Legal Bulletin No. 273

Issued 14 August 2026

Welcome to the two hundred and seventy-third edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.

Supreme Court Decisions

Cox v Secretary, Department of Education [2026] NSWSC 945

Administrative law; judicial review; decision of appeal panel; psychological injury; whether jurisdictional error or error of law on the face of the record; whether Appeal Panel failed to consider plaintiff’s substantial and clearly articulated argument; whether constructive failure to exercise jurisdiction; whether Appeal Panel failed to take into account plaintiff’s evidence of the restrictions in functioning; whether Appeal Panel’s reasons adequate; whether material errors; Held – set aside the decision of the Appeal Panel dated 21 October 2025 and the Certificate of Determination issued by the Personal Injury Commission of New South Wales dated 25 November 2025; Direct that the matter be remitted to the President of the Personal Injury Commission for referral to a differently constituted Appeal Panel under section 328 of the Workplace Injury Management and Workers Compensation Act 1998 (NSW) to be determined in accordance with law; No order as to costs.

Decision date: 7 August 2026| Before: Price AJA

AAI LIMITED trading as AAMI v Patsalis [2026] NSWSC 953

Administrative law; judicial review; Personal Injury Commission; medical assessment under Motor Accident Injuries Act 2017 (NSW); Held – The Summons dated 15 April 2025 is dismissed; The plaintiff is to pay the first defendant’s costs.

Decision date: 7 August 2026| Before: Harrison AsJ

Presidential Member Decision

The Star Entertainment Group Ltd v Antoniak [2026] NSWPICPD 31

Workers compensation; Estoppel based on the principles in Port of Melbourne Authority v Anshun Pty Ltd [1981] HCA 45; 147 CLR 589 (Anshun estoppel); Miller v Secretary, Department of Communities and Justice [2022] NSWCA 190 (Miller No. 10); Habib v Radio 2UE Sydney Pty Ltd [2009] NSWCA 231; The Star Entertainment Group Ltd v Antoniak [2024] NSWPICPD 37; Kirk

v Industrial Court of New South Wales [2010] HCA 1; 239 CLR 531; Held – The Certificate of Determination dated 16 October 2025 is confirmed.

Decision date: 3 August 2026 | Before: Deputy President Michael Snell

Motor Accidents non-Presidential Member Decisions

Woolfman v Lifetime Care and Support Authority [2025] NSWPIC 666

Motor Accident Injuries Act 2017; miscellaneous claims dispute as to whether travel by claimant to the United Kingdom (UK) meets the definition of treatment of care; under section 1.4 of the Act; significant injuries including brain injury amputation; claimant travelled to UK in 2024 where members of her family resides; Held – trip contributed to the claimant’s wellbeing but the proximate purpose of the trip was not treatment; any benefit to the wellbeing of the claimant is an inherent benefit to the usual activities of life.

Decision date: 16 July 2025| Member: Elizabeth Medland

Jovicic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 441

Motor Accident Injuries Act 2017; procedural decision within a review of a medical assessment by a Review Panel; whether the insurer can introduce further material to be considered by the Review Panel; material includes surveillance reports and footage; provided to the claimant and the Review Panel after the Review Panel had conducted a medical re-examination of the claimant; consideration of Rule 67 and r 109 of the Personal Injury Commission Rules 2021; Held – allowing the introduction of the material is not necessary to facilitate the just, quick and cost effective resolution of the real issues in the proceedings; insurer had ample time to provide the material in advance of the re-examination and chose not to do so with knowledge of the requirements of the Rules.

Decision date: 4 June 2026| Member: Elizabeth Medland

Allianz Australia Insurance Limited v Smoothy [2026] NSWPIC 442

Motor Accident Injuries Act 2017; Review Panel; application for recusal and reconstitution; apprehended bias; claimant alleged professional associations between Review Panel members and insurer-retained psychiatrist, prior Commission decisions, internet commentary, lack of appropriate specialist expertise, and loss of confidence in the Review Panel; application of Ebner v Official Trustee in Bankruptcy, Johnson v Johnson, Isbester v Knox City Council, QYFM v Minister for Immigration, Citizenship, Migrant Services and Multicultural Affairs, and Gillies v Secretary of State for Work and Pensions; ordinary professional overlap within a specialist statutory jurisdiction distinguished from relationships capable of giving rise to a reasonable apprehension of bias; subjective loss of confidence and preference for different specialist expertise held insufficient to justify recusal; Held – no objective basis for apprehended bias established; application for recusal and reconstitution refused.

