Legal Bulletin No. 264

Issued 12 June 2026

Welcome to the two hundred and sixty-fourth 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 Decision

McMillan v Secretary, Department of Education [2026] NSWPICPD 24

Workers compensation; jurisdiction of the Personal Injury Commission determined and limited by the scope of the dispute; Skates v Hills Industries Ltd [2021] NSWCA 142 applied; the approach to statutory construction considered; SZTAL v Minister for Immigration and Border Protection [2017] HCA 34, ADCO Constructions Pty Ltd v Goudappel [2014] HCA 18; 254 CLR 1 applied; the meaning of ‘disease’ and ‘disease injury’ in section 4 of the Workers Compensation Act 1987 (the 1987 Act); ‘only if employment was the main contributing factor to contracting the disease’; considered Federal Broom Co Pty Ltd v Semlitch [1964] HCA 34; 110 CLR 626, Fletcher International Exports Pty Ltd v Barrow [2007] NSWCA 244; 5 DDCR 247, Taylor v J & D Stephens Pty Ltd [2018] NSWCA 267, Booth v Fourmeninapub Pty Ltd [2020] NSWCA 57 applied; whether there has been an ‘aggravation, exacerbation or deterioration’ of any disease within the meaning of section 4(b)(ii) of the 1987 Act considered; Semlitch applied; the construction and application of sections 4(b)(i) and s 15 of the 1987 Act; ‘employment to the nature of which the disease was due’ considered; Smith v Mann [1932] AC 30; 46 CLR 426, Tame v Commonwealth Collieries Pty Ltd (1947) 47 SR (NSW) 269, CSR Timber Products Pty Limited v Weathertex Pty Limited [2013] NSWCA 49; 83 NSWLR 433 applied; section 16 of the 1987 Act; ‘employment that was a substantial contributing factor’ considered; Rail Services Australia v Dimovski [2004] NSWCA 267; 1 DDCR 648, Australian Conveyor Engineering Pty Ltd v Mecha Engineering Pty Ltd (1998) 45 NSWLR 606 applied; Held – pursuant to section 352(6A) of the Workplace Injury Management and Workers Compensation Act 1998, orders 1 and 2 of the Certificate of Determination issued by Member Rimmer on 23 June 2025 are revoked; pursuant to section 352(7) of the Workplace Injury Management and Workers Compensation Act 1998; the matter is remitted to Member Rimmer to determine in accordance with this decision.

Decision date: 2 June 2026 | Before: Deputy President the Hon. Adam Searle

Motor Accidents non-Presidential Member Decisions

AAI Limited t/as GIO v Dyson [2026] NSWPIC 310

Motor Accident Injuries Act 2017; settlement approval; claimant was involved in an accident at a round-about; ambulance attended the scene and noted no injuries; later attended the general practitioner; diagnosed rib, sternum chest injuries; claimant made full recovery; working as casual cleaner; total incapacity for 2 weeks only; Held – settlement approved in the sum of $13,500, settlement just, fair and reasonable and within the range of likely potential damages assessment is the claim was to proceed to assessment taking into account the nature and extent of the claim, injuries, disabilities, impairments and losses.

Decision date: 29 May 2026 | Member: Elyse White

Allianz Australia Insurance Limited v Moar [2026] NSWPIC 311

Motor Accident Injuries Act 2017; approval of $55,000 pursuant to section 6.23; claimant liability in issue but no deduction for contributory negligence; claimant suffered fractures of the fifth-tenth ribs and an undisplaced transverse fracture at L3, substantial recovery, occasional twinge in the ribs and lower back discomfort; unlikely to be assessed to have greater than 10% whole person impairment; claim for past and future economic loss; Held – total settlement in the sum of $55,000.00 approved.

Decision date: 2 June 2026| Member: Michael Inglis

Mason-Balshaw v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 312

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 a passenger on a bus and was walking down the aisle of the bus in an endeavour to take a seat; driver of the bus braked suddenly in response to the presence of an unidentified motor vehicle, which caused the claimant to fall to the floor of the bus and sustain injuries; claimant commenced proceedings against the insurer of the bus, NRMA and Allianz, who is the insurer for the Nominal Defendant (the unidentified vehicle); claimant and NRMA resolved the claim for damages, but there remains the issue of liability apportionment between NRMA and Allianz; no allegation of contributory negligence on behalf of the claimant; determined the contribution by the NRMA to the accident is 80% and the contribution by Allianz to the accident is 20%; parties agreed on quantum and requested a determination of the issue of apportionment of liability; Held – contribution by NRMA to the accident is 80% and the contribution by Allianz to the accident is 20%.

