Legal Bulletin No. 249
This bulletin was issued on 27 February 2026
Issued 27 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.
Presidential Member Decisions
State of NSW (Mid North Coast Local Health District) v Schweikert [2026] NSWPICPD 4
Workers compensation; section 46 of the Workers Compensation Act 1987; dual benefits; Department of Corrective Services v Patikas [1993] NSWCA 81; subclause 2(3)(a) of Schedule 3 to the Workers Compensation Act 1987 and clause 8C of the Workers Compensation Regulation 2016; appeal; application of Metwally v University of Wollongong [1985] HCA 28; 60 ALR 68 and associated authorities; duty to give reasons; Fisher v Noncomformist Pty Ltd [2024] NSWCA 32; Held – paragraphs [1], [2], [5], [6] and [7] of the Certificate of Determination are confirmed; paragraphs [3] and [4] of the Certificate of Determination are rescinded; the matter is remitted to a different non-Presidential member for redetermination of the outstanding matters consistent with these reasons.
Decision date: 13 February 2026 | Before: Deputy President Michael Snell
Workers compensation; whether the appellant’s exposure to traumatic events during the course of his employment caused a psychological injury; State of New South Wales v Culhana [2025] NSWCA 157; adverse credibility finding and its effect on medical evidence and lay evidence; Lee v Lee [2019] HCA 28; reliance on video evidence; Held – the Certificate of Determination dated 1 June 2025 is confirmed; pursuant to rule 132 of the Personal Injury Commission Rules 2021, names of the parties to this dispute be de-identified.
Decision date: 16 February 2026 | Before: President Judge Phillips
Walker v Secretary, Department of Education [2026] NSWPICPD 6
Workers compensation; ‘affected by’ in section 352(5)of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act) considered; Toll Pty Limited v Morrisey [2008] NSWCA 197; Mars Australia Pty Limited v Knight [2025] NSWCA 229; Fisher Nonconformist Pty Ltd [2024] NSWCA 32; 114 NSWLR 1; Hays Specialist Recruitment (Australia) Pty Limited v Akbawy [2025] NSWPICPD 83 applied; practice and procedure; Personal Injury Commission Rules and Procedural Directions; Paterson v State of New South Wales (NSW Police Force) [2025] NSWPICPD 6; New South Wales Police Force v Winter [2011] NSWCA 330 applied; approach to fact finding by Presidential member of the Personal Injury Commission of New South Wales pursuant to section 352 of the 1998 Act; State of New South Wales v Culhana [2025] NSWCA157 applied; the meaning of civil standard of proof; CEG Direct Securities Pty Ltd v Cooper [2025] FCAFC 47 applied; test for causation; results from section 25 of the 1998 Act considered; Kooragang Cement Pty Ltd v Bates (1994) 35 NSWLR 452; Fisher v Nonconformist Pty Ltd [2024] NSWCA 32; 114 NSWLR 1 applied; Held – the Certificate of Determination dated 17 June 2025 is revoked; the matter is remitted to a different member to redetermine in accordance with this decision.
Decision date: 17 February 2026 | Before: Deputy President the Hon. Adam Searle
Motor Accidents non-Presidential Member Decisions
Allianz Australia Insurance Limited v Mahaffy-Toohey [2025] NSWPIC 618
Motor Accident Injuries Act 2017; recommendation for exemption; passenger in motor vehicle; allegation of voluntary assumption of risk; joint illegal enterprise; participating in an illegal street race; claimant complicit in the insured driver’s actions; complex legal or factual issues; difficulties in compelling witnesses to attend; requirement of parties to issue subpoenas; likely length of hearing; requirement for extension questioning; accident, reconstruction experts, and data retrieval experts; Held – recommendation made that the claim is not suitable for assessment; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 19 November 2025 | Member: Hugh Macken
Allianz Australia Insurance Limited v Mariam [2026] NSWPIC 94
Motor Accident Injuries Act 2017; insurer’s application for discretionary exemption from assessment under section 7.34(1)(b); preliminary assessment of claim; complex issues arising from a failure of the claimant to produce Centrelink records; Held – a court hearing is more likely to result in the just, quick and cost-effective resolution of the real issues in dispute between the parties; the claim is not suitable for assessment; recommendation made that the claim be exempted; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 14 January 2026 | Member: Philip Carr
Landeira Sanchez v AAI Limited t/as GIO [2026] NSWPIC 95
