Ka'akah v QBE Insurance (Australia) Limited

DETERMINATION OF REVIEW PANEL
CITATION:	Ka'akah v QBE Insurance (Australia) Limited [2025] NSWPICMP 801
CLAIMANT:	Khaldoon Ka'akah
INSURER:	QBE Insurance (Australia) Limited
REVIEW PANEL
MEMBER:	Alexander Bolton
MEDICAL ASSESSOR:	John Baker
MEDICAL ASSESSOR:	Steven Yeates
DATE OF DECISION:	20 October 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of decision of Medical Assessor (MA) who assessed the claimant as having 7% whole person impairment (WPI) and diagnosed a post-traumatic stress disorder with a major depressive disorder; claimant involved in an accident; insurer relied on video surveillance footage but Review Panel concluded this revealed nothing contradicting the claimant’s claimed disabilities; claimant had limited post-accident claims of psychiatric disability but explained by not having access to Medicare and insurer not willing to fund treatment; Held – Review Panel not satisfied the claimant had post-traumatic stress disorder as he did not experience a life threatening event in the accident; Review Panel assessed the claimant as having a 7% WPI and diagnosed a major depressive disorder; certificate of MA revoked.
DETERMINATIONS MADE:	CERTIFICATE OF DETERMINATION Determination 1. The Panel revokes the certificate of Medical Assessor Shen. 2. The Panel has diagnosed the claimant as suffering a major depressive disorder. 3. The Panel has assessed the claimant as having a 7% whole person impairment.

STATEMENT OF REASONS

INTRODUCTION

This is an application by the claimant for review of a certificate and reasons of Medical Assessor Shen (the Medical Assessor) dated 13 March 2024.
The Medical Assessor diagnosed the claimant as having post-traumatic stress disorder and major depressive disorder and assessed whole person impairment (WPI) of the claimant as 7%.
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 Act2017 (the Act).
The following injuries were referred by the Personal Injury Commission (Commission) for assessment:
(a) psychiatric condition / psychological.
The claimant was assessed for his physical injuries by Medical Assessor Bodel who found he had a WPI of 13% for the following injuries:
(a)    shoulder – soft tissue injury;
(b)    cervical spine – annular tear C6/7 with posterior annular protrusion
(c)    impinging the left C7 nerve root;
(d)    arm-soft tissue injury, and
(e)    shoulder – soft tissue injury.
The insurer sought a review of this determination, and the Medical Review Panel revoked the certificate of Medical Assessor Bodel and assessed 3% WPI. This Review Panel has not seen the original certificate of Medical Assessor Bodel but has seen the certificate and reasons of the Panel assessing the claimant’s physical disabilities.
The claimant now seeks a determination of this Panel by way of a review of the claimant's psychiatric injuries.

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 Panel notes the High Court judgment in Gamestar Pty Ltd v Lockhart [1993] HCA 79. The Court observed in the absence of submissions referring to specific documents that a tribunal is not required to search for references within documents where the submissions do not specifically address the materials. The Panel also notes the comments of Bellew J in Bevan v Bingham [2023] NSWSC 19 concerning the obligation of legal practitioners to place only the necessary evidence before the decision-maker.

The accident

The accident occurred on 4 April 2018 at approximately 6.20am. The claimant’s vehicle was stationary when the insured truck failed to stop and collided with the rear of the claimant’s car.

Claimant’s submissions

The claimant noted that the insurer relied on some video evidence. The claimant says that the Medical Assessor had regard to the totality of the video surveillance, including all alleged activity undertaken between 23 October 2020 and 22 December 2020.
The claimant says that when discussing the video footage with the claimant, the Medical Assessor only brought one alleged inconsistency to the attention of the claimant, namely that the footage apparently “demonstrated him working for half a day with a colleague”. The claimant submits that the Medical Assessor did not bring the totality of the alleged inconsistencies from the video footage to the claimant’s attention, but rather, focused on one single aspect of the footage.
The claimant submits that the failure of the Medical Assessor to bring to the attention the totality of the video surveillance footage to the claimant, denied the claimant the opportunity to respond to the inconsistent observations to ensure procedural fairness. The claimant says that the failure of the Medical Assessor to bring all of the alleged inconsistencies to the claimant’s attention and provide him with an opportunity to respond is particularly pertinent given that the Medical Assessor raised credibility issues based upon the video footage and report.
The claimant submits that the Medical Assessor erred in assessment of certain psychiatric impairment rating scale (PIRS) criteria.
The claimant submits that the Medical Assessor had no basis to conclude that the claimant could work in a part-time capacity based upon the video surveillance nor that he was undertaking his pre- injury role as the video footage did not confirm either conclusion. The claimant says that it was incorrect for the Medical Assessor to draw conclusions from limited video footage and to disregard the explanation provided by the claimant.
The claimant’s submissions regarding his initial application for assessment of WPI made no reference to any psychiatric or psychological disability other than to say a WPI assessment for a psychological disability was in dispute.