Decision date: 2 June 2026| Member: David Ford

Mason-Balshaw v Allianz Australia Insurance Limited [2026] NSWPIC 313

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 a passenger on a bus and was walking down the aisle of the bus in an endeavour to take a seat; driver of the bus braked suddenly in response to the presence of an unidentified motor vehicle, which caused the claimant to fall to the floor of the bus and sustain injuries; claimant commenced proceedings against the insurer of the bus, NRMA and Allianz, who is the insurer for the Nominal Defendant (the unidentified vehicle); claimant and NRMA resolved the claim for damages, but there remains the issue of liability apportionment between NRMA and Allianz; no allegation of contributory negligence on behalf of the claimant; determined the contribution by the NRMA to the accident is 80% and the contribution by Allianz to the accident is 20%; parties agreed on quantum and requested a determination of the issue of apportionment of liability; Held – contribution by NRMA to the accident is 80% and the contribution by Allianz to the accident is 20%.

Decision date: 2 June 2026| Member: David Ford

AAI Limited t/as GIO v Vergara [2026] NSWPIC 315

Motor Accident Injuries Act 2017; compensation to Relatives Act 1897; settlement approval; deceased was a Philippines citizen who was killed in a motor vehicle accident whilst on holidays in Australia; deceased was working at the time of the accident; when assessing the value of income received from a shareholding in a company the deceased was part owner, of an “offsetting benefit” received by the claimant; claimant is aware this approval resolves her damages claim; settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines; Held – settlement approved in the amount of $284,670.57.

Decision date: 3 June 2026| Member: Philip Carr

Insurance Australia Limited t/as NRMA Insurance v Burton [2026] NSWPIC 316

Motor Accident Injuries Act 2017; approval of $350,000 pursuant to section 6.23; 76 year old claimant, otherwise fit and healthy suffered non-threshold injuries in terms of soft tissue injuries to the shoulders cervical and lumbar spine; claimant also suffered a head injuries involving a glass fragment in the skull, and a bruised cheek resulting in large haematoma; claimant also had significant bruising of the left breast from the seat belt, abrasions to the right arm, and bruising to the right thigh; significant non-threshold; psychological injury diagnosed as prolonged grief disorder resulting from the claimant's husband's death in the accident; symptoms including persistent presence of distressing and disruptive grief; symptoms daily since the loss; further symptoms associated with difficulty accepting the death and yearning, difficulty, difficulty moving on with life, a sense of emptiness, difficulty finding meaning and purpose; grief impacted on social and day-to-day functioning; inability to perform heavier household and domestic tasks; claim limited to non- economic loss; Held – proposed settlement in the sum of $350,000 for that head of damage approved.

Decision date: 3 June 2026| Member: Michael Inglis

Arab v Allianz Australia Insurance Limited [2026] NSWPIC 317

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; delay of 12 months; insurer wrote to the claimant on three occasions before the expiration of the limitation period and informed her that: she had a potential entitlement to damages; if she wanted to make a claim for damages she needed to complete a “form”; the “form” must be received by the insurer within three years after “the date of accident”; if she had any questions she could contact the insurer and/or SIRA, and if she wanted to seek legal advice she could contact the Law Society; Russo v Aiello, Walker v Howard, Karambelas v Zaknic (No. 2), Hunter v Roberts, Rahman v Al-Maharmeh, and Dahdah v Witte applied; Held – the claimant’s explanation for the delay was neither full nor satisfactory; the late claim may not be made; the claim cannot be referred for assessment.

Decision date: 3 June 2026| Senior Member: Brett Williams

Workers Compensation non-Presidential Member Decisions

Anderson v The Casino Food Co-op (Formerly Northern Co-operative Meat Company Ltd) [2026] NSWPIC 302

Workers Compensation Act 1987; claim for surgery; disease provisions held to apply such that the respondent was not the employer who last employed the worker in employment that was a substantial contributing factor to the disease or aggravation, acceleration, exacerbation or deterioration of the disease; Held – award for the respondent.

