Legal Bulletin No. 257

Issued 24 April 2026

Welcome to the two hundred and fifty-seventh 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

Angileri v Allianz Australia Insurance Limited [2026] NSWPIC 139

Motor Accident Injuries Act 2017; motor vehicle accidents in 2019 and 2021; medical assessment of permanent impairment (2019 accident/GIO claim) and threshold injury (2021 accident/Allianz claim); reviews heard together; original whole permanent impairment assessment greater than 10%; surveillance then obtained by insurer; issue of admission of surveillance on both reviews pursuant to rule 109 of the Personal Injury Commission Rules; admitting party must show exceptional circumstances; application of test in San v Rumble requires “unusual or out of the ordinary”; surveillance undertaken in August and November 2024 is inconsistent with histories recorded by original Medical Assessor in July 2024; inconsistencies constitute exceptional circumstances; Held – surveillance admitted and considered by Review Panel; claimant provided with notice of ruling and provided an opportunity to admit evidence in response and prior to examination.

Decision date: 27 February 2026| Principal Member: John Harris

Singh v QBE Insurance (Australia) Limited [2026] NSWPIC 186

Motor Accident Injuries Act 2017; damages assessment pursuant to section 7.6; separate hearing on liability with assessment on the papers requested by the parties; claimant asserted he entered an intersection with a green light and the insured, travelling in the opposite direction, disobeyed a red arrow when turning across the claimant’s path of travel thereby breaching his duty of care to the claimant; insured asserted he had a green arrow sanctioning his entry into the intersection; both parties had expert evidence who generally agreed on analysis of the speed of both vehicles at impact; some aspects of both experts’ evidence rejected but insured version preferred as corroborated by his passenger with certain aspects of the claimants evidence found to be unreliable; Held – accident was caused by claimant proceeding through a red light and failing to keep a proper lookout which had he done so could have avoided the accident regardless of the colour of the traffic lights he was facing; claimant has no entitlement to damages; costs not awarded in favour of claimant.

Decision date: 1 April 2026 | Member: Terrence Broomfield

AAI Limited t/as AAMI v Lines [2026] NSWPIC 201

Motor Accidents Compensation Act 1999; claims assessment dispute about the amount of damages to be paid to the claimant under section 94(5); claimant was riding his bicycle through a roundabout when he was struck by the insured motor vehicle; claimant sustained  grade 4 AC joint dislocation of the left shoulder; claimant employed as a site engineer at the time of the accident and was also working as an infantry officer in the Army Reserve; claimant was unable to continue his career with the Army Reserve and also determined he suffered an ongoing diminution in his earning capacity as an engineer; insurer admitted liability and no allegation of contributory negligence claim for non-economic loss, past and future economic loss, past and future care; Held – claimant is entitled to damages for non-economic loss, past and future economic loss, past and future care.

Decision date: 9 April 2026 | Member: David Ford

Thompson v Allianz Australia Insurance Limited [2026] NSWPIC 202

Motor Accident Injuries Act 2017 (MAI Act); Civil Liability Act 2001; miscellaneous claims dispute; whether claimant wholly or mostly at fault; insured vehicle turning right at intersection; claimant travelling straight in opposite direction; night-time; both parties with green light to proceed; no right turn green arrow for insured;  collision in intersection; claimant found to be travelling at an excessive speed; not reasonably foreseeable that an approaching vehicle would be travelling at excessive speed; contributory negligence assessed at 67%; claimant mostly at fault; consideration of claim for exceptional costs under section 8.10(4) of the MAI Act; exceptional circumstances not present; AAI Ltd t/as Evic, Insurance Australia Limited t/as NRMA v Richards, Allianz Australia Insurance Limited v Shuk, Ayre v Swan, and AAI Ltd trading as GIO v Moon considered; Held – regulated costs awarded.

Decision date: 9 April 2026 | Member: Elizabeth Medland

Workers Compensation non-Presidential Member Decisions

Dunphy v City of Canda Bay Council [2026] NSWPIC 199

Workers Compensation Act 1987; claim for right total hip replacement pursuant to section 60; weekly compensation; whether right hip condition results from accepted left hip injury; Held – applicant sustained a right hip injury as a result of the accepted left hip injury on 30 June 2022; respondent is to pay weekly compensation and medical or related expenses including the costs of the right total hip replacement on 14 August 2025.

