Legal Bulletin No. 280

Issued 2 October 2026

Welcome to the two hundred and eightieth 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

Sonic Health Plus Pty Ltd v Wong [2026] NSWPICPD 49

Workers compensation; weekly compensation; calculation of pre-injury average weekly earnings; medical practitioner working in multiple medical practices; differing wage schedules between the parties; adequacy of reasons; Held – the appeal is upheld; the Certificate of Determination dated 4 December 2025 is revoked; pursuant to s 352(6A) of the Workplace Injury Management and Workers Compensation Act 1998 a new decision is made in its place that the appellant pay to the respondent the sum of $16,402.48 as compensation for loss of weekly earning capacity for the period 9 October 2023 to 15 July 2024.

Decision date: 18 September 2026 | Before: Acting Deputy President Kylie Nomchong SC

Motor Accidents non-Presidential Member Decisions

Aziz v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 541

Motor Accident Injuries Act 2017 (MAI Act ); whether injury resulted from a motor vehicle accident; claimant punched by pedestrian while he was in his stationary vehicle on a pedestrian crossing; CCTV footage of incident; Insurance Commission of Western Australia v Container Handlers Pty Ltd, Allianz Australia Insurance Ltd v GSF Australia Pty Ltd, Herne Investments (NSW) Pty Limited v Don Watson Proprietary Limited, QBE Insurance (Australia) Ltd v Smith, RG & KM Whitehead Pty Ltd v Lowe, Leach v Nominal Defendant (QBE Insurance (Australia) Ltd), and QBE Insurance (Australia) Ltd v Abberton applied; Held – the claimant was injured while driving the vehicle; temporal requirement established; the "dominant cause" or that which was "proximate in efficiency" and "the real effective cause" of the claimant’s injury was the punch thrown by the assailant not the driving of the vehicle; use or operation of vehicle did not cause the claimant’s injury; the claimant’s injury did not result from a “motor accident”; ss 1.9 and 3.1 not engaged; the MAI Act does not apply; claimant not entitled to statutory benefits under Part 3 of the MAI Act.

Decision date: 18 September 2026 | Member: Senior Member Brett Williams

Allianz Australia Insurance Limited v Suman [2026] NSWPIC 542

Motor Accident Injuries Act 2017 (MAI Act); Motor Accident Guidelines (Guidelines ); settlement approval; claimant was injured on 8 July 2023; claimant was working at the time of the accident; claimant is aware this approval resolves her common law damages claim; settlement complies with clause 7.37 of the Guidelines; Held – settlement approved in the amount of $100,000, consisting of nil non-economic loss, past economic loss of $50,000 and $50,000 by way of buffer for future economic loss.

Decision date: 18 September 2026 | Member: Philip Carr

AAI Limited trading as GIO Insurance v Moir [2026] NSWPIC 544

Motor Accident Injuries Act 2017; proposed settlement approval; liability wholly admitted; claimant 74 years old passenger; whole person impairment (WPI) assessed at 5%; claimant working as a casual music teacher; insurer assessed past economic loss on previous year’s tax return plus a buffer; future economic loss approached by way of a buffer considering her future life expectancy of 15 years; Held – proposed settlement approved in the sum of $42,000 under section 6.23(2)(b); statutory benefits paid in the sum of $4,921.68 for which the insurer is to receive a credit; claimant satisfied with the process; settlement just, fair and reasonable, and within the range of likely potential damages if the claim was to proceed to assessment.

