Legal Bulletin No. 262
This bulletin was issued on 29 May 2026
Issued 29 May 2026
Welcome to the two hundred and sixty-second 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
Brickworks Ltd v Wright [2026] NSWSC 554
Workers compensation; judicial review of Personal Injury Commission Appeal Panel decision; section 323 of the Workplace Injury Management and Workers Compensation Act 1998 (NSW); clause 11 of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment; whether section 323 was misapplied; deduction for a pre-existing condition; whether Panel’s reasons were inadequate; matter remitted to Personal Injury Commission; Held – The Panel’s decision be set aside; the matter be remitted to the Personal Injury Commission to be dealt with according to law, by a differently constituted appeal panel; and the parties are each to bear their own costs of these proceedings.
Decision date: 21 May 2026 | Before: Schmidt AJ
Presidential Member Decisions
Sentinel Community Services Pty Ltd v Clark Chesaites [2026] NSWPICPD 22
Workers compensation; undisclosed used of generative AI considered; Personal Injury Commission Act 2020 sections 3, 42, and 43; rule 133C of the Personal Injury Commission Rules 2021 and Procedural Direction PIC13 applied; section 352(3) of the Workplace Injury Management and Workers Compensation Act 1998 considered; Brown v Toll Transport Pty Ltd [2026] NSWPICPD 12 applied; section 352(3A) of the Workplace Injury Management and Workers Compensation Act 1998; test for whether a decision is interlocutory considered; Licul v Corney [1976] HCA 6; 180 CLR 213 applied; Held – the application is dismissed.
Decision date: 19 May 2026 | Before: Deputy President the Hon Adam Searle
Macarthur Fresh Wholesalers Pty Ltd v Deitz [2026] NSWPICPD 23
Workers compensation; section 38(3)(c) of the Workers Compensation Act 1987; statutory construction; Project Blue Sky Inc v Australian Broadcasting Authority [1998] HCA 28; 194 CLR 355; Esso Australia Pty Ltd v Australian Workers Union [2017] HCA 54; 350 ALR 404; SAS Trustee Corporation v Miles [2018] HCA 55; error to vitiate a decision; Trazivuk v Motor Accidents Authority of New South Wales [2010] NSWCA 287; State of New South Wales v Culhana [2025] NSWCA 157; 117 NSWLR 448; Held – the orders in the Certificate of Determination dated 17 July 2025 are revoked; in lieu thereof there is an award for the respondent employer.
Decision date: 21 May 2026| Before: Acting President Michael Snell
Motor Accidents non-Presidential Member Decisions
AAI Limited t/as GIO v Schiavon [2026] NSWPIC 203
Motor Accident Injuries Act 2017; insurer’s application for discretionary exemption from assessment under section 7.34(1)(b); preliminary assessment of claim; complex factual and liability issues relating to causation, liability and contributory negligence; Held – a court hearing is more likely to result in the just, quick and cost-effective resolution of the real issues in dispute between the parties; claim is not suitable for assessment; recommendation made that the claim be exempted; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 9 April 2026| Member: Philip Carr
Furlong v Transport Accident Commission [2026] NSWPIC 210
Motor Accident Injuries Act 2017; discretionary exemption application by claimant and insurer consented; basis not suitable; claim involves complex liability, fault and causation, factual issues, novel legal argument and non-CTP parties; related proceedings in District Court on foot; workers compensation section 151Z; recovery and defence in both claims under section 1.9(2); Personal Injury Commission Rules 2021 rule 99(3)(a),(b) and (d); claims to be heard together; Held – claim not suitable for assessment at the Personal Injury Commission pursuant to section 7.34 (1)(b); recommendation made that the claim be exempted; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 15 April 2026| Member: Shana Radnan
Bousfield v Allianz Australia Insurance Limited [2026] NSWPIC 220
Motor Accident Injuries Act 2017; discretionary exemption application by insurer and claimant consented; basis not suitable; claim involves complex liability, fault and causation, factual issues two collisions, multiple parties and claims to be heard together; claimant’s compensation to relatives claim and three other related claims already exempted from the Personal Injury Commission (Commission); Related claim against other insured also exempted; Personal Injury Commission Rules 2021 rules 99(3)(a) and (b); other factors include length of hearing, number of witnesses to be called and subpoena likely, one forum for all matters; Held – claim not suitable for assessment at the Commission pursuant to section 7.34; recommendation made that the claim be exempted; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 21 April 2026| Member: Shana Radnan
Perez v AAI Limited t/as AAMI [2026] NSWPIC 264
Motor Accident Injuries Act 2017; claimant’s application for medical assessment; dispute about whether an English language course comes within the definition of “treatment and care” in section 1.4; insurer alleges course is not a form of rehabilitation on the basis it is not aiming to rehabilitate any injury and because it is providing an additional skill never held by the claimant; issue determined after preliminary conference with legal representatives for the parties; Held – definition of rehabilitation in section 1.4 is a process so that the injured person can attain and maintain various abilities; it is focused on the person as a whole not the specific or particular injuries; definition of treatment and care in section 1.4 includes “education and vocational training”; course is a form of education and relevant vocational training for someone who does not speak English well or at all; English language course can be a form of treatment; whether it is related to the injuries and is reasonable and necessary in the claimant’s circumstances is a medical assessment matter; Held – matter referred for medical assessment.