Decision date: 27 May 2026| Member: Jane Peacock

Giordano v ARG Ginger & Smart Pty Ltd [2026] NSWPIC 303

Workers Compensation Act 1987; workers compensation; claim for root canal treatment as a result of infection sustained due to fracture arising from bruxism; respondent accepts bruxism as a consequential condition arising from multiple orthopaedic injuries; respondent maintained treatment did not ‘result from’ nor was ‘materially contributed’ by accepted injury rather root canal treatment in 2024 was due to a prior infection present prior to injury in 2021; Kooragang v Bates, Murphy v Allity Management Services, and Taxi’s Combined Services v Schokman considered; Held – applicant sustained multiple orthopaedic injuries on 26 December 2021 which has resulted in chronic pain and the consequential condition of bruxism; the bruxism and use of opioid medication to treat injury on 26 December 2021 has resulted in dental deterioration which materially contributed to the requirement of root canal to tooth 36; respondent is to pay the reasonably necessary costs associated with root canal treatment to tooth 36 pursuant to section 60.

Decision date: 27 May 2026| Member: Diana Benk

Cheldavi v Prestige Form Group NSW Pty Ltd [2026] NSWPIC 304

Workers Compensation Act 1987; claim for lump sum compensation in respect of psychological injury; accepted physical injury after fall from a ladder; consequential psychological condition accepted; whether worker sustained a primary psychological injury in the fall; diagnosis of post-traumatic stress disorder almost seven years after the event; Romanous Constructions Pty Ltd v Arsenovic considered; Held – worker sustained a primary psychological injury; matter remitted for assessment of permanent impairment resulting from primary psychological injury.

Decision date: 27 May 2026| Senior Member: Rachel Homan

Culhana v State of New South Wales (NSW Police Force) & Ors [2026] NSWPIC 306

Workers Compensation Act 1987; identification of dependants and apportionment of lump sum death benefit; Held – orders for weekly compensation in respect of dependent children; funeral expenses; discretionary interest; uplift for complexity on costs.

Decision date: 28 May 2026| Senior Member: Rachel Homan

Seuala v New Horizons Pty Ltd [2026] NSWPIC 307

Workers Compensation Act 1987; claim for lump sum payment for whole person impairment (WPI) for injury to left knee and consequential conditions affecting the left ankle and lumbar spine due to development of gout and altered gait; respondent accepts injury to left knee, but disputes consequential conditions affecting the left ankle and lumbar spine; consideration of Kooragang Cement v Bates, and Moon v Conmah Pty Ltd; Held – the worker has suffered consequential conditions affecting his left ankle and lumbar spine as a result of the injury to the left knee; Held – referral to Medical Assessor for assessment of WPI.

Decision date: 28 May 2026| Member: John Isaksen

Chrul v State of New South Wales (Central Coast Local Health District) [2026] NSWPIC 308

Workers Compensation Act 1987; claim for weight loss treatment said to have arisen from an accepted injury to the lumbar spine; applicant suffered an accepted lumbar injury; at the time of her injury, she had pre-existing issues with her weight but had gained weight since the injury; applicant sought payment of expenses associated with weight loss treatment, including the prescription of Mounjaro, as part of her treatment for her lumbar injury; respondent denied liability, saying there was no consequential weight gain condition caused by the injury, and that the treatment was not reasonably necessary as a result the lumbar injury; Held – it is not necessary for the applicant to demonstrate a consequential weight gain in order for the proposed treatment to be reasonably necessary as a result of her back injury; where it was necessary for a consequential condition to be established, the applicant has discharged the onus of proof in any event; proposed weight loss treatment is reasonably necessary as a result of the lumbar injury and for that injury; applicant’s treating pain specialist, her GP and one of the respondent’s independent medical examiner indicate her condition would improve if she lost weight, and the evidence discloses she has benefitted from weight loss medication in the past; respondent ordered to pay the costs of and incidental to the proposed treatment.

Decision date: 28 May 2026| Member: Cameron Burge

Weber v The McHardy Family Pty Ltd [2026] NSWPIC 309

Workplace Injury Management and Workers Compensation Act 1998; injury; whether applicant suffered injury to the thoracic spine in a fall; thoracic spine fracture identified on radiology long after the event; attempt to age fracture; whether thoracic spine fractures are symptomatic; weighing of competing medical opinions on age of fracture and whether it would have been symptomatic; clinical records shows complaint of upper back pain shortly after injury; case litigated in different ways over time; Held – applicant suffered an injury to his thoracic spine; matter referred for assessment of whole person impairment.

