Legal Bulletin No. 253

Issued 27 March 2026

Welcome to the two hundred and fifty-third 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.

Supreme Court Decision

Insurance Australia Limited t/as NRMA Insurance v Kwarteng [2026] NSWSC 225

Administrative law; review of medical assessment by review panel; judicial review of review panel decision; where medical assessment certificate revoked and replaced by review panel; whether review panel failed to exercise its collective judgment, expose its actual path of reasoning and/or respond to a substantial and clearly articulated argument; Held – the summons filed on 4 September 2025 is dismissed, with costs.

Decision date: 24 March 2026| Member: Griffiths AJ

Motor Accidents non-Presidential Member Decisions

AAI Limited t/as GIO v Despot [2026] NSWPIC 136

Motor Accident Injuries Act 2017; claim not suitable for assessment; claimant injured in an incident on premises occupied by Woolworths in an area which was within the interior of a warehouse; claimant was driving a forklift which collided with a motorised pallet transporter; both vehicles owned by Woolworths; claimant employed as a warehouse storeman with Woolworths; claimant intends to issue a claim against the Nominal Defendant on the basis the pallet transporter that caused the incident was unregistered and uninsured for CTP purposes; main issue for determination is whether the incident occurred on a road or road related area which is open to the public and consequently, whether the claimant is precluded from bringing a claim against the Nominal Defendant; liability has been denied by the insurer; claimant  also intends to issue a claim against Ready Workforce on the basis it was the employer of the driver of the motorised pallet transporter (which is denied); claimant intends to issue a statement of claim in the District Court both those parties and also a claim against the driver of the motorised pallet transporter seeking damages; claimant submits the matter be exempted in the interests of justice in order for all claims to be determined concurrently in the jurisdiction of the District Court; submitted on behalf of the claimant, the matter should be exempted on discretionary grounds; insurer consents to the application; Held – recommendation that the matter be exempted under section 7.34 (1)(b) on the grounds a claimant or insurer seeks to proceed against one or more non-CTP parties; rule 99(3)(d) of the Personal Injury Commission Rules 2021 (NSW); recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 20 March 2026| Member: David Ford

Unicomb v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 151

Motor Accident Injuries Act 2017; miscellaneous claims assessment; late claim for damages; whether claimant provided a “full and satisfactory explanation” under sections 6.14(3) and s 6.2; claim lodged more than three years after the statutory three year limit; claimant unrepresented until he noticed an email from the insurer sent, thirty months earlier, informing him of the time limit and entitlement to make a claim; insurer rejected the claim on the basis that full and satisfactory explanation for the delay had not been provided; claimant’s solicitors then provided his statements explaining the delay; claimant inter alia relied upon mental stress and psychological issues as part of explanation for delay; no evidence provided from treating doctor or treating psychologist; explanation for delay found not to be full hence decision as to whether explanation was satisfactory not required; Held – claimant had not provided a full and satisfactory explanation; a claim for common law damages could not be made; late claim for common law damages not referred for assessment; insurer to pay claimant’s costs as agreed or assessed.

Decision date: 4 March 2026| Member: Gary Victor Patterson

Allianz Australia Insurance Limited v Akkaoui [2026] NSWPIC 106

Motor Accident Injuries Act 2017; discretionary exemption; application of rule 99(3) of the Personal Injury Commission Rules 2021; claimant entitled to non-economic loss; insurer unable to compel witnesses to attend at assessment conference; application for exemption not opposed; allegations of false and misleading statements; allegations of inaccurate pre-accident weekly earnings; alleged that claimant was in receipt of payments from Centrelink  and insurer post-accident; multiple pre-accident employers identified in error; consideration of comparative limitations and advantages of the PIC forum; insurer alleged fraudulent statements and documents led to overpayment; Held – recommendation to the President that matter be exempt from assessment; recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 6 March 2026| Member: Hugh Macken

AAI Limited t/as GIO v CEE [2026] NSWPIC 161

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); proposed settlement $350,000; claimant in mid-seventies; various injuries including aggravation of pre-existing degenerative changes in neck, back, and left knee; likely left knee replacement; insurer agreed claimant entitled to damages for non-economic loss; claimant retired at time of accident; no entitlement to economic loss damages; no deductions to be made from settlement; Held – proposed settlement approved.