Motor Accident Injuries Act 2017; application by the claimant seeking an exemption from assessment; insurer supports the exemption application; claim involves non-CTP party and complex factual and legal issues; claimant commenced proceedings in the District Court pleading allegations of medical negligence; issues not within the majority of cases assessed by the Personal Injury Commission; recommend the claim is not suitable for assessment; Held – preliminary assessment claim not suitable for assessment; recommendation to the President pursuant to section 7.34(1)(b) that the matter be exempt from assessment; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 15 January 2026 | Member: Elyse White
Bajouri v Allianz Australia Insurance Limited [2026] NSWPIC 96
Motor Accidents Compensation Act 1999; recommendation claim not suitable for assessment; submitted by the claimant the matter is not suitable for assessment on the basis it involves allegations of inconsistent evidence, surveillance, criminal records, and economic loss claims that are unusually complex; claimant has a lengthy criminal history including charges of common assault resulting in a conviction, and was fined for contravene prohibition/restriction in AVO (domestic); solicitor for the insurer does not oppose this application for discretionary exemption; submitted on behalf of the claimant the matter should be exempted on discretionary grounds; Held – the matter be exempted under section 92(1)(b) and rule 99 of the Personal Injury Commission Rules 2021 on the grounds that the claim involves allegations of inconsistent evidence, surveillance, criminal records, and economic loss claims that are unusually complex; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 20 January 2026 | Member: David Ford
Leedham v QBE Insurance (Australia) Limited [2026] NSWPIC 99
Motor Accident Injuries Act 2017; damages assessment; passenger in a high impact crash; sustained injuries to her low back, left hand, rib fractures, and psychological injuries; poor work history; entitlement to damages for non-economic loss and economic loss; Held – damages assessed; non-economic loss $350,000; plus past economic loss by way of a buffer $40,000; future loss by way of a buffer of $30,000; total assessment $424.694.
Decision date: 13 February 2026 | Member: Elyse White
Workers Compensation non-Presidential Member Decisions
EMA v Westpac Banking Corporation [2026] NSWPIC 6
Workers Compensation Act 1987; claim for weekly benefits arising from a psychological injury; Held – section 11A defence not made out as the onus of “wholly or predominantly” not made out; consideration of section 46; respondent to pay reasonably incurred expenses.
Decision date: 12 January 2026 | Senior Member: Elizabeth Beilby
Workers Compensation Act 1987; accepted psychological injury; defence raised under section 11A(1) with respect to performance appraisal and discipline; claim for weekly compensation and medical expenses disputed; Held – the respondent has not discharged its onus of establishing the applicant’s accepted psychological injury was wholly or predominantly caused by reasonable action taken or proposed to be taken by or on its behalf with respect to performance and discipline within the meaning of section 11A(1); respondent to pay weekly payments and reasonably necessary medical or related expenses.
Decision date: 22 January 2026 | Member: Fiona Seaton
Foote v Seven Network (Operations) Pty Ltd [2026] NSWPIC 97
Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); weekly payments; whether applicant’s aggravation of an underlying condition was brought about by the conditions of her employment, namely insomnia and prolonged exposure to severe ultraviolet radiation while filming a television segment for long periods in tropical sunlight; whether the applicant is statute barred from recovering compensation; nature and extent of any incapacity for employment; Held – determination of the cause of the applicant’s condition requires a commonsense evaluation of the causal chain to determine whether, having regard to the totality of the lay and medical evidence, the applicant has proven on the balance of probabilities her employment was the main contributing factor to the aggravation; Kooragang Cement Pty Ltd v Bates applied; applicant has established her work conditions were the main contributing factor to the aggravation of her underlying condition; defence in relation to sections 254 and 261 of the 1998 Act is not made out; applicant had a reasonable explanation for the delay in lodging her claim; respondent ordered to pay the applicant weekly benefits.
Decision date: 29 January 2026 | Member: Cameron Burge
Witt v NWFS Employment Pty Ltd [2026] NSWPIC 98
Workers Compensation Act 1987; sections 33, 32A, 37, 38, and clause 9, Schedule 3 considered; incapacity; suitable duties; current work capacity; Kooragang Cement Pty Ltd v Bates considered and applied; Held – applicant had no current work capacity from 14 December 2022 to 19 August 2025; respondent to pay the applicant; respondent is to pay the costs of and incidental to an upright standing MRI scan of the right shoulder.