Decision date: 29 April 2026| Member: Belinda Cassidy
Yaghi v QBE Insurance (Australia) Limited [2026] NSWPIC 265
Motor Accident Injuries Act 2017; miscellaneous claims assessment; whether claimant wholly or mostly at fault; sections 3.11 and 3.28; motor vehicle accident on 28 December 2022; claimant alleged driving straight ahead when insured driver failed to give way and turned left into his lane causing a collision; insured driver alleged claimant turning right and failed to give way to insured causing collision; AAI Limited t/as GIO v Evic applied; Held – insurer not discharge onus; claimant travelling straight ahead when insured driver turned left causing collision; insured driver failed to exercise reasonable care; no failure of care by claimant; claimant not wholly or mostly at fault.
Decision date: 7 May 2026| Senior Member: Susan McTegg
Unal v Insurance Australia Limited trading as NRMA Insurance [2026] NSWPIC 266
Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about whether claimant mostly at fault for the accident; claimant pedestrian crossing 7 lane road at night, not at a controlled intersection; claimant had crossed 6 lanes of traffic and was hit as he moved into the kerbside lane; insured vehicle travelling at 20 kmph and driver’s ability to see claimant affected by poor lighting, claimant wearing dark clothing and crossing at an angle with his back towards oncoming traffic; Nominal Defendant v Corbin, AAI Limited t/as GIO v Evic, Allianz v Shuk, Verryt v Schoupp, Mamo v Surace, Axiak v Ingram, and Davis v Swift considered and applied; Held – claimant’s contributory negligence assessed at 70%; claimant mostly at fault for the accident.
Decision date: 7 May 2026| Member: Belinda Cassidy
Penrose v Transport Accident Commission of Victoria [2026] NSWPIC 267
Motor Accident Injuries Act 2017; claim for damages; dispute about whether claimant has a full and satisfactory explanation for the delay in making the claim; accident May 2019, claim made 5 February 2024; claimant injured at work and made workers compensation claim; when treatment refused saw solicitors; solicitors initially advised only in respect of workers compensation claim; new solicitor at firm identified motor accident and made claim within seven weeks; assessment conference held; insurer conceded explanation full; Karambelas v Zacnik (no 2), Walker v Howard, Buller v Black, Hunter v Roberts, Diaz v Truong; Russo v Aiello, Figliuzzi v Yonan considered and applied; Ferizovic v IAG t/as NRMA Limited considered and distinguished; Held – claimant’s explanation was full and satisfactory; costs assessed.
Decision date: 12 May 2026 | Member: Belinda Cassidy
Felsch v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 268
Motor Accident Injuries Act 2017; damages assessment pursuant to section 7.6; claim for damages; violent collision with both vehicles travelling highway at speed on a country road when insured failed to give way at a give way sign; assessment of damages with no allegation of contributory negligence; insurer alleged pre-existing condition would have caused retirement on medical grounds at the time it in fact did so and hence impact of accident injuries did not affect claimant’s economic circumstances; Held – no medical opinion informed of the extent of pre-existing condition that sanctioned the accident related injuries altered the claimants likely future economic circumstances that could be preferred over the specialist treating the claimant for his preexisting condition that opined such condition caused the incapacity that resulted in claimant’s inability to work and resultant retirement on medical grounds; claimant can only sustain a closed period of economic loss immediately after the accident together with reimbursement of income tax paid on statutory payments.
Decision date: 12 May 2026| Member: Terrence Broomfield
Razek v Allianz Australia Insurance Limited [2026] NSWPIC 274
Motor Accident Injuries Act 2017; miscellaneous claims assessment dispute; statutory benefits; whether accident caused wholly or mostly by the fault of the claimant for the purposes of sections 3.11 and 3.28; claimant requested assessment conference be vacated and subsequently discontinued proceedings by consent; costs sought by insurer pursuant to sections 8.3(4); claimant opposed insurer’s costs order and sought regulated costs; AAI Limited t/as GIO v Moon & Ors, San v Rumble (No 2), and Ho v Professional Services Review Committee No 295 considered and applied; consideration of Grinter v CIC Allianz Insurance Limited; Held – claimant’s legal costs permitted pursuant to section 8.10(3) up to 16 monetary units; insurer’s reasonable and necessary legal costs permitted pursuant to section 8.3(4).
Decision date: 18 May 2026 | Member: Bianca Montgomery-Hribar
Greer v AAI Limited t/as Suncorp Insurance [2026] NSWPIC 279
Motor Accidents Compensation Act 1999 (MAC Act); claims assessment dispute about the amount of damages to be paid to the claimant under section 94(5) of MAC Act; claimant was driving his motor vehicle when the insured motor vehicle crossed over on the incorrect side of the roadway and collided head on with the claimant’s vehicle; claimant sustained closed articular fracture affecting the right calcaneus, injuries to both knees, hips and lower back, as well as sleep disorder, psychological injury claimant is a self-employed master builder, his injuries have severely restricted his ability to work in his profession and has suffered a significant diminution in earnings since the accident and also for the remainder of his working life; claimant is now 60 years of age; 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, and future care.