Decision date: 6 March 2026| Senior Member: Brett Williams

Sharpe v Allianz Australia Insurance Limited [2026] NSWPIC 163

Motor Accident Injuries Act 2017 (MAI Act); rule 99(3) (d) of the Personal Injury Commission Rules 2021 (NSW); claimant injured in a motor vehicle accident when he was standing on the step located at the back of a garbage truck, when the step collapsed from under him, causing him to fall off and fracture his collarbone; claimant has rights under the MAI Act, Civil Liability Act 2002, and Workers Compensation Act 1987 for the same injuries; statement of claim has been issued in the District Court against J.R. and E.J. Richards Pty Ltd pursuant to a public liability insurance policy; submitted the matter is unsuitable for resolution in the Personal Injury Commission as there are jurisdictional issues related to the matter; claimant submits the matter be exempted in the interests of justice in order for all claims to be determined concurrently in the jurisdiction of the District Court; submitted on behalf of the claimant, the matter should be exempted on discretionary grounds; Held – recommendations claim not suitable for assessment; the matter be exempted under section 7.34 (1)(b) on the grounds a claimant or insurer seeks to proceed against one or more non-CTP parties; recommendation subsequently approved by the Division Head, as the President’s delegate.

Decision date: 12 March 2026| Member: David Ford

Belford v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 164

Motor Accident Injuries Act 2017; damages assessment; contributory negligence alleged due to the driver of the vehicle, of which the claimant was a passenger, charged with driving under the influence of alcohol; contributory negligence settled at the assessment conference; damages for past and future economic loss with no entitlement to non-economic loss; Medical Assessment Certificates totalling 8% WPI; motor accident of 6 November 2021 causing a fractured C5 of the cervical spine; insurer’s case of no ongoing incapacity; Held – ongoing incapacity accepted on basis of some ongoing pain and symptoms and a disadvantage on the open labour market; damages assessed after contributory negligence of $168,367.79 plus costs of $34,245.36.

Decision date: 16 March 2026| Member: Elizabeth Medland

Singh v Allianz Australia Insurance Limited [2026] NSWPIC 165

Motor Accident Injuries Act 2017; miscellaneous claims assessment; motor vehicle accident; rear end collision conceded; whether the injury caused by a motor vehicle accident as defined; miscellaneous claims assessment; whether injury sustained by the claimant on 7 May 2024 resulted from a motor accident; section 1.9; claimant involved in a rear end collision on 7 May 2024; insurer disputed whether the impact was sufficient to cause injury; Held – dispute as to whether injury sustained was not a medical assessment matter and could not be referred for medical assessment; injury requires a distinct physiological change or physiological disturbance for the worse which was both sudden and identifiable; injury established by attendance and complaints at Nepean Hospital; on evidence a lurch forward and change in speed of 5 to 8 kmph meets threshold at which whiplash injury can occur; injury sustained by the claimant a result of or caused by the collision; injury sustained by claimant was caused by a motor accident.

Decision date: 16 March 2026| Senior Member: Susan McTegg

Allianz Australia Insurance Limited v Buttigieg [2026] NSWPIC 167

Motor Accident Injuries Act 2017; settlement approval sought under section 6.23(2)(b); accident as driver; claimant trapped in car; sustained left ankle, lower back fracture, lacerations and psychological conditions; insurer’s independent medical examiner assessed she is not entitled to non-economic loss but with continuing pain; one week off work but claimant informed the Personal Injury Commission (Commission) that she is permanently restricted in her pre-injury duties; reason for returning to work was pressure from her then employer; claimant accepted insurer’s offer; Commission would not approve agreed figure; claimant expressed herself as having agency to decide on accepting settlement; stood over so claimant could seek legal advice and negotiated with insurer to increase offer; insurer declined last claimant offer; settlement was not fair, just and reasonable; Held – settlement not approved.