Insurer’s submissions

The insurer submits that the Medical Assessor appropriately dealt with the clear inconsistency revealed by the surveillance footage. That is, he raised the evidence of the claimant performing working half a day for comment and recorded the claimant’s response to this evidence.
The insurer noted that the Medical Assessor provided the following, detailed reasons in relation to his assessment:
“I raised the surveillance footage and report from 2020 that demonstrated him working for half the day with a colleague. He said that was just one day, and he was supervising and helping his brother out on that day, rather than painting. He said that was in 2020, and he said it was just one day for a short period of time. I said that on reviewing the footage, it showed a person wearing the same shirt he was wearing while getting out of the car that was painting indoors. He said he was using a small brush and just doing a touch-up. I asked why he could not continue working as he had done, and he asked who would employ someone like him, who could do touch up with a small brush.
His adaptation by Gerard Glancey was moderately impaired as he was unable to work full time in an alternative capacity.”
The video surveillance demonstrates some capacity to work in a part-time capacity at least, given he was able to work for half a day, in a similar role to his pre-injury role, so he would have mild impairment.
The insurer submits there is no error in the approach of the Medical Assessor and his findings in relation to the inconsistencies revealed by the surveillance footage and the claimant’s presentation.
The insurer submits the following:
(a)    the claimant’s opinion on what the Medical Assessor “ought” to have assessed is irrelevant. The insurer says that the Medical Assessor's duty is to come to his or her own opinion and take his or her own history [Farr v Insurance Australia Limited t/as NRMA Insurance [2014] NSWSC 1435];
(b)    the insurer says that the Medical Assessor did not accept the “claimant’s inability to return to work” in circumstances where he demonstrated his capacity, at least for half a day, to perform his pre-injury duties in the surveillance footage;
(c)    the insurer submits that the Medical Assessor clearly outlined his path of reasoning in determining the appropriate class for Adaptation was Class 2. Whilst a Medical Assessor’s obligation to give reasons requires it to set out ‘the actual path of reasoning’ by which they arrived at their assessment; the reasons are to be given a ‘beneficial construction’: Wingfoot Australia Partners Pty Ltd v Kocak (2013) 252 CLR 480, and
(d)    the insurer submits that the Medical Assessor’s assessment of the PIRS did not contain any error which is incorrect in a material respect.
The insurer submits that there is evidence of gross signs of illness behaviour on examination of the claimant’s physical injuries. The insurer says there is evidence of embellishment and exaggeration of the claimant’s purported symptoms and disabilities.
The insurer submits that the claimant’s self-reported incapacity and disabilities are not compatible with examination and pathological findings nor the surveillance footage of him working as a painter.
The insurer says that the certificate of capacity dated 29 October 2020, signed by the claimant, states that he did not have capacity to work from 30 October 2020 to
30 November 2020. The certificate of capacity dated 1 December 2020, also signed by the claimant, states he did not work since the last certificate was provided however, the insurer says that this is the period in which surveillance footage has captured the claimant working as a painter.
The insurer submits that there is no contemporaneous medical evidence of the claimant sustaining a psychological injury in the subject accident. The clinical notes of Moorebank Shopping Village Medical Centre revealed that the claimant did not make any complaints of any psychological symptoms from the date of the accident until at least 29 June 2020, over two years post-accident.
The insurer referred to a Medical Review Panel Certificate dated 18 May 2022 with respect to the claimant’s physical injuries. The insurer noted that the Review Panel in that determination found that there were various inconsistencies in the claimant’s reported history and presentation to medical practitioners and which was demonstrated in the surveillance footage. The insurer noted that the physical Review Panel ultimately concluded that the claimant “exaggerated the extent of his disability in his presentation to medical practitioners”.
The insurer submits that while the claimant reported to Dr Glancey that following the accident he experienced an emotional disturbance with memories of the accident, suffered sleep disturbance, experienced anxiety with car travel and experienced a low mood, none of these symptoms are supported by the contemporaneous medical evidence.

Medical evidence

The Medical Assessor assessed the claimant on 11 March 2024. At the time of assessment, the claimant was residing in Jordan.
Regarding any inconsistencies by the claimant in the examination, the Medical Assessor said:
“There is an inconsistency with his:
·Self-reported level of functioning regarding his self-care and ability to shop, ability to work and interact with people, against the video surveillance demonstrating his capacity to shop at a 7-11 shop, being able to work indoors painting and able to assist with his brother at work. This raises issues regarding his credibility, and so where there is any conflict between information regarding his functioning, I have preferred the video footage over his evidence.
·There is an inconsistency he has provided about not being allowed to access psychiatric treatment, whereas that is usually not a barrier in Australia with regards to being referred to a psychologist by his GP, or commenced on medication treatment if necessary by his GP.”
The Medical Assessor concluded that there was some evidence for a diagnosis of
post-traumatic stress disorder, and major depressive disorder. However, the Medical Assessor said that given the issues regarding his credibility, it was difficult to know for sure how much of his symptoms were exaggerated.
Going to the PIRS assessment, the Medical Assessor provided the following table:

Psychiatric diagnoses

1. Post-Traumatic Stress Disorder

2. Major Depressive Disorder

3.

4.

Psychiatric treatment description

Nil

Category

Class

Reason for Decision

1. Self-Care and Personal Hygiene

2

He said he has been showering twice a week, and he said he had no answer as to why he was not showering more frequently. He said he sometimes skips meals, and sometimes just one or two meals a day. He said his mother has been cooking for him. He said he has not been doing any housework. He said he goes out to shop only for cigarettes, which he goes shopping every 3-4 days. He said prior to the subject accident, he would shower every day, when he goes out to work.

His description of his self-care would be consistent with a mild to moderate level of dysfunction, however there may be a degree of exaggeration. He retains the capacity to shower himself, he retains the capacity to go shopping, if only for cigarettes as his mother prepares meals for him

otherwise, so he is not so impaired as to require regular

community support.