Decision date: 8 April 2026 | Member: Fiona Seaton

Kim v Koen Pty Ltd [2026] NSWPIC 200

Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); section 4 of the 1987 Act; Kooragang Cement Pty Ltd v Bates, and Briginshaw v Briginshaw considered; Held – there is an award for the respondent in respect to the alleged injury to the cervical spine/neck, lumbar spine/lower back, left shoulder and right knee on 14 October 2022; matter remitted to the President for referral to a Medical Assessor pursuant to section 321 of the 1998 Act for assessment.

Decision date: 8 April 2026| Member: John Turner

Pohutuhutu v Cobar Shire Council & Anor [2026] NSWPIC 205

Workplace Injury Management and Workers Compensation Act 1998; lump sum claim; undisputed psychological injury in employment of first respondent; first respondent sought to attribute liability to pay compensation to the second respondent; the highest that can be put on the evidence when the totality of the evidence is weighed in the balance including all of the expert medical opinions is that the applicant’s psychological injury was aggravated in the employment of the second respondent but the contribution of employment to the aggravation was a minor one; cannot be considered a substantial contributing factor to the aggravation and cannot be considered the major contributing factor to an aggravation; this is based on the expert medical opinion weighed in the balance with the applicant’s own evidence; no injury in the employment of the second respondent and results in an award in favour of the second respondent; Held – matter remitted to the President for referral to a Medical Assessor.

Decision date: 9 April 2026| Member: Jane Peacock

Taysi v Bega Dairy and Drinks Services Pty Ltd [2026] NSWPIC 206

Workers Compensation Act 1987; permanent impairment compensation; applicant suffered accepted injury by way of bilateral hernia which do not sound in permanent impairment compensation; applicant also claims bilateral hip injuries; no issue claimant has pathological changes in his hips, however, the issue is whether the nature and conditions of his employment were the main contributing factor to the onset of those changes; applicant had worked for over 25 years as a machine operator, carrying out heavy and repetitive work; on balance, having regard to a commonsense evaluation of the totality of the evidence relating to causation, the applicant’s employment was the main contributing factor to his bilateral hip injury; Held – matter remitted to the President for referral to a Medical Assessor.

Decision date: 9 April 2026| Member: Cameron Burge

Motor Accidents Medical Review Panel Decisions

AAI Limited t/as GIO v Angileri [2026] NSWPICMP 148

Motor Accident Injuries Act 2017; motor accident on 24 June 2019; claimant driving when the insured vehicle turned in front resulting in a T-bone collision; assessment of whole person impairment (WPI) for psychological injuries previously found as post-traumatic stress disorder; subsequent motor accident in 2021 found to have aggravated post-traumatic stress disorder; review of that medical assessment; both reviews heard together; claimant is a treating psychologist working on reduced hours; concurrent pain condition not explicable by radiology; somatic symptom disorder not assessable as part of permanent impairment; improvement in functionality shown by surveillance since original medical assessment; claimant assessed at 7% WPI; 2021 motor accident did not contribute to assessment; no deduction pursuant to clause 6.34 of the Motor Accident Guidelines; Held – original assessment revoked; certificate issued for psychological injury not greater than 10%.

Decision date: 27 February 2026| Panel Members: Principal Member John Harris, Dr Matthew Jones, and Dr Ronald Gill| Injury module: Mental and Behavioural

Angileri v Allianz Australia Insurance Limited [2026] NSWPICMP 149

Motor Accident Injuries Act 2017; motor accident on 19 December 2021; rear end collision; issue of threshold psychological injury; prior motor accident in 2019 found to have caused post-traumatic stress disorder (PTSD); related review of medical assessment for 2019 motor accident of assessment of permanent impairment; both reviews heard together; findings made that 2021 exacerbated PTSD and aggravated somatic symptom disorder with predominant pain; aggravation or exacerbation of a psychological injury a further injury for the purposes of the Act; sufficient that there is an increase in symptoms and further loss of functioning in the past; Held – original assessment confirmed with additional diagnosis of aggravation of somatic symptom disorder with predominant pain.