Decision date: 12 February 2026 | Member: John Turner
Bene v Kindaburra Early Learning Centre [2026] NSWPIC 100
Workers Compensation Act 1987; claim for the cost of a left L5 nerve decompression; whether the surgery is reasonably necessary as a result of the work injury; whether an order for payment can be made pursuant to section 60(5); Widup v Hamilton considered; Held – proposed surgery is reasonably necessary as a result of the work injury but no order made pursuant to section 60(5).
Decision date: 13 February 2026 | Member: John Isaksen
Irving v State of New South Wales (NSW Police Force) [2026] NSWPIC 103
Workers Compensation Act 1987; claim for psychological injury and for payment of weekly compensation and medical expenses pursuant to section 60; whether the psychological injury was wholly or predominantly caused by reasonable action taken by the respondent with respect to discipline pursuant to section 11A; Held – the respondent has failed to establish its defence under section 11A; respondent to pay weekly compensation and the applicant’s reasonably necessary medical treatment expenses as a result of the injury; respondent to pay the applicant’s costs as agreed or assessed.
Decision date: 16 February 2026 | Member: Fiona Seaton
Motor Accidents Medical Review Panel Decisions
Coveney v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 888
Motor Accidents Compensation Act 1999; whole person impairment (WPI) dispute; claimant’s vehicle was travelling around a right-hand bend when the insured vehicle travelling in the opposite direction hit the back end of the claimant’s vehicle twice; claimant took several days off work; claimant then returned to work as enrolled nurse in an aged care facility; Medical Assessor (MA) found 5% WPI for lumbar spine after deduction for pre-existing impairment; MA also found 1% WPI for scarring as agreed; Held – Review Panel found 10% WPI for lumbar spine and no basis for deduction for pre-existing impairment pursuant to paragraph 6.31 of the Motor Accident Guidelines; Review Panel found 1% WPI for scarring; certificate revoked.
Decision date: 13 November 2025 | Panel Members: Member Gary Victor Patterson, Dr David Gorman, and Dr Shane Moloney | Injury module: Spine, Upper Limb, Lower Limb, and Minor Skin
Felsch v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 899
Motor Accident Injuries Act 2017; review of medical assessment; whole person impairment (WPI); prior work injury to both knees; claimant medically retired post-accident; high-speed accident; airbags deployed; head injury; right shoulder girdle injury; lumbar spinal injury; relevant physiotherapy documentation; reduce sensory appreciation in a S1 distribution; external and rib fractures; inaccurate history of right wrist fracture; soft tissue injury to the pelvis; Held – Review Panel assessed 5% WPI; medical certificate revoked.
Decision date: 18 November 2025 | Panel Members: Member Hugh Macken, Dr Christopher Oates, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, and Lower Limb
Denton v QBE Insurance (Australia) Limited [2025] NSWPICMP 964
Motor Accident Injuries Act 2017; review of medical assessment; whole person impairment (WPI); major depressive disorder; unspecified alcohol related disorder; prior history of depression; alcohol use in an attempt to reduce feelings of depression; mild impairment of self-care and personal hygiene; moderate impairment of social functioning; severe impairment of adaptation; mild impairment of concentration, persistence and pace; no requirements for apportionment; Held – Review Panel assessed 17% WPI; medical certificate revoked.
Decision date: 9 December 2025 | Panel Members: Member Hugh Macken, Dr Christopher Rikard-Bell, and Dr Ronald Gill | Injury module: Mental and Behavioural
Asrag v Allianz Australia Insurance Limited [2026] NSWPICMP 107
Motor Accident Injuries Act 2017; review of a single medical assessment; whether psychological injury caused by the accident is a threshold injury for the purposes of the Act; pre-existing psychological symptoms; Review Panel found a persistent depressive disorder that pre-dates the motor accident, with the accident not causing an aggravation; found the claimant did not suffer a psychological condition caused by the accident; determination as to whether injury a threshold injury is not required; Held – medical certificate revoked; new certificate provided.
