Allianz Australia Insurance Limited v Laycock

DETERMINATION OF REVIEW PANEL
CITATION:	Allianz Australia Insurance Limited v Laycock [2025] NSWPICMP 597
CLAIMANT:	Shannon Laycock
INSURER:	Allianz Insurance Australia Limited
REVIEW PANEL
MEMBER:	Alexander Bolton
MEDICAL ASSESSOR:	Melissa Barrett
MEDICAL ASSESSOR:	Surabhi Verma
DATE OF DECISION:	12 August 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); MAC found the claimant had post-traumatic stress disorder (PTSD) which was assessed at 15% whole person impairment (WPI); insurer relied on social media posts suggesting the claimant was managing better than she alleged and causing the psychiatric expert jointly retained by the parties to alter his opinion about the claimant’s condition and diagnosis; claimant avoidant of accident scene; claimant required psychiatric treatment; Held – Medical Assessors diagnosed PTSD and assessed the claimant as having 7% WPI; MAC revoked.
DETERMINATIONS MADE:	CERTIFICATE OF DETERMINATION Determination 1. The Panel revokes the certificate and reasons of Medical Assessor Nagesh dated 16 January 2024. 2. As a result of the incident on 23 December 2018, the claimant suffered a psychiatric injury. 3. The Panel has diagnosed the claimant’s injury as post-traumatic stress disorder. 4. The Panel assesses the claimant’s whole person impairment as 7%.

STATEMENT OF REASONS

INTRODUCTION

The insurer has sought a review of a certificate and reasons of Medical Assessor Nagesh (the Medical Assessor) dated 16 January 2024.
The Medical Assessor concluded that the claimant had a post-traumatic stress disorder and assessed whole person impairment (WPI) at 15%.
There is a dispute between the claimant and the insurer about: the degree of permanent impairment under Schedule 2, s 2(a) of the Motor Accident Injuries Act 2017 (the Act). The following injuries were referred by the Personal Injury Commission (Commission) for assessment
(a) post-traumatic stress disorder.

Bundles of documents

The parties have each presented their respective bundles of documents upon which they rely. The Panel have read all the documentation. If a particular document is not referred to by the Panel, this does not mean that the Panel or a Panel Member has not read it, in much the same manner as parties not referring to or not specifically relying on a document in their own bundle and submissions.
The fact that evidence is not referred to in these reasons does not mean it has been overlooked and nor is it required that each piece of evidence be mentioned – see WAEE v Minister for Immigration and Citizenship (2003) 75 ALO 630 at [46].The Panel is not required to “analyse every piece of information from every opinion contained in a document with which he [it] was provided” – see Farr v Insurance Australia Limited t/as NRMA Insurance Ltd [2014] NSWSC 1435 at [46]. The Panel has come to its own conclusion and has taken its own history.

The accident

The accident is not the “usual” motor accident. It occurred on 23 December 2018. The claimant was sitting in her car as a front seat passenger in a car wash. Immediately behind her was her infant son.
Without warning, a stranger jumped into her car and threatened the claimant to get out. The stranger physically pushed her and assaulted her. According to a report provided by the claimant to the Medical Assessor, the stranger came over to the passenger side of the seat and screamed at her to get out of the car. He pushed her and he pulled her. In the interim, the claimant’s partner came to assist her. When the stranger jumped out of the car, he got into his van which was parked nearby and escaped.
A few days after the accident, the claimant and her partner went camping. They noticed that there was a syringe in the car with a needle filled with pink fluid. They were worried that they had sustained a needle stick injury. The claimant and her partner went to the local hospital to get checked for any needle stick injuries. She had to have blood tests.
The parties would appear to accept the circumstances as being a motor accident, noting that at all times, the engine was running.

Insurer’s submissions

The insurer says the Medical Assessor erred in his assessment of the claimant pursuant to the psychiatric impairment rating scale (PIRS). The insurer says the Medical Assessor’s assessment of permanent impairment was incorrect in a material respect pursuant to s 7.26 of the Act.
Regarding the PIRS assessments, the insurer submits that the Medical Assessor erroneously found a moderate impairment for Social and Recreational activities.
With the initial assessment before the Medical Assessor, the insurer submitted on
3 May 2023;
(a)    Self care and personal hygiene, a Class 1 assessment is appropriate,
(i)some degree of the intermittent self-care would be due to the age and dependency levels of her young children. There is also no evidence to support that the claimant obtains, or has the need for, supportive care from anyone other than her husband. The updated social media material shows the claimant is able to care for herself and her two children.
(b)    Social and recreational activities, a Class 1 assessment is appropriate.
(i)the insurer submits the social media material contradicts this notion. The claimant is seen to be socially active on social media, with some photographs of outings taken with family post-accident. There is one instance of an outing with another family on one occasion, which the insurer submits contradicts the claimant’s assertion to
Dr Mason that she is unable to maintain friendships, and
(ii)the claimant also re-located from Mackay to Airlie Beach. Her children’s dependency levels at their current ages would impact her ability to engage in social activities.
(c)    Regarding travel the insurer submits that Class 1 is appropriate,
(i)the insurer again relies upon the claimant’s social media material, which shows the claimant enjoying many outdoor activities with her children. The claimant also shows interest in many local activities such as community movie night or active mother’s fitness classes.
(d)    With social functioning the insurer submitted that a Class 1 assessment is appropriate,
(i)the insurer submits that the claimant reports significantly reduced contact with extended family members and friends, however her relationship with her partner and her children is intact, and
(ii)the social media material shows ongoing contact with numerous individuals and family members, as well as an external outing with another man and woman.
(e)    With concentration, persistence and pace the insurer submitted that a Class 1 assessment was appropriate,
(i)the insurer submits there is no evidence of any impairment to the claimant’s concentration, persistence or pace as a result of any alleged psychiatric symptoms. The insurer submits that any minor concentration issues are likely as a result of the claimant’s recent childbirth and the ongoing challenges of a young infant.
(f)    Regarding employability the insurer submits that a Class1 assessment is appropriate,
(i)the insurer submits the claimant’s allegation of a total incapacity to work is inaccurate. The insurer says that social media material shows the claimant having gained employment in at least two hospitality roles after the subject accident. The claimant had also undertaken some employment as a model, and
(ii)the insurer submits that any limitation in her employment capabilities would be due to the age and care requirements of her children. There is no evidence in support of any impairment due to psychiatric symptoms, and therefore a Class 1 is appropriate.
The insurer referred to a jointly commissioned report of Dr Mason dated
14 November 2022. Dr Mason assessed WPI at 15%. The insurer pointed out
Dr Mason diagnosed the claimant with post-traumatic stress disorder and said;
“With regard to causation, from a medical point of view there is no doubt in my mind that the event gave rise to post-traumatic stress disorder. From a legal point of view I find it difficult to differentiate between the motor accident and the man's intention of stealing the motor vehicle with the child inside. This is the trauma suffered by Ms Laycock. In my opinion these events are so interconnected that it is impossible to differentiate between the motor accident per se and the attempt to steal the motor vehicle containing an 18-month-old child.”
The insurer says that subsequently, it provided Dr Mason with social media extracts of the claimant. In response, in a supplementary report of Dr Mason dated 6 March 2023, a revised WPI assessment was provided of 7% WPI as follows:
Self-Care and Personal Hygiene – Class 2
Social and Recreational Activities – Class 2
Travel – Class 2
Social Functioning – Class 2
Concentration, Persistence and Pace – Class 2
Adaptability – Class 3.

