Sharafi v Insurance Australia Limited t/as NRMA Insurance
[2025] NSWPICMP 846
•3 November 2025
| DETERMINATION OF REVIEW PANEL | |
CITATION: | Sharafi v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 846 |
CLAIMANT: | Esmaeil Sharafi |
INSURER: | Insurance Australia Limited t/as NRMA |
REVIEW PANEL | |
MEMBER: | Hugh Macken |
MEDICAL ASSESSOR: | John Baker |
MEDICAL ASSESSOR: | Christopher Canaris |
DATE OF DECISION: | 3 November 2025 |
CATCHWORDS: | MOTOR ACCIDENTS – Personal Injury Commission Act 2020; review of medical assessment; psychiatric injury being major depressive disorder; pre-accident diagnosis of anxiety and depression; application of a psychiatric impairment rating; no pre-existing impairment; symptoms and treatment post-accident; diagnosis of major depressive disorder; no subsequent psychiatric injury; requirement for medication; Held – Review Panel assessed 7% whole person impairment (WPI). |
DETERMINATIONS MADE: | CERTIFICATE OF DETERMINATION ASSESSMENT OF DEGREE OF PERMANENT IMPAIRMENT Certificate of Review Panel Assessment – Whole Person Impairment 1. The Review Panel confirms the certificate of Medical Assessor Himanshu Singh dated |
STATEMENT OF REASONS
INTRODUCTION
The claimant is a 33-year-old man who was injured in a motor vehicle accident on
7 March 2021. Following the accident, he lodged an Application for Personal Injury Benefits and thereafter sought a concession from the insurer that his injuries ought to be considered non-threshold injuries. Following a review the insurer declined to make this concession.
The claimant was examined by Medical Assessor Herald on 30 May 2022 who, in a certificate dated 7 July 2022, determined that he has sustained a non-minor injury.
Thereafter the claimant sought a concession from the insurer that his injuries exceeded 10% whole person impairment (WPI). The insurer, after a review, declined to make this concession. The claimant was examined by Medical Assessor Robin Fitzsimons on
4 July 2024, who in a certificate dated 20 July 2024 determined that the injuries sustained by the claimant were not yet stable and accordingly an assessment of the degree of permanent impairment could not be made.
The claimant was examined by Medical Assessor Singh on 4 June 2024, and a certificate dated 20 June 2024 determined that the claimant has sustained a psychiatric injury being a major depressive disorder and sustained a permanent impairment of 7%. The claimant sought a review of this determination and, in a certificate dated 24 September 2024 President's delegate Ratula Gupta certified that there is a reasonable cause to suspect that the medical assessment is incorrect in a material respect. The matter was then referred to this Medical Review Panel.
Clause 14F of Schedule 1 of the Personal Injury Commission Act 2020 (the PIC Act) provides that the new review provisions apply in relation to a decision of a new decision-maker. A “new decision maker” is defined in cl 14A(1) of the Schedule 1 of the PIC Act.
As the medical assessment, the subject of the review, was made on or after 1 March 2021, the new review provisions apply.The new review provision provide that a review panel consists of two Medical Assessors and a Member assigned by the Motor Accidents Division of the Personal Injury Commission (the Commission).
Part 5 of the PIC Act enables the Commission to make rules with respect to its practice and procedure including proceedings before a panel reviewing a decision of a Medical Assessor.
Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the PIC Act. A Review Panel determines how it conducts and determines the proceedings and may determine the matter solely based on the written application.
The review of the medical assessment is by way of a new assessment of all the matters with which the medical assessment is concerned.
Thereafter directions were issued to the parties to upload to the portal material which was before Medical Assessors at the time of the assessment. This was done.
Following the examination of the claimant by the Medical Assessors the Panel reconvened to discuss the findings on examination, consider the material before the Panel and settle on the certificate and reasons following the whole of the Panel’s deliberations.
Medical re-examination
The claimant was examined by Medical Assessors Baker and Canaris on 17 October 2025. Their report follows.
Who attended the assessment
Mr Sharafi (the claimant) attended the assessment on 17 October 2025 by MS Teams. He was unaccompanied for the duration of the 100-minute re-examination by Medical Assessors Baker and Canaris.
