Taseski v AAI Limited t/as GIO

DETERMINATION OF REVIEW PANEL
CITATION:	Taseski v AAI Limited t/as GIO [2023] NSWPICMP 432
CLAIMANT:	Zoran Taseski
INSURER:	AAI Limited t/a GIO
REVIEW PANEL
MEMBER:	Alexander Bolton
MEDICAL ASSESSOR:	Paul Friend
MEDICAL ASSESSOR:	Samuel Lim
DATE OF DECISION:	1 September 2023
CATCHWORDS:	MOTOR ACCIDENTS – Claimant was a pedestrian injured on 28 June 2018 when the insured driver lost control of her car which brushed past the claimant who narrowly avoided serious physical injury; subsequently the claimant was discharged from the police force with post-traumatic stress disorder and right shoulder impingement and some other physical injuries; the Medical Assessor (MA) diagnosed a bipolar affective disorder but found that the claimant’s symptoms are due to a mood disorder which was unrelated to the accident; the MA assessed 0% whole person impairment (WPI); claimant was examined by the Panel who confirmed the claimant had symptoms from time to time consistent with post-traumatic stress disorder; the Panel was satisfied that the claimant developed bipolar disorder with a chronic manic state as a direct result of the accident; Held – the Panel assessed the claimant as having a whole person impairment of 8%.
DETERMINATIONS MADE:	Review Panel Assessment Certificate issued under s 7.23(1) of the Motor Accident Injuries Act 2017 Determination The Review Panel revokes the certificate of Medical Assessor Samuell dated 16 June 2021 and issues a new certificate determining that the claimant has: (a) bipolar disorder with recurrent chronic manic state, and (b) a whole person impairment assessment of 8%.

STATEMENT OF REASONS

INTRODUCTION

This is a dispute between the claimant and the insurer about:
· the degree of permanent impairment under Schedule 2, s 2(a) of the Motor Accident Injuries Act 2017 (MAI Act).

Permanent impairment dispute to be assessed

The following injury was referred by the Personal Injury Commission (Commission) for assessment:
· psychological injury.
Medical Assessor Samuell (the Medical Assessor) found that the claimant suffered a post-traumatic stress disorder following the subject accident. He said that there was considerable contemporaneous evidence that the accident satisfied the stressor criteria of a post-traumatic stress disorder. The Medical Assessor found that the claimant subsequently experienced symptoms that satisfied the balance of the required criterion. Subsequently, the claimant developed, and had been treated for a mood disorder, a bipolar affective disorder. The Medical Assessor said that bipolar disorders are constitutional conditions not caused by external stressors. On that basis, the Medical Assessor said that the bipolar disorder was not considered to be caused by the subject accident. The Medical Assessor determined that the degree of permanent impairment caused by the accident was 0% whole person impairment (WPI).

The accident

The accident occurred on 28 June 2018. The claimant was a pedestrian facing oncoming traffic. The claimant walked to a point of approximately 50m before a small bend. He saw a motor vehicle heading towards him. The vehicle oversteered and slid onto the incorrect side of the road over double white lines. The car apparently jack-knifed, veered to its left and travelled straight towards the claimant. The claimant stepped back, climbing up an embankment. He was hit by the vehicle, which rolled onto its roof. The claimant was conveyed to the Emergency Department (ED) at Liverpool Hospital and was discharged on the same day.
On 18 March 2021, the claimant was discharged from the New South Wales Police Force medically unfit with the infirmities of:
(a)   post-traumatic stress disorder;
(b)   right shoulder impingement;
(c)   severe right knee osteoarthritis;
(d)   moderate left knee osteoarthritis;
(e)   chronic strain of the neck (cervical spine);
(f)    chronic strain of the back (lumbar spine), and
(g)   right elbow posttraumatic stiffness.

The Review

The application for referral of the medical assessment of the Medical Assessor was made by the claimant within 28 days after the parties were issued with the original certificate for the medical assessment for which the review is sought.[1]
[1] Section 7.26(10) of the MAI Act.
The delegate of the President referred the medical assessment to the Panel as she was satisfied that there was reasonable cause to suspect that the medical assessment was incorrect in a material respect having regard to the particulars set out in the application.
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 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 provisions provide[2] that a Panel consists of two Medical Assessors and a Member assigned to the Motor Accidents Division of the Commission.
[2] Section 7.26(5A) of the MAI Act.
Part 5 of the PIC Act enables the Commission to make rules with respect to the practice and procedure before the Commission including proceedings before a Panel reviewing a decision of a Medical Assessor.[3]
[3] Section 41(2) of the PIC Act.
Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the PIC Act. A Panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application.[4]
[4] Rule 128 of the PIC Rules.
All Panel members have had no previous involvement with the claimant or with this matter.
The review of the medical assessment is by way of new assessment of all the matters with which the medical assessment is concerned.[5]
[5] Section 7.26(6) of the MAI Act.