Claimant’s submissions

The claimant says that with respect to the assessment of the Medical Assessor of Class 3 for social and recreational activities, the Medical Assessor has taken a complete and accurate history from the claimant, engaged with evidence before them, including particular reference to the claimant’s social media profile, and provided a clear path of reasoning in finding Class 3 for ‘Social and Recreational Activities’.
The claimant further submits that a Class 3 impairment is consistent with the reports of
Dr Mason dated 14 November 2022 and Dr Gertler dated 5 June 2023.
Concerning the Class 3 assessment for social functioning, the claimant submits that the insurer has made the assumption that the separation from the claimant’s partner “appears to be due to his alcohol intake” and refers to the report of treating psychologist Ms Franklin dated 28 August 2023. The claimant submits that this comment has been removed from the crucial context in which it applies.
The claimant says that she and her former partner were both involved in the subject accident, and the claimant relies on the history recorded by Dr Gertler in his report of
5 June 2023 where he says:
“The relationship with her partner deteriorated because of his symptomatology related to the incident and the fact that he had begun to drink heavily.” (at page 3).
The claimant submits that the subject motor accident and the psychological injuries sustained have caused the breakdown in the relationship with her former partner.
The claimant submits that the fact that her relationship has been severely strained, evidenced by periods of separation, is sufficient to satisfy an assessment of Class 3 impairment.
The claimant referred to the submission on the insurer who alleged that the Medical Assessor had erroneously found a moderate impairment for social functioning. The insurer had said that “there is no evidence of severely stained relationships or reduced contact of friends as a result of the accident.” The claimant submits that this is not correct.
The claimant says that the Medical Assessor took the following history from her during the assessment:
“Ms Laycock has been separated from her partner a couple of times…She has lost contact with the majority of her friends.” (at page 6).
The claimant submits that this history is consistent with that recorded by Dr Gertler in his report dated 5 June 2023.
The claimant says that the insurer has made the assumption that the separation from the claimant’s partner “appears to be due to his alcohol intake” and refers to the report of treating psychologist Christine Franklin dated 28 August 2023. The claimant submits that this comment has been removed from the crucial context in which it applies.
The claimant submits that while the insurer may disagree with the assessment of Class 3 by the Medical Assessor, this does not automatically result in an incorrect assessment.
As to the assessment by the Medical Assessor of Class 3 for adaptation, the claimant says that the Medical Assessor provided a summary of the relevant documentation relied upon. This included both the social media material and joint medico-legal report of Dr Mason dated 6 March 2023 which the insurer relies upon in its review application.
The claimant also refers to the submission that the insurer says “there is no evidence the claimant would be unable to work for less than 20 hours per week on psychiatric restrictions...”
To this, the claimant submits that this is incorrect and refers to the reports of Dr Mason dated 14 November 2022 and 6 March 2023 who has similarly assessed a Class 3 impairment for Adaptability. The claimant notes page 20 of the report dated
14 December 2022, where Dr Mason says that “Ms Laycock is totally unable to work in her previously hospitality positions because of anxiety. It is possible she could do less than 20 hours/week in some other form of employment…”
The claimant also notes the comments of her treating psychologist, Ms Franklin, who says that “she is currently unfit for paid employment” in her report of 28 August 2023.
The claimant also relies on a report of Dr Gertler dated 5 June 2023 where he says the claimant “May be able to work several hours a week in a secure environment, in which she does not come into contact with situations associated with potential confrontations with the general public.” Dr Gertler assessed Class 4 impairment for Adaptation.
The claimant submits that the Medical Assessor has made the appropriate finding of 15% permanent impairment based on his clinical judgment.

Medical evidence

The Medical Assessor provided a certificate dated 16 January 2024. He diagnosed post-traumatic stress disorder. He said the claimant met criteria under the Diagnostic and Statistical Manual of Mental Illnesses (DSM-5) as follows:
Criteria A - The subject motor vehicle accident was severe enough that Ms Laycock was exposed to death and threatened by death.
Criteria B - She has developed nightmares and flashbacks.
Criteria C - She has avoided driving for a while, the very thought of returning to a petrol station makes her anxious and she's fearful.
Criteria D - Negative alteration and cognition where her mood is depressed, she feels numb, she has guilt feelings, and she worries about being attacked again.
Criteria E - Arousal symptoms which include insomnia, irritability, and a diminished ability to concentrate.
Criteria F - Her symptoms have been present for more than a month.
Criteria G - Her symptoms are not due to substance misuse or general medical conditions.
Criteria H - Her symptoms have caused significant distress and socio-occupational impairment.
The Medical Assessor said that at the time of the subject accident, the claimant, was threatened, intimidated, and physically assaulted, which was a severe traumatic event. The claimant was exposed to death during the accident. The claimant had no previous history of mental illness, and the subject accident had given rise to her post-traumatic stress disorder. His PIRS assessment follows.

