Legal Bulletin No. 260
This bulletin was issued on 15 May 2026
Issued 15 May 2026
Welcome to the two hundred and sixtieth 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
Hill v The A2 Milk Company (Australia) Pty Ltd [2026] NSWPICPD 19
Workers compensation; weekly compensation; section 46 of the Workers Compensation Act 1987; Held – Order 2 of the Certificate of Determination dated 5 September 2025 is revoked; the matter is remitted to another non-Presidential Member for further determination in accordance with these reasons.
Decision date: 5 May 2026| Before: Acting Deputy President Geoffrey Parker SC
Catholic Education Office ACT v Rees; Rees v Catholic Education Office ACT [2026] NSWPICPD 20
Workers compensation; section 352(4) of the Workplace Injury Management and Workers Compensation Act 1998; guiding principles under rule 133A of the Personal Injury Commission Rules 2021; extension of time to file appeal permitted; exceptional circumstances and demonstrable and substantial injustice; Lazio Formwork Pty Ltd v Kelly; Kelly v Lazio Formwork Pty Ltd [2023] NSWPICPD 40 considered and applied; psychological injury; section 11A of the
Workers Compensation Act 1987; the concept of reasonableness does not require a counsel of perfection; Van Vliet v Landscape Enterprises Pty Ltd [2022] NSWPICPD 49 considered and applied; reasonableness is a question of fact weighing all relevant factors; Northern NSW Local Health Network v Heggie [2013] NSWCA 255; decision maker required to explain fact finding process; Held – I extend time for the worker to file his appeal in A2-W2553/25 to 11 November 2025 pursuant to s 352(4)(b) of the WorkplaceInjury Management and Workers Compensation Act 1998; the Certificate of Determination dated 29 August 2025 is revoked. The matter is remitted to be heard and determined by another member.
Decision date: 6 May 2026| Before: President Judge Phillips
Motor Accidents non-Presidential Member Decisions
Miller v Nominal Defendant by its agent AAI Limited t/as AAMI [2026] NSWPIC 198
Motor Accident Injuries Act 2017; Personal Injury Commission Act 2020 (PIC Act); application for damages; claimant’s application for exemption under section 7.34(1)(b); late claim pursuant to section 6.14; whether claimant’s explanation for delay full and satisfactory; vehicle said to be at fault unidentified; whether due inquiry and search conducted by claimant; Personal Injury Commission’s determination on both preliminary issues not binding; consideration and application of rule 99 of the Personal Injury Commission Rules 2021 and objects as set out in section 3 of the PIC Act; Gudelj v Motor Accidents Authority of New South Wales considered and applied; complex factual and legal issues; allegation of inconsistencies made by insurer; Held – claim is not suitable for assessment by Commission based on preliminary assessment; recommendation that claim be exempt; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 8 April 2026 | Member: Bianca Montgomery-Hribar
Serrano v AAI Limited t/as GIO [2026] NSWPIC 230
Motor Accidents Compensation Act 1999; damages assessment; admitted liability motorcycle collision; claimant sustained serious scrotal and testicular injury with permanent residual impairment; broader claims for ongoing neck, lumbar, knee and psychiatric injury substantially contested; accident accepted to have caused cervical soft tissue injury and exacerbation of pre-existing psychiatric condition, but no enduring lumbar or knee impairment established; economic loss claim poorly substantiated; modest buffers allowed for past and future economic loss; treatment expenses allowed in limited sum; gratuitous and commercial care claims not made out; Held – damages assessed at $37,500, subject to credit for $10,000 hardship payment.
Decision date: 23 April 2026| Member: Bridie Nolan
AAI Limited t/as AAMI v Antecki [2026] NSWPIC 241
Motor Accident Injuries Act 2017; motor accidents settlement approval; 80 year old Pedestrian struck by the insured motor vehicle whilst attempting to cross an intersection sustained multiple fractures to the ribs, vertebral body compression fracture of T5-T7, fracture of the right proximal neck of the humerus, fractures of facial bones and left temporal lobe acute subdural haemorrhage; insurer wholly admitted liability; conceded non threshold injury and also conceded entitlement to damages for non-economic loss; claimant is retired; amount proposed for non-economic loss is $285,000; Held – the proposed settlement is just, fair and reasonable, Settlement approved; this proposed settlement is approved; the proposed settlement is approved under section 6.23 (2)(b).
