marshal Douglas, Dr Margaret Gibson, and Dr James Bodel | Body system: Lumbar Spine, Upper Digestive Tract, Lower Digestive Tract, and Anus

Scott v INA Operations Pty Ltd ATF INA Operations Trust No.1; INA Operations Pty Ltd ATF INA Operations Trust No.1 v Scott [2026] NSWPICMP 95

Workplace Injury Management and Workers Compensation Act 1998; appeal by worker and cross appeal by respondent employer; both appeals made on the grounds of the assessment being made on the basis of incorrect criteria and demonstrable error; a supplementary statement of the worker was not admitted as fresh evidence; worker submitted error in the psychiatric impairment rating scale categories of self-care and personal hygiene, self-social functioning; application of section 323 deduction; Appeal Panel found no error in assessment of self-care and personal hygiene and self-social functioning; Appeal Panel found error in deduction pursuant to section 323 as deduction based in part on vulnerability; Appeal Panel made a one-tenth deduction for pre-existing psychiatric conditions; in appeal by employer Appeal Panel found no error in the assessment of travel or the assessment of concentration, persistence and pace; assessment of total whole person impairment by the Appeal Panel was the same as made by the Medical Assessor and in those circumstances the review has not lead to a different result and should not be interfered with; Held – Medical Assessment Certificate confirmed.

Decision date: 9 February 2026 | Panel Members: Member Carolyn Rimmer, Dr Douglas Andrews, and Dr Michael Hong | Body system: Psychological/Psychiatric

Rock Logistics Pty Ltd v Miller [2026] NSWPICMP 97

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred by not disregarding any impairment respondent had from secondary psychological injury; whether MA erred with his ratings of respondent’s impairment in social and recreational activities, concentration persistence and pace, and employability; Appeal Panel held there was no agreement between the parties that respondent had suffered a secondary psychological injury nor had the Personal Injury Commission determined he had; MA consequently did not err by not disregarding any impairment of the respondent that may be due to any supposed secondary psychological injury; MA did not err with his ratings of respondent’s impairment in concentration, persistence and pace, and employability; MA did err by taking into account an irrelevant factor when rating the appellant’s impairment in social and recreational activities, but if that factor is ignored, there is no difference to outcome; Held – Medical Assessment Certificate confirmed.

Decision date: 9 February 2026 | Panel Members: Member Marshal Douglas, Dr Graham Blom, Dr John Lam-Po-Tang | Body system: Psychological/Psychiatric

Grant v Albury City Council [2026] NSWPICMP 101

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; appellant worker alleged assessment on the basis of incorrect criteria; demonstrable error in the making of assessments under the psychiatric impairment rating scale (PIRS) categories, namely travel and concentration, persistence and pace; challenged assessments under PIRS were both confirmed on appeal; appellant also appealed the making a of one-tenth deduction under section 323 for a pre-existing vulnerability to anxiety; deduction was made in error and was revoked by the Appeal Panel; Held – Medical Assessment Certificate revoked.

Decision date: 10 February 2026 | Panel Members: Member Jane Peacock, Professor Nicholas Glozier, and Dr John Lam Po Tang | Body system: Psychological/Psychiatric

ACN 608733302 Pty Ltd t/as T1 Engine Parts v Chander [2026] NSWPICMP 102

Workplace Injury Management and Workers Compensation Act 1998; appeal by respondent employer on the grounds of the assessment being made on the basis of incorrect criteria and demonstrable error; assessment by Medical Assessor (MA) of left and right upper extremities, cervical spine, and scarring; Appeal Panel rejected the submission that the MA erred by taking into account photographs which were not admitted in the proceedings on the basis that the appellant failed to establish how this was a material error; Appeal Panel accepted that MA made errors in assessment of thumb impairment, assessment of right thumb arthroplasty, and conversion of upper extremity impairment to whole person impairment (WPI); Appeal Panel accepted that MA erred in using the term “WPI” at the table in the Medical Assessment Certificate (MAC) but this was not a material error; Held – MAC revoked.

Decision date: 10 February 2026 | Panel Members: Member Carolyn Rimmer, Dr Todd Gothelf, and Dr Tommasino Mastroianni | Body system: Left Upper Extremity, Right Upper Extremity, Cervical Spine, and Scarring (TEMSKI)

State of New South Wales (NSW Police Force) v Harland [2026] NSWPICMP 103

Decision date: 10 February 2026 | Panel Members: Member Jane Peacock, Professor Nicholas Glozier, and Dr Douglas Andrews | Body system: Psychological/Psychiatric

Ha v Descartes Underwriting Australia Pty Ltd [2026] NSWPICMP 104

Decision date: 10 February 2026 | Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr Douglas Andrews | Body system: Psychological/Psychiatric

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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