Decision date: 19 May 2026| Member: David Ford
Quigley v Insurance Australia Limited trading as NRMA Insurance [2026] NSWPIC 280
Motor Accident Injuries Act 2017; motor vehicle accident; claims assessment;liability; contributory negligence; traumatic brain injury; shoulder injury; motorbike; non-economic loss; past and future economic loss; most likely future circumstances; assessment of damages; 17 -year-old claimant sustained injury in a motor bike accident; claimant no recollection accident; insurer relied upon CCTV footage of poor quality to allege excessive speed by claimant; independent witness saw insured driver turn right across path claimant causing him to lose control and sustain injury; dispute as to presence of traumatic brain injury; Held – breach of duty by insured driver; on available evidence not satisfied claimant riding at excessive speed; no reduction for contributory negligence; claimant sustained traumatic brain injury; injury to left shoulder, lower back and left ankle; residual scarring; future capacity for light work, likely part time and subject to periods of unemployment; non-economic loss assessed at $400,000; past economic loss assessed at $230,000; future economic loss including superannuation assessed at $910,273; interest assessed at $41,638; total damages assessed $1,581.911 plus costs.
Decision date: 20 May 2026| Senior Member: Susan McTegg
Sharma v AAI Limited t/as AAMI [2026] NSWPIC 281
Motor Accident Injuries Act 2017; claims assessment dispute about the amount of damages to be paid to the claimant under section 7.36 (3) and 7.36 (4); claimant was driving his motor vehicle through an intersection when a collision occurred with the insured motor vehicle; insured driver failed to comply with red light traffic signal; insurer admitted liability; claimant sustained soft tissue injuries to neck, thoracic and lumbar spine, and psychological injuries; at the time of the accident claimant was an Uber driver aged 63 years; claimant unable to resume employment since the accident; insurer conceded non threshold injuries; no claim for non-economic loss; claim for damages for past and future economic loss; determined claimant entitled to damages for past economic loss for a closed period only; Held – claimant is entitled to damages for past economic loss.
Decision date: 20 May 2026| Member: David Ford
Workers Compensation non-Presidential Member Decisions
Workers Compensation Act 1987; whether employment with the later employer main contributing factor to aggravation injury where initial injury sustained with earlier employer; Perry v Tanine Pty Ltd t/as Ermington Hotel, Fletcher International Exports Pty Ltd v Barrow, Taylor v J & D Stephens Pty Ltd, AV v AW, and BHP Billiton Limited & Anor v Bourke & Ors considered and applied; Held – apportionment of separate injuries between employers.
Decision date: 18 March 2026 | Member: Mitchell Strachan
Usui v Krohne Australia Pty Ltd & Ors [2026] NSWPIC 240
Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998; claim for payment of death benefit; liability admitted; apportionment between dependents; approval by the Personal Injury Commission (Commission) of proposed apportionment; Held – apportionment proposed by the parties was appropriate and reasonable in the circumstances, and the evidence satisfies the Commission no other persons were dependent on the deceased at his date of death.
Decision date: 30 April 2026| Member: Cameron Burge
Hayatullah v BDZ Group Pty Ltd [2026] NSWPIC 270
Workers Compensation Act 1987; medical expenses; claim for radiofrequency ablations in the lumbar spine; onus of proof; applicant had not been treated since November 2024; inconsistencies in clinical presentation; no consideration of later radiological evidence and alternative treatment recommendations; weight to be given to opinions in such circumstances; Held – award for the respondent.
Decision date: 13 May 2026| Member: Parnel McAdam
Holbrook v PR Productions Pty Ltd [2026] NSWPIC 271
Workers Compensation Act 1987; injury to cervical spine not disputed; issue in dispute was whether the spinal decompression, spinal fusion and fixation at C5/6 and C6/7 surgery proposed by the applicant’s treating neurosurgeon is reasonably necessary treatment as a result of the injury sustained by the applicant on 21 February 2019 within the meaning of section 60; value of contemporaneous evidence; caution in considering clinical records; expert opinions; Murphy v Allity Management Services Pty Ltd, Rose v Health Commission (NSW), Diab v NRMA Ltd, Mason v Demasi, and Hancock v East Coast Timbers Products Pty Ltd considered and applied; Held – the proposed spinal decompression, spinal fusion and fixation at C5/6 and C6/7 surgery is reasonably necessary treatment as a result of the injury sustained by the applicant in the course of his employment with the respondent on 21 February 2019 within the meaning of section 60; respondent is to pay for the cost of and ancillary to the proposed spinal decompression, spinal fusion and fixation at C5/6 and C6/7 surgery in accordance with the State Insurance Regulatory Authority fees order in force at the time of the service.