The claimant did require a Farsi interpreter, who was booked and organised through the Commission. The claimant said he could understand the interpreter well. The interpreter said that she could understand the claimant.
The claimant was living in rented accommodation in Greater Western Sydney. He said he shared a unit with one other house mate.
History
Psychosocial history and pre-accident
The claimant was born in Ahvaz, Khuzestan, Iran. His father was aged about 63 years and was unemployed. His father had served for an extended period for the Iranian military during the Iran–Iraq war. His worked as a labourer for the remainder of his career and was not reported as been injured due to his military service. His mother was also about 63 years of age. All of the claimant’s large extended family live in Iran except for one brother who lives in Melbourne, Victoria. The claimant said he had little contact with this person before and after the accident.
The claimant was the fifth child, of 11 children. He provided the age range as between 1359 to 1381 using the Islamic Calander. He said he was born in 1370 (1991). He said he was a single man who had no children and had never married prior to this re-examination.
The claimant said that he attended a government school whilst living in Iran. He was educated in Farsi. His first language is Farsi. His second language is Arabic. He completed about 12 years of education without gaining a certificate of higher education in Iran. He then attended the Iranian Army to serve his national service. He reported that due to his father’s extended military service he only had to perform a short period of national service. He said he was never injured whilst serving his less than one year of national service. He was not deployed to a border zone and he had not witnessed military or warlike conditions.
The claimant said on discharge from the military he found employment working as the equivalent of an Uber driver in his hometown of Ahvaz for about one year. He said he had never had any motor accident whilst working as an Uber-driver in Iran.
The claimant said he had been arrested in Iran due to his political beliefs whilst living in Iran. Whilst living in his home province of Khuzestan he was arrested. He was placed in a van and taken to a facility for two days. He said he was not physically harmed. He said he was repeatedly asked to sign a “paper and work for the police.” He said he refused and was released. He decided to travel to Sydney Australia with the hope of a better life.
The claimant organised to travel to Australia. He flew from Iran to Indonesia. After about 40 days he boarded a boat to enter Australia. He said the boat was stopped by the Australian Navy and he was taken to the Christmas Island detention centre. He said he was the only member of his family on the boat and he travelled alone. He said he was fearful of the travel however he did not state that his life was ever in danger prior to entering Australia.
The claimant was released from detention into the general Australian community in Perth, WA. He moved to Sydney, NSW to work in 2013. He said he had applied to become a permanent resident and then an Australian citizen. He said his application had progressed slowly. He had an immigration lawyer who helped him with his application. He said he had a general medical practitioner and psychologist who helped him with his application for citizenship. The claimant said he was frustrated, irritable and would become depressed in his mood due to the prolonged process to become an Australian citizen. He said he had attended a clinical psychologist and was said to have “anxiety and depression.” He said that during his time living in Australia prior to the motor accident he had always looked for and found employment.
The claimant said that he initially worked in a pizza shop and then progressed to working as a cleaner. He then found work in construction as a “concrete patcher.” He would labour in the construction industry. He enjoyed his work and the community of workers where he worked.
The claimant said that prior to the motor accident he had never had any workplace injuries or motor accidents. He said he was physically fit. He said he had never had any fractured bones or medical conditions. He would smoke tobacco socially. He did not drink alcohol or smoke cannabis. He did not gamble. He said he was not allergic to any medications before the accident on 7 March 2021. At the time pf the re-examination his only income was from Centrelink, as a Jobseeker. He said his family did not support him financially.
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.
The claimant had been diagnosed with “anxiety and depression” by his general medical practitioner and psychologist. He had received a brief course of treatment. He attributed his psychological condition due to the slow progress of his citizenship application. He said that during 2019 and 2020 his “visa had been rejected.” He said at the time of this
re-examination, he had recently passed his Australian citizenship test and he was now waiting on the date of the Australian Citizenship Ceremony.