2. Social and Recreational Activities	3	He said he has no friends he is in contact with, and this has been for the past 2 years, after the doctors told him about the operation and he lost hope. He said he now does nothing at all, apart from sitting inside his room, smoking and drinking tea. This is consistent with Gerard Glancey’s rating of moderate impairment, and there is no conflicting information, and the surveillance footage does not provide any evidence that contradicts this rating, so he has moderate impairment.
3. Travel	2	He said he has not been driving, and he said he last drove when he was in Australia, and when he was in Australia, he said he had difficulties with his driving, and he could not drive more than 15 minutes, and most of the driving was done by his wife. The Glancey report rated him as being not impaired, being able to drive with some degree of anxiety, and being able to walk without impairment. He has retained some capacity to drive, and there has been consistent reporting of anxiety associated with his driving, so it is plausible that he has mild impairment.
4. Social Functioning	2	He said that he remains together with his wife, but there has been strain in the relationship due to him losing his temper, and he said there has not been any physical violence or separation. He said he is in contact with his wife every 2-3 days. He said prior to the subject accident, his relationship with his wife was good, when he was a loving and happy person. He said that his relationship with his children have been isolated, and he said when he was still in Australia he was not able to hold them or be loving since the subject
accident, and exchanges a short greeting with them. His two sons visit once a week on weekends for an hour. He said prior to the subject accident, he would play soccer with his children and go out with them, and go swimming with them. He said that he has six brothers and three sisters, and he said he is in infrequent contact with them, perhaps once every 2-3 months. He said prior to the subject accident, he would be in contact with them every 7-10 days, and they would talk about their hobbies and family. He said he has no friends he is in contact with, and this has been for the past 2 years, after the doctors told him about the operation and he lost hope. As he remains in regular contact with his wife and children, and there being some strain without separation or violence with his wife, and he maintains regular contact with his children and siblings, albeit with reduced frequency, he has mild impairment. While the Glancey rating was of moderate impairment as he was living away from home, this is more due to requirement to be close to his sons in Jordan, rather than a separation from his family in Australia, whom he remains in regular contact.
5. Concentration, Persistence and Pace	3	He said that his concentration now has been generally poor and he cannot concentrate on reading or talking to people, and he said that he can barely read anything for 1- 2 minutes. He said he rarely watches TV now. He was alert, appeared grossly cognitively intact and was able to sustain his concentration for the duration of the assessment.
He was reported as having moderately impairment by Gerard Glancey as he had poor concentration for TV viewing. As there was no significant impairment as to be easily discerned in a brief conversation, his impairment would be moderate at most. There is no significant contradictory evidence, so he has moderate impairment.
6. Adaptation	2	He said he has not been able to work, with his arm being numb all the time. He said he has not been able to engage in alternative work. He said he has not been able to find other work. He said he last worked since the subject accident in 2018. I raised the surveillance footage and report from 2020 that demonstrated him working for half the day with a colleague. He said that was just one day, and he was supervising and helping his brother out on that day, rather than painting. He said that was in 2020, and he said it was just one day for a short period of time. I said that on reviewing the footage, it showed a person wearing the same shirt he was wearing while getting out of the car that was painting indoors. He said he was using a small brush and just doing a touch-up. I asked why he could not continue working as he had done, and he asked who would employ someone like him, who could do touch up with a small brush. His adaptation by Gerard Glancey was moderately impaired as he was unable to work full time in an alternative capacity. The video surveillance demonstrates some capacity to work in a part-time capacity at least, given he was able to work for half a day, in a similar role to his pre-injury role, so he would have mild impairment.
List classes in ascending order: 222233
Median Class Value:2
Aggregate Score: 14
% Whole Person Impairment: 7%

The Medical Assessor made no deduction for any pre-existing psychiatric disability. He said that there was none.
The claimant obtained a report from Mr Glancy, psychologist, of 15 December 2022. The assessment was with the assistance of an interpreter and was by way of a teleconference and not audio visual.
The claimant reported that:
“…he was very frightened following the accident. He kept thinking about the accident. He experienced emotional disturbance with memories of the accident. He suffered sleep disturbance; he experienced bad dreams. He would wake from dreams with physiological hyper- arousal and emotional disturbance. He considered that he could have died in the accident. There was evidence of emotional disturbance as he reported his view that the accident represented a near death experience.
He reported having experienced anxiety associated with car travel following the accident. He experienced anxiety when the car in which he was travelling was in close proximity to trucks and heavy vehicles.”

The claimant reported to Mr Glancy that he suffered sleep disturbance with nightmares. He woke from sleep with nightmares and hyper-arousal. He reported the view that he could have died in the accident. He considered the accident a near death experience. He claimed pain to have persisted. He did not return to his former employment as a painter, he said as a consequence of his injuries and pain condition.
Mr Glancy diagnosed an adjustment disorder with mixed anxiety and depressed mood. He said that his assertions of pain and physical restrictions would likely prevent him from work of a physical capacity. Mr Glancy made no comment about psychological or psychiatric issues preventing work.
Mr Glancy confirmed that the claimant had not made a complaint of psychiatric or psychological disturbance to his general practitioner (GP).
Mr Glancy said the claimant provided convincing reports of a depressive disturbance. He said that a major stressor underpinning depression appears frustrations with the insurer and the dispute of his claim of physical injury. He went further and said,
“The credibility of his pain condition is a matter for specialist medical opinion. Should he be considered to suffer pain and restrictions associated with the subject accident, those injuries would be considered significant in the onset of frustration and mood disturbance.”
Mr Glancy said that reports of trauma related anxiety were a direct consequence of the subject accident. Low mood typically co-exists with trauma related anxiety. He said that depression however, appeared primarily a consequence of his disputed claim of pain and physical restrictions.
All of the certificates of capacity and allied health recovery requests relating to the claimant’s post-accident treatment and recovery, deal only with what is described as: “ Left shoulder pain from partial tear of supraspinatus and subacromion bursitis”. There is no mention of any psychiatric disorder.
The clinical notes of Moorebank Shopping Village Medical Centre make only one reference to psychiatric disorders when on 12 January 2022 the claimant was said to be depressed “given his situation”. The only other entry relative to this review was on 23 November 2018 when the claimant was recorded as “good mood no history of psych disease”.
The claimant relies on a report by Dr Bentivoglio dated 4 March 2020 for his physical disabilities. He assessed the claimant as having a combined WPI of 20% for his neck and his left shoulder.
Dr Bentivoglio reported that the claimants then most recent MRI scan taken of his left shoulder in September 2019 showed evidence of some age-related early degenerative change involving his acromioclavicular joint, but no other significant abnormality. There was no evidence of any tearing of his rotator cuff tendons. He was not at risk of developing degenerative osteoarthrosis in his shoulder at a later stage.
Dr Bentivoglio said that the claimant should avoid activities which require him to use his left
upper limb at or above shoulder height region and should avoid arduous-type activities.
The Panel has been provided with a copy of a Medical Review Panel certificate for the claimant’s physical injuries arising from the accident. Medical Assessor Bodel assessed the claimant at 13% WPI. The Panel has not been provided with a copy of the certificate of Medical Assessor Bodel.
The Medical Review Panel revoked the certificate of Medical Assessor Bodel and found that the claimant had a total WPI for physical injuries of 3% and that related to his left shoulder.