Psychiatric diagnoses	1. Post Traumatic Stress disorder.
	Psychiatric treatment description	Pharmacotherapy, CBT, and Supportive psychotherapy.

Category	Class	Reason for Decision
1. Self Care and Personal Hygiene	2	I have assessed her as class two, mild impairment. My rationale is that Ms. Laycock is able to cook and clean, however, she's anxious to shop. She showers only once every couple of days. Even though she struggles with activities of daily living, in my opinion, she's capable of living independently as she has the capacity to care for herself and two children.
2. Social and Recreational Activities	3	I have assessed her as class three, moderate impairment. My rationale is that Ms. Laycock states that she has become socially withdrawn and she's anxious to attend social events, which include weddings, dinner parties, barbecue parties, and anniversaries. She states that she has lost interest in her hobbies, and she does not find anything pleasurable. She states that in the last few years, she's attended only a couple of social events that were prompted by her partner. I have reviewed the documentation provided to me where the claimant has been observed modelling, which the claimant states was at the behest of her psychologist who encouraged her to do modelling, but these modelling sessions were on an individual setting and not in a group setting. Also, the claimant's visit to Whitsunday's Sailing Club was a disaster where she had to return prematurely due to her anxiety. During the family photo shoot, the photographs depict her to be smiling, the claimant states that internally she was anxious and depressed.
3. Travel	2	I have assessed her as class two, mild impairment. My rationale is that the claimant is capable of travelling independently to local areas, that is to drop her children at school every day. She cannot travel to far away and unfamiliar places without a support person.
4. Social Functioning	3	I have assessed her as class three, moderate impairment. My rationale is that the claimant has lost contact with the majority of her friends. She has separated from her ex- partner due to her irritability and lack of intimacy.
5. Concentration, Persistence and Pace	2	I have assessed her as class two, mild impairment. My rationale is that the claimant states that her attention and concentration has diminished, but she states that she can focus for a period of up to 30 minutes to an hour and she can do paperwork for 30 minutes. She states that her memory is not the best. The claimant states that she can concentrate while watching a movie for up to 30 minutes.
6. Adaptation	3	I have assessed her as class three, moderate impairment. The claimant has not been able to return to work. She's tried a couple of times to return to work. At the time of the subject MVA, the claimant was not working. In my opinion, the claimant's ability to handle stress has been significantly reduced since the subject MVA due to her PTSD symptoms.

WPI was assessed at 15%.
Dr Gertler provided a report for the claimant of 5 June 2023.
The claimant described recurrent panic attacks and hyperactivity to reminders of the incident.
Dr Gertler said that the claimant was suffering from a post-traumatic stress disorder with associated depression. He said that this had resulted from the incident of 23 December 2018 which posed a real threat, not only to her physical integrity but to that of her young son at the time.
The claimant had developed characteristic symptoms of the condition including sleep disturbance with nightmares related to the incident, hyperreactivity to and avoidance of situations which remind her of the incident, hypervigilance, and anxiety and panic attacks particularly when she is away from home. She also continued to have anxiety when driving.
Dr Gertler assessed WPI at 17%.
Ms Franklin, psychologist, provided a report of 28 August 2023 following her treatment of the claimant. She believed her presentation to be consistent with symptoms of post-traumatic stress disorder. Her anxiety levels remained high, her mood was low, she regularly presented as teary and emotional. It was reported that she could also present as agitated and hypervigilant. She reported poor sleep and intrusive thoughts. Her appetite was poor and she had experienced significant weight loss.
Ms Franklin attributed the claimant’s condition to the accident.
Regarding the social media posts of the claimant, she provided both a statement and comments specifically on some of the posts. While the claimant acknowledges that she does not appear anxious or unhappy, she explains that she is always uncomfortable in groups and working with people she does not know.
Dr Mason provided a joint report dated 14 November 2022.
Dr Mason said that the claimant developed post-traumatic stress disorder as a result of the accident and the intrinsic threat it posed to her child, herself and her partner. Particularly distressing for her was the fact that she initially almost acted on the man's order for her to get out of the car; and it was only the thought of the welfare of her child that stopped her from doing so. Immediately after the event she experienced severe anxiety and was unable to return home at the planned time. She experienced nightmares and intrusive recollections of the event. She had difficulty driving a car. She was anxious in her own home and for a period was housebound. She was anxious outside the home. She withdrew from social interaction. As she resumed driving, she was extremely anxious while getting the children into and out of the car; she remains terrified of their potential abduction.