Decision date: 1 May 2026 | Member: David Ford
Chraif v Allianz Australia Insurance Limited [2026] NSWPIC 242
Motor Accident Injuries Act 2017; late claim; full and satisfactory explanation; section 6.13; the claimant sustained injury in a rear end collision on 20 June 2025; the application for personal injury benefits was received by the insurer on 19 December 2025; whether the claimant had provided a full and satisfactory explanation for the failure to make the claim within 3 months of the accident; insurer conceded the explanation was full; Held – the claimant’s explanation was satisfactory; claimant has provided a full and satisfactory explanation for the delay in making the claim; costs assessed in favour of the claimant.
Decision date: 1 May 2026| Senior Member: Susan McTegg
Odisho v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 248
Motor Accident Injuries Act 2017; assessment of damages; claim limited to past and future economic loss; insurer disputed entitlement to any award; claimant 66 at time of assessment; Held – claimant had pre-existing conditions that gave rise to a loss of earning capacity; neck, back and psychological injuries caused by the accident gave rise to a loss of capacity to earn productive of financial loss; claimant’s earning capacity also reduced as a result of symptomatic degenerative changes in the right knee; awards for past and future economic loss; total award $53,000.
Decision date: 4 May 2026 | Senior Member: Brett Williams
Tiwari v AAI Limited t/as GIO [2026] NSWPIC 251
Motor Accident Injuries Act 2017; assessment of damages pursuant to section 7.6; liability admitted; physical and psychological injuries; claimant entitled to damages for non-economic loss and economic loss; dispute regarding quantification of non-economic loss; dispute regarding most likely circumstances but for accident; dispute regarding quantification of past and future economic loss; Held – non-economic loss award of $400,000; past economic loss assessed as $19,695.10; future economic loss assessed as a buffer of $377,000.
Decision date: 4 May 2026| Member: Bianca Montgomery-Hribar
QBE Insurance (Australia) Limited v Jaderpour [2026] NSWPIC 254
Motor Accident Injuries Act 2017; settlement approval; claimant 31 yrs old in July 2026, involved in an accident which appeared to aggravate pre-accident psychological symptoms; assessed whole person impairment not greater than 10%; no loss of earning capacity productive of economic loss; insurer agreed to settle and submitted application for proposed settlement; no statutory benefits paid and insurer agreed to pay claimant former legal representative’s costs; Held – settlement approved in the sum of $37,000; settlement just, fair and reasonable and within the range of likely potential damages assessment; claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.
Decision date: 5 May 2026| Member: Elyse White
Workers Compensation non-Presidential Member Decisions
Dedic v TAFE NSW [2026] NSWPIC 238
Workers Compensation Act 1987; order sought for the respondent to pay for the cost of eight further sessions of exercise physiology for a psychological injury; whether proposed treatment is reasonably necessary as a result of the injury; Held – no order made as proposed treatment not reasonably necessary as a result of the work injury.