Claimant’s submissions for review

The claimant asserts the assessment is incorrect in the following material respects:
(a)   the diagnosis of bipolar affective disorder;
(b)   the finding that the claimant’s symptoms including mania, euphoria and grandiosity are due to a mood disorder (which is unrelated to the accident) and are not related to the post-traumatic stress disorder (which is caused by the accident);
(c)   taking into account the opinion of Dr Virgona dated 1 October 2020 and
22 December 2020;
(d)   the failure to have proper regard to the findings of the claimant’s treating psychiatrist, Dr Victoria Kim, which establishes a clear temporal link between the onset of the symptoms referred to by the Medical Assessor and the accident;
(e)   the failure to have proper regard to the opinions of Dr Anderson dated
27 March 2020 and Dr Clark dated 12 November 2020;
(f)    the failure to have proper regard to the lay evidence of Leesa Taseski, Jack Taseski, Tiarnne Brown and Sergeant Adam Cragg, and
(g)   the finding that the post-traumatic stress disorder caused by the accident is in remission.
At pages 2 and 3 of his report the Medical Assessor refers to some of the documentation with which he was provided. He made detailed reference to the supplementary report of Dr Virgona dated 22 December 2020. Dr Virgona was qualified by the insurer. The claimant says that the Medical Assessor made little reference to his primary report of 1 October 2020, which the claimant says was supportive of the claimant’s case.
The claimant says that the Medical Assessor made only passing reference to the findings of
Dr Anderson, qualified by the claimant. The claimant says that the Medical Assessor’s own findings are similar to those of Dr Virgona in his supplementary report of 22 December 2020.
The Medical Assessor was provided with the clinical notes of the claimant’s treating psychiatrist, Dr Victoria Kim yet the claimant says that his report makes negligible reference to those consultations and the symptoms recorded or Dr Kim’s opinion. The claimant says that this was relevant material which the Medical Assessor failed to consider.
The claimant says that on page 6 of his report, the Medical Assessor said there is strong evidence that the claimant suffered a post-traumatic stress disorder following the accident and now has a bipolar affective disorder in a partially treated manic state. On the same page he said the post-traumatic stress disorder was in remission. At page 7 the Medical Assessor said bipolar disorders are constitutional conditions not caused by external stressors and on that basis the bipolar disorder was not considered to be caused by the subject accident.
The claimant says that the Medical Assessor did not give any consideration to the temporal link between the onset of the symptoms he related to the bipolar disorder and the accident, nor did he give any proper consideration to the body of medical opinion which links those symptoms to the accident, nor to the statements of Leesa Taseski, Jack Taseski, Tiarnne Brown and Sergeant Adam Cragg which describe, in some detail, that the claimant did not have these symptoms prior to the accident but has had them since the accident.
The claimant referred to a report of Dr Virgona, psychiatrist, who saw the claimant at the request of the insurer on 1 October 2020 and provided a report of that date. Dr Virgona was subsequently asked to provide a supplementary report which he did on 22 December 2020.
Dr Virgona’s reports were provided to Medical Assessor Samuell and were referred to in his certificate and reasons. The claimant says that the Medical Assessor forms a similar opinion to that of Dr Virgona.
However, the claimant then refers to Part 8.4 of the Motor Accident Guidelines (the Guidelines) which states:
“A health practitioner is not authorised to give evidence in proceedings unless the practitioner is authorised under these Guidelines at the time the evidence is given. For evidence to be given by written report, this means that the health practitioner must be authorised at the time they examine the claimant and write the report.”
The delegate of the President found that Dr Virgona was not an Authorised Health Practitioner at the time of seeing the claimant and writing his reports. The delegate found that Dr Virgona’s reports were inadmissible for this reason.
The claimant says that the Medical Assessor’s certificate and reasons dated 15 October 2021 refers to and relies on the opinion of Dr Virgona. In circumstances where the Medical Assessor had access to inadmissible reports and has formed a similar opinion to that contained in these reports. The claimant submits this is sufficient to establish material error.
The claimant relies on a report of Dr Kim who saw him in November 2018 on referral from his general practitioner (GP), Dr Phuah. This was approximately five months after the accident, which occurred on 28 June 2018.
In her report of 12 November 2018 Dr Kim said:
“I think he has some features of post-traumatic stress disorder, particularly
flashbacks and hyperarousal particularly at night time, which leads to poor sleep
with initial and middle insomnia. There is also evidence of hypomania with psychosis in the context of the recent traumatic incident…”
The claimant says that in her report of 8 January 2019, Dr Kim said she found the claimant preoccupied with the accident and said he tends to over analyse his experience. The claimant’s wife told Dr Kim he was euphoric and more expressive emotionally after the accident.
In her report of 4 April 2019, Dr Kim said there was no evidence of paranoia, grandiose delusions, or elated mood in the claimant’s presentation that day. The claimant submits that it is plain, however, that those symptoms, which were also observed by the Medical Assessor, were present in earlier consultations closer in time to the accident.
The claimant says that Dr Kim saw him on 12 June 2019 and her report of that date makes reference to another stressor which reminded the claimant of his own accident, and he experienced feelings of being drained, exhausted and having a high level of anxiety.
The claimant says that Dr Kim’s report of 25 July 2019 refers to the claimant’s decision to discharge himself from the Police Force, which the claimant submits was an understandably emotional event. Dr Kim expressed concerns about the claimant’s vulnerability if his hours had been increased.
The claimant says that Dr Kim’s report of 13 September 2019 refers to an occasional sense of grandiosity. The claimant submits that Dr Kim’s reports establish a clear temporal link between the accident and symptoms described by the Medical Assessor three years later. This evidence is relevant to the question of causation. The claimant submits that the only reference made by the Medical Assessor in his report is on page 7, where he states:
“I reviewed the records of Dr Victoria Kim. On 13/9/19 the claimant was noted to be
responding well to medication other than the occasional sense of grandiosity.”
The claimant says that the failure of the Medical Assessor to properly consider the evidence of Dr Kim, the claimant’s treating psychiatrist, is, of itself, sufficient to establish material error. It is submitted that it will be necessary for the Review Panel to give proper consideration to the reports of Dr Kim.
Dr Peter Anderson, psychiatrist, was qualified by the claimant for the purposes of this claim and provided a report dated 27 March 2020.
Dr Anderson’s summary and opinion appears at page 9 of his report. The claimant says that he drew a clear temporal link between the accident and the onset of symptoms which included the following:
“…There have been marked affective symptoms, which have included both depression and euphoria. His preoccupation with religious themes concerning his survival has led treating personnel to question reality testing and at one stage to suggest a diagnosis of brief reactive psychosis following a particular stressor (the accident).”
The claimant says that Dr Anderson then diagnosed post-traumatic stress disorder, which he said was caused by the accident. The claimant says that again, the opinion of Dr Anderson establishes a clear temporal link between the accident and symptoms of a kind of those observed by the Medical Assessor.
The claimant refers to Dr Clark, psychiatrist, who saw the claimant to assess his fitness for work. His report of 12 November 2020 referred to hypomania and religiosity. Dr Clark diagnosed post-traumatic stress disorder and said the claimant will be unable to return to work in the police because of that condition. The claimant says that Dr Clark repeated his diagnosis in clear terms at page 7 of his report.
The claimant submits that there is a strong body of medical evidence which linked the onset of the symptoms described by the Medical Assessor to the accident. The claimant says that the opinions of Drs Kim, Anderson and Clark were clearly expressed. The claimant submits there is a clear temporal link between the accident and the onset of symptoms and there is no alternative precipitating cause.
The claimant has relied on various statements from family or associates of his.
Sergeant Adam Cragg, the claimant’s work colleague; Leesa Taseski, the claimant’s wife; Jack Taseski, the claimant’s son; and Tiarnne Brown, the claimant’s future daughter-in-law prepared statements commenting on the claimant’s presentation both before and after the accident on 28 June 2018 in statements dated 25 February 2021, 31 March 2021 and
6 April 2021 (x2) respectively. The claimant says that they all comment on the differences they have observed in the claimant since the accident which, the claimant submits, combined with the medical opinions of Drs Kim, Anderson and Clark, show there is a clear temporal link between the accident and the onset of symptoms.

Claimant’s submissions for whole person impairment

The claimant sustained the following injuries:
•      post-traumatic stress disorder;
•      right shoulder impingement, and
•      injury to left ankle.
The insurer, GIO, admitted fault by way of a s 81 Notice dated 6 August 2018.
On 20 July 2018, the claimant's GP, Dr Phuah referred the claimant to Ms Arnold, clinical psychologist. He was first seen by Ms Arnold in early August 2018. On 24 August 2018, Dr Phuah referred the claimant for further treatment with Dr Kim, psychiatrist, who first consulted him on or about 12 November 2018 and diagnosed him with post-traumatic stress disorder as a result of the accident on 28 June 2018.
On 18 March 2021, the claimant was discharged from the NSW Police Force medically unfit with the infirmities of 'post-traumatic stress disorder; right shoulder impingement; severe right knee osteoarthritis; moderate left knee osteoarthritis; chronic strain of the neck (cervical spine); chronic strain of the back (lumbar spine); and right elbow post-traumatic stiffness' (claimant’s emphasis). The claimant says that the certified infirmities included post-traumatic stress disorder and right shoulder impingement arising out of the accident.

Claimant’s statement

The claimant said in his statement of 11 June 2021:
“a. My psychological symptoms include the following:
i.I put my hands behind my head (shadow) after the accident, I felt euphoric, on a high, I felt like I was shot to heaven, kissed by God on the forehead and flung back down to earth only to land on cloud nine.
ii.I imagined the inside of my left ankle was a hook and my right shoulder was a shield.
iii.I felt euphoric after the accident.
iv.I grieved for myself, I hugged people I did not know, I told people I loved them.
v.I cried when I saw people after the accident, I gave my wife a hug in the kitchen. Crying and shaking, I told her ‘please hold on tight as I don't know where this is taking me’
vi.I saw the driver of the vehicle about 4 days after the accident on the street and stopped to give her a hug. On another occasion, I saw her with her husband in IGA and waved to her as if I knew her.
vii.I walk down towards Picton walking track and hear voices but I cannot see anyone. The voices are loud and clear. I reach the manmade bridge on Stone Quarry Creek, see joggers and cry because they are real.
viii.At Coles, I see kidneys, pick them up and cry because I can cook them.
ix.I walk amongst shoppers and feel blessed.
x.I see a neighbour and give her a hug but it is not reciprocated and I feel terrible I trespassed her space.
xi.I cross paths with (someone) in Picton and I tell him people want to kill me.
xii.I continue walking, hoping to clear my head but it gets worse, the accident repeats,
xiii.I go through movement after movement
xiv.On the second weekend after the accident, my wife went to Canberra with some friends leaving me home alone. I thought I was superior whilst holding a knife in my right hand with my left forearm exposed, I thought the knife could not possibly penetrate me. I felt I was bulletproof.
xv.I exercise and walk 3 to4 times a day. I started walking after the accident and could not ease up. I feel I must work my body to keep up with my brain otherwise it will fail.
xvi.Whilst walking, my heart rate gets to 140, 180, 184 without effort.
xvii.When walking on the side of the road following the accident, I close my eyes as cars travel past me.
xviii.I suffer from survival guilt/acceptance.
xix.Following the accident, I recalled jobs I had attended throughout my service with the NSW Police Force.
xx.l avoid social gatherings and mixing with people. I recently failed to go to my police class reunion, marking 36 years. I do not take public transport unless it is unavoidable.
xxi.I usually avoid any physical contact with anyone. I am not comfortable visiting people's homes.
xxii.I do not sleep well with Olanzapine, Lithium and Melatonin. With exhaustive exercise, the Lithium and Olanzapine, a short sleep fills me with energy.
xxiii.My relationships with my wife, my children, my family, and friends are strained. I am too intense to be around. I am short with everyone. My relationship with my oldest son, especially, is strained. He does not talk to me because we had an argument about the Ben Robert-Smith soldier over the perceived culture of soldiers. I used the accident as a benchmark. I have lost friendships as a result.
xxiv.I am so philosophical today, but I cannot manage it. l want to be happier. My cognitive understanding of my near-death experience has left with me using it as a benchmark in conversations which tends to upset others. Even my sister has said to me:
‘You are so draining to talk to’. The accident has preoccupied my time and I just cannot shake it from my head. Sometimes, I do not know I am doing it. Currently, my medication is doing wonders with assisting me in 'seeing the colours of the world'
xxv.My ability to communicate has been compromised. People do not understand me. I am starting not to understand myself. I have lost confidence; I am less approachable.
xxvi.I do not know what to do when someone tells an obvious lie. I cannot stand mess.
xxvii.I cannot mix with people. I have lost a lot of friendships because of my symptoms since the accident. I am more hesitant to go out as I do not like crowds, which Is not how I used to be prior to the accident. l will often refuse to attend an event, even if I have, I committed to going, because of my psychological symptoms.
xxviii.I used to be an easy going, friendly and relaxed person. I am not anymore. I feel I cannot relax.
xxix.I used to laugh often but will rarely laugh now.
xxx.I question everything around me and take things too seriously.
xxxi.In 2020, I spent 8 months at our holiday home in Culburra on my own, with my wife occasionally attending on weekends. It was not often that I saw people, it was isolated.
xxxii.I spent my time fishing and connecting with God. I have spent 6 weeks there in 2021.”