Decision date: 13 February 2026 | Panel Members: Member Elizabeth Medland, Dr Christopher Canaris, and Dr Tom Newlyn | Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Jebara [2026] NSWPICMP 108
Motor Accident Injuries Act 2017; threshold injury dispute; claimant was the seat-belted driver of her vehicle which was stopped in traffic when it was struck in the rear by the insured vehicle; claimant began to experience painful symptoms after a few days causing her to report the accident to police; claimant was grieving the death of her husband which occurred not long before the accident; Medical Assessor (MA) certified exacerbation/aggravation of somatic disorder with predominant pain, unspecified depressive disorder, and unspecified anxiety disorder ; as non-threshold injuries; insurer’s review application; claimant reassessed; Held – Review Panel agreed with original MA concerning his diagnosis of somatic disorder with predominant pain; Review Panel satisfied that all of the prescribed criteria for a diagnosis of PTSD are met; not a threshold injury; medical certificate revoked.
Decision date: 13 February 2026 | Panel Members: Member Gary Victor Patterson, Dr Ankur Gupta, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural
Youssef v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 110
Motor Accident Injuries Act 2017; review of permanent impairment assessment under section 7.23(1); claimant involved in high-speed roundabout collision; initial Medical Assessor (MA) found combined physical whole person impairment (WPI) at 10%; claimant sought review alleging under-assessment and causation error; Review Panel accepted injuries to lumbar spine, right shoulder, right knee, and right ankle were caused by the motor accident; cervical spine and right hip not found to be causally related; lumbar spine injury previously determined to involve radiculopathy, but current examination found no objective neurological signs; impairment assessed at 0%; right shoulder assessed by analogy at 4% WPI due to pain-limited range of motion and imaging-confirmed pathology; right knee and ankle injuries caused by the accident but did not result in assessable impairment; Held – combined WPI assessed at 4%; not greater than 10%; certificate of MA revoked and new certificate issued.
Decision date: 16 February 2026 | Panel Members: Member Bridie Nolan, Dr Rhys Gray, and Dr Shane Moloney | Injury module: Spine, Upper Limb, and Lower Limb
Allianz Australia Insurance Limited v Lee [2026] NSWPICMP 111
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; threshold injury dispute; Medical Assessor (MA) found threshold injuries to spine, pelvis, and shoulders; MA found non-threshold injury to elbow; insurer’s application for review; issue of causation in respect of injury to elbow; whether claimant had a pre-existing elbow injury; whether contemporaneous records of elbow injury following accident; claimant examined; Held – Review Panel found threshold injuries to spine, pelvis, and shoulders; Review Panel satisfied elbow injury involved a tendon tear and is a non-threshold injury; elbow pain documented shortly after the accident with no inconsistency with hospital records; Review Panel satisfied elbow injury was caused by the accident and was not pre-existing; MAC confirmed.
Decision date: 16 February 2026 | Panel Members: Member Bianca Montgomery-Hribar, Dr Les Barnsley, and Dr David Gorman | Injury module: Spine, Lower Limb, and Upper Limb
Heydari v QBE Insurance (Australia) Limited [2026] NSWPICMP 114
Motor Accident Injuries Act 2017; threshold injury dispute; claimant sustained injuries in a motor vehicle accident; insured vehicle struck the claimant’s vehicle causing it to spin and strike the kerb with the driver’s side of the vehicle; claimant has a prior history of some mental illness due to difficulties with some family members, his former partner and his former employer; Medical Assessor (MA) found accident caused an adjustment disorder with depressed mood which is a threshold injury; claimant’s review application on basis of evidence from a number of experts that claimant suffers from a serious psychiatric diagnosable illness; claimant examined by both MAs on the Medical Review Panel who found adjustment disorder with anxiety and depressed mood; Held – medical certificate confirmed.
Decision date: 17 February 2026 | Panel Members: Member Gary Victor Patterson, Dr Christopher Rikard-Bell, and Dr Ankur Gupta | Injury module: Mental and Behavioural
Ahmed v Allianz Australia Insurance Limited [2026] NSWPICMP 115
Motor Accident Injuries Act 2017; review of medical assessment; degree of permanent impairment; cervical compression testing negative; lumbar spine disc protrusion with annual tear compressing L4 nerve root; previous significant lumbar pain with scans showing L4/5 disc protrusion; right shoulder soft tissue injury; restrictions on range of motion on uninjured left shoulder; right soft tissue injury; scarring well healed almost and almost imperceptible; Held – Review Panel determined a 10% whole person impairment; medical certificate revoked.