Prior functioning before the accident on 7 March 2021
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 was a pre-existing psychological condition that had been diagnosed before the accident. The diagnosis reported by the claimant and recorded in the documents included, depression, anxiety and brief periods of unemployment. The main stressor was stated by the claimant to be the slow citizenship application. The claimant had received treatment and reported returning to work before the accident. The Medical Assessors agree that having the main stressor of citizenship behind him, the claimant’s DSM-5-TR F 43.23 adjustment disorder with mixed anxiety and depressed mood was the best diagnosis to fully explain the claimant’s pre-existing assessable psychological condition.
Assessment of WPI pre-existing before the accident on 7 March 2021
Self-care and 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 other housemates. He said he would shower daily after work. He was able to maintain his nutrition. He was able to cook, clean and assist with the maintenance of the rental. He could wash and launder his own clothes. He was able to purchase his own groceries from his local supermarket. He was not required to attend the maintenance or garden of the rental house as this duty was performed by the landlord.
The claimant said that he did not have any physical restriction in relation to his self-care and personal hygiene.
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 weddings, the club, Persian musical events in Sydney and funerals within his local community. He would enjoy dancing and participating in his local community celebrations. He would celebrate cultural events such as Ramadan and Eid with friends. He enjoyed watching football (soccer) and playing social football with his friendship circle. He would also enjoy listening to Iranian popular music. He said he could read Farsi and Arabic as his two languages. He had not learnt English prior to his arrival in Australia.
The claimant said that he did not have any physical restriction in relation to his social and recreational activities.
Travel
The claimant said that he was capable of travelling internationally alone from Iran to Australia. He had travelled to Australia accepting substantive risk to himself. 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 travel to unfamiliar locations without impairment. He had never returned to visit family in Iran or Melbourne since entering Australia.
The claimant said that he did not have any physical restriction in relation to his travel.
Social functioning
The claimant said that he had no partner, children or extended family living in Sydney, NSW.
He said he had little contact with his brother in Melbourne before the accident.
The claimant said he had kept in contact with his mother and father in Iran.
The claimant was able to form new friendships since living in Australia.
The claimant said that he did not have any physical restriction in relation to his social functioning.
Concentration persistence and pace
The claimant said that he was able to concentrate and persist at complex tasks such as maintaining a strict financial budget. He said he had to manage his own finances and he was not supported by any other person. He was able to keep his accounts and manage his small income. He said he was able to read in Farsi better than Arabic. He would listen to international news in Farsi as his language of choice. He said he could speak limited English. He could watch Farsi serial dramas and media before the accident without impairment.
The claimant said that he did not have any physical restriction in relation to concentration, persistence and pace.
Adaptation
The claimant said that before the motor accident, he was working in his role as a concrete patcher and construction labourer. He said he was working so he could save money to commence his own business before the accident. He said he had some periods not working due to his “anxiety and depression.” However he could work and maintain his independence before the accident.
The claimant said that he did not have any physical restriction in relation to adaptation.
History of the motor accident
The claimant stated that he was driving his car as he had an appointment with his immigration lawyer. He said he was driving on Parramatta Road and the car in front of him stopped. He said he stopped his car. He said he had his foot on the brake. He said he was stationary waiting when he was hit from behind by another car. He said his car was shunted forward into the car in front of him. He said he was forced forward in his seat and then forcibly restrained by his seatbelt forcing him back into his seat.
The claimant said he remembered the crash sounded like a bomb going off. He said he was unconscious for a brief period. He said that he was still dazed when the driver at fault, a woman spoke to him through the passenger side window. He said the female driver asked if he was “OK.”
The claimant said that he was able to exit the car. He said he started using his phone to take photographs of the damage to his car. He said he had damage to the rear of his car and his front bumper bar.
The claimant said he then experienced pain in his neck and upper thoracic spine, (between his shoulder blades). He said his left hand and arm became numb. He explained that he was right hand dominant. He said he also suffered abdominal pain from where the seatbelt clasp had forced itself hard against his anterior abdominal wall (stomach). He said that a short time later he suffered from “electrical shock” pain affecting his left leg.
The claimant reported that he was transferred to hospital by ambulance. He was discharged from hospital after about four days. He reported that he did not have any surgical treatment. He said he was told by the medical team at the hospital that he had injured his muscles and nerves. He said he was referred for physiotherapy and follow-up with his general medical practitioner (doctor).