Decision date: 27 July 2026| Member: Bridie Nolan

Insurance Australia Limited t/as NRMA Insurance v Bitar [2026] NSWPIC 438

Motor Accident Injuries Act 2017; settlement approval; claimant front seat passenger when insured driver lost control of the vehicle and crashed into a brick wall trapping the claimant; claimant 86 years old with pre-existing medical symptoms; sustained spinal and rib fractures; whole person impairment assessed at 40%; claimant received aged pension for many years pre-accident; damages limited to non-economic loss; Held – settlement approved in the sum of $360,000; settlement just, fair and reasonable and within the range of likely potential damages assessment if the claim was to proceed to assessment taking into account the nature and extent of the claimant’s injuries, disabilities, impairments and losses.

Decision date: 28 July 2026| Member: Elyse White

Malufuka v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 452

Motor Accident Injuries Act 2017; motor vehicle accident; driver; claims assessment; damages for non-economic loss; damages for future economic loss; past economic loss; most likely future circumstances; buffer; assessment of damages; 47-year-old claimant sustained injury when he was run down whilst working in traffic control on 23 March 2023; serious injury left thumb and left wrist; aggravation of pre-existing lumbar spondylosis; soft tissue injury to left hip; associated psychological injury; returned to work after 10 months; currently working two jobs; unable to undertake physical tasks; question of extent of impairment of future earning capacity; Held – non-economic loss assessed at $400,000; past economic loss agreed $150,944.32; past super $27,197.17; allowance for Fox v Wood; buffer of $400,000 for future economic loss in accordance with Penrith City Council v Parks where claimant has future working life 18 years; may have to retire early; may have difficulty in securing or maintaining suitable supervisory roles; restricted ability to undertake future security work; need to take strong narcotic medication; condition likely to worsen; total damages assessed in sum of $978,141.49 plus costs assessed in favour of the claimant.

Decision date: 4 August 2026| Senior Member: Susan McTegg

Workers Compensation non-Presidential Member Decisions

Brito v Alex De Brito Fire and Remedial Building Works Pty Ltd [2026] NSWPIC 426

Workers Compensation Act 1987; whether the applicant suffered consequential condition of the left shoulder as a result of an accepted right shoulder injury; claim for whole person impairment;     applicant claims that injuries sustained in a fall on 18 January 2022 was the result of right shoulder injury 26 March 2020; Nguyen v Cosmopolitan Homes, and Kooragang Cement Pty Ltd v Bates considered; the fall and subsequent injury on 18 January 2022 was independent to any right shoulder injury on 26 March 2020; left shoulder injury arose from a slip and fall and broke the causal chain required to establish a consequential condition; Held – applicant suffered an injury to his right shoulder on 26 March 2020; applicant suffered an injury to his left shoulder on 18 January 2022.

Decision date: 22 July 2026| Member: Diana Benk

Singh v Redi-Strip NSW Pty Ltd [2026] NSWPIC 443

Workers Compensation Act 1987; applicant alleged incapacity arising from an injury in the respondent’s employ on 26 April 2018; applicant sought a finding regarding causation and an order that proposed surgery was reasonably necessary; Held – the Commission found that his incapacity arose from underlying pathology and issued an award for the respondent.

Decision date: 29 July 2026 | Member: Lea Drake

Almansor v Formed Up Projects Pty Ltd [2026] NSWPIC 444

Workers Compensation Act 1987; claim for lump sum payment for whole person impairment (WPI) for injury to the right upper extremity and neck and/or consequential conditions affecting the right upper extremity and neck; the respondent accepts injury to the right hand but disputes injury or consequential conditions to those other body parts; whether the worker has features of Complex Regional Pain Syndrome (CRPS) caused by the injury which warrants a referral for WPI; Moon v Conmah Pty Ltd considered; Held – worker did not sustain an injury to the right upper limb (other than to the right hand) and neck; worker suffered consequential conditions affecting his right upper limb by the development of features of CRPS; award for the respondent on the claim of a consequential condition affecting the neck; referral to Medical Assessor for assessment of WPI.

Decision date: 30 July 2026 | Member: John Isaksen

Saadeddine v Sydney International Container Terminals Pty Ltd [2026] NSWPIC 445

Workers Compensation Act 1987; weekly compensation and permanent impairment; accepted neck injury. Left shoulder injury and lumbar spine consequential condition disputed; applicant suffered an accepted neck injury when struck in the head by a steel bar in the course of her employment; applicant claims neck and left shoulder frank injuries as a result of that injury, and a consequential condition to her lumbar spine said to be caused by having to drive a container carrier when she returned to work as part of her modified duties; Held – applicant suffered a neck injury in the incident at issue; as a result, the applicant suffered a consequential condition to her lumbar spine brought about by her modified duties; award for the respondent on the alleged left shoulder injury; permanent impairment claim remitted for medical assessment; weekly compensation claim adjourned until after the issuing of a Medical Assessment Certificate.