Decision date: 29 May 2026 | Member: Parnel McAdam

Dawson v Inner West Council [2026] NSWPIC 314

Workers Compensation Act 1987; section 11A(1); wholly or predominantly; retrenchment; performance appraisal; reasonable action; cross-examination; Aluminium Louvres & Ceilings Pty Limited v Xue Qin Zheng, Jackson v Work Directions Australia Pty Ltd, Ponnan v George Weston Foods Ltd, Manly Pacific International Hotel Pty Ltd v Doyle, Dunn v Department of Education and Training, and Irwin v Director-General of Education; Held – respondent has not made out the defence under section 11A(1); respondent is to pay the applicant pursuant to section 37; payment of $2,569.60 per week from 28 April 2025 to 30 September 2025; $2,604.80 per week from 1 October 2025 to 31 March 2026, and $2,662.10 per week from 1 April 2026 to date and continuing subject to indexation;  the respondent is to pay the applicant’s reasonably necessary medical and treatment expenses pursuant to section 60.

Decision date: 2 June 2026| Member: John Turner

Carrasco v RKDOIG Pty Ltd [2026] NSWPIC 319

Workers Compensation Act 1987; claim for lump sum compensation for shoulder injuries and scarring, a neurological injury (insomnia) and consequential respiratory condition; shoulder injuries and claim for injury to the peripheral and central nervous system referred to two Medical Assessors (MA); applicant awarded compensation for his shoulder injuries and scarring in accordance with the Medical Assessment Certificate; claim for consequential respiratory condition settled by consent; MA (neurologist) confirmed that insomnia is a symptom and not a neurological injury; Held – award for the respondent.

Decision date: 5 June 2026| Principal Member: Glenn Capel

Motor Accidents Medical Review Panel Decisions

Martin v QBE Insurance (Australia) Limited [2026] NSWPICMP 379

Motor Accident Injuries Act 2017; permanent impairment dispute; claimant riding pushbike through a roundabout when hit by a car; multiple musculoskeletal injuries referred for assessment including fractures to the sacrum and right thumb; original Medical Assessment Certificate (MAC) assessed total whole person impairment (WPI) of 1% for medial lateral instability of the right thumb MP joint; Review Panel re-examined and found MP joint to be stable; impairment from loss of range of motion amounted to 1% WPI; sacral fracture healed with nil impairment; Held – Review Panel found impairment to be the same as MAC; MAC confirmed.

Decision date: 21 May 2026| Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Sophia Lahz| Injury module: Spine, Upper Limb, and Lower Limb

Insurance Australia Limited t/as NRMA Insurance v Cashin [2026] NSWPICMP 359

Motor Accident Injuries Act 2017; threshold injury dispute; claimant was a front seat passenger in car that was rear-ended by a 4WD; neck and psychological injuries claimed; pre-existing medical history of post-traumatic stress disorder and depression; original medical assessment certificate (MAC) found the motor accident caused an exacerbation of persistent depressive disorder; Review Panel noted heightened risk of further psychological injury due to pre-existing history; delay of documented psychiatric symptoms a relevant consideration in context of pre-accident history; Held – Review Panel not satisfied motor accident caused a new psychiatric disorder or exacerbated a pre-existing disorder; Review Panel found nil psychiatric injuries caused by the motor accident; MAC revoked; new MAC issued.

Decision date: 22 May 2026| Panel Members: Member Jeremy Lum, Dr Ronald Gill, and Dr Christopher Rikard-Bell| Injury module: Mental and Behavioural

Harlock v AAI Limited t/as Suncorp Insurance [2026] NSWPICMP 381

Motor Accident Injuries Act 2017; panel review of medical assessment; whether injuries caused by the motor accident give rise to a whole person impairment (WPI) greater than 10%; fracture to fifth metacarpal sustained in motor accident; subsequent development of chronic regional pain syndrome; original Medical Assessor found a 12% WPI with assessment of range of movement of digits in addition to assessment of ulnar nerve injury for sensory and motor deficits; insurer asserts an impermissible duplication of assessment referring to clause 6.58 of the Motor Accident Guidelines; Held – the loss of range of motion of the digits not solely due to peripheral nerve injury, and predominant cause due to post traumatic stiffness; clause 6.58 therefore does not apply; complex regional pain syndrome found to have resolved; Medical Assessment Certificate confirmed.