Symptoms and treatment after the accident
The claimant said he attended his doctor as he was in pain after the motor accident. He said that the pain affected his neck, between his shoulder blades, abdomen, left arm and left leg. He said as his pain progressed he suffered from pain in his right hand and leg. He was prescribed physiotherapy and analgesic medication. He was prescribed Tramal 50mg if required for break through pain in combination with Gabapentin 400mg twice daily. The claimant said his pain had persisted from the time of the accident to the re-examination and he had not worked since the motor accident as he had difficulty lifting and labouring. The claimant said he had not been referred to a pain clinic. He had not had surgery for the injury sustained in the accident.
The claimant developed the following psychological symptoms because of the accident.
The claimant said that he developed a depressed mood, a low-esteem and feelings of hopelessness and worthlessness as he had lost his job after the accident.
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 sadness as he had not recovered from the accident;
· 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 participate in community celebrations or social football events;
· poor sleep with difficulty initiating sleep with the claimant having initial insomnia;
· fatigue and loss of energy nearly every day with the claimant delaying his activities of daily living and slowing the pace such that he could maintain his independence;
· persistent feelings of worthlessness every day since the accident because of his loss of his job;
· diminished ability to concentrate with marked indecisiveness whilst making simple everyday decisions due to his ongoing worries about his future since the accident, and
· recurrent thoughts of death and not wanting to “be around” without any plans to harm himself or others.
The claimant said he was prescribed mirtazapine 30mg at night as his psychiatric medication. He said he had psychological treatment 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 the claimant reported depressive symptoms are consistent with a diagnosis of DSM-5-TR F 32.0 major depressive disorder.
The claimant also reported symptoms consistent with post-traumatic stress disorder. These symptoms include anxiety, irritability, angry outbursts, poor concentration and poor sleep. The Medical Assessors agree that the claimant’s behaviour at the time of the motor accident as well as since the accident was inconsistent with the diagnosis of post-traumatic stress disorder. The claimant did not demonstrate symptoms of avoidance of driving a car and did not report avoidance of the scene of the accident. The claimant was able to sustain his independence in his house and he was able to be successful in his citizenship tests resulting in his Australian citizenship been completed at the time of the re-examination with his ceremony in the near future. He was able to affirm his plan to attend his Australian citizenship ceremony when he was informed of the date of this event.
Both Medical Assessors agree that the accident did not meet Criterion A, for DSM-5-TR F 43.10 post-traumatic stress disorder criteria. The claimant was able to exit his car unaided after the accident. He was able to engage in activities including exchanging information and photographing the damage to his car. He did not receive surgical treatment at the hospital as would be expected had he suffered from a life-threatening injury. For these reasons the claimant was not diagnosed with post-traumatic stress disorder.
The claimant also had symptoms related to his physical experience of pain related to his left and right upper limbs and hands, between the shoulder blades, abdomen, 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 and his capacity to lift and labour since the accident. He said he would have angry outbursts when he had pain and was not able to do what he knew he should be doing to help in the house 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 not returned to employment since the accident. The claimant had an outburst of frustration and anger during the re-examination. He reported a depressed mood and a low self-esteem. He reported worries for his future as he had lost his job and had not returned to work. He felt shame that he was reliant on Jobseeker payments from the Australian Government.
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 accident and his losses since the accident.
The claimant was able to drive less as he was restricted by pain and the length of time he could sit. He would change position between sitting and standing throughout the assessment at a frequency of once every 10 to 15 minutes.
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’s concentration was impaired by his brief episodes of agitation and irritability. The re-examination continued at a slow pace and took about 100 minutes as the claimant required time to pause and settle his emotions and agitation prior to answering questions.
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 form of speech did not
demonstrate any common features that might be associated with any abnormality of speech or thought form.
The claimant did not report delusional ideas or psychotic symptoms.
The claimant did report thoughts of death and “not being around.” He had no history of acting on his thoughts about death. He did not report 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 psychiatric impairment rating scale (PIRS) must not be used to measure impairment due to somatoform disorders or pain. The Medical Assessors agree that pain for any cause is not to be assessed as part of the assessable WPI using the PIRS Scale.
Guideline: 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 WPI using the PIRS Scale.