Decision date: 30 July 2026| Member: Cameron Burge

Foster v Secretary, Department of Communities and Justice (Corrective Services) [2026] NSWPIC 446

Workers Compensation Act 1987; psychological injury; weekly compensation and medical expenses; whether applicant suffered a psychological injury as alleged; if so, whether applicant is incapacitated as alleged notwithstanding a period of post-injury employment; extent of incapacity; Held – the applicant suffered a psychological injury to which his employment was the main contributing factor; as a result of the injury, the applicant remains totally incapacitated for employment for the period claimed; respondent to pay the applicant weekly compensation as claimed, subject to periodic indexation; respondent to pay the applicant’s reasonably necessary section 60 expenses.

Decision date: 30 July 2026| Member: Cameron Burge

Clarke v State of New South Wales (NSW Police Force) [2026] NSWPIC 447

Workers Compensation Act 1987; hip injury; osteoarthritis; disease; aggravation, acceleration, exacerbation or deterioration; sections 4, 9A, and 60; left hip total replacement; claim for cost of left total hip replacement surgery; injury 21 September 2023 to lumbar spine; alleged injury to left hip; aggravation of underlying osteoarthritis; left hip symptoms masked by lumbar spine symptoms; dispute as to injury under section 4, as to substantial contributing factor under section 9A and as to treatment under section 60; Held – aggravation, acceleration, exacerbation or deterioration of left hip osteoarthritis injury arising out of employment under section 4(a); employment substantial contributing factor to injury per section 9A; aggravation, acceleration, exacerbation or deterioration of the left hip osteoarthritis in the course of his employment on 21 November 2023 to which the employment was the main contributing factor as per section 4(b)(ii); left total hip replacement surgery reasonably necessary treatment; respondent to pay applicants costs as agreed or assessed.

Decision date: 31 July 2026| Senior Member: Susan McTegg

Iqbal v Zreika [2026] NSWPIC 448

Workers Compensation Act 1987; section  60; undisputed workplace injury to applicant worker’s lumbar spine; request for spinal fusion surgery at L4/5; surgery contended to be reasonably necessary as a result of workplace injury; disputed by respondent employer; contends natural fusion process known as ‘autofusion’ has occurred making proposed fusion surgery redundant; whether autofusion has occurred; Held – although natural fusion process may be in process, symptoms persisting and worsening; evidence insufficient to establish completed natural fusion; proposed fusion surgery accepted to be reasonably necessary to treat ongoing and worsening symptoms; respondent liable for the cost of the fusion surgery.

Decision date: 31 July 2026| Member: Adam Halstead

Turner v Iannelli Holdings Pty Ltd & Anor [2026] NSWPIC 449

Workers Compensation Act 1987; claim under section 25(1) for lump sum death benefit; deceased worker died in a truck crash while enroute to deliver produce for employer; whether injury arising out of or in the course of employment for the purposes of section 4(a); evidence that deceased worker’s wife was possibly driving the vehicle at the time of the accident; post-mortem toxicology results revealing high levels of illicit drugs; Workcover Authority of NSW v Walsh, Badawi v Nexon Asia Pacific Pty Limited trading as Commander Australia Pty Limited, and Tarry v Waringah Shire Council considered; Held – on the balance of probabilities the deceased worker was the driver; the ingestion of illicit drugs took the deceased worker outside the course of employment; section 14(1) not satisfied; nevertheless, injury arose out of employment; employment a substantial contributing factor to injury pursuant to section 9A; death resulted from an injury.

Decision date: 3 August 2026| Senior Member: Rachel Homan

Nasser v Secretary, Department of Communities and Justice [2026] NSWPIC 450

Workers Compensation Act 1987; claim for ongoing weekly benefits and medical and related treatment expenses in respect of a psychological injury; whether injury was wholly or predominantly caused by reasonable action with respect to the provision of employment benefits for the purposes of section 11A(1); previous flexible work arrangement which allowed the worker to provide care to her grandson with a medical condition; change in management and applicant’s duties; worker provided with shifts which were incompatible with her flexible work arrangement and asked to provide evidence in support of her request for flexibility; Held – respondent’s actions with respect to the flexible work arrangement were the predominant cause of the injury; the Commission not satisfied that the relevant actions were reasonable; awards in favour of the applicant.

Decision date: 3 August 2026 | Senior Member: Rachel Homan

Motor Accidents Medical Review Panel Decisions

Allianz Australia Insurance Limited v Laws [2026] NSWPICMP 529

Motor Accident Injuries Act 2017; review of the medical assessment certificate of a Medical Assessor; dispute about whether the motor accident caused an ear-hearing injury and whether the injury is  threshold injury; where section 3.24 of the Act; claim for statutory benefits for payment of treatment and care expenses; dispute about whether a request by the claimant for an audiology and vestibular function test is related to the injury caused by the accident and whether the treatment is reasonable and necessary in the circumstances; claimant re-examined; Held – the certificate of the MA’s finding that the proposed treatment is reasonable and necessary in the circumstances and is related to the injuries caused by the accident is revoked.