Decision date: 17 March 2026| Member: Terence O'Riain

Allianz Australia Insurance Limited v Grubb [2026] NSWPIC 168

Motor Accident Injuries Act 2017; settlement approval; damages limited to past and future economic; claimant injured her right wrist in the accident; she made a good recovery from her injury; she has some stiffness and a feeling of tightness when picking up grandchildren but otherwise copes well; claimant had recently retired before the accident; insurer made an allowance for past and future economic loss; Held – settlement approved under section 6.23(2)(b) in the sum of $18,000; amount within the range of settlement expected if assessed by a Member in the Personal Injury Commission;  satisfied that the settlement is just, fair and reasonable.

Decision date: 17 March 2026| Member: Elyse White

AAI Limited t/as AAMI v Poudel [2026] NSWPIC 172

Motor Accident Injuries Act 2017; settlement approval; claimant was injured and was working at the time of the accident; claimant is aware no entitlement to future statutory benefits once settlement is approved; settlement complies with clause 7.37 of the Motor Accident Guidelines (version 9.3); Held – settlement approved in the amount of $85,000.00, consisting of nil non-economic loss, past economic loss of $5,000.00, and $80,000.00 future economic loss.

Decision date: 18 March 2026| Member: Philip Carr

Workers Compensation non-Presidential Member Decision

Neaves v Campbelltown City Council [2026] NSWPIC 162

Workers Compensation Act 1987; hearing loss; whether the applicant was engaged in noisy employment with the respondent over the course of his 14 years primarily engaged as a parking patrol officer; applicant worked for the respondent as a parking patrol specialist for a period of 14 years; he claims to have been exposed to excessive noise in the course of that employment, which he alleges was employment to which the nature of his hearing loss was due; respondent denies liability and alleges it was not a noisy employer as that term is relevantly defined; Held – applicant carries the onus of proving the employment was noisy; it is necessary that there be evidence brought concerning the tendency, incidents or characteristics of the relevant employment, so as to determine whether the employment was one to the nature of which the injury was due; Blayney Shire Council v Lobley & Anor applied; the fact-finding exercise does not require the employment to have actually caused the injury; it is not necessary in every case for expert evidence of the actual noise levels to led, however, there must be sufficient evidence on which to find the employment was relevantly noisy; evidence discloses the applicant was periodically exposed to noisy traffic in the course of his employment, however, there is insufficient evidence to establish that exposure was either loud enough or of a sufficient duration to cause the applicant’s hearing loss; both independent medical examiners agree is a baseline of 85dB for eight hours per day; any exposure above 85dB was intermittent and of relatively short duration; the applicant has not discharged the onus of proving the employment was to the nature of which his injury was due; award for the respondent.

Decision date: 11 March 2026| Member: Cameron Burge

Jajaw v State of New South Wales (NSW Police Force) [2026] NSWPIC 166

Workers Compensation Act 1987; claim for section 60 expenses for consequential cervical spine condition as a result of accepted psychological injury; prior motor vehicle accident for which damages paid for neck injury; section 151A argument; Held – applicant suffered separate consequential cervical spine condition, subsequent to motor vehicle accident; award for applicant pursuant to section 60.

Decision date: 16 March 2026| Member: Michael Wright

Whittaker v Wilson & Anor [2026] NSWPIC 169

Workers Compensation Act 1987; permanent impairment; medical expenses and weekly compensation claim; applicant suffered an accepted right knee injury; claimant also claimed to have suffered low back and neck injuries in the same injurious event together with a consequential condition in the lumbar spine and a consequential sleep disorder; Held – applicant suffered a consequential condition to the lumbar spine as a result of the accepted right knee injury; award for the respondent on the claimed consequential sleep disorder; right knee injury and lumbar spine consequential condition remitted to the President for referral to Medical Assessor; awards for the respondent on the claimed injuries to the cervical spine, lumbar spine and the consequential sleep disorder; weekly payments and medical expenses claims adjourned for further preliminary conference upon issuing of a Medical Assessment Certificate.