Dr Mason said that the claimant met DSM-5 criteria for post-traumatic stress disorder as follows:
“Criterion A. Exposure.
1)   Directly experiencing the traumatic event.
2)   Witnessing, in person, the event as it occurred to others.
Criterion B. Intrusion symptoms.
1)   Recurrent, involuntary intrusive distressing memories of the traumatic event.
2)   Recurrent distressing dreams related to the traumatic event.
3)   Intense or prolonged distress at exposure to internal or external cues.
4)   Marked physiological reactions to internal or external cues.
Criterion C: Avoidance symptoms.
1)   Avoidance or efforts to avoid distressing memories, thoughts or feelings about the event.
2)   Avoidance or efforts to avoid external reminders that arouse distressing memories, thoughts or feelings.
Criterion D: Negative cognitions and mood.
1.   Persistent negative beliefs about themselves, others or the world.
2.   Persistent negative emotional state.
3.   Markedly diminished interest or participation in significant activities.
4.   Feelings of detachment or estrangement from others.
Criterion E: Arousal and reactivity.
1.   Irritability and angry outbursts.
2.   Hypervigilance.
3.   Exaggerated startle response.
4.   Concentration problems.
5.   Sleep disturbance.
Criterion F: Duration greater than 1 month.
Criterion G: Clinically significant distress or impairment in social, occupational or other important areas of functioning.
Criterion H: The disturbance is not attributable to a substance or another medical condition.”
Regarding causation, Dr Mason said that from a medical point of view, the event gave rise to post-traumatic stress disorder. However, he said from a legal point of view he found it difficult to differentiate between the accident and the man's intention of stealing the motor vehicle with the child inside. He said that this was the trauma suffered by the claimant.
Dr Mason said that in his opinion these events were so interconnected that it is impossible to differentiate between the motor accident per se and the attempt to steal the motor vehicle containing an 18-month-old child.
Dr Mason did not believe the direct assault of the claimant and the needlestick injury of her partner made a significant contribution to her anxiety. He said that while the needle stick injury to her partner occurred during the scuffle, it was not discovered until the following day and by then her anxiety had already commenced. Dr Mason said that it was possible the anxiety was exacerbated until the blood test results were available, but there was no ongoing anxiety related to the needle stick injury or the scuffle.
Dr Mason assessed the following PIRS classes;
(a)    Self-care and hygiene 3;
(b)    Social and recreational activities 3;
(c)    Travel 2;
(d)    Social functioning 2;
(e)    Concentration, persistence and pace 2, and
(f)    Adaptability 3.
Total WPI was assessed at 15%.
Dr Mason provided a supplementary report of 6 March 2023. This was in response to the insurer obtaining access to Facebook posts of the claimant. It is not known when this documentation became available to the insurer and if the insurer had it at the time of the examination by Dr Mason on 10 November 2022. Dr Mason was critical that the information had not been made available to him at the time of his examination.
Dr Mason, referring to the family and modelling photographs uploaded by the claimant, said that despite the claimant’s statements that she was uncomfortable in the process of modelling, particularly in the presence of other people, she nonetheless persisted over a period of 21 months.
Dr Mason commented that while he accepted that social media images always portray a person at their best, the multiple images and the persistence with which they were posted is not suggestive of psychiatric impairment in social and work situations.
With the assessment of self-care and personal hygiene, Dr Mason, on the basis of the further Facebook information, said that he reluctantly accepted that a mild level of impairment was appropriate. He reduced this assessment from Class 3 to Class 2.
Dr Mason said that images from social media, plus supportive comments from friends, indicated that the claimant was not totally socially inactive. He said that this was inconsistent with the information she provided at interview. Dr Mason concluded that a mild impairment was more likely to be an accurate descriptor of her current situation regarding social and recreational activities.
No other changes were made by Dr Mason. This left a total score of the values at 13 and with a median class value at 2. The revised WPI assessment was then 7% WPI.
Clinical notes of Dr Khan general practitioner (GP), as of 4 November 2019 show;
“22 March 2019 symptoms consisted of stress, anxiety, poor sleep and constantly thinking about the episode. Partner lost job causing financial difficulty. Diagnosis was post-traumatic stress disorder. Lovan (fluoxetine) 20 mg prescription withdrawn. Aropax (paroxetine) 20 mg prescribed.
3 April 2019 GPMHCP prepared; K10 30/50. Symptoms were described as early morning wakening and depressed mood. There had been a positive response to treatment consisting of being less irritable and tearful, sleeping better and reduction in flashback memories. The report specifically stated no suicidal thoughts.
4 April 2019 referred to Connect To Wellbeing.
24 April 2019 feeling heaps better with paroxetine for PTSD; see psychologist next month.
25 July 2019 support form provided.
4 November 2019 paroxetine 20 mg prescribed; not heard from Anglicare re counselling.”
Connect to Wellbeing Assessment from 3 May 2019. The claimant was assessed by clinical psychology registrar Ms Scholz on 3 May 2019. Presenting symptoms were “depression, anxiety, panic disorder, PTSD and grief and loss due to 2 dogs recently killed. Ms Laycock’s mother has been diagnosed with bipolar affective disorder and her father died when she was 12 years of age”. Medication at that time consisted of paroxetine 20 mg. The report stated she had indicated suicidal ideation to her GP on 4 April 2019. It is noted that this was not recorded by Dr Khan in his clinical notes.
Various certificates of capacity note a diagnosis of post-traumatic stress disorder and anxiety. The claimant was referred to Anglicare for counselling.

Medical examination

The claimant was examined by Medical Assessor Barrett and Medical Assessor Verma on
3 June 2025. Their report follows:
1. Who attended the assessment
Ms Laycock attended the appointment unaccompanied.