Decision date: 23 July 2026| Panel Members: Member Maurice Castagnet, Dr Brian Williams, and Dr Margaret Gibson| Injury module: Ear, Nose, Throat and Related Structures; Treatment Type: Audiology and Vestibular Function Test

Tucker v AAI Limited trading as AAMI [2026] NSWPICMP 530

Motor Accident Injuries Act 2017; review of the medical assessment certificate of a Medical Assessor; dispute about whether the claimant’s physical injuries caused by the motor accident are threshold injuries; where the insured vehicle collided with the claimant’s motorcycle at a roundabout causing the claimant to roll over the bonnet and landing on the road; claimant re-examined; whether the claimant sustained a traumatic brain injury in the accident; no medically verifiable abnormality of Glasgow Coma Scale or any documented post-traumatic amnesia duration; brain imaging abnormalities noted in a brain MRI were considered on the balance of probabilities, not traumatic; whether the accident caused a tear of the Triangular Fibrocartilage Complex (TFCC) articular disc; reported site of pain was not consistent with the ulnar/medial location of the perforated TFCC at the wrist; Review Panel concluded that the MRI finding of the TFCC was incidental and not related to any trauma caused by the accident; where the review panel found that all the claimant’s physical injuries were threshold injuries; Held – original assessment confirmed.

Decision date: 23 July 2026| Panel Members: Member Maurice Castagnet, Dr Sophia Lahz, and Dr David Gorman| Injury module: Brain Injury, Upper Limb, Spine, and Urinary and Reproductive Systems

Lifetime Care and Support Authority (CTP Care) v Dagher [2026] NSWPICMP 531

Motor Accident Injuries Act 2017; review of medical assessment; whether treatment is related to the injury caused by the accident and whether it is reasonable and necessary;  request for initial consultation with rheumatologist; psychological injury arising from the claimant’s husband sustaining a severe injury in a motor accident; original medical assessment found related and reasonable and necessary due to the motor accident causing biopsychosocial factors; Held – consultation with rheumatologist not related to the injury caused by the motor accident; on evidence the consultation relates to pre-existing health issues with evidence not establishing a causal connection with the motor accident; Medical Assessment Certificate revoked.

Decision date: 23 July 2026 | Panel Members: Member Elizabeth Medland, Dr Les Barnsley, and Dr Margaret Gibson| Treatment Type: Medical Specialist Consultation

LBC v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 559

Motor Accident Injuries Act 2017; claimant injured in a motor accident 20 March 2020; medical dispute review under section 7.26 about whether the accident caused a whole person impairment (WPI) greater than 10%; accident arose out of domestic violence; insurer disputed causation and alleged pre-accident impairment; Medical Assessor found accident caused referred injuries with permanent impairment not greater than 10% ; claimant alleged error; Review Panel re-examined claimant; Held – claimant reassessed at 5% WPI; pre-accident impairment from drug treatment; accident caused post-traumatic stress disorder; different outcome; previous Medical Assessment Certificate revoked; decision de-identified.

Decision date: 30 July 2026 | Panel Members: Member Terence O’Riain, Dr Paul Friend, and Dr Abishek Nagesh| Injury module: Mental and Behavioural

Saad v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 560

Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; rear end collision; injuries to cervical spine, lumbar spine and both shoulders referred for assessment; where the Medical Assessor assessed whole person impairment (WPI) of 5% for the cervical spine injury, 0% WPI for the lumbar spine injury and found that the motor accident did not cause injury  to the right shoulder or the left shoulder; where an ultrasound performed about seven months after the accident revealed a full-thickness supraspinatus tear in the right shoulder; whether the motor accident caused the tear in the right shoulder; claimant re-examined; where the Review Panel also found that the motor accident did not cause an injury to the right shoulder or the left shoulder; Held – original MAC revoked; degree of WPI assessed at 0%.

Decision date: 30 July 2026 | Panel Members: Member Maurice Castagnet, Dr Shane Moloney, and Dr Rhys Gray| Injury module: Spine, and Upper Limb

Insurance Australia Limited t/as NRMA Insurance v Kim [2026] NSWPICMP 561

Motor Accident Injuries Act 2017; assessment of degree of permanent impairment; vehicle in which claimant was travelling stopped at a red light and was stationary for some little time when the insured vehicle ran into the back of it, pushing it forward; there was no deployment of airbags; claimant was not taken to hospital; Medical Assessor (MA) found injuries to cervical spine, both shoulders, lumbar spine and right foot all caused by motor accident; MA certified 12% WPI; insurer’s review application allowed on the basis that MA failed to appropriately consider the mechanisms of the accident, reflective of a minor rear-end collision, when considering causation of alleged spine injury; insurer relied on dashcam footage but no expert biomechanical engineering evidence; claimant re-assessed by another MA whose clinical findings were similar to those of the original MA; Held – Review Panel satisfied as to causation of all injuries; certificate confirmed.