Decision date: 17 March 2026| Member: Cameron Burge

Motor Accidents Medical Review Panel Decisions

Brennan (Nee Eley) v Allianz Australia Insurance Limited [2026] NSWPICMP 174

Motor Accident Injuries Act 2017; assessment of threshold injury; assessment of degree of permanent impairment; whiplash injury to the cervical spine with C5/6 Disc bulge and non-verifiable radiculopathy; left shoulder post traumatic stiffness; rear end collision; broad-based disc protrusion with spinal canal narrowing without nerve root impingement; contemporaneous complaints of a cervical injury; limitation of shoulder movement; Nguyen v The Motor Accidents Authority of NSW & Zurich Australian Insurance Ltd applied; trapezial muscle pain; Held –  whole person impairment assessed at 10%.

Decision date: 5 March 2026 | Panel Members: Member Hugh Macken, Dr Drew Dixon, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb

CAN v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 181

Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor vehicle accident when his vehicle was hit by a car from behind and he sustained both physical and psychiatric injury; dispute arose as to the claimant’s WPI as a result of psychiatric injury; MA determined the claimant’s WPI  assessed at 7%; claimant sought a review of the assessment under section 7.26; Review Panel re-examined the claimant; Held – Review Panel revoked certificate of the original MA; substituted determination of 6% WPI.

Decision date: 6 March 2026| Panel Members: Member Terence Stern OAM, Dr Ronald Gill, and Dr Gerald Chew| Injury module: Mental and Behavioural

Insurance Australia Limited t/as NRMA Insurance & Anor v McCarthy [2026] NSWPICMP 184

Motor Accident Compensation Act 1999; treatment dispute; psychological injury; post-traumatic stress disorder; medicinal cannabis; causation; reasonable and necessary; joinder of Lifetime Care and Support Authority; claimant sustained injury in a motor vehicle accident on 11 April 2019 whilst riding his motor bike; claimant was diagnosed with post-traumatic stress disorder; dispute as to whether medicinal cannabis reasonable and necessary and whether causally related to injury sustained in the accident; Medical Assessor (MA) had determined the prescription of medicinal cannabis was reasonable and necessary in the circumstances and related to injury caused by the accident; Held – best available evidence does not support use of medical cannabis for post-traumatic stress disorder;  claimant had a pre-existing generalised anxiety disorder; approval was for the treatment of anxiety; limited clinical benefit from use of medicinal cannabis; short term benefit does not outweigh the adverse effects; certificate of the original MA revoked; medicinal cannabis not related to the injury caused by the accident and not reasonable and necessary in the circumstances.

Decision date: 12 March 2026| Panel Members: Senior Member Susan McTegg, Dr John Baker, and Dr Surabhi Verma| Treatment Type: Medication - Prescription

Veljanovski v Allianz Australia Insurance Limited [2026] NSWPICMP 185

Motor Accident Injuries Act 2017; claimant’s application for review of Medical Assessor’s (MA) determination of permanent impairment; whether the accident caused injuries to the neck, lower back, knees and shoulders; where injuries in the form of fractures to the left hip and pelvis were not referred to the MA for assessment; where the claimant requested the Review Panel to assess the non-referred injuries; Mandoukos v Allianz Australia Insurance Ltd applied; where during the course of the review the insurer agreed to the non-referred injuries forming part of the dispute and to be assessed by the Review Panel; Held – original assessment of permanent impairment of 9% revoked and replacement certificate issued with a finding of permanent impairment of 12%.

Decision date: 12 March 2026| Panel Members: Member Maurice Castagnet, Dr Drew Dixon, and Dr Thomas Rosenthal| Injury module: Spine, Upper Limb, and Lower Limb

AAI Limited t/as AAMI v Zawit [2026] NSWPICMP 186

Motor Accident Injuries Act 2017; section 3.24; claim for statutory benefits for payment of treatment and care expenses; dispute about whether physiotherapy for the lumbar spine indicated in a request is reasonable and necessary in the circumstances; whether it relates to the injury caused by the accident; where the claimant has had physiotherapy treatment for about three years since the accident without sustained improvement of the lumbar spine symptoms; Held – certificate of the original Medical Assessor’s finding that the proposed treatment is reasonable and necessary in the circumstances and is related to the injuries caused by the accident, is revoked.