Decision date: 17 February 2026 | Panel Members: Member Hugh Macken, Dr Drew Dixon, and Dr David Gorman | Injury module: Spine, and Upper Limb
AAI Limited t/as GIO v Barzan [2026] NSWPICMP 116
Motor Accident Injuries Act 2017; review of medical assessment; threshold injury; treatment and care; reverse shoulder replacement; pre-accident bursitis; pre-accident partial tear rotator cuff tendon; no treatment in eight years pre-accident; rib fractures; full thickness supraspinatus tear with bursitis; left shoulder left arm symptoms; incapacity and widespread pain post-accident; shoulder replacement relates to injuries caused by the subject motor accident; Held – shoulder replacement surgery reasonable and necessary if the claimant is medically fit for such an operation; medical certificate confirmed.
Decision date: 17 February 2026 | Panel Members: Member Hugh Macken, Dr Sophia Lahz, and Dr Les Barnsley | Injury module: Spine, and Upper Limb; Treatment type: Surgery
Jabarian v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 121
Motor Accident Injuries Act 2017; permanent impairment dispute; claimant was driving to work; insured vehicle ran a red light and collided with the passenger’s side of the claimant’s vehicle; claimant could not sleep; GP prescribed night sedation which did not help; claimant started seeing a psychologist two months after the accident; claimant had suicidal ideation after the accident; her husband had a terminal illness and died not long before assessment; her son died suddenly some time before the accident; her mental health was affected; Medical Assessor (MA) found post-traumatic stress disorder and major depressive disorder for which he assessed 8% whole person impairment (WPI); Held – Review Panel made a different diagnosis of persistent depressive disorder; assessment of 9% WPI after adjusting for treatment effect; no pre-existing impairment found at time of assessment despite claimant’s recent bereavement and other life-stressors unrelated to the accident; certificate revoked.
Decision date: 18 February 2026 | Panel Members: Member Gary Victor Patterson, Dr Matthew Jones, and Dr Gerald Chew | Injury module: Mental and Behavioural
Workers Compensation Medical Appeal Panel Decisions
Workers Compensation Act 1987; appellant suffered from chronic fatigue due to vaccination; assessment by analogy with anaemia under Tables 9-1 and 9-2 of American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5); original assessment determined impairment at the lower end of Class 2 of Table 9-2 based on a lack of any objective blood abnormalities; appellant sought to admit statement concerning medical assessment; allegations inconsistent with the terms of Medical Assessment Certificate (MAC); evidence did not have substantial probative value; Lukacevic v Coates Hire Operations Pty, and Stolzenberg v Workers Compensation Nominal Insurer applied; application of incorrect criteria by original Medical Assessor finding at the lower end of class 2 because there were no objective blood abnormalities for determining chronic fatigue syndrome caused by the vaccine; reassessment under Table 9-1 of AMA 5 requires impact on activities of daily living, reference to Table 1-2 of AMA 5; consideration of secondary psychological injury to be disregarded; section 65A(2); observations of Basten AJA in Matheson v Baptistcare NSW & ACT considered; Held – claimant assessed at Class III under Tables 9-1 and 9-2 of AMA 5 at 40% whole person impairment; MAC revoked.
Decision date: 11 February 2026 | Panel Members: Principal Member John Harris, Dr Christopher Grainge, and Dr Drew Dixon | Injury module: Respiratory, and Chronic Fatigue
Steele v Rachael Steele Consulting Pty Ltd [2026] NSWPICMP 109
Workplace Injury Management and Workers Compensation Act 1998; whether the Appeal Panel should receive into evidence statements of the appellant and the appellant’s husband made after the medical assessment; whether the Medical Assessor (MA) erred by making a deduction under section 323(1); whether the MA explained his reasoning for making a deduction under section 323(1); Appeal Panel did not receive the statements into evidence because it was evidence the appellant could have obtained before the medical assessment; Appeal Panel found the MA did not adequately explain why he made a deduction under section 323(1); failure on the part of the MA was such that the Medical Assessment Certificate (MAC) contained a demonstrable error; Appeal Panel found however that a deduction under section 323(1) was required and that the required deduction was the same as the MA made; the Appeal Panel corrected the demonstrable error in MAC; same result was achieved; Held – MAC confirmed.
Decision date: 13 February 2026 | Panel Members: Member Marshal Douglas, Professor Nicholas Glozier, and Dr Douglas Andrews | Injury module: Psychological/Psychiatric
Mansell v Trustees of the Roman Catholic Church for the Diocese of Broken Bay [2026] NSWPICMP 112
Workplace Injury Management and Workers Compensation Act 1998; psychological injury; lump sum claim; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of two of the six assessments under the psychiatric impairment rating scale categories, namely self-care and personal hygiene, and social and recreational activities; assessment in the challenged domain of social and recreational activities revoked on appeal but due to the operation of the conversion tables, the overall assessment of whole person impairment remained the same; Held – Medical Assessment Certificate confirmed.