Surveillance

The Panel has reviewed the surveillance reports and footage of Quantum Corp, relied on by the insurer. There was close to 60 hours of surveillance undertaken and close to 55 minutes of surveillance recorded on 23 and 24 October 2020, and two bundles of surveillance on
2 November 2020.
The claimant was seen at times driving a van, with a ladder on the roof and with the van having a website in the back window advertising air conditioning. There is no indication that the claimant was practicing as an air conditioning technician.
Much of what the claimant said he could not do, such as walking for more than 15 minutes, sitting or standing for more than 30 minutes, or mowing lawns, was not contradicted by surveillance. The claimant, however, was seen to drive a utility/van for reasonable periods of time and was also observed carrying paint tins, with both his left and right hands, from his van and utility on a number of occasions. He was also observed, among other things, to raise his hands above shoulder height. This is contrary to the opinion of Dr Bentivoglio concerning use by the claimant of his left shoulder. The claimant laughed and gesticulated without restriction and moved his neck and shoulders freely.

Medical examination

The claimant was examined by Senior Medical Assessors Baker and Yeates on
17 September 2025. Their report follows:
“Who attended the assessment
Mr Ka'akah (the claimant) attended the assessment on 17 September 2025 by
MS Teams. His wife accompanied him for the duration of the 90-minute re-examination by Medical Assessors Baker and Yeates.
The claimant did require an Arabic interpreter, who was booked and organised through the PIC. The claimant said he could understand the interpreter well. The interpreter said that she could understand the claimant.
The claimant was living with his wife in Sydney. He said he had returned after a three-
year absence. He said he was living with his mother and his sister in Jordan. The claimant said he had travelled to Jordan in about 2022 and returned in 2025.
The claimant was reacquainted with the surveillance footage provided with the referral. The claimant initially said he was unaware what video surveillance was being referred for him to confirm his presence in the footage. To resolve this difficulty, the video footage was shared using the MS Teams share screen function. The claimant was then able to identify himself in each of the videos.
The claimant said he had been videoed whilst performing a “touch-up” job. He said he was holding a small bucket in his left hand and he was using his right-hand painting. He said it was his ardent belief that the insurer knew he was performing minor light duties in relation to his painting business.
History
Psychosocial history and pre-accident
The claimant was born in Jordan. His father worked on the family farm. He said his father died in 2023, aged about 72 years. His mother lives in Jordan and is 73 years old at the time of the re-examination. He said in keeping with family tradition and culture, his sister, who was unmarried and aged about 36 years, cared for his mother. His sister lived with his mother in the family home. The claimant said that he was one of nine siblings. He said he was the fourth child.
The claimant said that he attended a government school whilst living in Jordan, after completing about 11 years of education. He left school at age 17 to help his father work the family farm. He said he also would work in tourism close to the family home. He remained in these roles until he volunteered to join the Jordanian army.
The claimant said he was a volunteer when he joined the Jordanian army. He said he worked in the army for nine years. He said he was a soldier and he was not deployed to any warzones or war-like conditions. He said he was not injured whilst engaging in military service. He left the army at about 30 years of age.
The claimant said he had married for the first time in Jordan. He said he had two children from this first union. He said his children were aged 15 and 14 years and their mother was aged about 35 years. This extended family group lived in Jordan. He said he had separated and divorced his first wife before entering Australia in about 2014.
The claimant said that he had married for a second time in Australia to his wife, who lived in Australia. He said his wife had one son from a prior relationship who suffered from severe autism and received NDIS support. The claimant said he had a daughter through his union with his wife, and this child is now aged seven years and also suffers from autism. The claimant’s daughter was reported by her mother as having a level 3 autism spectrum disorder, and she had the NDIS package support. The daughter was “non-verbal” and spoke a few English words poorly.
The claimant’s wife received a family carer’s payment for her children. She said that she would work about two days each week to supplement the family’s income.
The claimant said he had not worked whilst in Jordan or in Australia since leaving Australia in about 2022. He said he was a permanent resident. He said he did not have a Medicare card at the time of the accident. He said he did not apply for the Jobseeker allowance from the Australian government. He said he did not have an NSW Government low-income card and had not applied for any disability support payment since his first arrival in Australia. He said on his return to Australia in 2025, his wife had assisted him in applying for a Medicare card. He said he was waiting on the card to be issued, but did not state that he had been given an interim Medicare number.
The claimant was asked about whether he had ever suffered from psychiatric illness before the accident on 4 April 2018. He said he had no past history or psychiatric or psychological conditions. He said he did not know of any other members of his family having mental illness or psychological conditions other than his 7-year-old daughter.
The claimant said he had never been injured in Jordan or Australia before the accident.
The claimant said he had come to Australia to start a new life. He said he was working in painting and maintenance before the accident. He said he would paint, and he confirmed he was doing a “touch-up” when the video of him was taken.
The claimant said he had no medical conditions prior to the motor accident. He had not had a motor accident either in Australia, Jordan or any other place before the accident.
The claimant said he did not drink alcohol. He did not gamble. He said he did not smoke cannabis. He said he smoked tobacco.
The claimant said he was not aware of any allergies.
Prior personal injury claims
The claimant had no history of post-traumatic stress disorder as a result of his military service. He was never deployed into combat or injured in training.
The claimant said that he had no prior motor accidents.
The claimant stated that he had not made any work cover claims.
Prior Functioning before the accident on 4 April 2018
The Medical Assessors reviewed the forwarded documents and asked questions of clarification regarding the claimant’s prior psychological health. The Medical Assessors agree that there is no pre-existing psychological condition that had been diagnosed before the accident.
Assessment of whole person impairment prior pre-existing the accident on
12 June 2018
Self-care in personal hygiene
The claimant said that before the accident, he was independent in his self-care and personal hygiene. He lived in rented accommodation with his wife and her son. He said he would shower regularly after work. He was able to maintain his nutrition. He was able to clean and assist with the maintenance of the family home. He could wash and launder his own clothes. He was able to purchase groceries from his local supermarket. He was able to help and support his wife with the cooking of meals and caring for the garden.
Social and recreational activities
The claimant said that he was able to socialise without impairment before the accident. He said he would socialise with friends, and he enjoyed going to the beach and driving to the ‘snow’ in NSW. He would watch television events with his wife. He would celebrate cultural events such as Ramadan and Eid. He would celebrate family birthdays with his wife and her son.
Travel
The claimant said that he was capable of travelling internationally alone to and from Jordan. He had travelled to Australia alone in about 2014. He had been able to drive before entering Australia. On entering Australia, he was able to drive himself to and from his work sites and other unfamiliar locations without difficulty.
Social functioning
The claimant said that he had not suffered from any psychological condition before the accident. He said he had left his first wife and her two children in Jordan. He said he had kept in contact with his mother, father and sister who lived in Jordan whilst he was in Australia. He formed a new relationship with his current wife in Australia prior to the accident. He had one daughter aged about seven years to this union. He was able to assist his wife with the care of her son from a prior relationship. This son was diagnosed with autism spectrum disorder before the accident.
Concentration persistence in pace
The claimant said that he was able to concentrate and persist at complex tasks like estimating quotes for future contracts, following the instructions required for the handling of paints and other chemicals in his work. He was able to keep his accounts and manage his book ledger so that when he handed the book to his bookkeeper, they were able to proceed with the necessary taxation requirements.
Adaptation
The claimant said that before the motor accident, he was working in his role as a maintenance and painting contractor in his own small business. He was working in his own small business before the accident. He said he was successful in his work.
History of the motor accident.