Decision date: 30 July 2026 | Panel Members: Member Gary Victor Patterson, Dr Drew Dixon, and Dr Michael Couch| Injury module: Spine, Upper Limb, and Lower Limb

Le v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 562

Motor Accident Injuries Act 2017; claimant injured; motor vehicle accident in April 2022; dispute as to Whole Person Impairment (WPI); Medical Assessor (MA) determined WPI at 2%; injury to the cervical spine; soft tissue and underlying degenerative change; injury to the lumbar spine; soft tissue underlying degenerative change; injury to the right shoulder; soft tissue; Injury to the left shoulder; restricted motion secondary to whiplash associated disorder; application for review; Review panel re-examined claimant; Review Panel concluded claimant sustained soft tissue injuries to cervical and lumbar spine, right shoulder, right arm, right elbow and chest; examination of cervical spine; no dysmetria, guarding or spasm; no non-verifiable radicular complaints; no signs of radiculopathy as required; no vertebral body compression or vertebral fracture; cervical injury assessed at Diagnosis-Related Estimate I namely 0% WPI; lumbar spine; no vertebral body compression or fracture, no dysmetria, guarding or spasm, no features to indicate non-verifiable radicular complaints; no signs of radiculopathy; assessed at Category I, 0% WPI; left shoulder assessed by range of motion; 2% total upper extremity impairment calculated by reference, converted to 1% WPI; right shoulder assessed by analogy with clavicular joint condition assessed at 2% WPI; right elbow assessed at 0% WPI; combined 2% for right shoulder and 1% for left shoulder giving final combined WPI of 3%; Held – MA’s determination revoked; Review Panel substitutes its determination of 3% WPI.

Decision date: 31 July 2026 | Panel Members: Member Terence Stern OAM, Dr Les Barnsley, and Dr Margaret Gibson| Injury module: Spine, and Upper Limb

Vu v Allianz Australia Insurance Limited [2026] NSWPICMP 563

Motor Accident Injuries Act 2017; whether injuries caused by the motor accident give rise to a whole person impairment (WPI) greater than 10%; fall on a bus onto left side; clavicle fracture; surgical repair; issues of causation; cervical spine symptoms only developed following surgery; no direct injury to the neck; whether consequential injury was part of the original dispute; Mandoukos v Allianz Australia Insurance Limited considered; Review Panel satisfied that consequential injury claimed and not considered by original Medical Assessor; cervical spine injury found to be caused by the motor accident; left shoulder injury caused overuse of right shoulder; clauses 6.51 and 6.52 of the Motor Accident Guidelines not applicable to assessment of left shoulder; Held – 12% WPI found; certificate revoked.

Decision date: 31 July 2026 | Panel Members: Member Elizabeth Medland, Dr David Gorman, and Dr Margaret Gibson | Injury module: Spine, Upper Limb, and Lower Limb

Min v Allianz Australia Insurance Limited [2026] NSWPICMP 564

Motor Accident Injuries Act 2017; claimant was injured in a motor accident on 27 March 2023 when she was a front seat passenger in a stationary car, which was waiting to turn right, and a bus collided with the rear of her car; dispute as to whether the degree of permanent impairment of the claimant that has resulted from the injury caused by the motor accident is greater than 10%; Medical Assessor (MA) found that soft tissue injuries to the claimant’s cervical spine, lumbar spine, right and left shoulders were caused by the motor accident and assessed the combined whole person impairment (WPI) for these injuries at 4% - 2% for the right shoulder and 2% for the left shoulder; MA found that the injuries to the claimant’s bilateral wrists, bilateral hands and bilateral knees were not caused by the motor accident; claimant sought review and was re-examined by another MA; Held – Panel found that the motor accident caused soft tissue injuries to the claimant’s cervical spine, lumbar spine, bilateral shoulders, bilateral wrists, bilateral hands and bilateral knees, and assessed WPI for these injuries at a total of 4% - 2% for the right shoulder and 2% for the left shoulder; there was no evidence of any pre-existing or subsequent causes of the WPI of the bilateral shoulders and there was no deduction for this from the assessed WPI for these injuries; Review Panel found that the injuries to the claimant’s bilateral wrists and bilateral hands had resolved with no assessable impairment; Held – Medical Assessment Certificate of MA revoked.