The statement by Adam Cragg, Sergeant, Liverpool Local Area Command dated 25 February 2021 states that prior to the motor accident Senior Constable Zoran Taseski was an easy going person who had no difficulty doing his duties as a police officer dealing with the public and criminals.
He recalled that following the accident on 28 June 2018, the claimant thought that he should be dead and did not understand why he was alive. He felt he was a changed person.
He described himself as a shadow of his previous self when he returned to work in January 2019. He said words to the effect, “I could die doing this job. I should be dead but now I realise we could be killed at any time in this job. It could go wrong any time”.
He started to exercise excessively following the motor accident as measured by his fitness with a seven day total of 120,000-140,000 steps, whereas previously it was 40,000-60,000 steps.
Statement of Leesa Taseski dated 31 March 2021 states that she is the wife of Zoran Taseski and been married for 25 years on 21 March 2021.
Her husband has always been strong, respectful, loving, trusting and in a fun relationship.
Initially following the accident, he was very loving, euphoric, spiritual, philosophical but increasingly questioned why he survived and had difficulties sleeping and switching off his mind.
He could not stop questioning why it had happened and how he had survived and just could not accept it. He avoided being in crowds and had difficulty listening to other people. He is a little antisocial. He could get up in the middle of the night and is tossing and turning. He started exercising. He lost a massive amount of weight.
The report of Jack Taseski, third child of Zoran Taseski, dated 6 April 2021 states that his father changed following the motor accident. He was overseas for university placement for one month.
His father had become fixated on the accident and dwelled on it. He received text messages from his father which described a fond value for life and his love for his family. His affection became somewhat unbearable.
His father’s love and affection had increased when he came home. This included saying “I love you”, kissing us, giving people hugs and embracing the family.
He would often sit for hours discussing the accident. He glorified himself on his survival and would often elevate himself and place himself on a pedestal, describe being kissed by God and that time had stopped. At times he would say “How do I get past the anxiety and stress of work?”. He would fill his days with fixating and worrying about things related to policing and crime.

Insurer’s submissions

The insurer says that the claimant’s application appears to be made, upon two bases.
Firstly, the insurer says that it is alleged by the claimant that the causal relationship of bipolar affective disorder to the accident, namely the Medical Assessor’s finding that this psychiatric condition is not related to the motor vehicle accident, is incorrect.
Secondly, the insurer says that it is alleged by the claimant that the Medical Assessor has failed to take into consideration appropriate medical evidence that was before him.
The insurer says that the Medical Assessor found that the claimant suffered from two separate psychiatric conditions that were not related to each other.
The insurer says that the Medical Assessor accepted that the claimant suffered from post-traumatic stress disorder as a result of the accident, but that this condition was in remission and not productive of a WPI finding.
The insurer says that the Medical Assessor found that the claimant suffered from a separate and unrelated medical condition of bipolar affective disorder which was not caused by the accident and was instead a constitutional condition and therefore a WPI assessment was not relevant and did not need to be undertaken for that condition.
The insurer says that the fact that the Medical Assessor found that the claimant’s psychiatric condition was not related to the motor vehicle accident, was open for the Medical Assessor to find based on his clinical examination of the claimant and his review of the available documentation.
The insurer submits that there is no evidence that the Medical Assessor failed to take due regard of the medical material that was submitted with the claimant’s application for assessment. The insurer says that the fact that the Medical Assessor plainly did not agree with the opinions expressed in these medical reports does not mean that the Medical Assessor failed to have due regard to this material.
The insurer says that there is no evidence available to suggest that the Medical Assessor failed to read or take account of the clinical records of the claimant’s treating psychiatrist,
Dr Victoria Kim. It is simply that the Medical Assessor, as he is entitled to do, reached a different conclusion from Dr Kim as to the cause of the claimant’s psychiatric condition.
The insurer refers to paragraph 5 of the claimant’s submissions in support of the application for review, where it is noted that the Medical Assessor found, in common with other Medical Assessors, that the claimant’s speech was slightly disorganised and that the content of his speech was dominated by euphoric and grandiose themes. The insurer says that the claimant then goes on to submit that because these findings are similar to findings of other medical examiners in this case, the Medical Assessor’s conclusion regarding the cause (insurers emphasis) of the claimant’s psychiatric condition should therefore also be similar. The insurer submits that whilst the Medical Assessor is required to consider the material that is put before him in the claimant’s application (and the insurer’s reply), he is not required to adopt the opinions expressed in that material and is entitled to, in fact required to reach his own clinical opinion based upon his own examination and clinical judgment.
The insurer says that the claimant’s submissions conclude by asserting that there was a clear temporal link between the motor vehicle accident and the onset of the claimant’s psychiatric symptoms and that there was no alternative precipitating cause. The insurer says that there is no evidence to suggest that the Medical Assessor ignored this information. The insurer says that it is simply the case that the Medical Assessor does not accept the view that the bipolar disorder was caused by trauma. The insurer says that in the Medical Assessor’s view this psychiatric condition cannot be caused by external stressors. It is a congenital condition.
The insurer says that the Medical Assessor clearly acknowledged (in common with the other medical experts in this matter) that the claimant suffered from a post-traumatic stress disorder because of the motor vehicle collision. However, the insurer says that he also clearly reached the view and expressed the opinion that this condition was in remission.
The insurer says that acknowledging that the claimant suffered from post-traumatic stress disorder, the Medical Assessor did not find that there was any permanent impairment which resulted because of this psychiatric condition.
The insurer submits that given that the Medical Assessor’s diagnosis was that the claimant suffers from a mental condition which is constitutional and unrelated to any form of trauma, the records of psychiatrist, Dr Kim, would have been unlikely to change the Medical Assessor’s decision or diagnosis. The insurer does however accept that the claimant is entitled to expect that the documents listed as part of its application should be put before the relevant Medical Assessor. The insurer says that it is not clear to it, whether or not the Medical Assessor did have access to these records. The Medical Assessor’s decision is silent on this point.
The insurer says that insofar as the reports of Dr Virgona are concerned, the insurer notes that at the time the insurer booked the assessment with Dr Virgona (August 2020), and specifically checked his active status on the authorised Health Practitioner Panel, Dr Virgona was an active Member. The insurer has been unable to locate a copy of the relevant authorised health practitioner’s list current for October 2020 when the assessment occurred, so cannot confirm the date that Dr Virgona subsequently became inactive.