The claimant stated that he was driving his car and stopped at a red stoplight. He said he was stationary waiting when he was hit from behind by a truck. The claimant said he was trying to relax and was waiting for the light to turn green when the accident happened. He said he was pushed forward in the accident. He said he is right-handed. He was wearing a seat belt and as he was pushed forward by the force of the accident he immediately experienced pain in his neck and left shoulder.
The claimant said that he was able to exit the car and he spoke to the truck driver. He said he then rang his wife. They did not call ambulance or police.
The claimant said his wife took him to Liverpool Hospital. The claimant said he was not registered with Medicare at the time he was in the accident. He said he was assessed at Liverpool Hospital. He paid the medical fee and after three hours was discharged home with his wife. He said the Liverpool Hospital medical team told him that he had not fractured any bones.
The circumstances of the accident were not described as life-threatening.
Symptoms and treatment after the accident
The claimant said he attended his general medical practitioner as he was in pain after the motor accident. he said that the pain affected his neck, left shoulder and back. He was prescribed Endone 5mg tablets for his pain. He was not prescribed any psychiatric medication. The claimant said he had physiotherapy and was also provided with an injection into his left shoulder.
The claimant said that he had not attended a clinical psychologist or psychiatrist either in Australia or in Jordan. He said he could not afford these treatments. He said he was not provided with any antidepressant medications or other psychiatric medications or treatments. The claimant said that after about 18 months, the physiotherapy ceased.
The claimant said he had not been referred to a pain clinic, and he could not afford to pay for a pain clinic.
The claimant said that he returned to Jordan in about 2022. Whilst in Jordan, he said he attended a medical practitioner. The medical practitioner recommended that he have surgical treatment for his left shoulder. He had not had surgery in Jordan as he could not afford the cost of treatment as recommended by the medical practitioner.
The claimant developed the following psychological symptoms because of the accident.
The claimant said that he had informed the insurer that he would be doing “touch-ups” and light work. He noted that the insurer’s surveillance video demonstrated the type of work he was able to do before returning to Jordan.
The claimant said that he developed a depressed mood. He said he had changed after the accident in 2018. He said he was sad and depressed. He went home to be closer to his family. His father died in 2023; he said he had resolved the grief due to the death of his father. The claimant stated that he was financially supported by his mother, sister, and extended family while in Jordan.
The claimant was asked what he did in Jordan. He reported that he would visit the family farm. The farm was where the family produced olives, citrus fruits, and some other produce. He said he spent his time sitting under his favourite orange tree in the grove of citrus fruit trees. He reported he had hoped for his condition to improve spontaneously; however, he said his mood became depressed, and he began to lose hope that he would recover.
The claimant reported the following symptoms of a major depressive episode at the re-examination:
·        depressed mood most of the day, nearly every day as indicated by the claimant reporting recurrent depressive worries of hopelessness and ongoing persistent sadness as his condition had not resolved with time;
·        markedly diminished interest and pleasure in all or almost all activities nearly every day as demonstrated by his loss of capacity to experience happiness and sharing family celebrations or events;
·        poor sleep with difficulty initiating sleep with the claimant having initial insomnia;
·        fatigue and loss of energy nearly every day with the claimant not been able to help his family, as he had before the accident;
·        persistent feelings of worthlessness every day since he had not worked or earnt an income since leaving Australia to live in Jordan between 2022 until 2025;
·        diminished ability to concentrate with marked indecisiveness whilst making simple everyday decisions, and
·        recurrent thoughts of death, and suicidal ideations without a specific plan to harm himself, with him having depressive ruminations with him reporting, ‘I’m meaningless…Why am I alive?.’
The claimant said he was prescribed no psychiatric medication. He said he had no psychological treatment either before or after the accident. The claimant said he had never experienced an elevated mood such as mania or hypomania in his life.
The Medical assessors both agree that from the re-examination and documents forwarded with the referral for re-examination, the claimant reported depressive symptoms consistent with a diagnosis of major depressive disorder.
The claimant also had symptoms related to his physical experience of pain related to his left shoulder, neck and back. He said his pain commenced at the time of his accident and had persisted. He reported that his pain would make him irritable and restrict his work capacity. He said he would have angry outbursts when he had pain and was not able to do what he knew he should be going to help in the home and return to work.
Mental State Examination
The claimant presented as an unkempt man who had not groomed himself prior to the re-examination. He said he had lost interest in his self-care and personal hygiene and he no longer maintained the same standard of self-care and personal hygiene he had before the accident.
The claimant said he had returned from Jordan about one month prior to the
re-examination. He said he had flown from Jordan to Australia alone.
The claimant reported that he had a depressed mood from the time he woke until he fell asleep. He quickly became irritable and agitated when talking about the video surveillance and spent time explaining that he had notified the insurer that he was doing these works.
The claimant was able to identify himself, driving, lifting a small bucket with his left hand and using his dominant right hand to pain. He was also able to identify himself behind a vehicle lifting a light object.
The claimant’s speech was normal throughout most of the re-examination. When he
became agitated, he would speak quickly and would gesticulate with his hands. The
claimant was observed to smoke cigarettes throughout the re-examination. At about 45 minutes into the re-examination, the claimant stood up and said, ‘I have talked enough.’ He left the chair he was seated in and walked off for a short pause. After
about three minutes, his wife went to ask the claimant if he wished to continue the re-
examination. The claimant returned, and the re-examination continued. The claimant’s concentration was impaired by his briefly becoming tearful when he spoke about his losses because of the accident. The re-examination continued at a slow pace and took about 90 minutes as the claimant required time to pause and settle his emotions and agitation whilst describing the accident. The claimant did not require to be prompted to remain on track, he could organise himself at a slower pace. He was able to persist throughout the re-examination and provide a coherent and understandable history of his condition before and after the motor accident.
The claimant was oriented in time, place, and person. His rate of speech did not demonstrate any common abnormality that might be associated with any abnormality of
speech or thought.
The claimant did not report delusional ideas or psychotic symptoms. The claimant did report suicidal thoughts, and he had no history of acting on his thoughts. He had no reported suicidal intent. The claimant was insightful about his condition. His judgment was normal.
Assessment of permanent impairment after the accident
The medical assessors note the following:
Guideline: 6.215 The PIRS must not be used to measure impairment due to somatoform disorders or pain. The Assessors agree that pain for any cause is not to be assessed as part of the assessable whole person impairment using the PIRS Scale.
6.214 Impairment due to physical injury is assessed using different criteria outlined in other parts of these Guidelines. The Medical Assessors agree that any impairment due to a physical condition is not to be used for assessment of the whole person impairment using the PIRS Scale.
Diagnosis
The medical Panel considers that the DSM-5-TR F 32.0 major depressive disorder is the most appropriate diagnosis to define this claimant’s primary psychological injury.
The following DSM-5-TR criteria for major depressive disorder are as follows:
Criterion A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
·        Depressed mood most of the day, nearly every day as indicated by the claimant reporting recurrent depressive worries of hopelessness and ongoing persistent sadness as his condition had not resolved with time.
·        Markedly diminished interest and pleasure in all or almost all activities nearly every day as demonstrated by his loss of capacity to experience happiness and sharing family celebrations or events.
·        Poor sleep with difficulty initiating sleep with the claimant having initial insomnia.
·        Fatigue and loss of energy nearly every day with the claimant not been able to help his family, as he had before the accident.
·        Persistent feelings of worthlessness every day since he had not worked or earnt an income since leaving Australia to live in Jordan between 2022 until 2025.
·        Diminished ability to concentrate with marked indecisiveness whilst making simple everyday decisions.
·        Recurrent thoughts of death, and suicidal ideations without a specific plan to harm himself, with him having depressive ruminations with him reporting, ‘I’m meaningless…Why am I alive.’