Decision date: 29 April 2026| Member: John Isaksen
Wylie v Employers Mutual Management Pty Ltd [2026] NSWPIC 239
Workers Compensation Act 1987; primary psychological injury; establishing psychological injury in circumstances of the worker's perception of events at work; defence under section 11A(1) in respect of discipline and employment benefits; entitlement to weekly benefits under sections 36 and 37; “current work capacity” and “no current work capacity” as defined in clause 9 of Schedule 3 considered; “suitable employment” as defined in section 32A considered; State Transit Authority (NSW) v Chemler, Baker v Southern Metropolitan Cemeteries Trust, Attorney General's Department v K, and Wollongong Nursing Home Pty Ltd v Dewar considered and applied; Held – applicant suffered a primary psychological injury in the course of her employment with the respondent deemed to have occurred on 11 July 2023 within the meaning of section 4(b); respondent has failed to discharge its onus under section 11A(1), namely, that the applicant’s primary psychological injury was wholly or predominantly caused by reasonable action taken or proposed to be taken by or on behalf of the respondent with respect to discipline and employment benefits; applicant had no current work capacity from 18 December 2023 to 21 February 2025 within the meaning of Clause 9 of Schedule 3; respondent to pay the applicant weekly compensation in respect of the injury sustained on 11 July 2023 (deemed) from 18 December 2023 to 21 February 2025 under sections 36(1) and 37(1) and thereafter, award for the respondent; respondent to pay the applicant’s reasonably necessary medical and related expenses as a result of injury on 11 July 2023 under sections 60 of the Act to 21 February 2025 and thereafter, award for the respondent.
Decision date: 29 April 2026 | Member: Anthony Scarcella
Fiddes v Secora APII Pty Ltd & Ors [2026] NSWPIC 244
Workers Compensation Act 1987; claim for death benefits pursuant to section 25; where worker suffered cardiac arrest due to severe coronary atherosclerosis and cardiomegaly; whether the requirement to travel for work and its effects on diet, lifestyle and sleep were the main contributing factor to an aggravation etc of pre-existing hypertension, hyperlipidaemia and coronary artery disease; effect of revocation of previous member’s Certificate of Determination on appeal; Held – the Personal Injury Commission (Commission) as presently constituted is not bound by the previous findings on diet; while there were work-related changes to diet, lifestyle and sleep there was no direct medical evidence of an aggravation; Fisher v Nonconformist Pty Ltd considered; Commission not satisfied that applicant’s expert opinions were based on a proper factual foundation; if there was an aggravation, employment was not the main contributing factor.
Decision date: 1 May 2026| Senior Member: Rachel Homan
Zaurrini v Trust Metro West Concrete Group Pty Ltd ATF Abruzzi Trust [2026] NSWPIC 245
Workplace Injury Management and Workers Compensation Act 1998; lump sum compensation; claim for consequential conditions in both shoulders; applicant suffered significant injury to left leg and a series of accepted consequential conditions after; whether consequential condition in shoulders existed due to extended use of crutches; whether surveillance video could be referred to Medical Assessor under rule 109 of the Personal Injury Rules; Held – applicant suffered consequential condition in both shoulders; no exceptional circumstances for surveillance footage; material not referred to the Medical Assessor.
Decision date: 1 May 2026| Member: Parnel McAdam
Panayi v Kambi Holdings Pty Ltd [2026] NSWPIC 246
Workers Compensation Act 1987; permanent impairment; whether applicant suffered an injury in the course of his employment to which his employment was a substantial contributing factor; applicant was involved in a motor accident in 2003 which caused the death of a pedestrian; applicant was not at fault; there is no issue at the time of the accident he was in the course of his employment; applicant claimed permanent impairment compensation; claim was denied on the basis the accident, while admittedly traumatic, had not given rise to a psychological injury, and if it had the applicant’s employment was not a substantial contributing factor to the development of the injury; Held – the preponderance of the lay and medical evidence reveals the applicant suffers a psychological condition, the causes of which are multi-factorial; among the causes of the applicant’s condition was the subject accident, which was a substantial contributing factor to his injury; matter remitted to the President for referral to a Medical Assessor to determine the applicant’s permanent impairment.