Decision date: 27 February 2026| Panel Members: Principal Member John Harris, Dr Matthew Jones, and Dr Ronald Gill| Injury module: Mental and Behavioural

Insurance Australia Limited t/as NRMA Insurance v Noshad [2026] NSWPICMP 222

Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by medical assessor (MA); claimant injured in motor vehicle accident of 2 July 2022 when the vehicle she was driving was hit from behind; claimant sustained both physical and psychiatric injury; dispute arose as to the claimant’s WPI as a result of physical injury; MA determined the claimant’s WPI at 13%; claimant sought a review of the assessment under section 7.26 of the Act; Review Panel re-examined the claimant on 30 January 2026; Held – Review Panel revoked certificate of the MA; substituted determination of 9% WPI.

Decision date: 26 March 2026| Panel Members: Member Terence Stern OAM, Dr Mohammed Assem, and Dr Margaret Gibson| Injury module: Spine, Upper Limb, and Lower Limb

Michailidis v AAI Limited t/as GIO [2026] NSWPICMP 249

Motor Accident Injuries Act 2017; review application of medical assessment certificate under section 7.26; dispute about whether the injuries caused by the accident were threshold injuries; where the original Medical Assessor found that the injuries referred for assessment to be threshold injuries; re-examination by the Review Panel; where the Review Panel reached different conclusions on causation of some injuries but ultimately found all referred injuries to be threshold injuries; Held – original medical assessment certificate revoked; replacement certificate issued.

Decision date: 9 April 2026| Panel Members: Member Maurice Castagnet, Dr David Gorman, and Dr Shane Moloney | Injury module: Spine, Upper Limb, and Lower Limb

AAI Limited t/as AAMI v JAA [2026] NSWPICMP 250

Motor Accident Injuries Act 2017; threshold injury review of certificate and reasons of Medical Assessor (MA) who found the claimant had a diagnosis of post-traumatic stress disorder (PTSD) and that this was not a threshold injury; claimant is an infant involved in an accident in December 2021 when a utility vehicle collided with the rear of a car driven by the claimant’s mother and smashing the rear window; claimant was seven years old at the time of the accident; submission by the insurer that the claimant’s mother was providing an incorrect history on behalf of the claimant but the Review Panel was not satisfied this was correct; marked increase by the claimant of absences from school following the accident; claimant involved in another motor vehicle accident when a telephone pole fell onto the roof of a car in which she was travelling with a short-term aggravation of her complaints then returning her level of disability following the first accident; Review Panel concluded the claimant was suffering from PTSD and finding that this was a non-threshold injury; Held – certificate of original MA affirmed.

Decision date: 9 April 2026| Panel Members: Member Alexander Bolton, Dr Paul Friend, and Dr Thomas Newlyn| Injury module: Mental and behavioural

Shaw v Allianz Australia Insurance Limited [2026] NSWPICMP 252

Motor Accident Injuries Act 2017; review of Medical Assessor’s (MA) determination of permanent impairment for psychological injury under section 7.26; where the Medical Assessor found that the claimant suffered from a post-traumatic stress disorder (PTSD) caused by the motor accident giving rise to a whole permanent impairment (WPI) of 8%; claimant re-examined by the Review Panel; where the Review Panel also found that the claimant suffered from PTSD caused by the motor accident; gave rise to a WPI of 15%; pre-existing bipolar disorder and substance use in remission; no apportionment for pre-existing psychological impairment; Held – the certificate of the MA is revoked.

Decision date: 10 April 2026| Panel Members: Member Maurice Castagnet, Dr Christopher Rikard-Bell, and Dr Ronald Gill| Injury module: Spine, Upper Limb, Lower Limb, and Digestive System

AAI Limited t/as GIO v Bustescu [2026] NSWPICMP 253

Motor Accidents Injuries Act 2017; threshold injury dispute; psychiatric injury; claimant was a pedestrian stepping off a kerb when he was struck by a vehicle; physical injuries assessed by the Personal Injury Commission as threshold injuries; original Medical Assessment Certificate (MAC) found that there was a somatic symptoms disorder that was aggravated by the motor accident; Review Panel accepted Medical Assessor’s finding that the claimant’s accident-related physical injuries were threshold injuries and therefore there could not be a somatic symptoms disorder; Review Panel found multiple situational stressors which caused the claimant’s depressive symptoms, none of which had any causal connection with the motor accident; Held – nil psychiatric injuries causally related to the motor accident; original MAC revoked; new certificate issued.