Diagnosis
The Medical Assessors agree 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 two 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 sadness as he had not recovered from the accident;
· 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 participate in community celebrations or social football events;
· poor sleep with difficulty initiating sleep with the claimant having initial insomnia.
· fatigue and loss of energy nearly every day with the claimant delaying his activities of daily living and slowing the pace such that he could maintain his independence;
· persistent feelings of worthlessness every day since the accident because of his loss of his job;
· diminished ability to concentrate with marked indecisiveness whilst making simple everyday decisions due to his ongoing worries about his future since the accident, and
· recurrent thoughts of death and not wanting to “be around” without any plans to harm himself or others.
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 job and he has decreased functional capacity in all areas of function, including loss of his capacity to participate in his community, play social football and attend community celebrations.
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, and restricted capacity to sit for long periods as well as lift heavy items which caused him to have symptoms of frustration irritability and angry outbursts, because of his limited capacity to work.
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 house such as cleaning common areas. He could lift lighter items such a lighter grocery bundles than prior to the accident. This impairment due to pain and physical conditions were not included in the PIRS assessment of WPI.
Assessment of assessable psychological injury
The claimant said that he would shower at least every second day. He appeared dishevelled, and he was ungroomed. He said he was living in a share house with a housemate. He said he was independent in his capacity to cook meals. He could wash his own clothes and care for his own room. He said he was independent in his self-care and personal hygiene.
Social and recreational activities
Assessment of impairments due to pain and physical conditions
The claimant said he was unable to engage in traditional dances, which would be performed at weddings or music events or attendance at clubs because he was not able to stand for long periods because of pain. He said he was not able to participate in these recreational and social activities like his social football 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. He said he could not sit for long periods.
This impairment due to pain and physical conditions was not included in the PIRS assessment of WPI.
Assessment of assessable psychological injury
The claimant said he would sometimes walk to his local 7-Eleven shop and sit whilst having a coffee. He said that sometimes he would meet members of his community he had known before the accident at the shop. He said he did not organise these meetings and the presence of someone he might know was “random.”
The claimant said he was not able to enjoy traditional music as he was unable to experience joy or happiness from his music like he could have before the accident. He said he was less interested in socialising and participating in his community. He said he could watch television or YouTube but he found these activities less enjoyable than before the accident. 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 not able to travel long distances alone as he would suffer from pain when sitting or standing for long periods. He said he required to move to ease his pain. He was observed during the re-examination to change his position from sitting to standing frequently, at a rate of about once every 10 to 15 minutes. This impairment due to pain and physical conditions was not included in the PIRS assessment of WPI.
Assessment of assessable psychological injury
The claimant said that he could leave his home and travel to the local shop alone. He could travel alone to his medical appointments. He could drive for short distances and remained in areas that were close to his house and familiar to him before the accident.
Social functioning
Assessment of impairments due to pain and physical conditions
The claimant said that his physical condition and pain did not impair his social functioning.
Assessment of assessable psychological injury
The claimant said that he was a single man. He said he had no partner before or after the accident. He said he had no children to any prior union. He said was living in a share house and he was less able to meet the needs of the social aspects of living in this manner. He said he was less interested in sharing any communal time with his housemate. He said he preferred to remain in his own room alone. He said his relationship with his parents was strained. He reported that he would not ask for financial help as his parents were not able to easily provide assistance.
The claimant had lost his social circle of friends and he was less interested in finding new friendships.
The claimant stated that his relationship with his brother in Melbourne was unchanged as they rarely communicated before or since the accident.
Concentration, persistence and pace
Assessment of impairments due to pain and physical conditions
The claimant did report any pain or physical condition affecting his concentration, persistence or pace. He was observed to have angry outburst and episodes of frustration, agitation and irritability when describing his pain. His concentration, persistence and pace were impaired with him, requiring brief pauses that slowed his pace of progress through the re-examination.
This impairment due to pain and physical conditions was not included in the PIRS assessment of WPI.
Assessment of assessable psychological injury
The claimant said his concentration was less since the accident. He said he could still read and speak his second language Arabic however it was not as fluent as prior to the accident. He said he had lost interest in following international news.