Decision date: 14 May 2026| Member: Anthony Scarcella
Latimer v Southern Aurora Express Pty Ltd [2026] NSWPIC 273
Workers Compensation Act 1987; claim for the cost of a right shoulder replacement (reverse prosthesis); whether the worker has suffered a consequential condition affecting his right shoulder as a result of an injury to the left shoulder; consideration of the first category in State Government Insurance Commission v Oakley; whether the surgery is reasonably necessary as a result of the work injury; consideration of Diab v NRMA Ltd; Held – the worker has suffered a consequential condition affecting his right shoulder as a result of an injury to the left shoulder; the proposed surgery is reasonably necessary as a result of the work injury.
Decision date: 15 May 2026| Member: John Isaksen
Shrestha v Opal Healthcare [2026] NSWPIC 275
Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998; claim for compensation in respect of psychological injury caused by alleged bullying and harassment in the workplace; whether there were real events in the workplace giving rise to a perception of being bullied and harassed; differential diagnosis of a frank psychotic disorder; Attorney General's Department v K, State Transit Authority of New South Wales v Fritzi Chemler, and Townsend v Commissioner of Police; Held – Personal Injury Commission (Commission) not satisfied that applicant was objectively bullied or harassed; many of the applicant’s allegations were bizarre and unusual and not accepted as “real”; while there may have been some real events in the workplace that contributed to the applicant’s condition; the Commission was not satisfied that these were “the main contributing factor” to the contraction of the psychiatric illness.
Decision date: 18 May 2026| Senior Member: Rachel Homan
Kelly v Ventora Group Pty Ltd [2026] NSWPIC 276
Workers Compensation Act 1987 (1987 Act); Workplace Injury Management and Workers Compensation Act 1998 section (1998 Act); 4(b)(ii) disease injury; whether aggravation of pre-existing lumbar spine condition a disease injury; whether undisputed aggravation on one occasion resolved; whether further aggravating incident disputed occurred; whether nature and conditions of employment contributed to general aggravation; claim for medical expenses under section 60 of the 1987 Act; surgery already performed; whether surgery was reasonably necessary as a result of workplace injury or the pre-existing condition; whether material contribution to need for surgery by work-related injury; weekly compensation; whether incapacity for work; whether late notice of injury and claim; sections 254 and 261 of the 1998 Act; Held – claim within time; disease injury by way of aggravation of pre-existing condition on two occasions and due to the type of employment duties; surgery was reasonably necessary as a result of the contribution by work-related injury; worker partially and totally incapacitated for work at various times during the relevant period.
Decision date: 18 May 2026| Member: Adam Halstead
Ichsan v State of NSW (South Western Sydney Local Health District) [2026] NSWPIC 277
Workers Compensation Act 1987; claim for costs of arthroscopic lateral release and partial lateral meniscectomy; accepted left knee injury; surgery recommended after more than three years’ of physiotherapy and corticosteroid injections; some improvement in knee condition; whether surgery reasonably necessary as a result of injury pursuant to section 60; Diab v NRMA Ltd, and Rose v Health Commission (NSW) applied; Held – while two specialists had recommended the applicant continue with conservative treatment, the treating surgeon had recommended a procedure, described by him as straightforward and capable of permitting a full recovery; the Personal Injury Commission satisfied that proposed surgery is reasonably necessary as a result of injury.
Decision date: 18 May 2026| Senior Member: Rachel Homan
Motor Accidents Medical Review Panel Decisions
Allianz Australia Insurance Limited v Alazheeri [2026] NSWPICMP 324
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); claimant was rear seat passenger when the driver sneezed and ran into a telegraph pole at speed; claimant sustained fractures to her ribs and clavicle with a pneumothorax; she also suffered psychological sequelae; original Medical Assessor found the accident caused post-traumatic stress disorder and assessed a 19% whole person impairment (WPI); Review Panel re-examined the claimant and agreed with the diagnosis of post-traumatic stress disorder as the accident was severe and the claimant suffered serious injuries; Impairment was assessed at 7% WPI; no pre-existing impairment as while the claimant had a period of emotional distress before the motor accident (abusive relationship), this had resolved before the subject motor accident; also no evidence of a psychiatric disorder or treatment before the subject motor accident; Held – MAC revoked; new MAC issued.
Decision date: 8 May 2026| Panel Members: Member Jeremy Lum, Dr Ankur Gupta, and Dr Thomas Newlyn| Injury module: Mental and Behavioural
Allianz Australia Insurance Limited v Eivazi [2026] NSWPICMP 325
Motor Accident Injuries Act 2017; review of medical assessment; assessment of treatment and care-causation; Anterior cervical discectomy and fusion; MRI mild to moderate spinal canal stenosis; posture of the head and neck within normal limits; flexion and extension of the cervical spine were full with no pain; no absolute indication for surgery such as radiculopathy or spinal cord compromise; Held – proposed treatment is not necessary as claimant did not suffer fracture or subluxation; no signs of spinal cord injury; proposed surgery would be to treat a non-specific cervical pain and is not warranted nor supported by radiological or clinical findings.
Decision date: 11 May 2026| Panel Members: Member Hugh Macken, Dr Michael Couch, and Dr Sophia Lahz| Treatment Type: Surgery
Haramis v Lifetime Care and Support Authority of New South Wales [2026] NSWPICMP 326
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); treatment and care dispute; domestic assistance, support worker companion transport and gardening assistance sought; whether treatment and care relates to accident caused injuries or is due to other incapacity; whether treatment and care reasonable and necessary given nature of injuries caused by accident; Held – the treatment and care is not related to the accident caused injuries and not reasonable and necessary in the circumstances; MAC confirmed.