Decision date: 10 April 2026| Panel Members: Member Jeremy Lum, Dr Christopher Rikard-Bell, and Dr Himanshu Singh| Injury module: Mental and behavioural

Li v Allianz Australia Insurance Limited [2026] NSWPICMP 254

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); physical injuries assessment; claimant was a cycling through a roundabout when struck by a car; causation of injury not in dispute; claimant assessed by original Medical Assessor as having 9% whole person impairment (WPI) for fractured ankles requiring surgery, a knee laceration and scarring; Held – Review Panel assessed WPI of right ankle and hindfoot at 4%, left ankle and hindfoot at 4% and overall scarring at 3%; total combined impairment at 11% which is greater than 10%; MAC revoked; new certificate issued.

Decision date: 10 April 2026 | Panel Members: Member Jeremy Lum, Dr David Gorman, and Dr Rhys Gray| Injury module: Lower Limb, and Scarring

Insurance Australia Limited t/as NRMA Insurance v Carroll [2026] NSWPICMP 256

Motor Accident Injuries Act 2017; review of medical assessment of Medical Assessor (MA); whether the claimant’s whole person impairment (WPI) from psychological injury caused by the motor accident is greater than 10%; claimant injured as a child pedestrian in a motor accident; developed psychological symptoms thereafter with treatment; original MA found a WPI of 17% due to post-traumatic stress disorder (PTSD); Review Panel found PTSD in partial remission and persistent depressive disorder caused by the motor accident; causation established by clear temporal relationship between accident and the documented symptomatology; WPI assessed at 7%; presentation at assessment different than that found by original MA; WPI to be assessed on the basis of the evaluation at the time of the assessment; clause 6.21; Held – certificate revoked.

Decision date: 13 April 2026| Panel Members: Member Elizabeth Medland, Dr Surabhi Verma, and Dr Thomas Newlyn | Injury module: Mental and behavioural

Ismail v Allianz Australia Insurance Limited [2026] NSWPICMP 259

Motor Accident Injuries Act 2017; claimant’s application for review of Medical Assessor’s (MA) determinations of threshold injury and permanent impairment disputes; where the MA found that all physical injuries referred for assessment were threshold injuries and gave rise to a whole person impairment of 6%; re-examination by the Review Panel; Review Panel found the injury to the right shoulder being aggravation of a pre-existing rotator cuff supraspinatus tendon tear was a non-threshold injury; Review Panel found a higher assessment of the applicant’s WPI at 10%; Held – original certificate revoked; new certificate issued.

Decision date: 14 April 2026 | Panel Members: Member Maurice Castagnet, Dr Christopher Oates, and Dr Shane Moloney| Injury module: Spine, and Upper Limb

Allianz Australia Insurance Limited v Kvackovski [2026] NSWPICMP 260

Motor Accident Injuries Act 2017; medical assessment of threshold injury and whole person impairment (WPI); insurer’s application for review under section 7.26; issue regarding causation of left shoulder injury; previous motor vehicle accident; claimant re-examined; Held – accident could have and did aggravate his left shoulder symptomology, however Review Panel satisfied any injury to the left shoulder caused by the accident was a threshold injury; causation found in respect of other injuries; claimant’s total WPI not greater than 10%; certificate revoked and new certificate issued.

Decision date: 14 April 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr Margaret Gibson, and Dr Shane Moloney| Injury module: Spine, and Upper Limb

Insurance Australia Limited t/as NRMA v Pidgeon [2026] NSWPICMP 261

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant suffered psychiatric injuries when his truck was involved in a head on collision with a car and the car driver was instantly killed; claimant assessed by original Medical Assessor who diagnosed post-traumatic stress disorder (PTSD) and assessed a whole person impairment (WPI) at 17%; Review Panel agreed with the diagnosis of PTSD but disagreed with the impairment assessment; Review Panel not bound by histories or opinions previously obtained; clause 6.21 of the Motor Accident Guidelines referred to and applied; Held – Review Panel assessed WPI at 7% which is not greater than 10%; MAC revoked; new certificate issued.

Decision date: 14 April 2026 | Panel Members: Member Jeremy Lum, Dr John Baker, and Dr Christopher Canaris | Injury module: Mental and behavioural

Siu v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 263

Motor Accident Injuries Act 2017; section 1.6(3); medical review panel; whole person impairment (WPI); persistent depressive disorder with a persisting major depressive episode; self-care and personal hygiene; social functioning; concentration, persistence and pace; claimant was injured in a motor vehicle accident on 25 July 2023; Medical Assessor (MA) certified the claimant had sustained a 9% WPI as a result of post-traumatic stress disorder and major depressive disorder caused by the accident; claimant sought review; Held – claimant had persistent depressive disorder with a persisting major depressive episode caused by the accident; WPI assessed at 19% as result of injury caused by the accident.