Decision date: 28 May 2026| Panel Members: Member Elizabeth Medland, Dr Drew Dixon, and Dr Michael McGlynn| Injury module: Upper Limb, and Skin

Capasso v Allianz Australia Insurance Limited [2026] NSWPICMP 383

Motor Accident Injuries Act 2017; degree of permanent impairment dispute; claimant was driving between work appointments; her vehicle was stationary at the intersection waiting for traffic lights to turn from red to green, when it was struck forcibly in the rear by the insured vehicle which was travelling at full speed; claimant was thrown around forcibly in her vehicle whilst restrained by her seatbelt; claimant attended her general practitioner the following day for assessment of pain in her lower right neck and low back; claimant was referred to a neurosurgeon who recommended ongoing conservative treatment with physiotherapy and medication, and subsequently two cortisone injections; ongoing pain in the neck with radiation down the right arm resulted in a bilateral C5/C6 foraminotomy together with a right-sided foraminotomy at C6/C7 on 18 April 2024 with a good result; many of her radicular symptoms resolved to a significant degree; Medical Assessor (MA) found accident-related injuries to the cervical spine, lumbar spine, thigh, hips and ankle; MA assessed a 9% whole person impairment (WPI) for cervical spine after making a one-tenth deduction for prior impairment; claimant’s review application allowed on basis that MA did not make clear if the claimant’s additional late documents have been considered; claimant re-examined by another MA on behalf of the Review Panel; parties agreed that claimant’s surgical scarring should be assessed notwithstanding not included in referred injuries; MAs agree that injuries to the left shoulder and hip not caused; Review Panel assessed a 12% WPI (5% cervical spine, 5% lumbar spine and 2% for scarring); Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 28 May 2026| Panel Members: Member Gary Victor Patterson, Dr Drew Dixon, and Dr Michael Couch| Injury module: Spine, Upper Limb, and Lower Limb

Rahimi v Allianz Australia Insurance Limited [2026] NSWPICMP 385

Motor Accident Injuries Act 2017; claimant suffered injury in a motor vehicle accident; Medical Assessor (MA) determined the claimant’s disputed treatment; the treating doctor proposed comprehensive dental treatment by way of extraction of teeth 16 and 15, socket preservation with a bone graft, implant placement for teeth 16 and 15, restoration of teeth 16 and 15, and restoration of tooth 46; however, this treatment did not relate to the injuries caused by the accident; the proposed treatment and care was reasonable and necessary in the circumstances; dispute about treatment; Review Panel conducted its own examination and concluded that the proposed treatment and care did not relate to the injury caused by the motor accident but was reasonable and necessary in the circumstances; Held – Medical Assessment Certificate of the original MA was affirmed.

Decision date: 28 May 2026| Panel Members: Member Terence Stern OAM, Dr Rohan Krishnan, and Dr Adrian Vertoudakis| Treatment Type: Dental Treatment

Insurance Australia Limited t/as NRMA Insurance v Magar [2026] NSWPICMP 388 

Motor Accident Injuries Act 2017; medical assessment of whole person impairment (WPI) by Medical Assessor (MA); claimant injured in motor vehicle accident crossing a street when she was hit by a vehicle from behind; claimant sustained psychiatric injuries; dispute arose as to the claimant’s WPI as a result of the injuries; MA determined the claimant’s WPI assessed at 16%; insurer sought a review of the assessment under section 7.26; Review Panel re-examined the claimant; Held – Review Panel revoked certificate of the original MA; substituted determination assessed a 14% WPI.

Decision date: 29 May 2026| Panel Members: Member Terence Stern OAM, Dr Christopher Rikard-Bell, and Dr Alan Doris| Injury module: Mental and Behavioural

Cengic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 389

Motor Accident Injuries Act 2017; review of Medical Assessor’s (MA) determination of a whole person impairment (WPI) for psychological or psychiatric injury under section 7.26; where the MA found that the claimant suffered from  a major depressive disorder and a chronic pain disorder, caused by the motor accident giving rise to a WPI assessed at 22%; claimant re-examined by the Review Panel; where the Review Panel found that the claimant suffered from a major depressive disorder - recurrent episode, caused by the motor accident which gave rise to a WPI assessed at 8%; no apportionment for pre-existing or subsequent impairment; Held – the certificate of the original MA is revoked; new MAC issued.