Decision date: 1 May 2026| Member: Cameron Burge
Warren v Woolworths Group Limited [2026] NSWPIC 247
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); purported claim for lump sum compensation pursuant to sections 66 and 67 of the 1987 Act prior to 19 June 2012; whether the worker complied with sections 260 and 282 of the 1998 Act and the WorkCover Guidelines, so that she was entitled to receive lump sum compensation for pain and suffering pursuant to section 67 of the 1987 when she made a claim in March 2024;OttomenPty Ltd ATF Labour ADM t/as Otto Design Interiors v Lee-Chee, Woolworths Ltd v Stafford, Goudappel v ADCO Constructions Pty Limited & Anor, ADCO Constructions Pty Ltd v Goudappel,Cram Fluid Power Pty Ltd v Green, Yildiz v Fullview Plastics Pty Ltd,and Woolworths Ltd v Wagg considered and applied; Held – worker entitled to award for pain and suffering in respect of thoracic spine injury in 2008, but not entitled to award in respect of injury to her wrist in 2009 as a claim was not duly made, resulting in an award for the respondent.
Decision date: 1 May 2026| Principal Member: Glenn Capel
Mathers v JS & WJ Investments Pty Ltd trading as West Tamworth News Agency & Anor [2026] NSWPIC 252
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act); claim for benefits in respect of the death of a worker; liability admitted by respondent to pay lump sum pursuant to section 25(1)(a) of the 1987 Act; determination needed as to those dependent on the worker for support; determination needed as to the applicant’s entitlements to interest pursuant to section 109 of the 1998 Act; consideration of statement evidence, claim correspondence, and factual material; Held – no other person but the applicant was dependent on the worker for support; award entered in favour of the applicant in relation to the entire lump sum payable pursuant to section 25(1)(a) of the 1987 Act, together with agreed interest pursuant to section 109 of the 1998 Act; no award entered in favour of the second respondent considering the finding that only the applicant was dependent on the worker for support.
Decision date: 4 May 2026| Member: Gaius Whiffin
Sangiuliano v Shellharbour Private Hospital [2026] NSWPIC 253
Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Personal Injury Commission Act 2020 (PIC Act); ss 327 and 329 of the 1998 Act; reconsideration; considered and applied: Samuel v Sebel Furniture Limited, Hilliger v Hilliger, Papalia v Transom Services Pty Ltd t/as Transom Scaffolding, Petrovic v BC Service No 14 Pty Limited and Ors; Held – the Certificate of Determination dated 10 May 2024 is rescinded pursuant to section 57(1) of the PIC Act; leave is granted to the applicant to file an appeal pursuant to section 327(3)(a) and/or (b) of the 1998 Act against the Medical Assessment Certificate of Medical Assessor dated 8 April 2024 within 28 days.
Decision date: 4 May 2026| Member: John Turner
Spiken v Holcim (Australia) Pty Ltd [2026] NSWPIC 236
Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Workers Compensation Act 1987 (1987 Act); claim for cervical spine surgery pursuant to section 60 of the 1987 Act; whether Commission had jurisdiction to determine the claim pursuant to section 289(2) of the 1998 Act; whether the applicant sustained a cervical spine injury on 7 December 2023 in addition to the accepted left shoulder injury; Held – the Personal Injury Commission has jurisdiction to determine the applicant’s claim for cervical spine surgery pursuant to section 289(2) of the 1998 Act; applicant sustained a cervical spine injury on 7 December 2023 in addition to the accepted left shoulder injury; respondent is to pay costs of and incidental to proposed C3/4 anterior decompression and fusion procedure at gazetted rates.
Decision date: 4 May 2026| Member: Fiona Seaton
Motor Accidents Medical Review Panel Decisions
RAB v AAI Limited t/as GIO [2026] NSWPICMP 297
Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident on 1 May 2022; Medical Assessor (MA) determined that the injury referred to him, persistent depressive disorder with anxious distress, was not a threshold Injury for the purposes of the Act; insurer sought a review of the Medical Assessment; Review Panel conducted its own examination; Review Panel revoked the determination of the original MA; Held – Review Panel held that the injury sustained in the accident, being Somatic Symptom Disorder with predominant and persistent pain, was not a threshold Injury for the purposes of the Act.