Criterion B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
This criterion is met because the claimant has lost his career, and he has decreased capacity for self-care and personal hygiene, which is an important area of functioning.
Criterion C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
This criterion is met because the claimant does not drink alcohol, use substances or suffer from a medical condition that may cause depressive symptoms.
Criterion D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified an unspecified schizophrenia spectrum and other psychotic disorders.
This criterion is met because the claimant does not suffer from any of the above conditions.
Criterion E. There has never been a manic episode or a hypomanic episode.
This criterion is met because the claimant does not suffer from any of the above conditions.
The claimant suffered from pain, which caused him to have symptoms of agitation, irritability and angry outbursts.
The claimant presented to his general medical practitioner for treatment of pain that had not remitted from the time of the accident to the date of the re-examination.
Self-care and personal hygiene
Assessment of impairments due to pain and physical conditions
The claimant reported that his pain did not prevent him from attending to his self-care and personal hygiene. He did state that he was less able to perform the heavy maintenance around the family home, and did less gardening due to pain in his shoulder, neck and back. This impairment due to pain and physical conditions were not included in the PIRS assessment of whole person impairment.
Assessment of assessable psychological injury
The claimant said that he would shower about three times each week. He said his wife would tell him to shower. He appeared dishevelled, and he was ungroomed. He said he was living with his mother and sister in Jordan and his wife and family in Australia. He said his sister cooked and provided laundry and other services in Jordan, and his wife cooked and assisted him in Sydney.
Social and recreational activities
Assessment of impairments due to pain and physical conditions
The claimant said he was unable to walk or engage in traditional dances, which would be performed at weddings. He said he was not able to participate in these recreational and social activities because of his pain. He said he could walk for short distances to the local corner shop, but he rarely walked long distances because of pain.
The claimant said his pain restricted the duration of play he could engage in with his daughter. This impairment due to pain and physical conditions was not included in the PIRS assessment of whole-person impairment.
Assessment of assessable psychological injury
The claimant said he had played with his daughter since his return from Jordan. He said he had shared time with his wife on his return from about a 3-year absence in Jordan.
The claimant said he was able to enjoy traditional celebrations within his family. He said he was less interested in socialising outside of the family home.
The claimant said he had socialised with various members of his large family whilst living in Jordan.
The claimant was less interest in watching television events or movies.
Travel
Assessment of impairments due to pain and physical conditions
The claimant said that he was able to travel long distances from Jordan to Sydney alone. He would manage his pain by gentle movement and stretches if needed to stiff areas of his body whilst traveling. He said he restricted his driving due to pain.
Assessment of assessable psychological injury
The claimant said that he could leave his mother’s home alone and travel to the family farm by taxi. He said he had travelled alone from Jordan to Australia in the month prior to the re-examination. The claimant could not provide a psychological symptom restricting his travel alone during the re-examination.
Social Functioning
Assessment of impairments due to pain and physical conditions
The claimant said that he was unable to lift, hug and show physical affection to his daughter as he could have before the accident. This impairment due to pain and physical conditions was not included in the PIRS assessment of whole-person impairment.
Assessment of assessable psychological injury
The claimant said that he was still in a relationship with his wife. He stated that he was living in her home at the time of the re-examination. He said the relationship was strained because he was not able to recover from the injury sustained in the accident.
The claimant stated that his relationship with his daughter was also strained, as he had less energy to play games and interact with her while in the family home.
The claimant was able to assist his wife with care of her son.
The claimant said in Jordan his mother was able to provide him with the culturally appropriate care for his condition.
Concentration, persistence and pace
Assessment of impairments due to pain and physical conditions
The claimant did not report any pain or physical condition affecting his concentration, persistence or pace.
Assessment of assessable psychological injury
The claimant said his concentration was less since the accident. He said he could still read in Arabic. He said he had lost interest in following Arabic news or news in general.
The claimant said that he could manage his own finances. He was able to participate, clarify and explain his condition and concerns throughout the re-examination. He took a pause for the first time at 45-minutes into the assessment. His concentration, persistence and pace was mildly impaired by his psychological injury as observed during the re-examination.
Adaptation
Assessment of impairments due to pain and physical conditions
The claimant was unable to perform heavy lifting work because of his physical condition and pain. He said his pain in his neck, left shoulder and back restricted his capacity to perform heavy work. He said he could lift a small light bucket and perform light duties. This impairment due to pain and physical conditions was not included in the PIRS assessment of whole person impairment.
Assessment of assessable psychological injury
The claimant said he had difficulty adapting to his condition since the accident. He said he had worked doing “touch-ups” and light duties before leaving Australia for Jordan in about 2022.
The claimant said he had not worked in Jordan. He would visit the family farm where his brother worked.
The claimant had not applied for Job seeker allowance, from the Australian government since the accident.
The claimant’s attendance at work would be erratic with him not able to attend more than 1 to 2 consecutive days of work due to his psychological condition.
Subsequent Conditions
The claimant had no subsequent conditions since the accident in 2018.
Causation and reasons
The claimant was independent in his lifestyle, employment role, relationship with his wife and caring for his daughter and his wife’s son to her first relationship before the accident in 2018. The claimant had no prior psychological injury or condition before the accident in 2018. The claimant had separated from his first wife and the two children of this union before entering Australia and forming a new relationship with his wife.
The claimant was stationary when his car was hit in the rear by a truck. He was able to exchange details with the other driver. Ambulance and police did not attend the scene of the accident. The claimant’s wife attended the accident scene. The claimant was transferred to Liverpool Hospital by his wife. He was assessed and discharged from Liverpool Hospital about three hours after his arrival into the care of his wife and general medical practitioner.
The claimant experienced immediate pain in his neck, left shoulder and back. He completed physiotherapy and had been treated with analgesic medication. He had not had surgical treatment other than an injection into his injury site.
The Panel’s Medical Assessors agree that the claimant’s diagnosed psychological injury, is DSM-5-TR F 32.0 major depressive disorder The claimant had not been treated for his psychological injury.
The medical record and the claimant do not report any prior episode of psychiatric or psychological illness before the accident. He did experience an emotional disturbance with memories of the accident, suffered sleep disturbance, experienced anxiety with car travel and experienced a low mood after the accident. It is clinically known that major depressive disorder may not fully remit. The reported behaviour of the claimant was in keeping with a failed attempt to return to work and then a long period of isolation from his wife and daughter in Australia whilst he remained spending time sitting under a tree on his family’s farm – not contributing to the management of the crops from this lot which was performed by others.
The Medical Assessors were told by the claimant that he did not have an Australian Medicare number at any time from his first entry into Australia and he had only just applied for registration a few weeks before the re-examination. He said this resulted in him lacking access to psychological or psychiatric treatment. His attendance at his general medical practitioner was limited. The claimant’s first language is Arabic and his psychological injury was documented in English. It is not uncommon in these clinical circumstances that there would be limited documentation in relation to the psychological injury. The accessible psychological injury of DSM-5-TR F32.0 major depressive disorder
Permanency of Impairment
The claimant’s permanent psychological impairment is now well stabilised and static.
The onset of the claimant’s psychological injury was in 2018 after the accident. The date of this re-examination was in September 2025. This permanent psychological impairment is unlikely to change substantially and by more than 3%WPI in the next year with or without psychological treatment.
Degree of Permanent Impairment Psychiatric Impairment Rating Scale