Decision date: 29 May 2026| Panel Members: Member Maurice Castagnet, Dr John Baker, and Dr Gerald Chew| Injury module: Mental and Behavioural

Sheldon v AAI Limited t/as AAMI [2026] NSWPICMP 390

Motor Accident Injuries Act 2017; review of the Medical Assessment Certificate (MAC) the Medical Assessor; dispute about whether an injury to the lower back was caused by the motor accident; whether the injury was a threshold injury; whether the accident caused a lumbar spine disc protrusion at L4-5; early complaint of low back pain; no prior back pain; claimant 18 years of age at the time of the accident; forceful collision; claimant re-examined; Momand v Allianz Australia Insurance Limited applied; Held – on the balance of probabilities, the motor accident caused the structural disc pathology at L4/5; a disc protrusion implies disruption of the fibrocartilaginous disc and is not a threshold injury; original MAC revoked; new MAC issued.

Decision date: 29 May 2026 | Panel Members: Member Maurice Castagnet, Dr Mohammed Assem, and Dr Shane Moloney | Injury module: Spine, and Upper Limb

Allianz Australia Insurance Limited v Markus [2026] NSWPICMP 392

Motor Accident Injuries Act 2017; application for medical assessment of threshold injury dispute; insurer’s application for review under section 7.26; claimant front seat passenger in vehicle hit from behind after stopping suddenly due to wildlife on the road; claimant alleged injuries to both left and right shoulder including up to five tendon and labrum tears; claimant had been injured in supermarket slip the year before the accident and commenced court proceedings alleging injury to one shoulder and symptoms in the other; claimant examined by both Medical Assessors (MA); claimant further examined by single MA to clarify parts of her history; Held – Review Panel satisfied claimant could have injured her shoulders in the accident but did not sustain shoulder joint injury including the multiple tears evident on MRI; claimant sustained soft tissue injury to neck which caused pain to radiate into the shoulder region; any injury to shoulder joints were further exacerbations or aggravations of pre-existing degenerative changes already symptomatic; claimant’s injuries were threshold injuries; Medical Assessment Certificate of original MA revoked; new MAC issued.

Decision date: 1 June 2026| Panel Members: Member Belinda Cassidy, Dr Ian Cameron, and Dr Les Barnsley| Injury module: Upper Limb

Insurance Australia Limited t/as NRMA Insurance v Mattar [2026] NSWPICMP 394

Motor Accident Injuries Act 2017; Review Panel of medical assessment; whether injuries caused by the motor accident are threshold injuries for the purposes of the Act; claim of radiculopathy and disc injuries in addition to annular tear; no radiculopathy found on examination nor evidence of radiculopathy satisfying the Motor Accident Guidelines criteria; issue as to whether annular tear in lumbar spine caused by the motor accident; test of balance of probabilities; Held – annular tear caused by the motor accident; Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 1 June 2026| Panel Members: Member Elizabeth Medland, Dr David Gorman, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, and Lower Limb

Ryoo v Allianz Australia Insurance Limited [2026] NSWPICMP 395

Motor Accident Injuries Act 2017; section 1.6(3); threshold injury: pre-existing condition; exacerbation of major depressive disorder; assessment of threshold injury under section 1.6(3); claimant suffered injury as a pedestrian in a motor vehicle accident; Medical Assessor (MA) found the claimant sustained an adjustment disorder with mixed anxiety and depressed mood caused by the accident, a threshold injury; claimant sought review; Held – claimant had sustained an exacerbation of a major depressive disorder caused by the accident; certificate of original MA revoked; claimant sustained a non-threshold injury; new MAC issued.