Decision date: 31 July 2026 | Panel Members: Member Cameron Thompson, Dr Shane Moloney, and Dr Thomas Rosenthal| Injury module: Spine, Upper Limb, and Lower Limb

Insurance Australia Limited t/as NRMA Insurance v Munjas [2026] NSWPICMP 567

Motor Accident Injuries Act 2017; review of medical assessment; whether psychological injuries caused by the motor accident give rise to a whole person impairment (WPI) that is greater than 10%; original medical assessment found post-traumatic stress disorder with 26% WPI;  functioning assessed with regard to exclusion of symptoms attributable to pain rather than psychological disturbance; Review Panel diagnosed persistent depressive disorder with 7% WPI; Held – Medical Assessment Certificate revoked.

Decision date: 3 August 2026| Panel Members: Member Elizabeth Medland, Dr Steven Yeates, and Dr John Baker | Injury module: Mental and Behavioural

El-Chiekh v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 568

Motor Accident Injuries Act 2017; review of medical assessment; whether injury caused by the motor accident is a threshold injury for purposes of the Act; predominate issue of whether a possible C7 transverse process fracture seen on radiology investigation after accident is present and caused by the accident; equivocal finding; balance of probabilities test applied; on evidence sufficiently satisfied that a CT transverse fracture present and caused by the motor accident; injury not a threshold injury; Held – Medical Assessment Certificate revoked.

Decision date: 3 August 2026| Panel Members: Member Elizabeth Medland, Dr Michael Couch, and Dr Margaret Gibson | Injury module: Spine, and Upper Limb

Gkoutsidis v Allianz Australia Insurance Limited [2026] NSWPICMP 569

Motor Accident Injuries Act 2017; review of medical assessment; dispute about whether psychological injury caused by accident is a threshold injury for the purposes of the Act; where Medical Assessor found the claimant had a chronic adjustment disorder with mixed anxiety and depressed mood caused by the accident and certified that the accident caused injury was a threshold injury; Held – the claimant had an adjustment disorder with mixed anxiety and depressed mood caused by the accident; the accident caused psychological injury is a threshold injury; Medical Assessment Certificate confirmed.

Decision date: 3 August 2026| Panel Members: Senior Member Brett Williams, Dr John Lam-Po-Tang, and Dr John Baker | Injury module: Mental and Behavioural

QBE Insurance (Australia) Limited v Hibbard [2026] NSWPICMP 570

Motor Accidents Compensation Act 1999; review of Medical Assessor’s (MA) determination of permanent impairment for psychological injury under section 63; where the MA found that the claimant suffered from a post-traumatic stress disorder caused by the motor accident giving rise to a permanent impairment of 15%; whether there was a pre-existing impairment and a subsequent impairment; claimant re-examined by the Review Panel; where the Review Panel also found that the claimant suffered from a post-traumatic stress disorder but also a major depressive disorder caused by the motor accident; no apportionment for pre-existing impairment or subsequent impairment; where permanent impairment was assessed at 8%; Held – the certificate of the MA is revoked.

Decision date: 3 August 2026 | Panel Members: Member Maurice Castagnet, Dr Surabhi Verma, and Dr Christopher Canaris| Injury module: Mental and Behavioural

Allianz Australia Insurance Limited v Hindy [2026] NSWPICMP 571

Motor Accidents Compensation Act 1999; review of medical assessment certificate (MAC); Medical Assessor certified 50% permanent impairment regarding urinary and reproductive systems, together with secondary injury of urinary incontinence caused by the accident; issue of causation; whether injuries a consequence of a spinal injury caused by the accident, and/or pain medication; claimant examined; Held – diagnosis of bladder atony and urinary incontinence; pre-accident symptoms and pain medication use, and significant delay in reporting any bladder or urinary issues post-accident; Review Panel not satisfied urinary and reproductive systems injuries nor secondary injury of urinary incontinence caused by accident; accordingly, Review Panel unable to assess permanent impairment; MAC revoked.

Decision date: 3 August 2026| Panel Members: Member Bianca Montgomery-Hribar, Dr John Schmidt, and Dr Norman Chan| Injury module: Urinary and Reproductive Systems

Hutson v AAI Limited t/as AAMI [2026] NSWPICMP 572

Motor Accident Injuries Act 2017; threshold injury dispute; claimant was seated in her stationary vehicle at a carpark when an out of control vehicle collided with the side of her vehicle; injury to lumbar spine; whether annular tear and disc protrusion at L4/L5 causally related to motor accident; original Medical Assessment Certificate (MAC) found lumbar spine injury to be a threshold injury; sufficient information for determination on the papers; MRI of lumbar spine found to be evidence of acute pathology with relevant factors including: claimant’s age (22 years); nil pre-accident history of back injury, conditions or symptoms; MRI showed disc desiccation but no prior imaging to confirm the extent of any disc disease; MRI showed surrounding discs to be healthy and pristine; immediate back pain at time of motor accident with numbness into right leg; continuation of back and leg symptoms particularly with prolonged sitting and standing; Held – Review Panel determined, on balance, disc protrusion and fissure at L4/L5 caused by motor accident; MAC revoked; new MAC issued.