History

2.   Psychosocial history and pre-accident history
Ms. Laycock was born on 28 February 1977 in Mackay. Her parents separated when she was three, and she continued living with her mother and elder sister. After her parent’s separation they used to visit him occasionally. As a result, she missed many Thursdays and Fridays at school and she began struggling academically. She said that her father was in hospital for about two years before he passed away when she was at the end of primary school. Her father's demise took a toll on her sister and her mother, causing her sister to rebel at school. Ms. Laycock took a year or two to come to terms with her father's death. She mentioned that they were unable to attend the funeral, which was about 13 hours away, as her mum could not drive. However, she stated that she did not experience any mental health symptoms from this incident.
She later completed grade nine and began working at the local supermarket, IGA. She said that she started enjoying earning money, more than studying. Subsequently, she was offered a job at Seabreeze restaurants and, at one point, was juggling two jobs. She worked variously in the bar, gaming area, and restaurants. She continued until complications arose during her first pregnancy at the end of 2015-2016. At the time of the accident, Ms. Laycock was living in Moranbah with her 18-month-old son. She had stopped working before the accident. She moved to Mackay towards the end of 2019 and started working in a café but left after a couple of months. She also worked at Byrnes Pies Factory in 2020 but only lasted two weeks. She reported that she started making coffee but was told it was not “quick enough" and was moved around frequently. Her daughter was born in November 2021, by which time she had separated from her partner. However, he "set up a shed and stayed with her about two months later on" even when she didn't want him there, as he was quite aggressive around the kids. She mentioned that he was later offered a job and subsequently moved out. Ms. Laycock attempted to work as a cleaner but found it challenging to maintain cleanliness in her environment. Struggling with the pressure, she eventually gave up. She last worked as a cleaner, for about two and a half hours, a couple of months ago.
She denied having any history of mental health symptoms before the accident and specified that she did not suffer from postnatal depression, asserting she bonded well with her daughter. Her mother and sister had Bipolar Affective Disorder, and her mother was on medication.
She denied drinking alcohol, stating she only consumed it socially. Additionally, she denied using illicit drugs or gambling and claimed no history of criminal convictions or incarcerations.
3.   History of the motor accident
Ms Laycock reported that on 23 December 2018, they were visiting her partner's family in Kyogle, New South Wales, for Christmas. They then decided to go to Lismore to buy supplies and nappies and also bought a new dashcam. On their return trip to Kyogle, they stopped at a self-service car wash. Ms Laycock was in the front passenger seat. Her son Hunter was in a forward-facing back seat. Her partner was standing outside, using a hose to clean the car. She said that since they had just bought the dashcam, she was trying to configure it and figure out how it worked. The car engine was running at that time to keep the air conditioning on. Ms Laycock recounted that the car wobbled, and at first, she thought it was her partner or someone from the car wash; however, when she turned around to look at the man, he looked “angry,” and she could tell that he was not a car wash worker. She thought he appeared substance affected and was about to steal the car. She reported that she started screaming in an attempt to get help. By that time, her partner, who was outside the car, realised something was wrong and opened the driver's door, grabbing the man by his throat. She estimated it took around 15 seconds for her partner to spring into action. Her partner became “wedged in the driver's seat with the perpetrator.” Then there was a struggle, she continued yelling that he could not do this and there was “pushing and shoving in the car.” The man managed to put the car into gear and drove for about 6 to 7 metres onto a garden bed, at which point Ms Laycock pulled the handbrake. The car then stalled and the man left the vehicle and ran. The man later got into a white van in the wash bay next to them while they went to the back of the car to check on the baby; the man then drove away at high speed on the highway.
She mentioned that she later called triple zero and spoke with the emergency operator while the detectives arrived shortly after. The detectives informed them that they had seen the man go down the road to a farm, change cars and drive off again. She felt frustrated and expressed her displeasure that the police were rather casual, stating they could have apprehended him if they had received the calls a few minutes earlier. However, they did not conduct further investigations and did not even make an effort to take fingerprints, etc. She said they did not even “look in the car for any evidence to get hold of the perpetrator.”
Ms Laycock reported that once they calmed down, they drove home and later found a packet of cigarettes as well. About two days later, she discovered a syringe that the perpetrator had possibly dropped on the side of the seat. They then called the police, who advised them to get blood tests and mentioned there was no rush to do it sooner. They later went to the Kyogle ED to be tested for any blood-borne infections. She was concerned about contamination and worried that they might have been infected. She noted that her partner was tested, but she was not as she had not been stabbed. They never heard back about the results of the test, but as far as she knows, he was not infected.
Ms Laycock reflected that the scariest part of the incident was the person “trying to steal the car with her son in that car.”
4.   History of symptoms and treatment following the motor accident
Ms. Laycock reported that she started experiencing mental health symptoms soon after the accident. She gradually lost her sense of confidence. Prior to the assault, when at the park, she had seen intoxicated people but never felt vulnerable. However, after this incident, she always felt that she could be in some sort of danger and was frightened to be in a car. She had “zero trust” and needed everything to be locked. She had difficulties driving the car and was unable to concentrate, as she was "not taking in everything that was going on" when she drove. She reflected that she was worried that it could take only two seconds for anyone to come and attack or assault her. She was particularly worried that “anytime you step out, anything could happen." She was always fearful and was apprehensive about the next thing that could happen. She reported that she stopped driving completely for a "little while” and then later started driving again. She said that when her partner got another job, she had “no choice but to drive." They later moved to Mackay, Queensland, in 2020 to be closer to her mum and her girlfriend. She mentioned that she had friends when she moved there. However, they did not offer much help or support. Her mum, however, would care for Hunter at times when she went to work.
She also reported experiencing nightmares that were “dark and about people yelling at her and screaming." She would wake up in a sweat and feel quite panicky. She was quite hyper-vigilant and often looked over her shoulder, catastrophising about the worst things that could happen. She was also avoidant of the area where the incident occurred, particularly the main roads, and did not want to drive there.
There were occasions when she had a few troubling thoughts but never had any plans or intent. She even talked to her psychologist about it but never acted on any thoughts.
She denied having any weight loss or weight gain after the incident.
When her mental health deteriorated, she saw her GP, who later referred her to a psychologist and a psychiatrist. She was referred to Dr Phil, a psychiatrist. This is the only recollection the claimant had of the name of this doctor. Dr Phil encouraged her to pursue a modelling career ,after she expressed her desire to become a model. However, she was not able to keep up with the weekly commitments. She signed a modelling contract with the agency but did not receive payment. She also started on medications after about a year post-accident. However, that too did not help much. Her mood remained low and depressed, and she “shut herself from everything and did not find enjoyment in anything in particular.”
5.   Details of any relevant injuries or conditions sustained since the motor accident
Nil reported.
6.   Current symptoms
Ms Laycock reported that she has been struggling with her mental health, as she had before. She recently had a conflict with her ex-partner and sister, which required her to call the police, resulting in her sister leaving the home. Her mood is “usually flat, tired” regardless of how many hours she sleeps. She finds it difficult to focus and often forgets day-to-day things. She shared an example of how she recently won a competition on Facebook for a clothing store in town, receiving a voucher. She mentioned that she and her son went to the store to buy face paint. However, when the receptionist discovered she was the competition winner, she made a loud announcement, and everyone in the store learned of it. Ms Laycock left immediately and later realised she had forgotten her phone in the shop. She continues to experience fear and anxiety, feeling that “all are strangers and does not know why they are here for." She feels particularly anxious when she sees “overweight people,” noting that she feels confronted by individuals who resemble the perpetrator. She remains worried about someone trying to steal her car. She expressed being in a heightened state and finds it challenging to speak at those times. She spends a lot of time on Facebook and scrolls through social media as a way to fill her time. She reported waking up between 2:30 and 3:30 am but stays in bed until morning.
She did not identify any specific stressors. She only drinks alcohol occasionally. She consumes about 3 to 4 V drinks per day, which she has been having "for about a year." She denies having any Coca-Cola, tea, or coffee. She had her last V drink around 6 pm. She has tried to cut back and has gone without V drinks for a couple of days, only to restart. She does not experience headaches when she stops drinking it. The longest she has gone without V drinks is about 4 days.
On a typical day, she gets up between 6:30 and 7:30 am and prepares breakfast for herself and her kids. She then gets them dressed. Her daughter stays at home on Mondays and Tuesdays, and she drops her off at daycare on the other three days. She drops her son at school every day. Afterwards, she does the washing and dishes, cleans the guinea pigs, and tidies up the lounge room. She then spends a lot of time scrolling through Facebook. Finally, she picks her kids up and spends the evening with them. She denied having any suicidal thoughts, plans, intent, or thoughts of harming her kids.
7.   Current and proposed treatment
She used to see Dr. Phil, psychiatrist. She mentioned that she only saw him three times, and Dr. Phil increased her dose of paroxetine. She is currently taking 60 mg of paroxetine and 5 mg of diazepam. She is not on any other medications.
She has seen a psychologist on a monthly or fortnightly basis, for the last three to four years. Her last appointment was two weeks ago. They are currently working to “deal with her life.”
Clinical Examination
Mental State examination
EXAMINATION:
Ms Laycock was assessed via video. She engaged well during the evaluation and was cooperative. She presented as a young woman wearing a green t-shirt and adorned with nose rings. She wore glasses, and her hair was left loose.
She provided a clear account of her symptoms and difficulties. She reported her mood to be low and anxious, and her affect was congruent with the described mood. Her thoughts were logical and goal directed. Her speech was spontaneous and normal in volume and tone. Currently, she reported ongoing ruminations, intrusive thoughts, low mood, anhedonia, and a lack of interest in activities. There was no evidence of any manic, psychotic, or perceptual abnormalities.
She was able to focus and maintain attention during the 1.5-hour assessment. She was not distracted.
She had insight into her condition, and her judgement was intact.
8.   Comments of consistency