Decision date: 12 March 2026| Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr Margaret Gibson| Treatment type: Physiotherapy treatment

Ali v QBE Insurance (Australia) Limited [2026] NSWPICMP 189

Motor Accident Injuries Act 2017; application for review by claimant of a certificate and reasons of Medical Assessor (MA) finding that the claimant had an adjustment disorder with anxiety and depressed mood giving rise to a whole person impairment of 5%; claimant was injured in a motor-vehicle accident on 5 June 2020 when crushed between the bumper bar of two cars requiring surgery and an internal fixation of his right tibia; claimant had suffered an earlier motorbike accident on 8 December 2019 leaving him with a traumatic brain injury which affected his subsequent recovery from the accident of 5 June 2020; Held – Review Panel determined that the claimant had suffered a somatic symptom disorder with predominant pain; whole person impairment assessed at 0%; certificate and reasons of the original MA revoked.

Decision date: 13 March 2026| Panel Members: Member Alexander Bolton, Dr Wayne Mason, and Dr Alan Doris | Injury module: Mental and Behavioural

Chih v AAI Limited t/as AAMI [2026] NSWPICMP 190

Motor Accident Injuries Act 2017; review of medical assessment; whether a psychological injury caused by the motor accident is a threshold injury; original Medical Assessor found a non-threshold injury; consideration of whether the claimant suffered a non-threshold injury at any point since the motor accident; trauma symptoms mild and did not meet threshold for a DSM-5 diagnosis; Held – adjustment disorder found (resolved) which is a threshold injury; Medical Certificate revoked.

Decision date: 13 March 2026 | Panel Members: Member Elizabeth Medland, Dr Christopher Rikard-Bell, and Dr Ankur Gupta | Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Gordon [2026] NSWPICMP 191

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute regarding psychological injury; consideration of pre-existing impairment and subsequent accident; Slade v Insurance Australia Ltd (t/as NRMA Insurance), and State Government Insurance Commission v Oakley (Oakley) considered and applied; claimant examined by Medical Assessors on Review Panel; Held – Review Panel satisfied claimant had a pre-existing impairment; diagnosis of post-traumatic stress disorder caused by the accident; Review Panel assessed nil deficit due to pre-existing impairment and therefore no apportionment made; Review Panel assessed 8% permanent impairment caused by the accident, which is not greater than 10%; Review Panel found second principle in Oakley applicable therefore any additional impairment caused by subsequent accident is said to have been caused by the accident; MAC revoked; new certificate issued.

Decision date: 13 March 2026 | Panel Members: Member Bianca Montgomery-Hribar, Dr Singh Himanshu, and Dr Melissa Barrett | Injury module: Mental and Behavioural

Insurance Australia Limited t/as NRMA Insurance v Kang [2026] NSWPICMP 200

Motor Accident Injuries Act 2017; Medical Review Panel; lumbar spine; cervical spine; right shoulder; whole person impairment (WPI); inconsistency; causation; claimant suffered injury in a rear end collision on 1 June 2022; Medical Assessor (MA) certified 17% WPI for injury to lumbar spine; injury to cervical spine; injury to right shoulder; insurer sought review; Held – inconsistencies in presentation; Briggs v IAG Limited Trading as NRMA Insurance applied; claimant sustained injury to cervical spine, lumbar spine and SLAP lesion of the right shoulder caused by the accident; lumbar spine assessed as DRE category I or 0% WPI; cervical spine assessed as DRE category II or 5% WPI; due to inconsistency right shoulder assessed by analogy at 2% WPI; certificate of the original MA revoked, total assessed at 7% WPI.

Decision date: 17 March 2026 | Panel Members: Senior Member Susan McTegg, Dr Les Barnsley, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb

Insurance Australia Limited t/as NRMA Insurance v Zaringhabei [2026] NSWPICMP 203

Motor Accident Injuries Act 2017; assessment of whole person impairment for psychiatric impairment injury; claimant presented with pre-existing psychological conditions based on trauma, asylum seeker and depression; claimant’s history to Medical Assessors of pre-existing condition and post-accident symptoms inconsistent with records; Review Panel did not accept uncorroborated claimant’s account; acceptance of aggravation dependent upon acceptance of claimant; Whisprun Pty Ltd v Dixon considered; history of pre-accident psychological symptoms; post-accident moving and financial activity inconsistent with claimant’s account; not seeking treatment post-accident; Review Panel not satisfied that accident caused or aggravated pre-existing psychiatric condition; no assessment of permanent impairment required; Held – original assessment revoked.