Decision date: 22 September 2026 | Member: Elyse White

Workers Compensation non-Presidential Member Decisions

Turner v Connected Advice Pty Limited [2026] NSWPIC 534

Workers Compensation Act 1987; claim for weekly compensation and treatment expenses arising out of workplace injury on 6 October 2023; applicant claimed subsequent injury at home whilst playing soccer caused aggravation or alternatively would not have occurred had it not been for the injury on 6 October 2023 relying on the first two limbs of State Government Insurance Commission v Oakley (Oakley); respondent maintains novus actus event causing a break in the causal chain between the original incident and the applicant’s subsequent hospitalisation post soccer event; no treatment, diagnosis or investigation following original workplace event on 6 October 2023; diagnosis, investigation and treatment only commenced after soccer incident in domestic circumstances; symptoms following the injury on 6 October 2023 confined to the back; symptoms following soccer incident resulted in severe leg pain and back pain; Held – limbs one and two of Oakley not established; applicant failed to discharge onus; award for the respondent.

Decision date: 14 September 2026 | Member: Diana Benk

Weller v Healthscope Operations Pty Ltd [2026] NSWPIC 538

Workers Compensation Act 1987 (1987 Act );Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); application seeking exercise of discretion under section 57 of Personal Injury Commission Act 2020 (PIC Act) to rescind prior Certificate of Determination and refer to further medical assessment under section 329 of 1998 Act where the Medical Assessment Certificate previously subject to unsuccessful appeal to Appeal Panel; Held – discretion exercised in favour of the applicant.

Decision date: 16 September 2026| Member: Mitchell Strachan

Kutty v Poly Films Reprocessing Pty Ltd [2026] NSWPIC 539

Workers Compensation Act 1987; claim for the cost of surgery to the right shoulder; whether the worker has sustained a disease injury to the right shoulder; consideration of AV v AW and State Transit Authority v El-Achi; whether the proposed surgery is reasonably necessary as a result of the injury to the right shoulder; Held – the worker sustained a disease injury to the right shoulder whereby the worker’s employment was the main contributing factor to the aggravation of a disease to the right shoulder; section 4(b)(ii ); the proposed surgery is reasonably necessary as a result the injury to the right shoulder; order made pursuant to section 60(5).

Decision date: 16 September 2026| Member: John Isaksen

JAR v State of New South Wales (NSW Police Force) [2026] NSWPIC 540

Workers Compensation Act 1987; exempt worker; claim for disease injury to right hand deemed 25 October 2025; task specific focal dystonia; claim for lump sum compensation and pain and suffering pursuant to sections 66 and 67; consideration of applicant’s statements and medical reports and claim correspondence; injuries alleged to have occurred due to nature and conditions; whether the applicant sustained an injury to his right hand as a result of frequent ticket writing up to 2011, which became symptomatic in 2018 upon work related post-traumatic stress disorder in accordance with sections 4 and 9A; whether the applicant is entitled to an award pursuant to sections 66 and 67; considered Owen v Motor Accidents Authority of NSW, and Fernandez v Tubemakers of Australia Ltd; Held – the applicant did not sustain claimed injury; award in favour of the respondent; no order as to costs.

Decision date: 17 September 2026| Member: Terence O'Riain

Motor Accidents Medical Review Panel Decisions

Sohail v Allianz Australia Insurance Limited [2026] NSWPICMP 681

Motor Accident Injuries Act 2017;review of medical assessment; assessment of threshold injury; assessment of degree of permanent impairment; statutory provisions; prior low back injuries; prior motor accident claim; cervical and lumbar spinal injury; treating neurosurgeon identified radicular symptoms; aggravation of pre-existing lumbar spinal discopathy; post-accident lumbar spine microdiscectomy; Held – two requisite signs of radiculopathy give rise to a finding of non-threshold injury; degree of permanent impairment caused by the motor accident 5%; previous certificate revoked.

Decision date: 10 September 2026 | Panel Members: Member Hugh Macken, Dr Margaret Gibson, and Dr Sophia Lahz| Injury module: Spine, Upper Limb, Lower Limb, and Skin

Kim v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 690

Motor Accident Injuries Act 2017; claimant injured in a motor accident on 28 November 2023; medical dispute review under section 7.26 about whether the accident caused whole person impairment greater than 10%; accident arose out of minor impact; insurer disputed causation; Medical Assessor found accident caused referred injuries with permanent impairment greater than 10% ; insurer alleged error; Review Panel re-examined claimant; Held – claimant reassessed at 22% permanent impairment; no pre-accident impairment; accident caused major depressive disorder with anxious distress; different outcome; previous certificate revoked.