Decision date: 4 August 2026 | Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr David McGrath| Injury module: Spine

Insurance Australia Limited t/as NRMA Insurance v Richards [2026] NSWPICMP 534

Motor Accident Injuries Act 2017; review of medical assessment; whether psychological injury caused by the motor accident gives rise to a whole person impairment (WPI) greater than 10%; serious motor accident; claimant a passenger; another passenger death caused by the accident; assertion of inconsistencies in evidence; fluctuation of psychological presentation found to be inherent in the nature of the diagnosis of post-traumatic stress disorder; oscillating functioning; bulk of impact is maintaining consistency in effort; WPI assessed at 17%; Medical Assessment Certificate revoked only due to difference of percentage.

Decision date: 12 August 2026 | Panel Members: Member Elizabeth Medland, Dr Christopher Canaris, and Dr Surabhi Verma| Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decisions

Prasad v The Real McCoy Snackfood Co Pty Limited [2026] NSWPICMP 555

Workplace Injury Management and Workers Compensation Act 1998; appeal from section 323 deduction to 16% whole person impairment (WPI) finding for lumbar spine injury, resulting in a combined value total of 14%: whether Medical Assessor (MA) had failed to appreciate that the referral indicated a deemed date of injury; whether MA had considered relevant evidence; Held – MA’s reasons inadequate; observations on issues raised by a deemed date claim; Cullen v Woodbrae Holdings Pty Ltd, and Craigie v Faircloth & Reynolds Pty Ltd considered and applied; terms of referral binding; Skates v Hills Industries Ltd considered and applied; demonstrable error established, but review of evidence revealed CT scan of lumbar spine in the year prior to claimant commencing employment; Held – Medical Assessment Certificate confirmed.

Decision date: 28 July 2026| Panel Members: Member John Wynyard, Dr Tommasino Mastroianni, and Dr Todd Gothelf| Injury module: Lumbar Spine

Mathias v Highland Pine Products Pty Ltd [2026] NSWPICMP 556

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred by not assuming, in accordance with section 323(2); deduction to be made under section 323(1) is 10%; Held – MA did err by not so assuming; Medical Assessment Certificate revoked.

Decision date: 29 July 2026| Panel Members: Member Marshal Douglas, Dr Rhys Gray, and Dr Mohammed Assem| Injury module: Cervical Spine, and Scarring

Mohammed v Community Health Group Pty Ltd [2026] NSWPICMP 557

Workplace Injury Management and Workers Compensation Act 1998; Medical Appeal Panel; section 327(3); demonstrable error, incorrect criteria, radiculopathy, lumbar category Diagnosis‑Related Estimates (DRE) II or DRE III, scope of referral, actual path of reasoning, radiculopathy and impairment assessment of lower extremity; Yates v Flavorjen Pty Ltd, and Skates v Hills Industries Ltd, Wingfoot Australia Partners Pty Ltd v Kocak considered and applied; Held – Medical Assessment Certificate revoked.

Decision date: 29 July 2026 | Panel Members: Member John Turner, Dr Sophia Lahz, and Dr David Crocker| Injury module: Lumbar Spine

National Workforce Agency v Javier [2026] NSWPICMP 558

Workplace Injury Management and Workers Compensation Act 1998; appeal by employer against finding of complex regional pain syndrome (CRPS) when MA unable to test for Table 17.1 sign of the Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^thed, but nonetheless found CRPS; Held – incorrect criteria applied, notwithstanding reasonable approach by the Medical Assessor in noting opposing specialists agreed as to diagnosis, however CRPS not an injury per se, and terms of referral sought assessment of “left lower extremity”; accordingly, American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed, Tables available to assess impairment; Skates v Hills Industries Ltd, and Sakr v Merrylands Christian Preschool Association Inc considered and applied; Medical Assessment Certificate revoked; new MAC issued.