Medical evidence

The Medical Assessor provided a certificate dated 16 June 2021. This certificate is at page 23 of the claimant’s bundle of documents. There is a second certificate of the Medical Assessor, attached to a joint bundle of documents prepared by the insurer, at page 328 and dated
15 October 2021.
The Medical Assessor observed that the claimant’s speech was slightly disorganised. The content of his speech was dominated by euphoric and grandiose themes. He made references to God, talked about being the “best fisherman ever created” and referred to himself as being the “best police officer ever, by far”. The Medical Assessor said that the claimant lacked insight into his grandiosity.
His affect was intense and reactive. It was consistent with his speech which the Medical Assessor said suggested a strongly elevated mood.
The claimant’s cognitive functioning was poor due to his mania. The Medical Assessor said that he also lacked insight into that.
The Medical Assessor said that the claimant had a paranoid grandiose state in accordance with his mania.
The Medical Assessor said that there was strong evidence that the claimant suffered from a post-traumatic stress disorder following the subject accident and now has a bipolar affective disorder in a partially treated manic state. The Medical Assessor provided no reasons for reaching this conclusion.
The Medical Assessor said that the diagnosis of post-traumatic stress disorder arising from the accident was in remission and as such, it should not be considered a permanent impairment.
The Medical Assessor said that the claimant suffered a post-traumatic stress disorder following the accident. Since that event, he has developed a pervasive euphoria and delusional state. He presently suffers from symptoms that satisfy the definition of mania. On that basis, the Medical Assessor said that the appropriate diagnosis was a bipolar affective disorder. The Medical Assessor has not provided any pathway for his reasons for reaching this conclusion.
Regarding causation, the Medical Assessor said the claimant suffered a post-traumatic stress disorder following the accident. The Medical Assessor said that there was considerable contemporaneous evidence that the accident satisfied the stressor criteria of a post-traumatic stress disorder. The applicant subsequently experienced symptoms that satisfied the balance of the required criterion. Subsequently, the applicant developed, and has been treated for a mood disorder, a bipolar affective disorder. The Medical Assessor said that bipolar disorders are constitutional conditions not caused by external stressors. On that basis, the bipolar disorder was not considered caused by the subject accident. It is the opinion of the Panel that the Medical Assessor has not addressed the question of causation and attributability of the accident to the claimant’s psychiatric condition however, his conclusion that the post-traumatic stress disorder was in remission, has not been challenged.
The second certificate of the Medical Assessor is briefer than the first certificate. In this certificate the Medical Assessor said that the claimant had 0% WPI.
The Medical Assessor said that the claimant suffered a post-traumatic stress disorder following the accident. Since that event, he has developed a pervasive euphoria and delusional state. At the time of this certificate, the claimant was said to suffer from symptoms that satisfy the definition of mania. On that basis, the appropriate diagnosis was a bipolar affective disorder. This disorder was said not to have been caused by the accident.
Pre-accident medical reports from Mr Gerard Glancey and Ms Linda Chamberlain relate to work-related conditions.
The treatment report by Gerard Glancey, psychologist, dated 29 September 1999 states that Mr Taseski reported several violent incidents in his time as a police officer and console operator.
On 16 June 1997 he was working alone at a service station when confronted by two Asian males who produced swords and demanded money. He was menaced, the assailants collected the money and absconded.
On 2 July 1997 he apprehended a drug dealer in his duties as a police officer. The assailant bit his hand breaking the skin. He took various blood tests for AIDS and hepatitis C and had six months of anguish and mental disturbance and entertained catastrophic speculation regarding infection and the implications of infection. He avoided contact with his wife and children including sexual contact with his wife. He reported depression and anxiety regarding the circumstances. He was later reassured he had not contracted any infection disease.
On 27 July 1999 he was the victim of a further armed robbery in his second job when approached by two males who had requested a toilet key. After he returned with the key they put on balaclavas and produced knives and a male jumped a counter. He was directed to open the till. The assailants collected the money and absconded.
Subsequently he was highly critical of his functioning. He thought that he should have overpowered at least one of the assailants and entertained fantasies of having responded in a more cavalier fashion. He described images of attacking one of the assailants as he jumped over the counter. He had sleep disturbance which he attributed to disturbing thoughts.
He had anxiety prior to leaving the house to go to work, dry retching in the shower and difficulty breathing.
He had depression, felt flat and low and expressed critical views about his functioning.
He continued to work as a console operator. He did not experience anxiety prior to console work.
The report by Linda Chamberlain, clinical psychologist, is a victims compensation claim report dated 6 November 2000 regarding acts of violence from 15 June 1997, 2 July 1997 and
26 July 1999.
Mr Taseski experienced three acts of violence over a period of 3½ years.
The first was whilst working as a console operator at the Crosswords BP Service Station [BG1] on
15 June 1997. Two young men of Asian appearance robbed the service station. Each was carrying a knife.
The second occurred when working as police officer. He was bitten by a man who was a known drug dealer on 2 July 1997.
The third was being the victim of a robbery at a BP service station in Lansvale, whilst he was working at the service station on 26 July 1999.
The report states he experienced a change in his attitude feeling he was more argumentative and inclined to lose his temper. He became angry when not treated with respect. He was counselled by a superior-ranking officer about his behaviour.
His ability to do police work did not deteriorate. The claimant had three visits with Mr Glancey, psychologist, and believed he did not need to continue. The report states that he had an attitude of being tough in his work as a police officer.
His social network had diminished. He did not socialise with friends.
Prior to the first incident, he was more socially active and enjoyed sport.
The relationship with his wife suffered following the second incident. They did not have a sexual relationship for at least six months.
His motivation and enthusiasm for life had diminished since 1997 and he was harder to talk to. He did not actively avoid thinking about the incidents and did not experience feelings of being distant from society.
He was administered the post-traumatic stress diagnostic scale (PDS) which is a self report instrument. The structure and content of the PDS mirrors the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
The score suggested he did not fulfil the criteria for post-traumatic stress disorder.
The score on the Beck Depression Inventory showed a moderate degree of depression.
The score on the State-Trait Anger Expression Inventory – 2 (STAXI-2) showed he scored in the 85th percentile for anger and that his trait and state anger scores were in the 98th and 40th percentiles. Fiftieth percentile was normal.
The report concluded he does not reach criterion for a post-traumatic stress disorder and his symptoms do not fully support a diagnosis of depression.
The ED discharge referral from Liverpool Hospital for the accident on 28 June 2018 states his injuries were head injury, right shoulder injury and left ankle injury.
He did not have any fractures or dislocations.
He did not have any evidence on CT scan of intracranial haemorrhage.
The report by Lisa Arnold, psychologist, dated 21 August 2018 states that Mr Taseski was displaying symptoms including delusional thoughts and disorganised speech. He was obsessive about the details of the accident and sometimes unable to stop himself thinking about it. He had periods of feeling invincible with one incident of holding a knife to his skin thinking he was protected from being cut. He admits that there is the person before the accident and the person now. He has poor sleep, only a few hours each night, which he feels is due to his shoulder pain.
He can have a rational mind and appears to have some insight that his thinking can be bizarre. He wants to return to work but has a fear of getting injured at work. He was previously very confident at work and could cope well with challenging situations.
He had a score of 40 on the PCL-5 is indicative of post-traumatic stress disorder and he meets the criteria of brief reactive psychosis with marked stressor. It recommends that he be referred to a psychiatrist.
A report by Dr Kim, psychiatrist, dated 12 November 2018 states that following the motor accident Mr Taseski appeared to be very elated. He feels extremely lucky to be alive and that the accident has changed his perspective on life.
He has engaged in excessive exercise and has lost 15mg over four months and wants to lose another 10kg.
He believes that God has given him a new life for a special purpose but he was unable to elaborate on it.
He reports that he feels invincible, surreal and euphoric and has restless sleep. He held a knife to his arm to see if he was protected from being cut. He did come to the conclusion that he is not invincible in that way. He continues to believe that he is special and has a different purpose in life.
He returned to work but only lasted for six hours. He had high levels of anxiety. There was no computer or desk assigned to him. He appears to have a fear of returning to work despite the euphoria. He is still not meeting the standards he sets for himself as a police officer.
He has flashbacks of the accident in the form of reliving and intrusive thoughts, details of the accident, processing how he survived and what it means to him.
It states he has some features of post-traumatic stress disorder, particularly the flashbacks and hyperarousal particularly at night which leads to poor sleep with initial and middle insomnia.
There is evidence of hypomania with psychosis in the context of recent traumatic events.
He was prescribed olanzapine.
He was not fit to return to work.
The report by Dr Kim, psychiatrist, dated 8 January 2019 states that Mr Taseski is scheduled to return to work on 21 January 2019. He feels more positive and less anxious. He says he has cognitive closure in regard to the accident and is ready to move on.
He is still preoccupied with the accident and tends to overanalyse this experience.
The report states he is gradually settling and is closer to his usual self, now sleeping five hours per night on average.
The olanzapine was increased to 5 mg at night.
His return to work needs to be gradual and slow starting with four hours per day, one day each week.
The report by Dr Kim, psychiatrist, dated 19 February 2019 states Mr Taseski returned to work on 21 January 2019 and is currently working six hours per day, one day a week.