Decision date: 30 April 2026| Panel Members: Member Terence Stern OAM, Dr John Baker, and Dr Gerald Chew| Injury module: Mental and Behavioural
Assaf v Allianz Australia Insurance Limited [2026] NSWPICMP 305
Motor Accidents Injuries Act 2017; threshold injury dispute; claimant is an 89 year old front seat passenger in car that was stationary at traffic lights and hit from behind; claimant alleged accident-related musculoskeletal injuries including a compression fracture of her T12; original medical assessment certificate (MAC) found threshold injuries; Review Panel made determination on the papers; pre-existing evidence of lumbar spine injury and complaints; mechanism of accident could cause spinal fractures; consideration of radiological evidence together with GP records of symptoms worsening consistent with an acute T12 compression fracture; Held – T12 compression fracture caused by the motor accident and is not a threshold injury; MAC revoked; new MAC issued.
Decision date: 5 May 2026| Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Shane Moloney| Injury module: Spine
Allianz Australia Insurance Limited v Ghaleb [2026] NSWPICMP 307
Motor Accident Injuries Act 2017; degree of permanent impairment dispute; claimant was involved in a motor vehicle accident while driving along a bridge; an old man was driving next to him and swerved into the left hand side of the claimant’s car; claimant was restrained by his seatbelt and did not hit his head or lose consciousness; both drivers pulled over to exchange details; as they were doing so, the insured van struck the back of the other driver’s vehicle, pinning the other driver between the two cars; claimant attempted to assist the other driver who unfortunately died at the scene; claimant developed psychological symptoms, including anxiety, depression and sleep problems; claimant says he never returned to normal and never returned to work; claimant says that he has no significant past medical history; insurer says the claimant has a pre-existing psychological history; Held – certificate revoked; new certificate issued.
Decision date: 5 May 2026| Panel Members: Member Gary Victor Patterson, Dr John Baker, and Dr Steven Yeates| Injury module: Mental and Behavioural
Morgan v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 310
Motor Accident Injuries Act 2017; reasonable and necessary care dispute; claimant was seat-belted driver of a utility vehicle; claimant applied his breaks and managed to avoid a collision but was rear-ended by a truck; claimant was shocked but managed to drive home; claimant consulted his general practitioner three weeks later for treatment of neck pain, lumbar back pain and bilateral wrist pain; claimant has a pre-accident history of recurrent left shoulder dislocation; Medical Assessor (MA) certified that referral to orthopaedic surgeon for treatment of left ankle injury and request for L5/S1 discectomy surgery of the lumbar spine does not relate to the injury caused by the motor accident, nor is reasonable or necessary, in the circumstances; claimant’s review application allowed by President’s delegate on basis of failure to consider claimant’s reply material and denial of procedural fairness; claimant re-examined by Review Panel; Held – Review Panel not satisfied that left ankle injury, additional structural compromise of lumbar spine or lumbar radiculopathy, caused by the motor accident; certificate confirmed.
Decision date: 6 May 2026| Panel Members: Member Gary Victor Patterson, Dr Alan Home, and Dr Rhys Gray| Treatment Type: Medical Specialist Consultant, Surgery
Krishna v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 311
Motor Accidents Injuries Act 2017; threshold injury dispute; claimant was the driver of a vehicle that was stopped in traffic when he was hit from behind by another vehicle; injuries to neck, shoulder and back; original medical assessment certificate (MAC) found all injuries to be threshold injuries; Review Panel re-examination found no radiculopathy in cervical or lumbar spines; whether radiculopathy present at any time following the motor accident; David v Allianz Australia Ltd applied; Review Panel found the necessary two signs of lumbar radiculopathy present in a medico-legal report obtained after the motor accident; Held – the presence of accident-related lumbar radiculopathy at any time following the motor accident is not a threshold injury; MAC revoked; new MAC issued.