Decision date: 14 September 2026 | Panel Members: Member Terence O’Riain, Dr Paul Friend, and Dr Thomas Newlyn| Injury module: Mental and Behavioural

Brown v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 693

Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) of a Medical Assessor (MA) under section 7.26; dispute about whether the injuries caused by the motor accident are threshold injuries; referred injuries include the cervical spine, thoracic spine, and lumbar spine; where the MA found that all referred injuries are soft tissue injuries and therefore threshold injuries; claimant re-examined; imaging studies reviewed by the MAs of the Review Panel; where the Review Panel found that the injury to the thoracic spine - T11 and T12 crush fractures and oedema at T11 and T12 level is not a threshold injury; Held – original MAC revoked.

Decision date: 14 September 2026 | Panel Members: Member Maurice Castagnet, Dr David Gorman, and Dr Michael Couch| Injury module: Spine

Allianz Australia Insurance Limited v Saood [2026] NSWPICMP 703

Motor Accident Injuries Act 2017; review of certificate and reasons of a Medical Assessor (MA) dated 13 November 2024 who diagnosed the claimant as having post-traumatic stress disorder which was a non-threshold injury; at the time of the accident on 28 October 2022 the claimant was a year 10 student; the claimant was a rear seat passenger in a front/left side impact which occurred without warning; suggestion in clinical notes that the claimant may have been suffering panic attacks and anxiety before the accident but Review Panel satisfied that this is a normal condition of students and that there was no loss of function following the accident; Review Panel not satisfied that the claimant had all relevant criteria for a diagnosis of post-traumatic stress disorder but was satisfied following clinical examination and a diagnosis of a panic disorder that she had suffered a non-threshold injury; certificate and reasons of MA revoked.

Decision date: 17 September 2026 | Panel Members: Member Alexander Bolton, Dr John Baker, and Dr Christopher Rikard-Bell | Injury module: Mental and Behavioural

KIA v QBE Insurance (Australia) Limited [2026] NSWPICMP 705

Motor Accident Injuries Act 2017; review of medical assessment certificate (MAC); dispute regarding degree of permanent impairment for purposes of Act; psychiatric injury; original Medical Assessor diagnosed somatic symptom disorder and certified 0% permanent impairment; pre-accident history of post-traumatic stress disorder and depression; claimant examined; Review Panel diagnosed other specified trauma and stressor related disorder, persistent depressive disorder, and somatic symptom disorder; permanent impairment assessed as 5%, after omitting any impact from pain; claimant was not suffering from a diagnosable psychiatric disorder at the time of the accident, therefore no deduction for pre-existing impairment; Held – MAC revoked.

Decision date: 18 September 2026 | Panel Members: Member Bianca Montgomery-Hribar, Dr Ankir Gupta, and Dr Alan Doris | Injury module: Mental and Behavioural

Romeo v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 707

Motor Accident Injuries Act 2017; claimant injured March 2023; defect in road; push bike tyre caught in defect; claim exempted; Medical Assessor (MA) determined whole person impairment (WPI) 8%; claimant applied for review; section 7.26; referral to Review Panel; Review Panel conducted own examination; Held – WPI 15%; Certificate of MA revoked; WPI 15% substituted.

Decision date: 21 September 2026 | Panel Members: Member Terence Stern OAM, Dr Margaret Gibson, and Dr Sophia Lahz| Injury module: Spine, Upper Limb, and Lower Limb

CTY v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 711

Motor Accident Injuries Act 2017; review of medical assessment; assessment of degree of permanent impairment; pre-accident diagnosis of post-traumatic stress disorder; pre-accident periods of excessive alcohol use; severe impairment of adaptation; post-traumatic stress disorder symptoms directly related to motor vehicle accident; 1% apportionment for pre-existing impairment; Held – certificate revoked; 7% whole person impairment.