Decision date: 16 February 2026 | Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr Graham Blom | Injury module: Psychological/Psychiatric
Phillips v Brighter Access Ltd [2026] NSWPICMP 113
Workplace Injury Management and Workers Compensation Act 1998; psychological Injury; lump sum claim; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of three of the six assessments under the psychiatric impairment rating scale categories, namely self-care and personal hygiene, travel and concentration, persistence and pace; assessment in the challenged domain of travel revoked on appeal; Held – Medical Assessment Certificate revoked.
Decision date: 16 February 2026 | Panel Members: Member Jane Peacock, Dr Michael Hong, and Professor Nicholas Glozier | Injury module: Psychological/Psychiatric
Ahmadi v Upscale Painting and Decorating Pty Ltd [2026] NSWPICMP 117
Workplace Injury Management and Workers Compensation Act 1998; appeal against 8% whole person impairment (WPI) for psychological injury; whether Medical Assessor (MA) erred in social and recreational activities category; whether MA failed to take account of the claimant's subjective motivation in performing the various activities; whether the reasons given were inadequate; Held – Chapter 11.11 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed, provides for an evaluation of behavioural consequences; descriptors are not concerned with subjective motivation; reasons adequately explained in presence of inconsistent statements; Held – Medical Assessment Certificate confirmed.
Decision date: 17 February 2026 | Panel Members: Member Marshal Douglas, Dr James Bodel, and Dr Tommasino Mastroianni | Injury module: Left Upper Extremity, and Scarring
Gibson v State of New South Wales (NSW Police Force) [2026] NSWPICMP 118
Workplace Injury Management and Workers Compensation Act 1998; appeal against 8% whole person impairment (WPI) for psychological injury; whether Medical Assessor (MA) erred in social and recreational activities category; whether MA failed to take account of the claimant's subjective motivation in performing the various activities; whether the reasons given were inadequate; Held – Chapter 11.11 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed, provides for an evaluation of behavioural consequences; descriptors are not concerned with subjective motivation; reasons adequately explained in presence of inconsistent statements; Held – Medical Assessment Certificate confirmed.
Decision date: 17 February 2026 | Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Douglas Andrews | Injury module: Psychological/Psychiatric
Greening v The Sleeping Giant Pty Ltd [2026] NSWPICMP 119
Workplace Injury Management and Workers Compensation Act 1998; review against assessment which deducted 50% for injury caused by aggravation of pre-existing degenerative condition where treatment had included cervical surgery; whether Medical Assessor (MA) correct to find that surgery did not address structural pathology caused by injury but rather addressed a constitutional condition; whether MA had redetermined causation contrary to the terms of the referral; whether error made in application of section 323; whether error made in assessment of 1% for restriction in activities of daily living and/or 0% for scarring; Held – MA’s determination complied with terms of the referral; reliance by claimant on note to consent orders misplaced; MA erred in application of section 323; MA function to assess contribution of pre-existing condition to baseline impairment, not to consider treatment caused by injury;ElCheikh v Diamond Formwork (NSW) Pty Ltd (in liquidation) considered and applied; quantum of contribution difficult to determine as claimant asymptomatic prior to injury; assessment of restrictions in activities of daily living and scarring matter of clinical judgement and open to MA; Medical Assessment Certificate revoked.
Decision date: 17 February 2026 | Panel Members: Member John Wynyard, Dr David Crocker, and Dr Todd Gothelf | Injury module: Cervical Spine, and Scarring (TEMSKI)
Motor Accidents Merit Review Decisions
Cisera v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMR 4
Motor Accident Injuries Act 2017; merit review; dispute under Schedule 1, clause 2; whether the claimant is an earner; self-employment; invoices created after the accident; inconsistencies in evidence; late concession by claimant; reliability of evidence; absence of contemporaneous documents; whether documents misrepresented as contemporaneous records; onus of proof; promissory estoppel; insurer’s duty of utmost good faith; Held – the reviewable decision is affirmed.
Decision date: 16 February 2026 | Merit Reviewer: Katherine Ruschen
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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