Decision date: 6 May 2026| Panel Members: Member Jeremy Lum, Dr Mohammed Assem, and Dr Shane Moloney| Injury module: Spine, and Upper Limb
Workers Compensation Medical Appeal Panel Decisions
Dawking v Secretary, Department of Education [2026] NSWPICMP 296
Workplace Injury Management and Workers Compensation Act 1998; appeal from 9% whole person impairment (WPI) psych assessment; whether Medical Assessor (MA) had failed to apply the principles of assessment; whether MA had erred in failing to find Treatment Effect WPI; whether error made in class rating for self-care and personal hygiene, travel, or concentration persistence and pace; whether procedural fairness denied; Held – submissions regarding assessment principles and Treatment Effect misguided and made with an eye too keenly attuned to the perception of error; Zoric v Sec, Wingfoot Australia Partners Pty Ltd v Kocak, and Cheers v Mid Coast Council considered and applied; no error in rating for self-care and personal hygiene, travel or concentration persistence and pace; Medical Assessment Certificate confirmed.
Decision date: 28 April 2026| Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Michael Hong| Injury module: Psychiatric/psychological
Burzynski v State of New South Wales (Ambulance Service of NSW) [2026] NSWPICMP 298
Workplace Injury Management and Workers Compensation Act 1998; appeal from Medical Assessor (MA); whether MA errd in not making assessment; Held – MA conflated maximum medical improvement with whether degree of permanent impairment fully ascertainable and in doing so failed to provide sufficient reasons for decision; re-examination required; Medical Assessment Certificate revoked and new MAC issued.
Decision date: 30 April 2026| Panel Members: Member Mitchell Strachan, Professor Nicholas Glozier, and Dr John Lam-Po-Tang| Injury module: Psychiatric/psychological
Pouya v Wagga Women's Health Centre [2026] NSWPICMP 299
Workplace Injury Management and Workers Compensation Act 1998; appeal from 13% whole person impairment psych assessment; whether self-care and personal hygiene class 2 assessment incorrect; whether class 1 assessment for travel incorrect; whether class 3 assessment for employment incorrect; Held – no error made; observations on function of Medical Assessor (MA); Wingfoot Australia Partners Pty Ltd v Kocak, and State of New South Wales (NSW Department of Education) v Kaur applied; self-care and personal hygiene expert for appellant assessed same rating as MA, observations on onus by claimant under those circumstances; travel rating confirmed; claimant had moved to another city she was unfamiliar with and travelled by motor vehicle and tram, motive for one driving episode not relevant; employment rating confirmed; claimant moved to new city for job opportunities and had applied for university course; Medical Assessment Certificate confirmed.
Decision date: 30 April 2026| Panel Members: Member John Wynyard, Dr Michael Hong, and Dr Douglas Andrews| Injury module: Psychiatric/psychological
Farhang v Aussie Pacific Constructions Pty Ltd [2026] NSWPICMP 300
Workplace Injury Management and Workers Compensation Act 1998; assessment of right and left upper extremities and scarring/TEMSKI; appeal in respect of assessment of scarring /TEMSKI only on basis of the Medical Assessment Certificate containing a demonstrable error and the assessment being made on the basis of incorrect criteria; Appeal Panel found that the Medical Assessor failed to refer to all of the criteria in Table 14.1 of the Guidelines and failed to provide adequate reasons for his assessment, such failure being a demonstrable error; worker re-examined; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 1 May 2026| Panel Members: Member Carolyn Rimmer, Dr Robert Kuru, and Dr Andrew Porteous| Injury module: Right Upper Extremity, Left Upper Extremity, and Scarring (TEMSKI)
Narayanadas v Costco Wholesale Australia Pty Ltd [2026] NSWPICMP 302
Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred with respect to the additional percentage of whole person impairment (WPI) he rated for the appellant pursuant to paragraphs 4.33-4.35 of the Workers Compensation for the Evaluation of Permanent Impairment Guidelines, 4th ed (Guidelines); whether MA erred by not explaining why his assessment of the appellant’s permanent impairment differed from assessments from independent medical examiners (IMEs) had made; whether MA erred by not adequately explaining the reasons for his assessment of the appellant’s right lower extremity impairment; Appeal Panel held MA made no error with respect to rating of the appellant’s impairment under paragraphs 4.33-4.35 of the Guidelines; Appeal Panel held MA was not required to explain why his assessment differed from the assessments other IMEs had made; Appeal Panel held that MA’s reasons for one aspect of his assessment of the appellant’s lower extremity impairment was inadequate, because it was likely to confuse a reader of the Medical Assessment Certificate (MAC), and this was an error; appellant re-examined; Appeal Panel following re-examination, assessed the degree of the appellant’s WPI the same as the MA had; Held – MAC confirmed.