Decision date: 18 March 2026 | Panel Members: Member Terence O'Riain, Dr Christopher Canaris, and Dr Surabhi Verma | Injury module: Mental and Behavioural

Enwiya v AAI Limited t/as AAMI [2026] NSWPICMP 204

Motor Accident Injuries Act 2017; motor accident; sideswipe collision; issue of threshold physical injury; original Medical Assessor found threshold injuries; pre-existing history of back, neck and shoulder symptoms; post-accident scans showed bilateral shoulder tears in context of degenerative pathology; tears likely pre-existed accident given long history of symptoms and presence amongst degenerative pathology; Review Panel not satisfied that shoulder tears caused or aggravated by the motor accident; cervical radiculopathy; objective signs as defined by the Motor Accidents Guidelines can be present at any time; David v Allianz Australia Ltd applied; clinical records and reports do not show sensory loss referable to an appropriate spinal nerve root distribution; complaints of pain not radiculopathy; not satisfied that motor accident caused any change in pathology; Held – original assessment confirmed.

Decision date: 18 March 2026 | Panel Members: Principal Member John Harris, Dr Shane Moloney, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb

Workers Compensation Medical Appeal Panel Decisions

McNeill v Freestyle Kings Pty Ltd [2026] NSWPICMP 182

Workplace Injury Management and Workers Compensation Act 1998; both parties appealed against medical assessment; worker submitted the ratings of the Medical Assessor (MA) in the psychiatric impairment rating scale categories of self-care and personal hygiene, social and recreational activities, and social functioning involved error; insurer contended that the MA did not disregard the worker’s symptoms and impairments resulting from an agreed secondary psychological injury, or alternatively did not explain how he had disregarded those symptoms and impairments when assessing the worker’s impairment from his primary psychological injury; Held – MA did not cogently explain how he had disregarded worker’s symptoms and impairments from an agreed secondary  psychological injury, and that was an error amounting to a demonstrable error; worker re-examined; Medical Assessment Certificate revoked.

Decision date: 11 March 2026 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Dr Michael Hong | Injury module: Psychological/Psychiatric

Blacktown City Council v Dous [2026] NSWPICMP 183

Workplace Injury Management and Workers Compensation Act 1998;  appeal by employer against findings in psychiatric impairment rating scale categories for social and recreational activities, social functioning, travel, concentration, persistence and pace; whether history taken by Medical Assessor (MA) contradicted earlier statement; social functioning; whether alleged improvement in relationships ignored by MA; whether recent trip to the US warranted a class 1 rating; whether MA ignored claimant’s ability to concentrate during the assessment; Held – alleged contradiction in social and recreational activities dismissed; no factual basis for allegation in social functioning, concentration, persistence, and pace submissions misconceived; Abdal v Insurance Australia Limited t/as NRMA Insurance, and Ferguson v State of New South Wales considered and applied; MA explained his rating in ignoring trip to US in travel; Chapter 11.12 of the Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed, 1 March 2021 applied; Medical Assessment Certificate confirmed.

Decision date: 11 March 2026 | Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Michael Hong | Injury module: Psychological/Psychiatric

State of New South Wales (South Western Sydney Local Health District) v Badman [2026] NSWPICMP 187