Decision date: 11 May 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr Shane Maloney, and Dr Margaret Gibson| Treatment Type: Domestic Assistance
BZX v AAI Limited t/as GIO [2026] NSWPICMP 330
Motor Accidents Compensation Act 1999 (1999 Act); review of a medical assessment under section 63 of the 1999 Act; dispute about permanent impairment; Medical Assessor certified that accident caused psychological injury gave rise to an impairment of 7%; Held – as a result of the accident the claimant developed generalised anxiety disorder and somatic symptom disorder; permanent impairment as a result of the accident caused generalised anxiety disorder is 17%; no subsequent or pre-existing impairment; accident caused impairment greater than 10%; Medical Assessment Certificate assessment under review revoked.
Decision date: 15 May 2026| Panel Members: Senior Member Brett Williams, Dr Matthew Jones, and Dr Douglas Andrews | Injury module: Mental and Behavioural
Romano v AAI Limited t/as GIO [2026] NSWPICMP 331
Motor Accident Injuries Act 2017; threshold injury dispute; claimant attempting a right hand turn when her car was rear-ended by another vehicle; whether “tears” described in MRI radiology are causally related to the motor accident; original Medical Assessment Certificate (MAC) found injuries to the lumbar spine and bilateral hips to be threshold injuries; Review Panel obtained and viewed actual MRI images; Review Panel’s review of MRI images consistent with reported radiologists’ findings; entire clinical picture relevant when determining causation of pathology shown in imaging; clauses 5.5 and 5.6 of the Medical Assessment Guidelines; tears (fissures) more likely than not to be chronic and age-related having regard to claimant’s age; Held – claimant sustained soft tissue injuries to her lumbar spine and left hip, which are threshold injuries; MAC revoked as the right hip was found by the Review Panel to be not causally related to the motor accident; new Medical Assessment Certificate issued.
Decision date: 15 May 2026| Panel Members: Member Jeremy Lum, Dr Michael Couch, and Dr Margaret Gibson| Injury module: Spine, and Lower Limb
Allianz Australia Insurance Limited v Pereira [2026] NSWPICMP 332
Motor Accident Injuries Act 2017; medical assessment dispute; review of Medical Assessment Certificate (MAC); dispute regarding assessment of permanent impairment for the purposes of the Act; diagnosis of post-traumatic stress disorder and major depressive disorder by Medical Assessor, resulting in a 17% permanent impairment; whether claimant’s alcohol and cannabis use precluded diagnoses; claimant examined; Held – diagnosis of post-traumatic stress disorder, persistent depressive disorder, alcohol use disorder – mild, and cannabis use disorder – mild; use of alcohol and cannabis found to be a coping strategy for symptoms arising from the accident; does not preclude diagnoses; determination of a 7% permanent impairment as a result of accident caused injuries; Medical Assessment Certificate revoked.
Decision date: 15 May 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr Ankur Gupta, and Dr Himanshu Singh | Injury module: Mental and Behavioural
AAI Limited t/as GIO v Batmaz [2026] NSWPICMP 336
Motor Accident Injuries Act 2017; threshold injury and whole person impairment (WPI) disputes; claimant was the seat-belted driver on his way to work about 2.30am and was stopped at traffic lights; insured vehicle was turning left from a side street at speed when the driver lost control; insured vehicle collided with the right side of the claimant’s vehicle behind the central pillar; claimant’s vehicle was spun and thrown about 15 -20 metres; claimant was able to self-extricate after removing his seatbelt; claimant fell out of the vehicle onto the grass verge; claimant was taken to the Hospital; claimant was complaining of a painful left shoulder and left elbow; claimant had radiology performed including a CT scan of the brain; claimant was kept for observation and discharged; claimant alleges he sustained soft tissue injuries to the neck, back, both shoulders and left elbow; Medical Assessor (MA) found that accident-related injury to the left and right ears-tinnitus/deafness, is not a threshold injury and assessed a 5% whole person impairment; insurer’s review application allowed on basis that inconsistent histories were not put to the claimant with respect to pre-accident hearing loss; claimant re-examined by a MA on behalf of Review Panel which was not satisfied there was any hearing loss caused by subject accident; WPI due to tinnitus is not assessable absent hearing loss due to accident; Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 18 May 2026| Panel Members: Member Gary Victor Patterson, Dr Margaret Gibson, and Dr Brian Williams| Injury module: Ear, nose, throat and related structures
Muter v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 342
Motor Accident Injuries Act 2017; motor accident; insured vehicle collided with the claimant’s vehicle throwing the claimant off his motor bike; significant orthopaedic injuries to left shoulder, right wrist and right knee requiring surgery; assessment of whole person impairment for physical injuries; inconsistency of shoulder movement assessed by analogy to moderate AC joint crepitus; physical examination of right knee difficult to assess due to poor muscle relaxation; seriousness of right knee injury and explanation that laxity existed; Held – claimant assessed at 11% permanent impairment; original assessment revoked; certificate issued for physical injuries greater than 10%.