Psychiatric diagnoses	Major depressive disorder
Psychiatric treatment description	The claimant had been assessed and treated by his general medical practitioner for this mild condition.

1. Self-Care and Personal Hygiene	3	The claimant said that he would shower about three times each week. He said his wife would tell him to shower. He appeared dishevelled and he was ungroomed. He said he was living with his mother and sister in Jordan and his wife and family in Australia. He said his siter cooked and provided laundry and other services in Jordan and his wife cooked and assist him in Sydney.
2. Social and Recreational Activities	2	The claimant said he had played with his daughter since his return from Jordan. He said he had shared time with his wife on his return from about a 3-year absence in Jordan. The claimant said he was able to enjoy traditional celebrations within his family. He said he was less interested in socialising outside of the family home. The claimant said he had socialised with various members of his large family whilst living in Jordan. The claimant was less interested in watching television events or movies.
3. Travel	1	The claimant said that he could leave his mother’s home alone and travel to the family farm by taxi. He said he had travelled alone from Jordan to Australia in the month prior to the re-examination. The claimant could not provide a psychological symptom restricting his travel alone during the re-examination.
4. Social Functioning	2	The claimant said that he was still relationship with his wife. He said he was living in her own home at the time of the re-examination. He said the relationship was strained because he was not able to recover from the injury sustained in the accident. The claimant said his relationship with his daughter was also strained as he had less energy to play games and interact with her whilst in the family home. The claimant was able to assist his wife with care of her son. The claimant said in Jordan his mother was able to provide him with the culturally appropriate care for his condition.
5.Concentration, Persistence and Pace	2	The claimant said his concentration was less since the accident. He said he could still read in Arabic. He said he had lost interest in following Arabic news or news in general. The claimant said that he could manage his own finances. He was able to participate, clarify and explain his condition and concerns throughout the re-examination. He took a pause for the first time at 45-minutes into the assessment. His concentration, persistence and pace was mildly impaired by his psychological injury as observed during the re-examination.
6 Adaptation	4	The claimant said he had difficulty adapting to his condition since the accident. He said he had worked doing “touch-ups” and light duties before leaving Australia for Jordan in about 2022. The claimant said he had not worked in Jordan. He would visit the family farm where his brother worked. The claimant had not applied for Job seeker allowance, from the Australian government since the accident. The claimant’s attendance at work would be erratic with him not able to attend more than 1 to 2 consecutive days of work due to his psychological condition.