Decision date: 2 June 2026| Panel Members: Senior Member Susan McTegg, Dr Christopher Canaris, and Dr Steven Yeates| Injury module: Mental and Behavioural

AAI Limited t/as AAMI v Kim [2026] NSWPICMP 396

Motor Accident Injuries Act 2017; motor accident; insured vehicle collided with claimant’s vehicle; assessment of whole person impairment (WPI) for psychological injuries; claimant working 15 hours per week in husband’s business as a cashier; some decline in various psychiatric impairment rating scale categories; no issues of principal; Held – claimant assessed at 6% WPI; original Medical Assessment Certificate (MAC) revoked; certificate issued for psychological injury not greater than 10%; new MAC issued.

Decision date: 2 June 2026| Panel Members: Principal Member John Harris, Dr Thomas Newlyn, and Dr Gerald Chew| Injury module: Mental and Behavioural

Mohamed v Allianz Australia Insurance Limited [2026] NSWPICMP 399

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); whole person impairment (WPI) dispute; claimant was at the kerbside of a taxi rank when a taxi ran over his left foot; original Medical Assessor (MA) found non-displaced fractures of the 2nd and 3rd metatarsal bones, peripheral nerve impairment and reduced plantar flexion of the left ankle; total WPI assessed at 12%; issue in dispute concerned whether left ankle should be included in the assessment of the left foot as left foot only referred for medical assessment; Review Panel found crush injury to the foot involved the foot and ankle complex; management of left foot injury in CAM boot caused prolonged immobilisation, altered gait, stiffness, and reduced movement involving the left foot and ankle complex; Held – Review Panel found impairment due to restriction of ankle and hindfoot causally related to the motor accident; there was also impairment due to loss of motion to the great toe interphalangeal flexion and all lesser toes; no neurological involvement; total WPI assessed at 12% WPI; MAC confirmed.

Decision date: 3 June 2026| Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Mohammed Assem| Injury module: Lower Limb

Workers Compensation Medical Appeal Panel Decisions

Schmatz v Ganden Pty Limited [2026] NSWPICMP 362

Workplace Injury Management and Workers Compensation Act 1998; appeal from a whole person impairment (WPI) assessed at 6% for psychiatric illness; whether error made in social functioning or concentration persistence and pace categories of the psychiatric impairment rating scale; whether class 1 rating for social functioning vitiated for failing to consider evidence; whether class 2 rating vitiated for finding ability to self-medicate diabetes medication indicative of concentration ability;  Held – Medical Assessor not obliged to refer to every piece of evidence; State of New South Wales (NSW Department of Education) v Kaur, and Wingfoot Australia Partners Pty Ltd v Kocak applied; submission misconceived that evidence not considered, but class 1 inappropriate in general circumstances; concentration persistence and pace assessment also compromised by inclusion of self-medication as relevant to category; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 22 May 2026| Panel Members: Member John Wynyard, Professor Nicholas Glozier, and Dr Ash Takyar| Injury module: Psychiatric/psychological

General Mills Manufacturing Australia Pty Ltd v Leota [2026] NSWPICMP 380

Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Workers Compensation Act 1987 (1987 Act);psychological injury; lump sum claim; appellant employer did not challenge the overall whole person impairment assessment; appellant complained on appeal that section 65A of the 1987 Act not taken into account; appellant further complained that a deduction should have been made under section 323 of the 1998 Act; error found in the failure to make a deduction under section 323 of the 1998 Act; Held – Medical Assessment Certificate revoked; new MAC issued.

Decision date: 27 May 2026| Panel Members: Member Jane Peacock, Michael Hong, Professor Nicholas Glozier| Injury module: Psychiatric/psychological

Singhdeo v Secretary, Department of Transport [2026] NSWPICMP 386

Workplace Injury Management and Workers Compensation Act 1998; appeal from 7% whole person impairment assessment for cervical spine injury; whether Medical Assessor misdescription of date of injury is an appealable error; whether adequate reasons given; whether irrelevant considerations taken into account; whether procedural fairness had been afforded; Bojko v ICM Property Service Pty Ltd, Wingfoot Australia Partners Pty Ltd v Kocak, and Doyle v QBE Insurance (Australia) Ltd applied; Held – misdescription of date of injury not prejudicial to claimant case; submissions misconceived as to adequate reasons; submissions regarding irrelevant considerations again concerned with adequacy of reasons; mere expressions of doubt about meaning not sufficient without setting out passages relied on to support argument; procedural fairness afforded in the right of appeal and to adduce additional evidence; the right to file evidence before the assessor to support case; Medical Assessment Certificate confirmed.