Ms Laycock’s presentation was internally consistent.

Determinations

9. Diagnosis and reasons
Ms Laycock was involved in a motor vehicle accident on 23 December 2018, during which the offender attempted to hijack the vehicle in which she and her 18-month-old child were passengers. She and her partner subsequently engaged in a physical struggle with the offender to prevent the hijacking. Ms Laycock later discovered a syringe in the vehicle and went to Kyogle Hospital for testing for any blood-borne infections. Ms Laycock’s current presentation aligns with a diagnosis of Post-Traumatic Stress Disorder.
The diagnosis is based on the presence of DSM-5 criteria, which includes criteria A, directly experiencing the traumatic event and witnessing it as it occurred to others. She also experienced recurrent involuntary intrusive memories of the traumatic incidents, criteria B, recurrent distressing dreams, prolonged distress, and avoidance of external reminders that provoke distressing memories, Criteria C, as well as persistent negative cognitions and mood, criteria D. This includes a persistent negative emotional state, markedly diminished interest or participation in significant activities, and changes in arousal, criteria E, such as exaggerated startle response and hypervigilance, along with sleep disturbances. She continues to experience symptoms, fulfilling duration criterion in F, her symptoms cause her distress and impaired functioning, fulfilling criterion G and her symptoms are not due to another condition, fulfilling criterion H.

Causation and reasons
Ms Laycock's current presentation was caused by the incidents that day. Ms Laycock acknowledged that she felt particularly threatened and fearful of potentially being kidnapped and hijacked on that day, with the PTSD largely resulting from the threat of kidnapping. The panel does not believe that the needle stick injury sustained by either her or her partner significantly contributed to her mental health presentation; because her partner was quite confident that the chances of them contracting a blood-borne infection were quite low, which is in keeping with him not following up on the results of the hospital’s testing for blood-borne illnesses.
The following injury were caused by a motor accident: Post-Traumatic Stress Disorder.
Ms Laycock’s impairment is now permanent. She has received ongoing psychological interventions for more than three years now. She has also been under the care of a psychiatrist and has received an antidepressant, paroxetine, in high doses of 60 mg. Unfortunately, her mental health has not substantially changed with the ongoing treatment. The panel believe that her mental health is unlikely to change substantially as she has now received evidence-based treatment for Post-Traumatic Stress Disorder.

PERMANENCY OF IMPAIRMENT

Permanent impairment is defined in the American Medical Association’s Guides to the Evaluation of Permanent Impairment (Fourth Edition) (p 315) as follows:
“Permanent impairment is impairment that has become static or well stabilised with or without medical treatment and is not likely to remit despite medical treatment.
A permanent impairment is considered to be unlikely to change substantially and by more than 3% in the next year with or without medical treatment.”

Degree Of Permanent Impairment Psychiatric Impairment Rating Scale

10.The determination as to permanent impairment is made in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment (Fourth Edition) and Part 6 of the Motor Accident Guidelines.

Psychiatric diagnoses	1. Post-Traumatic Stress Disorder
	3.	4.
Psychiatric treatment description	Psychological interventions, treatment with antidepressant Paroxetine 60 mg and Diazepam 5 mg.