Decision date: 23 September 2026 | Panel Members: Member Hugh Macken, Dr Christopher Rikard-Bell, and Dr Graham Blom| Injury module: Mental and Behavioural

AAI Limited trading as GIO Insurance v Nasari [2026] NSWPICMP 712

Motor Accident Injuries Act 2017; section 1.6(3);medical review panel; whole person impairment (WPI); major depressive disorder with anxious distress, and generalised anxiety disorder; pre-existing condition; self-care and personal hygiene; social functioning; concentration, persistence and pace; adaption ; assessment of WPI; claimant was injured in a motor vehicle accident on 7 September 2020; Medical Assessor (MA) certified the claimant had sustained a 13% WPI as a result of persistent depressive disorder with major depressive disorder and specific phobia of driving caused by the accident; insurer sought review; Held – claimant had major depressive disorder of mild severity with anxious distress caused by the accident; pre-existing condition of generalised anxiety disorder; current WPI 8%; pre-existing WPI 0%; certificate of MA revoked; claimant sustained 8% WPI caused by accident.

Decision date: 23 September 2026 | Panel Members: Senior Member Susan McTegg, Dr John Baker, and Dr Christoper Canaris| Injury module: Mental and Behavioural

Abdal v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 713

Motor Accident Injuries Act 2017; Medical Assessor (MA) determined whole person impairment (WPI) at 8%; claimant’s application for review under section 7.26; psychiatric injuries developed following motor accident in June 2021 including driving phobia; insurer obtained surveillance of claimant and documentation relevant to the claimant’s ability to drive after the accident; claimant re-examined by both MAs; diagnosis made of posttraumatic stress disorder; pain and physical injuries a component of impairment to functionality; impairment assessed at 6%, no matter of principal; Held – outcome not changed but diagnosis and degree of WPI altered; certificate revoked.

Decision date: 23 September 2026 | Panel Members: Member Belinda Cassidy, Dr Christopher Rikard-Bell, and Dr Surabhi Verma| Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decision

MGQ v State of New South Wales (New South Wales Police Force) [2026] NSWPICMP 678

Workplace Injury Management and Workers Compensation Act 1998; psychological injury; lump sum claim; appellant worker challenged the assessments in two of the six psychiatric impairment rating scale categories, namely social and recreational activities and employability; error found in the domain of employability; Held – Medical Assessment Certificate revoked.

Decision date: 28 September 2026| Panel Members: Member Jane Peacock, Dr Michael Hong, and Dr John Lam-Po-Tang| Injury module: Psychiatric/Psychological

Motor Accidents Merit Review Decisions

Nabi v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMR 41

Motor Accident Injuries Act 2017; merit review; weekly payments of statutory benefits; pre-accident working capacity; meaning of pre-accident weekly earnings; pre-accident earnings; appropriate method of determining pre-accident earning capacity; no evidence as to intentions; best evidence to establish actual earnings; no compelling reason for period of calculation of pre-accident earnings being three years; application of section 3.8; Held – reviewable decision revoked.

Decision date: 13 September 2026| Merit Reviewer: Hugh Macken

Hakimi v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMR 42

Motor Accident Injuries Act 2017; merit review matter under Schedule 2, clause 1(y); dispute about whether claimant complied with duties to cooperate with insurer under Div 6.4; obligation to provide relevant particulars of claim; failure to answer request for relevant particulars of claim sufficient to enable the insurer, as far as practicable, to make a proper assessment of the claimant’s full entitlement to damages; deemed withdrawal of damages claim; costs; Held – insurer’s reviewable decision set aside;for the purposes of section 6.25 the claimant provided all relevant particulars about his claim before 10 April 2026.

Decision date: 21 September 2026| Merit Reviewer: Terence O'Riain

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.

Subscribeto receive legal bulletins to your inbox.