Workplace Injury Management and Workers Compensation Act 1998; appeal against Medical Assessor’s (MA) assessment of a 10% deduction to be applied pursuant to section 323 to his otherwise unchallenged assessments as to the respondent’s whole person impairments; error found due to the MA’s failure to adequately consider ‘relevant and significant material’; MA failed to explain his actual path of reasoning in sufficient detail; there being more than a ‘mere difference of opinion on a subject about which reasonable minds may differ’ when considering the MA’s application of section 323; Ferguson v State of New South Wales, Cole v Wenaline Pty Limited, Bojko v ICM Property Service Pty Ltd, Merza v Registrar of the Workers Compensation Commission, Campbelltown City Council v Vegan, Fire & Rescue NSW v Clinen, Ryder v Sundance Bakehouse, Tattersall v Registrar of the Workers Compensation Commission of NSW and Anor, and Wingfoot Australia Partners Pty Ltd v Kocak considered; Held – on re-assessment, deduction to be applied pursuant to section 323 found to be one-third; Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 12 March 2026 | Panel Members: Member Gaius Whiffin, Dr Doron Sher, and Dr David Crocker | Injury module: Right Lower Extremity, and Scarring (TEMSKI)

Camden Council v Ross [2026] NSWPICMP 188

Workplace Injury Management and Workers Compensation Act 1998; medical disputes relating to degree of permanent impairment of the respondent’s left lower extremity (ankle and hip), lumbar spine, ear nose throat and related structures (temporomandibular joint dysfunction), and scarring; matter referred to two Medical Assessors to assess; appellant appealed against both medical assessments, relying only on ground for appeal provided in section 327(3)(b) with respect to one medical assessment, and on grounds for appeal provided in section 327(3)(c) and (d) with respect to other medical assessment; Held – section 327(3)(b) established and section 327(3)(d) established; respondent re-examined; Medical Assessment Certificate revoked.

Decision date: 12 March 2026 | Panel Members: Member Marshal Douglas, Dr Gregory McGroder, and Dr Malcolm Linsell| Injury module: Left Lower Extremity, Lumbar Spine, Scarring and ENT and related structures - temporomandibular joint dysfunction

CBE v CTT [2026] NSWPICMP 192

Workplace Injury Management and Workers Compensation Act 1998; Medical Appeal Panel; section 327(3) s 58(1)(a); Personal Injury Commission Act 2020; Personal Injury Commission Rules 2021; rules 131(1) and 132; demonstrable error; incorrect criteria; de-identification; Jenkins v Ambulance Service of New South Wales, Ferguson v State of New South Wales, and Wingfoot Australia Partners Pty Ltd v Kocak considered and applied; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 13 March 2026 | Panel Members: Member John Turner, Dr Graham Blom, and Dr Ash Takyar | Injury module: Psychological/Psychiatric

Stuart v Federation Council [2026] NSWPICMP 193

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

Decision date: 13 March 2026 | Panel Members: Member John Turner, Dr Michael Hong, and Dr Graham Blom | Injury module: Psychological/Psychiatric

Gibbs v State of New South Wales (NSW Police Force) [2026] NSWPICMP 194

Workplace Injury Management and Workers Compensation Act 1998; whether the ratings of the Medical Assessor (MA) of the appellant’s impairment in social and recreational activities, travel, concentration, persistence and pace accorded with the evidence and the history the MA obtained; Held – Appeal Panel found no error with the MA’s ratings of appellant’s impairment in social and recreational activities, but found the MA’s ratings of the appellant’s impairment in travel and in concentration, persistence and pace did not accord with the evidence; Medical Assessment Certificate revoked

Decision date: 16 March 2026 | Panel Members: Member Marshal Douglas, Dr John Baker, and Dr Ash Takyar | Injury module: Psychological/Psychiatric

Osman v State of New South Wales (NSW Police Force) [2026] NSWPICMP 196

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; lump sum claim; appellant worker challenged assessment in four of the six psychiatric impairment rating scale categories- self-care and personal hygiene, travel, concentration, persistence and pace and employability; Held – error found and re-examination considered necessary in the circumstances of a finding of error; Medical Assessment Certificate revoked.

Decision date: 16 March 2026 | Panel Members: Member Jane Peacock, Dr Graham Blom, and Dr Ash Takyar | Injury module: Psychological/Psychiatric

Reilly v State of New South Wales (NSW Police Force) [2026] NSWPICMP 197

Workplace Injury Management and Workers Compensation Act 1998; appeal from assessment of Medical Assessor; psychological injury; whether demonstrable error or application of incorrect criteria made out; Ferguson v State of New South Wales considered and applied; Held – no error established, Medical Assessment Certificate confirmed.