Category	Class	Reason for Decision
1. Self-Care and Personal Hygiene	2	Ms Laycock is able to change into clean clothes daily, but there are times when she does not brush her teeth and shower regularly. She, however, does her best to ensure that her children’s needs are being met, taking care of their personal hygiene and nutrition. She does all the household chores and is able to cook for herself and for the children. She is able to cook things like pasta and other recipes in slow cooker. The panel consider this represents a mild impairment, given that she can live independently, and look after herself and the needs of her children, but her self-care is impacted at times and she may appear unkempt occasionally.
2. Social and Recreational Activities	2	Ms Laycock reported that prior to the incident, she enjoyed hanging out with friends, going to different places and parties but she does not engage in these activities significantly now. In regard to the Facebook images, Ms Laycock reported that she once went out to Whitsunday Sailing Club because she had won an entreé and a dessert competition. She reported that she had participated in modelling sessions which she only did at the behest of her psychiatrist who encouraged to do modelling. Althoughhe photographs of the family photoshoot depicted Ms Laycock to be smiling, she reported herself to be feeling anxious and depressed. However, Ms Laycock reported that she goes to the beach everyday with her son and with her children, often also in the company of her neighbour Jane and her children. She went to and attended Jane's birthday and saw a magic show and said that she “drank a lot and had lots of fun.” She organises birthday parties for her children which are often attended by her neighbours, her mother and her mother's girlfriend. She also socialises, and buys presents for other children, when her son attends their birthday parties. She also socialises with another friend who owns the creche where her son attends. They often meet up and they often socialise with them. Considering there is a change in the types of environments in which she socialises, due to her PTSD related anxiety, but noting she does engage in social and recreational activities with her children, up to daily, she has a mild impairment.
3. Travel	2	She leaves her house to drop her children to day care, to go to nearby pools, to buy food, shopping. She denied travelling interstate or going for any holidays. Given she can travel locally, but avoids further travel, this is a mild impairment.
4. Social Functioning	2	Ms Laycock reported that she separated from her ex-partner which she attributed to her partner's drinking and aggression. She however was able to form another relationship with an old school friend who lived in Airlie Beach. She met him prior to the accident when she was working in Seabreeze in Mackay when they were younger but had not spoken to him since 2015, before they started meeting up when he was back in Mackay. They formed a relationship, which started around December 2024 and ended in January 2025. She continues to have good relationship with her children and takes good care of them. She has also bonded well with her neighbour Jane and her son's friend's parents, and they go to the beach and have long conversations. She and Jane are close and she has often encouraged her to return to work. This is consistent with a mild impairment.
5. Concentration, Persistence and Pace	2	Ms Laycock reported that she forgets to hang the washing and her memory is horrible. She gave the example that she forgets to plug in her sons’ skateboard. She described her attention and concentration as “lose.” She said that she gets distracted during conversation and is unable to recollect the conversation. She however is able to deal with the lawyers on her own but only has to respond to those forwarded emails. She occasionally watches TV and denied having any difficulty. She hears two podcasts and audiobooks, but finds it overwhelming and has to rehear or reread. She is however able to budget with whatever income she receives via Centrelink. She is now working on a plan to pay back the loan which she had with her children's father. She was able to focus and pay attention during the assessment and was not distracted. Taken as a whole, and noting the objective findings, she has a mild impairment.
6. Adaptation	4	Ms Laycock reported that after the motor vehicle accident, she tried working a couple of times, including as a barista during COVID period. She also tried working as a cleaner. However, was not able to work in a team setting. Noting she provides sole care for her children in an unpaid role, the panel consider she has capacity to work less than 20 hours per fortnight with reduced pace and in a supportive environment, consistent with a severe impairment.
List classes in ascending order: 2,2,2,2,2,4
Median Class Value:2
Aggregate Score: 14
% Whole Person Impairment:7 %

*%WPI ^{= Percentage Whole Person Impairment}
No deductions were made for any pre-existing illness, as she has no history of mental health issues. The panel also did not make any adjustments for treatment effects, as she has not/ noticed significant improvement in her mental health.”

The Panel met on 17 June 2025 to discuss the Medical Assessors findings on examination. The legal Member of this Panel did not participate in the medical examination but prior to the Panel meeting on 17 June 2025, the legal Member has had the benefit of reading and considering the Medical Assessors examination report. On 17 June 2025 the Panel discussed the examination findings and the issues going to causation and assessment of WPI. It is from this teleconference of the Panel that the Panel has agreed and reached its final conclusion and determination. Further discussions took place and the Panel agreed on its findings.
The Panel adopts the findings of Medical Assessor Barrett and Medical Assessor Verma.