Decision date: 28 May 2026| Panel Members: Member John Wynyard, Dr Gregory McGroder, Dr Robert Kuru| Injury module: Cervical Spine

Visy Board Pty Ltd v Dodds [2026] NSWPICMP 387

Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor erred in the deduction he made pursuant to section 323(2) in light of all of the evidence; Held – Appeal Panel agreed; deduction made was at odds with all the available evidence; Medical Assessment Certificate revoked; new MAC issued.

Decision date: 28 May 2026 | Panel Members: Member Deborah Moore, Dr Gregory McGroder, and Dr Doron Sher| Injury module: Right Lower Extremity

Steane v M A Swinnerton Engineering Pty Ltd [2026] NSWPICMP 391

Workplace Injury Management and Workers Compensation Act 1998; appeal from 7% whole person impairment (WPI) Medical Assessment Certificate (MAC) for psychological injury: whether Medical Assessor (MA) erred in all categories of the psychiatric impairment rating scale save employment; whether error by MA in failing to have regard to claimant’s statements, in expressing views that the claimant could not understand, in making findings that were contrary to claimant’s statements; State of New South Wales (NSW Department of Education) v Kaur, Wingfoot Australia Partners Pty Ltd v Kocak, and Lancaster v Foxtel Management considered; Held – there is no obligation on an MA to refer to documents that claimant regarded as important; MA’s function discussed, including that path of reasoning be clear for appellate tribunal or court to see whether error occurred; function of Appeal Panel to determine whether evaluative reasoning complied with descriptors; observations on objective nature of descriptors; importance of face-to-face consultation referred to; class 1 rating for social functioning erroneous; MAC revoked; new MAC issued.

Decision date: 29 May 2026 | Panel Members: Member John Wynyard, Dr Douglas Andrews, and Dr Michael Hong | Injury module: Psychiatric/psychological

State of New South Wales (NSW Police Force) v Keiselis [2026] NSWPICMP 397

Workplace Injury Management and Workers Compensation Act 1998; appeal by employer from 15% whole person impairment assessment for psychological/psychiatric disorder; whether error in class 3 rating for social and recreational activities; whether error in concentration persistence and pace class 3 rating; Held – Medical Assessor recorded claimant as participating regularly in cricket club for at least 2 seasons and visiting the gym for an hour several times per week; class 1 and 2 descriptors considered; sporting activities comparable with class 1 rating but rating reduced to class 2, as some elements of this category compromised; concentration persistence and pace rating confirmed;  employer submission that ability to concentrate demonstrated by sporting activities rejected as speculation; Medical Assessment Certificate revoked; new MAC issued.

Decision date: 2 June 2026| Panel Members: Member John Wynyard, Dr John Baker, and Dr Ash Takyar| Injury module: Psychiatric/psychological

Motor Accidents Merit Review Decisions

Padernilla v AAI Limited t/as AAMI [2026] NSWPICMR 22

Motor Accident Injuries Act 2017; merit review dispute as to the rate per kilometre to be reimbursed to a claimant for travel to and from treatment pursuant to section 3.24(1); whether a rate of $0.66km applied by the insurer is reasonable; claimant asserts a rate of $0.88km is reasonable; consideration of prescribed rates for other classes of travel within the Motor Accident Injuries scheme and the NSW workers compensation scheme; clause 33 of the Motor Accident Injuries Regulation; whilst not binding for the purposes of section 3.24 of the Act, it provides relevant guidance; Held – it would be an undue cumbersome task, if not impossible, to calculate the actual costs of travel in each case. Reasonable to apply a standard rate, $0.66/km considered reasonable; reviewable decision affirmed.

Decision date: 26 May 2026| Merit Reviewer: Elizabeth Medland

Rayat v AAI Limited t/as AAMI [2026] NSWPICMR 23

Motor Accident Injuries Act 2017; claim for statutory benefits; dispute about calculation of pre-accident weekly earnings (PAWE); whether bank deposits reliable evidence of wages; sole director and employee of a company; where there is  significant discrepancy between bank records and payslips; lack of contemporaneous evidence; undisclosed evidence; purpose of deposits by Company into claimant’s account; whether director loans are earnings; whether sufficient evidence to calculate PAWE; clause 4(1); Held – the reviewable decision is affirmed.

Decision date: 29 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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