Decision date: 29 July 2026 | Panel Members: Member John Wynyard, Dr David Crocker, and Dr Drew Dixon | Injury module: Left Lower Extremity

Rentokil Initial Pty Ltd v Chavez [2026] NSWPICMP 565

Workplace Injury Management and Workers Compensation Act 1998; appeal by appellant against Medical Assessor’s assessment of impairment in relation to psychiatric and psychological disorders, on the basis that the Medical Assessor (MA) erred in his assessment of the respondent with regard to the PIRS categories of ‘social functioning’ and ‘employability’; Ferguson v State of New South Wales, Parker v Select Civil Pty Limited, Jenkins v Ambulance Service of New South Wales, Bojko v ICM Property Service Pty Ltd & Ors, Vitaz v Westform (NSW) Pty Ltd, and Wingfoot Australia Partners Pty Ltd v Kocak considered; error found on the basis that the MA had not explained his path of reasoning in reaching his assessments in sufficient detail, such that speculation was involved in determining whether the assessments involved merely a disagreement or a difference of opinion, or whether they involved error; further medical examination of respondent by member of Appeal Panel ordered in order to re-assess her impairment; Held – as a result of this re-assessment, Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 31 July 2026| Panel Members: Member Gaius Whiffin, Dr Graham Blom, and Dr Michael Hong| Injury module: Psychiatric/Psychological

Asplin v State of New South Wales (NSW Police Force) [2026] NSWPICMP 566

Workplace Injury Management and Workers Compensation Act 1998; appellant submits that the Medical Assessor erred in in his whole person impairment assessment of two of the psychiatric impairment rating scale categories, namely social functioning and concentration, persistence and pace; Appeal Panel found no errors; the ratings were consistent with the evidence; Held – Medical Assessment Certificate confirmed.

Decision date: 31 July 2026| Panel Members: Member Deborah Moore, Professor Nicholas Glozier, and Dr Michael Hong| Injury module: Psychiatric/Psychological

Potter v Qube Ports Pty Ltd [2026] NSWPICMP 573

Workplace Injury Management and Workers Compensation Act 1998; lump sum claim for injury to lumbar spine which resulted in surgery; appeal by the worker in respect of 0% whole person impairment for scarring; assessment made in accordance with the correct criteria in the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed; no error found; Held – Medical Assessment Certificate confirmed.

Decision date: 4 August 2026 | Panel Members: Member Jane Peacock, Dr David Gorman, and Dr Mohammed Assem| Injury module: Lumbar Spine, and Scarring

Moldovan v Snow Software Pty Ltd [2026] NSWPICMP 574

Workplace Injury Management and Workers Compensation Act 1998; appeal from below threshold assessment in psychiatric injury case; whether error in Medical Assessor (MA) referring to the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA5); whether errors made in self-care and hygiene, travel or concentration persistence and pace categories; Held – appellant submissions misconceived and mischievous as to inadvertent reference to AMA5 guides by the MA; comments made as to reasonable expectation that parties will have some familiarity with the jurisdiction they are appearing in; surprise expressed that appellant would make unsubstantiated allegations of facts during submissions; general principles  concerning assessments pursuant to Chapter 11 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment,4^thed, considered; pre-eminence of clinical observations discussed vis a vis claimant’s reliability; NSW Police Force v Daniel Wark discussed; Held – Medical Assessment Certificate confirmed.

Decision date: 4 August 2026| Panel Members: Member John Wynyard, Dr Douglas Andrews, and Dr John Lam-Po-Tang| Injury module: Psychiatric/Psychological

Ryan v Secretary, Department of Education [2026] NSWPICMP 575

Workplace Injury Management and Workers Compensation Act 1998; lump sum claim under the nervous system; closed head injury when appellant worker struck by a soccer ball; worker appealed a finding of 0% whole person impairment; Appeal Panel upheld the Medical Assessor’s finding that there is no rateable impairment under the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed (Guidelines) which prevail over American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed, and require that clinical assessment must include at least one of the following: significant medically verified abnormalities in the Glasgow Coma Scale score; significant medically verified duration of post-traumatic amnesia, and significant intracranial pathology on CT scan or MRI; none of the requisite criteria were satisfied and in accordance with the correct criteria in the Guidelines; there is no rateable impairment; no error found; Medical Assessment Certificate confirmed.

Decision date: 4 August 2026 | Panel Members: Member Jane Peacock, Dr Ross Mellick, and Dr Sophia Lahz | Injury module: Nervous system

Motor Accidents Merit Review Decisions

Dev v AAI Limited t/as GIO [2026] NSWPICMR 32

Motor Accident Injuries Act 2017; claim for statutory benefits; duty of claimant to cooperate; section 6.24; insurer requested explanation, bank statements, company records and contact details concerning company of which claimant was director and shareholder; payments from company deposited into claimant’s personal bank account while claimant received weekly benefits based on total loss of earnings; claimant asserted company operated by his brother; whether insurer’s request reasonable; whether claimant had reasonable excuse for non-compliance; request relevant, sufficiently specific and proportionate to investigation of post-accident earnings and validity of claim; claimant given adequate opportunity to respond; no reasonable excuse established; Held – insurer’s request determined to be reasonable; no reasonable excuse for non-compliance.

Decision date: 23 July 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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