The claimant said that he could manage his own finances as his bills were few. He was able to participate, clarify and explain his condition and concerns throughout the re-examination. He took a few brief pauses during the re-examination.
The claimant could concentrate to cook larger amounts of food to freeze and eat later. Persistence and pace were 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, shoulders, legs and back restricted his capacity to perform labouring jobs. He said he could lift lighter bundles of groceries and he did perform lighter duties for himself. This impairment due to pain and physical conditions was not included in the PIRS assessment of WPI.
Assessment of assessable psychological injury
The claimant said he had difficulty adapting to his condition since the accident. He said he had not worked since the accident.
The claimant had applied for Job seeker allowance, from the Australian Government since the accident. He said at the time of this assessment he had a medical certificate and he was not required to look for work as part of his mutual obligation requirements for Job seeker.
The claimant’s attendance at work would be erratic with him not able to attend more than one to two consecutive days of work due to his psychological condition alone.
Subsequent conditions
The claimant had no subsequent conditions since the accident in 2021.
Causation and reasons
The claimant was independent in his lifestyle and employment role before the accident in 2021. The claimant did have a pre-existing condition of adjustment disorder with mixed anxiety and depressed mood due to episodes of unemployment and slow progress of his visa to permit him to live in Australia. The adjustment disorder’s primary stressor related to his visa had remitted in full prior to this re-examination as the claimant was recently successful in passing his citizenship test. He was waiting for his Australian citizenship ceremony to receive his certificate in the near future.
The claimant was stationary when his car was hit in the rear by another car in the accident. His car was shunted forward and hit a third car in front of him. He was able to exchange details with the at fault driver. Ambulance attended the scene of the accident. The claimant was transferred to hospital by ambulance. He was assessed and discharged from hospital about four days after the accident. He did not receive any surgical treatment. The claimant’s physical and psychiatric treatment was conservative.
The claimant experienced immediate pain in his neck, between his shoulder blades, in his stomach and his legs. He completed physiotherapy and had been treated with analgesic medication. He had not had surgical treatment.
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 been treated for this psychological injury with evidence based psychological treatment and evidence-based antidepressant medication. He was compliant with psychological treatment and mirtazapine 30mg at night.
The Medical Assessors both agree that the accident could cause the psychological injury defined as major depressive disorder.
The Medical Assessors both agree that the accident on 7 March 2021 did cause the psychological injury as described in the re-examination report.
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 March 2021 after the accident. The date of this re-examination was in October 2025. This permanent psychological impairment is unlikely to change substantially and by more than 3% WPI in the next year with or without treatment.
Degree of Permanent Impairment Psychiatric Impairment Rating Scale (PIRS)
| Psychiatric diagnoses | Major depressive disorder | ||||
| Psychiatric treatment description | The claimant had been assessed and treated by his general medical practitioner and psychologist for this mild condition. | ||||
| 1. Self-Care and Personal Hygiene | 2 | The claimant said that he would shower at least every second day. He appeared dishevelled, and he was ungroomed. He said he was living in a share house with a housemate. He said he was independent in his capacity to cook meals. He could wash his own clothes and care for his own room. He said he was independent in his self-care and personal hygiene. | |||
| 2. Social and Recreational Activities | 2 | The claimant said he would sometimes walk to his local 7-Eleven shop and sit whilst having a coffee. He said that sometimes he would meet members of his community he had known before the accident at the shop. He said he did not organise these meetings and the presence of someone he might know was “random.” The claimant said he was not able to enjoy traditional music as he was unable to experience joy or happiness from his music like he could have before the accident. He said he was less interested in socialising and participating in his community. He said he could watch television or YouTube but he was found these activities less enjoyable than before the accident. The claimant was less interest in watching television events or movies. | |||
| 3. Travel | 2 | The claimant said that he could leave his alone and travel to the local shop alone. He could travel alone to his medical appointments. He could drive for short distances and remained in areas that were close to his house and familiar to him before the accident. | |||