The recent news of the death of a colleague who died in a car accident had a significant impact.
He is still ruminating on his own accident and how he survived. He is more redirectable.
He goes to the gym for aerobic exercises and mindfulness training.
He continues to take olanzapine 5 mg at night.
The report by Dr Kim dated 4 April 2019 states Mr Taseski is managing six hours per day, one day per week at work and wishes to upgrade so he can return to full-time work.
There is no evidence of paranoia, grandiose delusions or elevated mood. He recently contacted a witness to his accident and this helped him come to closure with his accident.
It states that he seems to have a good insight so far and is continuing to take olanzapine 5 mg.
It recommends that his next step should be six hours per day, two days per week for four weeks.
A report by Dr Kim dated 8 May 2019 states that Mr Taseski is doing fairly well. It appears his wife is concerned about his excessive sleep and tiredness despite sleeping 9-10 hours each night.
The dose of olanzapine was reduced to 2.5 mg at night. There is no evidence of hypomania or psychosis.
A report by Dr Kim dated 12 June 2019 states that since the previous review he received news of a police officer serving a warrant being attacked by the offender’s family. He felt drained, exhausted and had a high level of anxiety.
It states he should not be upgraded to more than three days per week, six hours per day because of the challenging nature of his job which is issuing warrants.
A report by Dr Kim dated 25 July 2019 states that Mr Taseski decided to discharge himself medically from the police and yesterday was his last day at work.
The recent return to work was manageable but there was concern about upgrading his hours to fulltime duties considering his vulnerability.
He continues to take olanzapine 2.5 mg at night.
The report by Dr Victoria Kim 13 September 2019 states that Mr Taseski is reasonably well apart from an occasional sense of grandiosity which he identifies and manages reasonably well.
His reality testing is intact.
He continues to take olanzapine 2.5 mg at night.
A report of Dr Bodel, orthopaedic surgeon, dated 14 February 2020 states his orthopaedic medical conditions are bilateral osteoarthritic change in the knees and musculoskeletal injuries in neck, back, right shoulder and right elbow. He is currently incapable of exercising all the normal functions of an operational police officer.
A report by Dr Anderson, psychiatrist, dated 27 March 2020 states that following the motor accident Mr Taseski felt driven to exercise.
He walked around Picton, had continuous flashbacks of the accident and could not put all the details together.
He said it was obvious that he had done a lot of things right. He could not sleep.
He sought treatment from Employee Assistance Program (EAP) and saw Karen at Liverpool because of his anxiety.
He vigilantly assessed all the people in the waiting room. He felt the need to know why he was shaking and why there was so much in his head. He needed to know how he survived and why he survived. It was a catastrophic accident and yet he had survived.
He was next referred to Lisa Arnold, psychologist.
He was referred to Dr Victoria Kim who prescribed olanzapine.
He described being overcome by the idea he did not want to attend any more suicides or homicides. He remembered a suicide in 1987 or 1988 of a man who was a recluse. He finished up doing a destitute burial. He said it was not only traumatic scenes but the imperfections in various investigations which preoccupied him.
He had ideas at one point that suicide was acceptable and he was “comfortable to die”.
At another time he felt that a knife could not cut his skin. That was shortly after having the idea of being “Superman”.
He was trying to make sense of what happened and had spoken to a witness about the accident.
He continued to do a great amount of physical training. He felt anxious in crowds and avoided them. He was continuing to have flashbacks of the accident, poor sleep, anxiety and vigilance, avoidance, near total preoccupation with the driver, physical fitness and training and a mental preoccupation with how and why the accident occurred.
The report states, under the heading of Findings on Examination, that he was cooperative and answered questions.
He has had periods of elation and depression but did not appear to be grossly disturbed at the time.
He had a clear history of re-experiencing symptoms of post-traumatic stress disorder including the accident which is accompanied by anxiety and distress. His account was that much of his life since then has been driven by a need to understand what had happened and why it had happened. He regarded it as a near-death experience.
He also touched on previous experiences from before the accident which have not given rise to any psychiatric symptoms but following this accident caused some intrusive thinking. He felt that he could not continue to work as a police officer.
Dr Anderson made a diagnosis of post-traumatic stress disorder noting he had flashbacks, intrusive imagery and memory, total preoccupation with the accident, anxiety, insomnia, hypervigilance and avoidance.
He also had affective symptoms including depression and euphoria and has been preoccupied with religious themes concerning his survival. This led to treating personnel to question reality testing at one stage to suggest a diagnosis of a brief reactive psychosis following a particular stressor (the accident).
Dr Anderson assigned a WPI of 19% on the Permanent Impairment Rating Scale and added 1% for treatment effect, making a total of 20% WPI.
The report of Dr Clark, psychiatrist, dated 12 November 2020 states that following the accident, Mr Taseski described crying frequently, feeling anxious but also sometimes euphoric and on top of the world like climbing Mount Everest with doing the hard yards.
He wanted to hug someone he saw in town even though she was uncomfortable with him doing so.
He was also very anxious and spontaneously bursting into tears in Coles buying groceries. His energy level was high. He described feeling as if he was being kissed by God and that he was in space and on cloud 9.
He would go walkabout to keep fit.
He remembers seeing a group of people doing a fun run who he could not see but could hear their voices, which made him cry.
He consulted an EAP psychologist six weeks after the accident. He wanted to know how he had survived when the car had hit him and flipped over.
He only attended one session. He subsequently felt anxious, felt invincible and described a labile mood, high energy, euphoria, intrusive memories and psychological arousal. He avoided walking on the road for some time.
He said he was influenced by when he read the book by Stuart Diver, who was trapped and suffered trauma in a landslide event in Thredbo.
He attempted to return to work in his usual position as a summons and warrant officer in early October 2018. He lasted six hours and could not carry out work because his computer had been taken away.
He returned to work in 2019 one day per week. He was very anxious, did not feel safe and worried he might get put back on general duties. He was upset after hearing that a police officer had been stabbed in the neck when going to serve a warrant.
He was treated by the psychologist Lisa Arnold and referred to Dr Kim, psychiatrist, who prescribed olanzapine. He stated this made him feel droopy, and he was drooling but felt clear in his thinking.
The treating psychologist caused him to open up compartments in his brain. He had intrusive recollections of some previous experiences involving murder, suicide and neglected children.
The report states under the heading of Current Status that he has experiences where he becomes angry and irritated. He had a low tolerance, getting irritated, feeling angry and reported people felt he was negative.
He described intrusive recollections of confronting experiences he has had and triggers such as seeing crosses in the road where automobile accidents had occurred. He could sometimes see things on the side of the road or in bushes that remind him of fatal accidents. News of pedestrian accidents would trigger these recollections. He disliked being in a train or any situation where there were too many people.
He had an increased heart rate, and increased energy levels, along with anxiety, irritability, and anger.
He had recurrent dreams of accidents but did not call them nightmares. His sleep was often interrupted, but sometimes the olanzapine helped him stay asleep.
He would exercise vigorously each day, and his appetite was normal.
It states under the heading of Summary and Assessment that there was no evidence of hypomania that day, but there was some mood lability with irritability and anger as well as continuing posttraumatic stress symptoms. It states that Mr Taseski has a diagnosis of post-traumatic stress disorder and this causes his incapacity.
The Panel does not propose considering the reports of Dr Virgona. At the time of examination by him of the claimant, Dr Virgona was not an authorised health practitioner.

Material before the Review Panel

As previously noted, the Panel requested the parties to provide bundles of documents upon which they relied. These were provided by both parties.
The parties should understand that all documentation in each party’s respective bundle of documents has been read however, the fact that some document or documents is not referred to in these reasons should not be taken as an indication that the document has not been considered, given the large amount of documentation in each bundle.