Causation and reasons

The Motor Accident Guidelines set out the test for causation in cls 6.5 and 6.6.
Causation is defined in the Glossary at page 316 of the American Medical Association Guides, 4th edition (AMA 4 Guides). It is in the same terms as cl 6.6 of the Guidelines.
Clause 6.6 provides:
“Causation means that a physical, chemical or biologic factor contributed to the occurrence of a medical condition. To decide that a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has, in fact, done so, it is necessary to verify both of the following:
(a) The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination.
(b) The alleged factor did cause or contribute to worsening of the impairment, which is a non-medical determination.”
Clause 6.7 provides:
“6.7 There is no simple common test of causation that is applicable to all cases, but the accepted approach involves determining whether the injury (and the associated impairment) was caused or materially contributed to by the motor accident. The motor accident does not have to be a sole cause as long as it is a contributing cause, which is more than negligible. Considering the question 'Would this injury (or impairment) have occurred if not for the accident?' may be useful in some cases, although this is not a definitive test and may be inapplicable in circumstances where there are multiple contributing causes.”
The circumstances of the accident are unusual. As Dr Mason noted, the event gave rise to post-traumatic stress disorder. However, he said from a legal point of view, and for which he is not qualified, he found it,
“difficult to differentiate between the accident and the man's intention of stealing the motor vehicle with the child inside. He said that this was the trauma suffered by the claimant. Dr Mason said that in his opinion these events were so interconnected that it is impossible to differentiate between the motor accident per se and the attempt to steal the motor vehicle containing an 18-month-old child.”
It is not for the Panel to consider the circumstances of the accident falling within the definition of a motor accident under the Act. However, the claimant was “assaulted” by the perpetrator jumping into the car and shouting at her to get out of the car. She did not do so as she feared for the safety of her child. The claimant did not suffer any physical injury while the car was slowly moving a few metres before the unidentified man who was at the time the technical driver, abandoned the car.
The Panel does not intend to decide if the “incident” on 23 December 2023 was a “motor vehicle accident” coming within the terms of what an accident is under the Act. The claimant was faced with a stranger entering her car, without permission, and forcibly requiring her to get out of her car, while her baby was in the back seat behind her.
Subsequently, the claimant and her partner found a hypodermic syringe in the car and were concerned that they may have suffered a needle stick injury during the assault. There is no evidence before the Panel to confirm how that hypodermic syringe came to be in the car and if the stranger was responsible for this. That appears however, to be the conclusion drawn by the claimant. The Panel is not satisfied that the discovery of the hypodermic syringe can be attributed to the claimant’s psychiatric condition. It may have had an impact but there is no evidence to suggest that this implement was introduced to the car by the perpetrator. The claimant has suffered a demonstrable psychiatric injury as a result of the actions of the perpetrator initially, at the car wash.
Accepting therefore that the Panel will assess the claimant’s psychiatric injury as one that occurred after the incident at the car wash, the Panel must ask itself a number of questions to establish causation of that injury.
Asking the question 'Would this injury (or impairment) have occurred if not for the accident?” the Panel is satisfied that it would not have occurred if not for the accident. There was no indication before the accident to a susceptibility of the claimant suffering a psychiatric condition and one assumes that without the intervention of some other cause, the claimant would have continued her life without a psychiatric incident arising.
The Panel must ask itself whether the accident was a contributing cause of the claimant’s psychiatric disorder and whether it was caused by the accident, noting two incidents being the personal assault of a stranger jumping in the car and ordering the claimant to get out. The other, connected, incident involved the claimant and her partner subsequently finding a hypodermic syringe in the car and fearing that they both may have suffered a needle stick injury. As has been discussed, the claimant assumes the hypodermic syringe was introduced into the car by the stranger but there is no evidence to confirm this.
In Metro North Hospital and Health Service v Pierce [2018] NSWCA 11, the Court of Appeal said, in relation to causation, as follows at [138] (White JA, Macfarlan and Payne JJA agreeing):
“138 Whether the Hospital’s negligence in not responding to the induced seizures in a timely manner materially contributed to Ms Pierce’s worsened condition is not to be determined on the basis of scientific certainty, but on the balance of probabilities”
In Briggs v IAG Limited trading as NRMA Insurance [2022] NSWSC 372, Wright J, regarding causation and the issues to be addressed, said;
“Furthermore, a finding of causal connection may be open without any medical evidence at all to support it, or when the expert evidence does not rise above the opinion that a causal connection is possible: Fernandez v Tubemakers of Australia Ltd [1975] 2 NSWLR 190 at 197 (Glass JA); Metro North Hospital at [140].
73 The second review panel did not address the question of whether on the balance of probabilities the motor vehicle accident caused the annular tear even though there might be no scientific certainty. Furthermore, the second review panel’s reasoning did not reflect the approach to determining causation in cll 6.6 and 6.7 of the Guidelines, which in my view is consistent with the legal principles I have outlined.
74 The present case is not one where medical science established that there was no possible connexion between the motor accident and Mr Brigg’s relevant injuries. From the material available, the second review panel accepted that the motor accident in this case could have caused or contributed to Mr Brigg’s L4/5 left posterolateral annular tear. Indeed, the panel expressly accepted that.”
On the balance of probabilities, can it be said that the psychiatric condition suffered by the claimant was caused by the accident? The Panel is satisfied that this is the case. The claimant, at the time of the accident, was confronted by a threatening stranger, seemingly endangering both the claimant and her 18-month-old son who was also in the car. Because of this, the Panel is satisfied that on the balance of probabilities, with no previously diagnosed psychiatric symptoms, the psychiatric condition suffered by the claimant was caused by the accident.
Would the impairment have occurred, if not for the accident? As far as the Panel is aware, the claimant did not have a pre-existing psychiatric condition and was not undergoing psychiatric treatment before the incident. The Panel is satisfied that the incident has brought about the claimant’s psychiatric condition and a need for treatment of this. The Panel is not aware of any other cause or condition that may have brought about the claimant’s diagnosis following the accident on 23 December 2018.
The Panel is satisfied that the incident occurring in the claimant’s car was a contributing cause of the claimant’s psychiatric disorder of post-traumatic stress disorder. Until that moment, the claimant had no known psychiatric disorder. The incident, involving immediate threat and personal harm to both the claimant and her infant son in the rear seat of the car, was alarming to the claimant. It was only after this incident that the claimant developed psychiatric symptoms and the Panel is satisfied that the accident was a contributing cause to this development.
The Panel is satisfied that the incident has had a more than negligible effect on the condition suffered by the claimant and diagnosed as post-traumatic stress disorder.

Conclusion

As a result of the incident on 23 December 2018, the claimant has suffered a psychiatric injury and developed post-traumatic stress disorder.
The Panel is satisfied that on the balance of probabilities the claimant’s injury is causally related to the incident on 23 December 2018. This is because the claimant did not have any psychiatric disability before the incident and was not receiving psychiatric treatment at the time of the accident for any other disability. The incident involved a stranger invading the claimant’s car and ordering her out of it so that he could take control and drive away in the car, with the claimant’s 18-month-old child restrained in the back. This would have been a situation which was alarming and one involving fear and danger.
While the claimant may have also attributed the introduction of a hypodermic syringe into the car by the assailant, this cannot be confirmed. The claimant was concerned that she and/or her partner may have suffered a needle stick injury because of the syringe being in the car but there appears to be no confirmation that subsequent tests revealed no direct injury from this. The claimant has never pursued the test results.
Following medical examination of the claimant, she has been assessed by the Panel as having acquired post-traumatic stress disorder and a 7% WPI.

Determination

The Panel revokes the certificate and reasons of Medical Assessor Nagesh dated
16 January 2024.
As a result of the incident on 23 December 2018, the claimant suffered a psychiatric injury.
The Panel has diagnosed the claimant’s injury as post-traumatic stress disorder.
The Panel assesses the claimant’s WPI as 7%

[2025] NSWPICMP 597

12 August 2025