Decision date: 16 March 2026 | Panel Members: Member Mitchell Strachan, Professor Nicholas Glozier, and Dr John Lam-Po-Tang | Injury module: Psychological/Psychiatric

El Saleh v C & M Associates Pty Ltd [2026] NSWPICMP 198

Workplace Injury Management and Workers Compensation Act 1998; lump sum claim for injury to cervical spine and left upper extremity (shoulder); worker appealed the assessment of the left upper extremity; complained on appeal that Medical Assessor (MA) did not apply correct criteria; Held –Appeal Panel found no error; Medical Assessment Certificate must be read as a whole and the MA has applied his clinical expertise to his findings on the day of examination in accordance with correct criteria; Medical Assessment Certificate confirmed.

Decision date: 16 March 2026 | Panel Members: Member Jane Peacock, Dr Drew Dixon, and Dr Andrew Porteus | Injury module: Left Upper Extremity, and Cervical Spine

Secretary, Department of Communities and Justice v Cotic [2026] NSWPICMP 199

Workplace Injury Management and Workers Compensation Act 1998; whether the Medical Assessor (MA) erred by not making a deduction under section 323(1); Appeal Panel found MA erred because the evidence demonstrated that the respondent had a pre-existing condition and that a proportion of her permanent impairment from her injury was due to that pre-existing condition; Held – Medical Assessment Certificate revoked.

Decision date: 16 March 2026 | Panel Members: Member Marshal Douglas, Dr Douglas Andrews, and Professor Nicholas Glozier | Injury module: Psychological/Psychiatric

Ability Options Limited v Clarke [2026] NSWPICMP 202

Workplace Injury Management and Workers Compensation Act 1998; appeal on grounds of availability of additional relevant information; assessment being made on basis of incorrect criteria and demonstrable error;  Medical Assessor (MA) assessed 12% whole person impairment of the lumbar spine; 3% WPI of the right upper extremity; fresh evidence not received into evidence as Appeal Panel satisfied that the fresh evidence was available to the appellant before the assessment by the MA; Appeal Panel satisfied that the MA did not err in not making a deduction pursuant to section 323 in respect of the lumbar spine; Appeal Panel satisfied that the subsequent injury amounted to no more than an aggravation of the work injury; Johnson v NSW Workers Compensation Commission considered and applied; Held –  Medical Assessment Certificate confirmed.

Decision date: 17 March 2026 | Panel Members: Member Carolyn Rimmer, Dr Todd Gothelf, and Dr Christopher Oates | Injury module: Lumbar Spine

Motor Accidents Merit Review Decisions

Turudic v Allianz Australia Insurance Limited [2026] NSWPICMR 8

Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about amount of claimant’s pre-accident weekly earnings (PAWE); claimant had ceased employment about nine months before the accident; set up a corporation and worked for that corporation; parties agreed the claimant’s earning circumstances had changed significantly within the meaning of schedule 1, clause 4(3) of the Act and that the method of calculation of PAWE is set out in clause 4(2)(b); Held – insurer and claimant referred to clause 4(2)(b) as passed in 2017 and not as amended in 2023; significant difference in the method of calculation; gross earnings received meant paid; Kipkorir v QBE applied; claimant was independent contractor working in a corporate structure and basis of PAWE begins with earnings of company less expenses of company; Insurance Australia Limited t/as NRMA v Iskander, and Sidebottom v AAI Limited t/as AAMI applied; insurer’s decision set aside and matter remitted to insurer for reconsideration pursuant to section 7.13(3)(d).

Decision date: 12 March 2026 | Merit Reviewer: Belinda Cassidy

Lee v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMR 9

Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about calculation of pre-accident weekly earnings (PAWE); clause 4(1); whether sufficient evidence to determine PAWE; onus of proof; inconsistencies in evidence; reconstruction of documents; contemporaneous evidence; whether evidence truthful, reliable and cogent; Held – reviewable decision is affirmed.

Decision date: 18 March 2026 | Merit Reviewer: Katherine Ruschen

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