Panel medical examination

The claimant was examined by Medical Assessor Lim and Medical Assessor Friend on
19 June 2023. Their report follows:
“RE-EXAMINATION
The claimant was examined by Medical Assessor Friend and Medical Assessor Lim by audio-visual link.
Mr Taseski stated the motor accident occurred on a Thursday morning, he believes at about 9.30 am. He had finished three days’ work as a police officer. This was a day off. He was walking along Barkers Lodge Road to the post office to pay some accounts. It had been a drizzly day, and the road was wet. He was wearing shorts, T-shirt and thongs.
He was walking past an easement that had a railing so that he had to walk on the side of the road rather than on a footpath.
He saw a vehicle coming towards him around a slight bend. The vehicle had veered to the wrong side of the road. He thought it would hit the railing. The driver suddenly braked, and the car came directly towards him.
He described the image of the vehicle ‘being frozen’ in his mind. He backed up an embankment that was behind him. He remembered the bonnet of the car striking his left ankle, causing him to be thrown backwards. At this point, his eyes were shut. He thought that the car would flip over on top of him. He thought of his wife and his life. His next memory is of being ‘face-planted' on top of the embankment.
He was able to get to his feet. He checked himself and determined that he was “intact”. He next looked at the vehicle, which was on its roof on the road. He walked down the embankment and yelled out because he could not see anybody in the vehicle.
He telephoned 000. At this time, there were no passers-by. As he was in the act of making the telephone call, he saw the door ‘creak open’, and a lady who was hanging by a seatbelt told him to cut the seatbelt. She said there was a knife in the back of the car.
A neighbour came up who had a knife and cut the seatbelt causing the lady to fall onto the roof of the car. She got up and walked or crawled out of the vehicle.
He took a photograph of his left leg and the back of the vehicle. Police and ambulance, and perhaps the fire brigade arrived. He was aware that his right shoulder was tingling and his left ankle was swollen.
He was taken by ambulance to Liverpool Hospital. Either before doing so or soon after, he telephoned his “boss” at work and advised him that he had been involved in an accident and could not work the next day.
History of Symptoms and Treatment Following the Motor Accident
Mr Taseski was taken to the Emergency Department of Liverpool Hospital, which he saw was very busy. He remembers a man being wheeled in with multiple injuries.
He described feeling like ‘Superman’ whilst he was waiting for a scan, presumably a CT or MRI scan. It was a great feeling, fantastic. ‘I was Superman who gets hit by a car and flips it’.
He repeated several times during this examination that he had “flipped the car” which had struck his left ankle.
He was advised that he had a tear at the supraspinatus tendon of the right shoulder and subsequently had two corticosteroid injections.
His wife collected him from the hospital about 10 hours later.
He slept well that night. He was contacted by Sergeant Adam Cragg either that night or the next day.
He described the next day feeling like he needed to exercise. His thoughts were ‘racing at a thousand miles per hour’, and ‘everything was crystal clear’. He felt that he needed ‘to feel society’. He started walking around Picton, which he described as a ‘walkabout’.
He remembers that in the subsequent days, he saw a fun run, heard all the voices, and felt that this was sensational and the best thing he had ever heard. He wanted to feel everything that was around him. He described everything as being so fast and also crystal clear. He remembered watching the Soccer World Cup at that time.
His son travelled to Ireland sometime after the motor accident. He telephoned his son in Ireland and said that he loved him.
He read the book written by Stuart Diver, who was the sole survivor of the Thredbo landslide in 1997. He described that as unbelievable and that he could relate to everything that Stuart Diver experienced, including being trapped for three days.
He felt that it was extraordinary that he was here.
The motor accident pre-occupied his thoughts. He stated that it ‘was the only thing in my life’. He neglected to attend a police reunion. He thought that everything made sense.
He repeated, ‘I froze the car to do something about it. I was hugging people at the same time, knowing that was inappropriate’.
He was telling everybody what had happened. He hugged a neighbour.
He met the driver of the other vehicle four days later and gave her a hug even though he knew it was inappropriate.
He repeatedly referred to the speed at which his brain was thinking.
He continued with his exercise regimen. He got up at 6.00 am and exercised for 30 minutes in his home gym. He next went to a coffee shop where he would do the crossword and have a cup of coffee and then do more exercise.
He initially consulted an employee assistance psychologist, Karen, because his mind was racing, and he could not stop it.
He felt happy to see everyone.
He found the interview with Karen ‘ridiculous’, especially when she told him that he needed to rate her.
He consulted his general practitioner Dr Phuah and advised her that he needed to see someone. She referred him to Ms Lisa Arnold, a psychologist whom he described as ‘fantastic’.
He consulted Ms Arnold for about 20 sessions but could not date the last consultation. been.
He described wanting to talk about the accident, feeling the vehicle hit his ankle and then having ‘a gap in my existence and being in a different realm’.
Ms Arnold, after three or four sessions, stated that he should consult a psychiatrist because he was ‘too fast’.
He, after some difficulty, obtained an appointment with Dr Victoria Kim at South Coast Private Hospital. The first appointment was on 12 November 2018.
Dr Kim prescribed olanzapine.
He stated that he had a near-death experience and needed to speak to Lisa Arnold about the expansion of his brain.
It appears that when he was walking around Picton that he was reminded of attending a deceased person in about 1989 when he worked at Bexley North Police Station.
He had to deal with the matter of a homeless man who had hanged himself. He had the thought, ‘Why would a man living in Utopia kill himself?’. He had another thought that ‘the man hanging there was me’.
His wife travelled to Canberra sometime after the motor accident. He was alone at home. He felt like he was ‘Superman’. During this time, he put a knife on his arm and believed that it would not penetrate his skin.
He described feeling extraordinary and that ‘my mind is racing’.
He stated that he grieved for himself even though he was not dead.
Dr Kim continued the olanzapine and, at some point, added lithium carbonate, probably 2- 2½ years ago.
The dose of olanzapine was later reduced from 5 mg to 2.5 mg daily because he was gaining weight, struggling to exercise and eating large amounts of chocolate.
Unfortunately, lithium carbonate gave him nocturia up to six times each night, and sometimes at least, he would struggle to get back to sleep after waking to go to the toilet.
Mr Taseski returned to work initially on 8 October 2018 but could not cope and took a further couple of months off, returning to work again in January 2019, initially one day a week and gradually increasing to about three days each week.
Soon after he returned, a fellow officer was killed in a motor accident, and he had to march at his funeral through the streets of Liverpool which he found difficult. He found it increasingly difficult to cope with work. He described policing as ‘an expansion of consciousness’. He stated that ‘you had to put up with people’s bullshit words’ and having to deal with the dynamics of people’s personality.
He described work being ‘a mill of people’ and that ‘police officers tried to find reasons for not doing something’.
He was thinking about whether he could continue to work as a police officer.
The final event in deciding to stop work in July 2019 was a young police officer being stabbed in the neck when he had gone to serve a summons on a man. The man’s son had stabbed the police officer.
The young police officer almost died. He did not elaborate further.
He described at that point continuing to feel speeded up, to have clarity of his thinking, expanded consciousness and still believing that he had flipped a car with his ankle.
Past History
Mr Taseski consulted Mr Gerard Glancey in 1999.
Dr Glancey’s report dated 29 September 1999 describes various incidents.
Mr Taseski, in 1997, was working at a service station, an approved second job and was threatened by two people who demanded money.
Later the same year, he was arresting a drug dealer who bit his hand. This occurred when HIV/AIDS and Hepatitis C were receiving a lot of publicity. He was very distressed by the need for repeated testing for six months before it was determined that he had not contracted either of these conditions. He was depressed and anxious.
On 27 July 1999, he was again the victim of a further armed robbery at a service station where he was working, which was an approved second job.
Mr Glancey described Mr Taseski as having a mixture of anxiety and depressive symptoms. He was treated with cognitive behaviour therapy and eye movement desensitisation and reprocessing.
Mr Taseski believes he made a full recovery from the three incidents. He continued to work full-time as a police officer throughout the treatment, despite saying that he felt ‘a mess’ at the time.
He injured his left knee when his knee hit a pylon when he tackled a suspect in the course of trying to apprehend him sometime in the 1980s.
He injured his right knee playing basketball in about 1996, which required a reconstruction. He recovered and was able to run again.
He re-injured his right knee in January or February 2018, getting out of a police car.
He suffered various bruises and perhaps abrasions in the course of his work as a general duties police officer. He described arresting offenders, wrestling with people and needing to tackle people.
Subsequent Medical History
Mr Taseski has not been involved in any new motor accidents or accidents of any kind.
He has not sustained any new injuries or undergone any surgery unrelated to the original accident.
Substance Use
Mr Taseski is a non-smoker and drinks 3-4 beers about twice each week.
He has never used illegal substances, drinks about two cups of coffee each day and has no other intake of caffeine.
Personal History or Psychosocial History
Mr Taseski was born in Macedonia and emigrated with his family in about 1970.
He completed secondary school at Tempe High School.
He enrolled in Nepean College with the goal of becoming an accountant but left after 1½ semesters because he could not afford to purchase the textbooks.
He applied to join the Police Service and was accepted 1½ years later, passing out from the Police Academy on 24 April 1985.
He subsequently worked at Rockdale, Kogarah, Hurstville and Peakhurst Police Stations. Peakhurst later became Riverwood Police Station.
He next worked at Kingsgrove Police Station for one year and next at Cabramatta Police Station, which he described as enjoyable but intense and a political hot potato because “the streets were awash with heroin”.