Decision date: 19 May 2026| Panel Members: Principal Member John Harris, Dr Sophia Lahz, and Dr David Gorman| Injury module: Brain injury, Upper Limb, Lower Limb, and Minor Skin
CAO v Allianz Australia Insurance Limited [2026] NSWPICMP 343
Motor Accident Injuries Act 2017; review of medical assessment; threshold injury dispute; whether pre-existing psychological conditions aggravated, accelerated or exacerbated by accident; Medical Assessor certified no accident caused psychological injury; Lynch v AAI Ltd, David v Allianz Australia Insurance Ltd, and Angileri v Allianz Australia Insurance Limited followed; AAI Limited t/as GIO v Hoblos not followed; Held – DSM-5 is a diagnostic tool; the legal test for causation is found in the Motor Accident Guidelines, the Civil Liability Act 2002 and the common law; Review Panel not satisfied the accident resulted in an increase in psychological symptoms and further loss of functioning at any time; Review Panel not satisfied the accident caused an aggravation, acceleration, or exacerbation of the claimant’s histrionic personality disorder which is more than negligible; claimant did not suffer a psychological injury as a result of the accident; question of whether the injury caused by the accident is a threshold injury for the purposes of the Act does not arise.
Decision date: 19 May 2026| Panel Members: Senior Member Brett Williams, Dr Paul Friend, and Dr Surabhi Verma| Injury module: Mental and Behavioural
Avila v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 345
Motor Accident Injuries Act 2017; review of medical assessment; threshold injury; assessment of treatment and care; prior back and left shoulder pain; rear end collision; delay in attending for medical treatment; subsequent falls unrelated to subject accident; contemporaneous evidence of neck back and right knee pain; no evidence of discreet injury to head, shoulders, right hips and left knee; cervical thoracic and lumbar spine; injuries are soft tissue injuries; no radiculopathy demonstrated; right knee injury was soft tissue injury; abnormalities are identified on imaging of the knees reflected degenerative change; claimant sustained threshold injury; Held – treatment and care not necessary or reasonable in the circumstances.
Decision date: 19 May 2026| Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Sophia Lahz| Injury module: Brain Injury, Spine, Upper Limb, and Lower Limb
Allianz Australia Insurance Limited v Saedi [2026] NSWPICMP 347
Motor Accident Injuries Act 2017; review of Medical Assessor’s (MA) determination of permanent impairment for psychological injury under section 7.26; where the MA found that the claimant suffered from major depressive disorder with anxious distress caused by the motor accident giving rise to a permanent impairment of 14%; claimant re-examined by the Review Panel; where the Review Panel also found that the claimant suffered from major depressive disorder with anxious distress caused by the motor accident which however gave rise to a permanent impairment of 7%; no apportionment for pre-existing psychological impairment; Held – the Medical Assessment Certificate (MAC) of the original MA is revoked; new MAC issued.
Decision date: 20 May 2026| Panel Members: Member Maurice Castagnet, Dr Christopher Canaris, and Dr John Baker| Injury module: Mental and Behavioural
AAI Limited t/as GIO v Ghazzaoui [2026] NSWPICMP 349
Motor Accident Injuries Act 2017; threshold injury dispute; early complaint of lower back pain; lack of any further complaint to health practitioners for 5 months after motor accident; return to heavy physically demanding work immediately after motor accident; Review Panel accepted soft tissue injury to lumbar spine caused by the motor accident; radiculopathy presented to original Medical Assessor not accepted by Panel as causal link to motor accident not established; disc herniation shown in MRI radiology also not considered caused by the motor accident; David v Allianz Australia Ltd considered; Held – Review Panel found soft tissue injury to the lumbar spine caused by the motor accident which is a threshold injury; Original Medical Assessment Certificate revoked; new Certificate issued.
Decision date: 20 May 2026| Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Sophia Lahz| Injury module: Spine
AAI Limited t/as GIO v Ghazzaoui [2026] NSWPICMP 350
Motor Accident Injuries Act 2017; whole person impairment (WPI) dispute; early complaint of lower back pain; lack of any further complaint to health practitioners for 5 months after motor accident; return to heavy physically demanding work immediately after motor accident; Original Medical Assessment Certificate (MAC) found 15% WPI due to lumbar spine radiculopathy caused by the motor accident; Review Panel accepted soft tissue injury to lumbar spine caused by the motor accident; Review Panel did not accept disc herniation in MRI to be caused by the motor accident; Review Panel re-examined and found asymmetrical loss of range of motion (dysmetria) in the lumbar spine; no signs of radiculopathy found; impairment assessed was a 5% WPI; Held – Review Panel found degree of WPI not greater than 10%; original MAC revoked; new MAC issued.
Decision date: 20 May 2026| Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Sophia Lahz| Injury module: Spine
Bucukovski v QBE Insurance (Australia) Limited [2026] NSWPICMP 351
Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) determined the claimant’s disputed treatment, being the proposed total left and right knee replacement, did not relate to the injury caused by the accident and was not reasonable and necessary in the circumstances; dispute about treatment and care; Review Panel conducted its own examination and concluded that the proposed total left and right knee replacement was not related to the injury caused by the accident and was not reasonable and necessary in the circumstances; Held – Medical Assessment Certificate of original MA was affirmed.