| 4. Social Functioning | 2 | The claimant said that he was a single man. He said he had no partner before or after the accident. He said he had no children to any prior union. He said was living in a share house and he was less able to meet the needs of the social aspects of living in this manner. He said he was less interested in sharing any communal time with his housemate. He said he preferred to remain in his own room alone. He said his relationship with his parents was strained. He reported that he would not ask for financial help as his parents were not able to easily provide assistance. The claimant had lost his social circle of friends and he was less interested in finding new friendships. The claimant stated that his relationship with his brother in Melbourne was unchanged as they rarely communicated before the accident. | |||
| 5. Concentration, Persistence and Pace | 2 | The claimant said his concentration was less since the accident. He said he could still read and speak his second language Arabic however it was not as fluent as prior to the accident. He said he had lost interest in following international news. The claimant said that he could manage his own finances as his billed were few. He was able to participate, clarify and explain his condition and concerns throughout the re-examination. He took a few brief pauses during the re-examination. The claimant could concentrate to cook larger amounts of food to freeze and eat later. 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 not worked since the accident. The claimant had applied for Job seeker allowance, from the Australian Government since the accident. He said at the time of this assessment he had a medical certificate and he was not required to look for work as part of his mutual obligation requirements for Job seeker. 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 alone. | |||
List of Classes in ascending order: 2, 2, 2, 2, 2, 4
Median Value: 2
Aggregate Score: 14
Whole person impairment 7%
| Pre-existing psychiatric diagnoses | Adjustment disorder with mixed anxiety and depressed mood | ||||
| Psychiatric treatment description | The claimant had been assessed and treated by his general medical practitioner and psychologist or this condition. | ||||
| 1. Self-Care and Personal Hygiene | 1 | The claimant said that before the accident, he was independent in his self-care and personal hygiene. He lived in rented accommodation with other housemates. He said he would shower daily after work. He was able to maintain his nutrition. He was able to cook, clean and assist with the maintenance of the rental. He could wash and launder his own clothes. He was able to purchase his own groceries from his local supermarket. He was not required to attend the maintenance or garden of the rental house as this duty was performed by the landlord. | |||
| 2. Social and Recreational Activities | 1 | 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 weddings, the club, Persian musical events in Sydney and funerals within his local community. He would enjoy dancing and participating in his local community celebrations. He would celebrate cultural events such as Ramadan and Eid with friends. He enjoyed watching football (soccer) and playing social football with his friendship circle. He would also enjoy listening to Iranian popular music. He said he could read Farsi and Arabic as his two languages. | |||
| 3. Travel | 1 | The claimant said that he was capable of travelling internationally alone from Iran to Australia. He had travelled to Australia accepting substantive risk to himself. 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. He had never returned to visit family in Iran or Melbourne since entering Australia. | |||
| 4. Social Functioning | 1 | The claimant said that he had no partner, children or extended family living in Sydney, NSW. He said he had little contact with his brother in Melbourne before the accident. The claimant said he had kept in contact with his mother and father in Iran. The claimant was able to form friendships since living in Australia. | |||
| 5. Concentration, Persistence and Pace | 1 | The claimant said that he was able to concentrate and persist at complex tasks such as maintaining a strict financial budget. He said he had to manage his own finances and he was not supported by any other person. He was able to keep his accounts and manage his small income. He said he was able to read in Farsi better than Arabic. He would listen to International news in Farsi as his language of choice. He said he could speak limited English. He could watch Farsi serial dramas and media before the accident without impairment. | |||
| 6. Adaptation | 2 | The claimant said that before the motor accident, he was working in his role as a concrete patcher and construction labourer. He said he was working so he could save money to commence his own business before the accident. He said he had had some periods not working due to his “anxiety and depression” however he would work to maintain his independence before the accident. | |||
List of Classes in ascending order: 1, 1, 1, 1, 1, 2
Median Value: 1
Aggregate Score: 7
Whole person impairment 0%
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 reason for this assessment is that the claimant continued to remain symptomatic and that the antidepressant medication had not resulted in any substantive change in the claimant’s condition.
The Medical Assessors both agree that under the Guidelines any effect of treatment due to analgesia and pain treatment are not included in the assessment of treatment effect for the assessable psychological injury.
The assessment of treatment effects was 0% WPI.
Conclusion
The Panel assesses the degree of WPI, consequent on this psychological impairment caused by the subject motor vehicle accident at 7%.
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