He had “a run-in” with his boss at Cabramatta Police Station and asked to transfer to Liverpool Police Station, where he commenced working in 1999. He continued to work at Liverpool Police Station until retiring from work in 2019.
He is married and has four children, three sons and a daughter who now live independently of him and his wife.
Current Symptoms
Mr Taseski continues to have the same symptoms as described previously. He feels speeded up. He talks excessively, which alienates others, including his children. He feels very speeded up in his thoughts. He continues to believe that he flipped the car with his ankle. He describes having clear thinking and feeling like there is an expansion of his brain or consciousness.
Current Treatment
Mr Taseski’s current treatment is as described before.
He takes olanzapine 2.5 mg in the morning and lithium carbonate 500 mg twice daily.
He takes a statin, possibly atorvastatin, for dyslipidaemia.
Specific Matters Raised with Mr Taseski
Mr Taseski describes symptoms consistent with an elevated mood. He was asked at least three times if there are any other types of symptoms that he experienced, and he repeatedly stated he did not understand the question.
At this point, he was asked about some of the content of the report of Dr Peter Anderson dated 27 March 2020.
‘He gave a clear history of typically re-experiencing symptoms of posttraumatic stress disorder. He re-experienced the accident itself. This was accompanied by anxiety and distress.’
‘He continues to have flashbacks of the accident, poor sleep, anxiety, vigilance, avoidance, a near-total preoccupation with drive, physical fitness and training, a mental preoccupation with how and why the accident occurred.’
Mr Taseski stated that he experienced these symptoms from time to time. He does not like it like them. He feels they do not distress him and do not cause him to change what he does each day.
Daily Activities
Mr Taseski gets up at 6.00 am each morning. He feels full of energy. He feels this way despite going to bed at 9.00 pm at night and waking up to six times because of nocturia and not getting back to sleep after at least some episodes of waking from sleep.
He initially does about 30 minutes exercise in his home gym. He next goes to a local coffee shop where he has coffee and does the crossword over about three hours.
He returns home and exercises from 9.30 am for 45 minutes by doing what he refers to as “intense exercise” in his home gym.
He then walks and reads for about two hours. He does garden and “lazing around” in the afternoon.
He described having to concentrate on a one square metre block in the garden to work on it otherwise, he starts ‘too many jobs’ and nothing gets done. He repeated this statement when this was questioned.
His wife cooks dinner, and he goes to bed at 9.00 pm.
His weight fell from 123 kg to 96 kg in response to the daily exercise program. He currently weighs about 109 kg. He attributes the weight gain to the medication that he is taking.
Mr Taseski stated that prior to the motor accident he had an active social life. He was president the Picton Rangers Soccer Club. He described himself as a social butterfly. He previously played squash. He went out to dinner with his wife and family and would interact with others.
He remains very physically active with his personal training regimen.
Many people no longer talk to him. His sister has told him he talks too much.
His children have withdrawn from contact with him for reasons that he does not understand.
He describes people saying, ‘the stupidest things’.
He lived in Culburra, on the South Coast of New South Wales, for seven months in a beach house. He was planning to raise terns, but this did not occur.
During that time, the lake was opened up to the sea, which he felt was fantastic, but local people disagreed with him.
Mr Taseski reported that he had no difficulty with driving, provided he had a specific destination for the journey. He described occasionally driving around a corner and having a ‘relapse recall’, by which he meant recalling his motor accident He described when asked that it was just a recall and it did not occur very often.
Mr Taseski remains in a relationship with his wife. He has little, if any, contact with his children and has no contact with friends.
He repeated that people say ridiculous things.
Mr Taseski stated that his brain is ‘very intense’. It continues to race. He struggles to read. It can take him three hours to do the crossword, and he makes many mistakes. He took four months to read the book ‘Moby Dick’ by Herman Melville.
He does not do any organised activities with others.
He struggles to concentrate when reading books or doing crosswords and needed to take repeated breaks, but he could not describe how long he took breaks. He reported that lithium makes him forgetful. Cognitive impairment is a recognised side of lithium carbonate.
Mr Taseski has not returned to work and has not attempted to undertake any work since retiring medically in July 2021 and being officially retired from the New South Wales Police in 2022.
He stated that he could no longer work in policing, which required an expansion of consciousness. He described the experience of being at work ‘as a mill of people’ and that he could not tolerate ‘the dynamics of people’s personalities’.
He stated that he could not cope with every aspect of policing.
It appeared that the incident where a young police officer was stabbed in the neck, combined with the death of a police officer in a motor accident soon after he returned to work led to him deciding that he could no longer continue to work.
Mental State Examination
Mr Taseski was examined by video teleconference. He sat in a chair in an office. He had a white beard which was neatly trimmed.
He did not appear to be distressed.
Mr Taseski described an ongoing elevated mood which he developed later on the day of the motor accident. He had a lot of energy. He described having an expanded consciousness, that his thoughts were racing at a thousand miles per hour and that he believed that he had flipped the car as a result of it striking his ankle. He described having crystal-clear thinking.
He described grieving for himself even though he did not die in the motor accident.
He also talked about a man whom he had found hanging as a deceased person living in Utopia and also thought that man was himself. He could not explain this further.
He described freezing the image of the vehicle in his mind at the time of the motor accident.
He believed that the current treatment medication had slowed him down and reduced his energy level, but that he continued to have a lot of energy each day and struggled to focus and concentrate.
He had disturbed sleep in that he woke up six times each night to pass urine since being prescribed lithium carbonate. Nocturia is a recognised side effects of lithium carbonate. Some of the frequent wakening during the night may in part be also caused by the ongoing elevated mod.
Comments on Consistency
Mr Taseski’s account is consistent to a degree with the report of Assessor Doron Samuell dated 16 June 2021.
Medical Assessor Samuell made a diagnosis of Bipolar Disorder and described symptoms consistent with this condition but stated this was a constitutional condition not caused by an external stressor.
Medical Assessor Samuell found that Mr Taseski did develop posttraumatic stress disorder arising from the injuries sustained in the motor accident but that this condition had resolved.
Medical Assessor Samuell determined that there was no current whole-person impairment attributable to psychiatric conditions arising from the injuries sustained in the motor accident.
The psychiatric reports of Dr Peter Anderson dated 27 March 2020 and Dr Scott Clark dated 12 November 2020 made diagnoses of post-traumatic stress disorder.
Mr Taseski’s account of his symptoms was consistent with the various reports of
Dr Victoria Kim.
Diagnosis and Reasons
Mr Taseski reaches the criterion for a diagnosis of Bipolar Disorder and is in a state of chronic mania or hypomania.
He has since soon after the motor accident high levels of energy, has had the ongoing beliefs that he flipped a car with his ankle and that he is Superman. At one stage he believed that a knife would not penetrate his skin. He remains very talkative and is preoccupied with how he survived the motor accident. He has at times felt invincible. He has been amorous or loving towards others. He has hugged others inappropriately. He repeatedly hugged and told his immediate family that he loved them. He has alienated his children, his sister and various friends with his excessive talking and amorous behaviour. These symptoms have been modified by the current treatment regimen and he has to some extent learned that he should not hug others.
He is easily distracted being only able to concentrate on a one square metre patch of a garden at a time or else he does not achieve anything.
He does have symptoms from time to time consistent with Post-traumatic stress disorder such as if he turns a corner when driving but these do not distress him or impair his daily functioning other than he does not want these thoughts.
Causation and Reasons
Mr Taseski has been diagnosed as having Bipolar Disorder and being in a chronic state of mania.
There is no documentation in the supplied documents of symptoms of this condition prior to the motor accident.
It is recorded that his previous trauma-induced symptoms in 1999 responded to treatment, and he continued to work full time as a police officer despite them and as far as can be determined, fully recovered from them.
He has not been involved in any subsequent motor accidents or other traumatic events and has not developed any unrelated medical conditions.
There is no other reason for him to develop this condition of Bipolar Disorder with a chronic manic state other than the motor accident on 28 June 2018.
There was a strong temporal correlation between the motor vehicle accident and the onset of Mr Taseski’s symptoms of Bipolar Disorder.
The review panel notes that Bipolar Disorder is an uncommon outcome for people injured in a motor accident. It was more likely in people who have suffered a traumatic brain injury in whatever circumstances.
Mr Taseski was thrown backwards by the force of the collision and “face-planted” ie landed face down on the ground of the embankment on which he was standing at the time of impact. However he did not have any signs of a significant traumatic brain injury, including on a CT scan in Liverpool Hospital where he was assessed after the motor accident.
Summary of Injuries Referred by the Parties
The following injuries were caused by the motor accident:
Bipolar Disorder in a chronic manic or hypomanic state
Permanency of Impairment
Mr Taseski’s motor accident occurred almost five years ago.
He is being treated by a psychiatrist and was treated by a psychologist. He is prescribed psychiatric medication which he reports has had some beneficial effect, on his symptoms, but has also caused side effects.
There is no evidence that his condition is improving or deteriorating. He has ceased work as he could no longer work and has not attempted to return to work in any capacity. His condition is stabilised and unlikely to change substantially by more than 3% in the next year with or without medical treatment.
Permanent Impairment Rating Scale