Decision date: 20 May 2026| Panel Members: Member Terence Stern OAM, Dr Rhys Gray, and Dr Shane Moloney| Treatment Type: Surgery
Erceg v Allianz Australia Insurance Limited [2026] NSWPICMP 352
Motor Accident Injuries Act 2017; degree of permanent impairment dispute; claimant was driving her new automatic vehicle, with her two sons as passengers; claimant was travelling through a roundabout when the car in front of her stopped suddenly and her vehicle was rear-ended by the insured vehicle; claimant recalls being jolted forward onto the steering wheel; claimant believes her knees struck the dashboard; claimant recalls being in shock and experienced generalised pain in her back, neck and shoulders; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 20 May 2026 | Panel Members: Member Gary Victor Patterson, Dr Tai-Tak Wan, and Dr Christopher Oates | Injury module: Spine, Upper Limb, and Lower Limb
Workers Compensation Medical Appeal Panel Decisions
Stagg v Secretary, Department of Education [2026] NSWPICMP 304
Workplace Injury Management and Workers Compensation Act 1998; appeal against assessment of a 9% whole person impairment (WPI) in respect of a psychological injury on grounds of demonstrable error; assessment being made on the basis of incorrect criteria; Appeal Panel satisfied that the Medical Assessor (MA) did not engage with all of the evidence in respect of the assessment of the psychiatric impairment rating scale of self-care and personal hygiene; worker re-examined; Appeal Panel assessed Class 2 for self-care and personal hygiene; assessment of total WPI by the Appeal Panel is the same as that made by the MA and those circumstances; Appeal Panel will confirm the Medical Assessment Certificate (MAC) as the review has not led to a different result and should not be interfered with; Robinson v Riley considered and applied; Held – MAC confirmed.
Decision date: 4 May 2026| Panel Members: Member Carolyn Rimmer, Dr Graham Blom, and Dr Michael Hong| Injury module: Psychiatric/psychological
Schouten v Canterbury Bankstown Council [2026] NSWPICMP 314
Workplace Injury Management and Workers Compensation Act 1998; appeal from a 9% whole person impairment assessment for psychological injury; whether Medical Assessor (MA) had adequately considered claimant’s supplementary statement; whether MA obliged to reflect the substance and detail of the worker’s account; whether such was a fundamental requirement of procedural fairness; whether MA had properly considered qualitative and quantitative details in the supplementary statement; Wingfoot Australia Partners Pty Ltd v Kocak, and State of New South Wales (NSW Department of Education) v Kaur considered; Held – submissions misconceived;, claimant forget to mention that she had lost weight because of treatment for cancer; medical opinion outdated and preceded cancer diagnosis; claim that weight loss of 19kg caused by injury rejected; weight of supplementary statement accordingly compromised; Medical Assessment Certificate confirmed.
Decision date: 6 May 2026 | Panel Members: Member John Wynyard, Dr Michael Hong, and Dr Douglas Andrews | Injury module: Psychiatric/psychological
Bunnings Warehouse v Harrison [2026] NSWPICMP 327
Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Workers Compensation Act 1987; medical appeal panel; section 327(3) of the 1998 Act; section 65A of the 1987 Act; demonstrable error; secondary psychological injury; secondary psychological impairments; path of reasoning; Matheson v Baptistcare NSW & ACT, Wingfoot Australia Partners Pty Ltd v Kocak, and State Government Insurance Commission v Oakley considered and applied; Held – Medical Assessment Certificate revoked.
Decision date: 13 May 2026| Panel Members: Member John Turner, Dr Ash Takyar, and Professor Nicholas Glozier| Injury module: Psychiatric/psychological
Metcalf v Stabilised Pavements of Australia Pty Ltd [2026] NSWPICMP 328
Workplace Injury Management and Workers Compensation Act 1998; claim for permanent impairment; no complaint on appeal about the overall impairment level assessed for the cervical spine; Medical Assessor (MA) made a one-half deduction under section 323 which was the subject of the appeal by the worker; no basis for the application of a deduction of one-half or any deduction to the impairment assessment in respect of the cervical spine as a result of the asymptomatic pre-existing condition (tumour); on the available evidence has not contributed to the overall level of impairment assessed in respect of the cervical spine based on the fusion surgery which the worker came to following the combined effects of the first injury after which he developed signs and symptoms and then experienced a rapid deterioration in his cervical spine following the second injury leading to fusion surgery; Appeal Panel considers that this is the correct view on all of the available evidence; fusion was necessary because of the combined effect of the injuries on 8 October 2019 and 15 April 2020 and had nothing to do with the tumour which contributed to the myelopathy but not to the need for surgery; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 14 May 2026| Panel Members: Member Jane Peacock, Dr Drew Dixon, and Dr Ross Mellick| Injury module: Cervical Spine
State of New South Wales (NSW Police Force) v Kingston [2026] NSWPICMP 333
Workplace Injury Management and Workers Compensation Act 1998; primary psychological injury; whether demonstrable error or application of incorrect criteria in Medical Assessors’ finding of a Class 3 impairment in the psychiatric impairment rating scale category of “Social Functioning”; where both independent medical examiners had assigned a Class 2 impairment; whether undue emphasis on romantic relationship; whether appropriate weight given to other family relationships; whether the evidence supported a finding that a deterioration in romantic relationship was causally related to the injury; Held – the evidence established that the worker’s romantic relationship was his primary relationship and it was appropriate to attach significant weight to evidence of a deterioration in it; effect of injury on other relationships appropriately considered; no error found in the Medical Assessment Certificate (MAC); MAC confirmed.