List of Classes in ascending order:        1, 2, 2, 2, 3, 4
Median Value:  2
Aggregate Score:  14
Whole person impairment   7%
Apportionment – pre-existing/subsequent impairment
The claimant had no pre-existing diagnosed psychiatric condition before the accident.
The assessment for pre-existing impairment is 0%WPI.
The claimant had no psychological injury subsequent to the accident.
The assessment for subsequent psychological impairment is 0%WPI.
Effects of treatment
The claimant had no effects of treatment for his assessable psychological injury.
The assessment of treatment effects was 0% WPI.
Final Whole person impairment
Whole person impairment was 7% WPI.
There were no other adjustments.
Final WPI: 7%WPI”

The Panel met on 15 October 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 15 October 2025, the legal Member has had the benefit of reading and considering the Medical Assessors examination report. On 15 October 2025 when the Panel met, the examination findings and the issues going to causation and assessment of WPI were all discussed. It is from this teleconference of the Panel that the Panel has agreed and reached its final conclusion and determination.
The Panel adopts the report of Senior Medical Assessors Baker and Medical Assessor Yeates.

Reasons/causation

Prior to the accident the claimant was not undergoing any treatment for a psychiatric disability. He was working as a self-employed painter, without restriction.
The claimant has not worked since the accident, either in Australia or in Jordan.
The clinical notes of Moorebank Shopping Village Medical Centre revealed that the claimant did not make any substantial complaint of any psychological symptoms from the date of the accident. These records show no reference to any psychiatric complaint, except for
12 January 2022 when it was noted he had been feeling depressed for a while, “given his situation”. As previously noted, clinical notes of Moorebank Shopping Village Medical Centre make only one other reference to the claimant’s psychiatric condition when on
23 November 2018 the claimant was recorded as “good mood no history of psych disease”.
When questioned by Mr Glancy, the claimant said he had not confided mental disturbance to his GP. The Panel notes that the absence of medical records is not evidence of an absence of psychological injury.
As reported in the body of the examination report, the Medical Assessors were told by the claimant that he did not have an Australian Medicare number at any time from his first entry into Australia. He said that the consequence of this was that he had a lack of access to psychological or psychiatric treatment. His attendances at his GP were limited. The claimant’s first language is Arabic and his psychological injury was documented in English. In the clinical experience of the Medical Assessors, it is not uncommon in these clinical circumstances that there would be limited documentation in relation to the psychological injury.
Predominantly, the claimant’s complaints related to his left shoulder restrictions and pain. He is right hand dominant according to Dr Bentivoglio who also said that the claimant’s main area of trouble was his left shoulder.
The Panel must also ask itself in considering whether the accident contributed to the claimant’s injuries as referred to it by the Commission, whether the claimant’s condition was caused by or materially contributed to by the accident. The Panel is satisfied that this can be answered affirmatively. The claimant is no longer employed, has limited contacts with friends and family and his symptoms only commenced after the accident and have persisted.
On the balance of probabilities, can it be said that the claimant suffered a recognisable psychiatric injury? For the reasons discussed above in the report of the Medical Assessors, the Panel does find that this can be answered in the affirmative. The claimant has a major depressive disorder-single episode of mild severity.
Would the impairment have occurred, if not for the accident? The Panel is satisfied that the accident and impact has had a more than negligible effect on the claimant’s psychiatric condition suffered by the claimant. This is because up to and at the time of the accident his activities of daily living were not restricted. He had a job, he had a car and could visit friends and relatives.
The insurer has relied on various moments of activity by the claimant, captured on video footage. The Panel has previously commented on this in this certificate. The Panel is not satisfied that the observations are contradictory to a major extent of any comment or history provided by the claimant. He admits that he can go for short drives, he can occasionally work but not to the extent undertaken by him before the accident.
The Panel is satisfied that it was only after the accident that the claimant demonstrated an inability to lead a normal unrestricted lifestyle both at home and at work. He was unable to continue his work as a painter, has had difficulty sleeping, has become less social and familial relationships are strained.
Mr Glancey commented that the claimant’s mental disturbance appeared primarily associated with frustrations associated with his disputed claims of injury and pain. Mr Glancey said that frustrations will persist until the matter of compensation is resolved. He said that frustrations may persist indefinitely beyond that and that trauma related anxiety is likely reinforced by the frustrations associated with his legal dispute. Depression is maintained by the frustrations of his life. It is the view of the Panel that this is evidence of the accident having had a more than negligible effect on the psychiatric condition of the claimant.
Mr Glancy said that reports of trauma related anxiety were a direct consequence of the subject accident. Low mood typically co-exists with trauma related anxiety. Depression however, appears primarily a consequence of his disputed claim of pain and physical restrictions. The Panel does not disagree with this.
The Panel is satisfied that its diagnosis of major depressive disorder, has been caused by the accident which occurred on 4 April 2018.
The Panel refers to the decision of Mandoukos v Allianz Australia Insurance Limited [2023] NSWSC 1023. It is arguable that the scope of the medical dispute referred to the Commission for determination is not defined by law but by the parties’ submissions. However, this is a hearing de novo and those issues raised before the Medical Assessor and for determination by the Panel now include consideration of major depressive disorder.
The Panel has not “gone looking” or sought alternative diagnoses when the specific diagnosis of post-traumatic stress disorder had been referred to it by virtue of that being the decision of the Medical Assessor in addition to a major depressive disorder. The Panel must examine the claimant and perform its assessment on the basis of its discussions with the claimant on the day of assessment. A psychiatric symptom might evolve over time and disappear over time for that matter. In this case, the Panel was not satisfied that the claimant had a post-traumatic stress disorder but was satisfied on the basis of the history provided by the claimant, and the clinical assessment of the Medical Assessors, that he was suffering a psychiatric disability of a major depressive disorder.

Conclusion

The claimant has suffered a major depressive disorder.

Determination

The Panel revokes the certificate of Medical Assessor Shen.
The Panel has diagnosed the claimant as suffering a major depressive disorder.
The Panel has assessed the claimant as having a 7% WPI.

PPP

MMMMMMA

Psychiatric diagnoses	1. Post-Traumatic Stress Disorder	2. Major Depressive Disorder
Psychiatric diagnoses	3.	4.
Psychiatric treatment description	Nil

[2025] NSWPICMP 801

20 October 2025