Decision date: 1 May 2026| Panel Members: Member Marshal Douglas, Dr Gregory McGroder, and Dr Drew Dixon| Injury module: Lumbar Spine, Right Lower Extremity, and Left Lower Extremity
The Hospitals Contribution Fund of Australia Ltd v Miller [2026] NSWPICMP 303
Workplace Injury Management and Workers Compensation Act 1998; appeal by employer against the 19% whole person impairment assessment for injury to visual system (left eye); whether Medical Assessor (MA) failed to give adequate reasons for finding maximum medical improvement (MMI) after the MA had issued earlier an Medical Assessment Certificate (MAC) due to no MMI; Held – MAC inconsistent with earlier findings; failure to adequately explain additional evidence; claimant inconsistent in ocular examinations; Chapter 1.15 & 16 of the Workers Compensation for the Evaluation of Permanent Impairment Guidelines, 4th ed (Guidelines), considered for MMI; chapter 1.36 considered of the Guidelines inconsistent presentation; MAC revoked; new MAC issued.
Decision date: 5 May 2026| Panel Members: Member John Wynyard, Dr Malcolm Capon, and Dr Ian Wechsler| Injury module: Visual System
Roukos v Recruitment Solutions Group Australia Pty Ltd ATF Recruitment [2026] NSWPICMP 308
Workplace Injury Management and Workers Compensation Act 1998; medical Appeal; sleep disorder; assessment of sleep apnoea; contribution from insomnia due to pain; appellant suffered from daytime somnolence; whether sleep apnoea materially contributes to appellant’s daytime somnolence and restriction in activities of daily living; Bogdanovic v Farlow Concrete Pty Ltd considered; application of clause 1.32 of the Workers Compensation for the Evaluation of Permanent Impairment Guidelines, 4th ed; worker’s sleep apnoea well controlled through CPAP therapy; Held – sleep apnoea materially contributes to daytime somnolence; sleep apnoea well controlled allowing for an addition for the effects of treatment; Medical Assessment Certificate revoked; new MAC issued.
Decision date: 5 May 2026| Panel Members: Member Parnel McAdam, Dr David Gorman, and Dr David Crocker| Injury module: Respiratory – Sleep Apnoea
Price v RSL LifeCare Ltd [2026] NSWPICMP 309
Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor (MA) erred in his whole person impairment assessment of five of the categories of the Psychiatric Impairment Rating Scale, namely, Self -care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace and employability; MA also erred in his section 323 deduction and the manner in which he dealt with the appellant’s treatment regime; Appeal Panel found no errors except as regards the section 323 deduction; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 5 May 2026| Panel Members: Member Deborah Moore, Dr Douglas Andrews, and Dr Michael Hong| Injury module: Psychiatric/psychological
Motor Accidents Merit Review Decision
Thomas v QBE Insurance (Australia) Limited [2026] NSWPICMR 16
Motor Accident Injuries Act 2017; merit review; dispute under Division 3.3 and section 3.12; weekly payment of statutory benefits after 104 weeks; whether there is a pending claim for damages; section 4.1; sections 5.1, 5.2, 5.4; liability in case of no-fault accident; whether asserted claim for damages is a legal nullity and therefore void or does not exist; liability in case of no fault accident; Thomas v QBE Insurance (Australia) Limited, and QBE Insurance (Australia) Limited v Lay considered and applied; Held – the reviewable decision is affirmed.
Decision date: 4 May 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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