Decision date: 15 May 2026 | Panel Members: Senior Member Rachel Homan, Dr Michael Hong, and Dr Ash Takyar | Injury module: Psychiatric/psychological
Schembri v Holdsworth Community Centre [2026] NSWPICMP 334
Workplace Injury Management and Workers Compensation Act 1998; assessment of right lower extremity (ankle, Achilles and foot) following injury; Medical Assessor (MA) found that the injury to right lower extremity was not yet stable and not at maximum medical improvement; worker appealed on basis of demonstrable error; Appeal Panel found that the MA failed to give adequate reasons; Appeal Panel accepted clinical findings of MA and assessed a 6% whole person impairment; Held – Medical Assessment Certificate revoked; new MAC issued.
Decision date: 15 May 2026| Panel Members: Member Carolyn Rimmer, Dr David Crocker, and Dr Gregory McGroder| Injury module: Right Lower Extremity
Freeman v Office of Environment & Heritage National Parks & Wildlife Service [2026] NSWPICMP 338
Workplace Injury Management and Workers Compensation Act 1998; assessment of impairment of the lumbar spine, and scarring/TEMSKI following injury; appeal by applicant on grounds of demonstrable error and the assessment being made on the basis of incorrect criteria; Appeal Panel satisfied that the Medical Assessor (MA) erred in making a deduction for pre-existing condition partly on the basis of vulnerability and for failing to make any assessment of scarring/TEMSKI; new MA re-examined the appellant and the Appeal Panel assessed at 2% for scarring under TEMSKI; Appeal Panel applied a one tenth deduction pursuant to section 323(2) in respect of pre-existing condition and injury on the basis that a more precise deduction was too difficult to determine and one tenth was not at odds with the evidence; Held – Medical Assessment Certificate revoked.
Decision date: 18 May 2026| Panel Members: Member Carolyn Rimmer, Dr Drew Dixon, and Dr Tommasino Mastroianni| Injury module: Lumbar Spine, and Skin (TEMSKI)
Navitas Pty Ltd v Mukherjee [2026] NSWPICMP 339
Workplace Injury Management and Workers Compensation Act 1998; medical appeal; challenge to assessment under the psychiatric impairment rating scales of social and recreational activities, concentration, persistence and pace, and employability; Ballas v Department of Education (State of NSW) considered; history in desktop surveillance material considered; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.
Decision date: 18 May 2026| Panel Members: Member Parnel McAdam, Dr Ash Takyar, and Dr Graham Blom| Injury module: Psychiatric/psychological
State of New South Wales (NSW Police Force) v Marshall [2026] NSWPICMP 340
Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor erred in his whole person impairment assessment of two of the categories of the psychiatric impairment rating scale, namely self -care and personal hygiene and travel; Appeal Panel found no errors; the assessments were consistent with the evidence; Held – Medical Assessment Certificate confirmed.
Decision date: 18 May 2026| Panel Members: Member Deborah Moore, Dr Douglas Andrews, and Dr Graham Blom| Injury module: Psychiatric/psychological
Merhi v El Sweetie Sydney Pty Ltd [2026] NSWPICMP 341
Workplace Injury Management and Workers Compensation Act 1998; assessment of psychiatric injury; appeal on the grounds of demonstrable error and assessment being made on the basis of incorrect criteria; appellant submitted that the assessments in the psychiatric impairment rating scale of travel, social functioning, concentration, persistence and pace were in correct in a material respect or there was a lack of reasoning in relation the assessment; Appeal Panel found no error; Medical Assessment Certificate (MAC) not based on incorrect criteria; Held – MAC confirmed.
Decision date: 18 May 2026| Panel Members: Member Carolyn Rimmer, Dr Michael Hong, and Dr Ash Takyar| Injury module: Psychiatric/psychological
Slater v State of New South Wales (NSW Police Force) [2026] NSWPICMP 346
Workplace Injury Management and Workers Compensation Act 1998; medical appeal; consideration of psychiatric impairment rating scale of social functioning, travel, and employability; demonstrable error found in the Medical Assessment Certificate (MAC); re-examination necessary; worker did small amount of volunteering in local rugby club; not sufficient evidence of employability; error in assessment of travel; worker had some restriction; inconsistent with class 1; Held – MAC revoked; new MAC issued.
Decision date: 19 May 2026| Panel Members: Member Parnel McAdam, Dr John Baker, and Dr Michael Hong| 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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