Decision date: 15 April 2026 | Panel Members: Senior Member Susan McTegg, Dr Christopher Canaris, and Dr Steven Yeates| Injury module: Spine, Upper Limb, and Lower Limb

Workers Compensation Medical Appeal Panel Decisions

CGB v Secretary, Department of Education [2025] NSWPICMP 946

Workplace Injury Management and Workers Compensation Act 1998; appellant raised nine grounds of appeal; only 3 relating to the psychiatric impairment rating scale (PIRS) assessments; Appeal Panel found no error in first six grounds of appeal; no error in PIRS except for the category of concentration, persistence and pace; Held – Medical Assessment Certificate revoked.

Decision date: 3 December 2025 | Panel Members: Member Deborah Moore, Professor Nicholas Glozier, and Dr Graham Blom| Injury module: Psychological/Psychiatric

Secretary, Department of Education v Butfield [2026] NSWPICMP 247

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred by incorrectly rating the respondent’s impairment due to a resection arthroplasty; whether MA erred by failing to rate respondent’s impairment due from a brachial plexus injury; Held – MA erred on both issues; respondent re-examined; Medical Assessment Certificate revoked.

Decision date: 12 March 2026 | Panel Members: Member Marshal Douglas, Dr Drew Dixon, and Dr Tommasino Mastroianni| Injury module: Left upper extremity

Newman v Secretary, Department of Customer Service [2026] NSWPICMP 248

Workplace Injury Management and Workers Compensation Act 1998; Workers Compensation Act 1987 (1987 Act); worker suffered psychological injury assessed at 19%; accepted deemed date of injury with last employer; Medical Assessor (MA) assessed a one-tenth deduction resulting in a 17% whole person impairment (WPI) attributable to previous employment; appellant’s submission that determination of previous relevant employment was a matter for a Member rejected; plain words of section 68B meant that MA and Appeal Panel determines the issue when assessing section 323 deduction; reasoning in Fleming v NSW Police Force not relevant to construction of section 68B; Medical Assessment Certificate (MAC) contained demonstrable error by including previous relevant employment as basis for section 323 deduction contrary to section 68B of the 1987 Act; medical evidence and opinion of Appeal Panel that worker’s employment with Sheriff’s Office was previous relevant employment as defined in section 68B; Vannini v Worldwide Demolitions Pty Ltd applied; re-assessment on papers; no basis to make a deduction as finings of MA and records show previous employment basis for one-tenth deduction; Held – MAC revoked; no deduction made under section 323; appellant assessed at 19% WPI.

Decision date: 27 March 2026 | Panel Members: Principal Member John Harris, Dr Graham Blom, and Dr Douglas Andrews| Injury module: Psychological/Psychiatric

Deas v Nielsen Connect Australia Pty Ltd [2026] NSWPICMP 251

Workplace Injury Management and Workers Compensation Act 1998; worker submits that the Medical Assessment Certificate (MAC) contained demonstrable error and/or the application of incorrect criteria in assessment of the psychiatric impairment rating scale (PIRS) categories of social functioning, and concentration, persistence and pace; Parker v Select Civil P/L considered; Held – no demonstrable error or incorrect criteria in assessment of PIRS categories of social functioning and concentration, persistence and pace; MAC confirmed.

Decision date: 9 April 2026 | Panel Members: Member John Isaksen, Dr Douglas Andrews, and Dr Michael Hong | Injury module: Psychological/Psychiatric

Szombati v State of New South Wales (NSW Police Force) [2026] NSWPICMP 255

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of all six assessments under the psychiatric impairment rating scale (PIRS) categories; the challenged assessments under PIRS were all confirmed on appeal; Held – Medical Assessment Certificate confirmed.

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

David Jones Ltd v Mirhosseini [2026] NSWPICMP 262

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; appellant employer 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 (PIRS) categories, namely social and recreational activities and employability; the challenged assessments under PIRS were both revoked on appeal; Medical Assessment Certificate revoked.

Decision date: 14 April 2026 | Panel Members: Member Jane Peacock, Dr Ash Takyar, and Dr Douglas Andrews| Injury module: 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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