Psychiatric Diagnosis

·     Bipolar Disorder, chronic manic or hypomanic state

Psychiatric Treatment
·     Treatment with lithium carbonate

·     Treatment with olanzapine

·     Treatment by a psychiatrist

·     Treatment by a psychologist

AREA OF FUNCTION CLASS REASON FOR DECISION

Self Care and Personal Hygiene 1 No impairment. Mr Taseski has no difficulty getting up in the morning, is very physically active, able to go out by himself to have coffee and to do a crossword and does not rely on others for his personal care.

Social and Recreational Activities 2 Mild impairment. Mr Taseski no longer has contact with friends and little, if any, contact with family outside of his wife but remains very physically active, able to go out and do activities. He has no difficulty leaving home unaccompanied. He goes to a coffee shop each day without difficulty. He can self initiate these activities.

Travel 1 No impairment. Mr Taseski reported no difficulty with driving or travelling and was able to live for seven months at Culburra south of Sydney.

Social Functioning 2 Mild impairment. Mr Taseski maintains a good relationship with his wife as far as could be determined, but he has lost contact with friends and has little or no contact with his sister and children. His children have been alienated by his overpowering manner which is a consequence of the ongoing grandiosity and excessive talkativeness which are symptoms of his condition and referred to in the statement of Jack Taseski rather than tension or arguments. Mr Taseski continues to live with his wife. He prefers to avoid contact with former police colleagues because it reminds him of his police career. Prior to the motor accident most of his socialisation was with police colleagues.

Concentration, Persistence and Pace 3 Moderate impairment. Mr Taseski did sit through an examination lasting about 1½ hours. He struggled to answer questions and repeatedly stated he did not understand questions when asked about his symptoms.
He struggled to focus on the crossword taking three hours to complete it and making mistakes. He had read several books but it appears they took months to complete, despite not working. He was easily distracted when gardening. He had difficulty concentrating and need to concentrate on a one square metre patch in the garden or else he achieved nothing.

Adaptation 5 Totally impaired. Mr Taseski officially notified the Police that he was retiring in July 2019 and was officially retired from the Police Force in March 2021.
His presentation today with feeling very speeded up in his thoughts, having thoughts that he could flip a car with his ankle, feeling that he was Superman, struggling to focus and concentrate and not being able to tolerate others would make him unable to return to work as a police officer and unable to work in any other capacity.

List classes in ascending order:               1, 1, 2, 2, 3, 5

Median class value:  2

Aggregate score:  14

Whole person impairment:  7%
Apportionment
Mr Taseski has not been involved in any previous motor accidents causing ongoing symptoms. He had no impairment of his functioning prior to the motor accident having worked as a police officer full time for many years.
He has not been involved in any subsequent motor accidents or traumatic incidents and has not developed any new medical conditions.
There is no need to do a pre- or post-accident apportionment.
Effect of Treatment
Mr Taseski stated that lithium carbonate is helpful and he is slowed down to a degree. He finds olanzapine difficult to tolerate in part because of the weight gain and in part because of its effect, as he stated, that it just makes him sit.
It is very likely that if his current medication, particularly lithium carbonate, was ceased, his elevated mood would become more prominent.
The Review Panel agreed to add 1% for the effect of treatment.
Current whole person impairment  7%
Apportionment   0 %
Effect of Treatment  1%
Final Whole Person Impairment   8 %”

The Panel adopts the findings of Medical Assessors Lim and Friend.

Causation and reason

The accident was sudden and unexpected. The claimant, a pedestrian, was confronted by a car which appeared out of control. The car was travelling towards him, and he was faced with a life-threatening situation.
Despite the claimant’s attempts to avoid being hit by the car, this occurred. He was taken to hospital and admitted but discharged on the same day. As part of the claimant’s condition, he thought that he did die at the time of the accident but somehow had survived.
Before the accident, the claimant had pre-existing psychiatric conditions. Dr Anderson however, said that the claimant, did not have any symptoms arising out of his police service prior to the accident, and did not have and does not have any diagnosable psychiatric disorder caused by the police service.
Dr Anderson said that the post-traumatic stress disorder evident from 28 June 2018 was the cause of the claimant’s incapacity to exercise the functions of a police officer. This causes him to be anxious, feel unsafe, feel overwhelmed, an inability to exercise discretion and judgment, to undertake active decision-making, maintain emotional stability and effective day-to-day contact with the public.
The claimant submitted that he should be examined by a different Medical Assessor who does not have access to, and who has not read, the opinion provided by either Dr Virgona or the Medical Assessor. The claimant has noted that the delegate of the President noted in her decision that;
“As the certificate and reasons of the Medical Assessor took into consideration inadmissible evidence, I agree with the applicant’s submission that his report should not be provided to the new Medical Assessor.”
In response to this, the Panel notes that this is a review de novo. The Panel is not bound by any decision previously made. The Panel confirms however that no medico legal report of
Dr Virgona should be allowed into evidence as he was not an authorised health practitioner at the time of his examination and reports, The Panel has not taken into account any report or reasons of Dr Virgona. The Panel has however, considered the certificate and reasons of the Medical Assessor.
The Panel is satisfied that the claimant has suffered a psychiatric injury as a result of the accident on 28 June 2018 when, as a pedestrian, he very narrowly missed serious impact with a vehicle that was out of control and passed by him.

Determination

The Review Panel revokes the certificate of Medical Assessor Samuell dated 16 June 2021 and issues a new certificate determining that the claimant has:
(a) bipolar disorder with recurrent chronic manic state, and
(b) a WPI of 8%.

CONCLUSIONS

The Panel agrees with the Medical Assessor that the claimant has suffered a bipolar disorder however the Panel is satisfied that this condition arises from the accident.
Based on the clinical observations by the Medical Assessors, the claimant has an 8% WPI assessment.

[BG1]CHECK

AREA OF FUNCTION	CLASS	REASON FOR DECISION
Self Care and Personal Hygiene	1	No impairment. Mr Taseski has no difficulty getting up in the morning, is very physically active, able to go out by himself to have coffee and to do a crossword and does not rely on others for his personal care.
Social and Recreational Activities	2	Mild impairment. Mr Taseski no longer has contact with friends and little, if any, contact with family outside of his wife but remains very physically active, able to go out and do activities. He has no difficulty leaving home unaccompanied. He goes to a coffee shop each day without difficulty. He can self initiate these activities.
Travel	1	No impairment. Mr Taseski reported no difficulty with driving or travelling and was able to live for seven months at Culburra south of Sydney.
Social Functioning	2	Mild impairment. Mr Taseski maintains a good relationship with his wife as far as could be determined, but he has lost contact with friends and has little or no contact with his sister and children. His children have been alienated by his overpowering manner which is a consequence of the ongoing grandiosity and excessive talkativeness which are symptoms of his condition and referred to in the statement of Jack Taseski rather than tension or arguments. Mr Taseski continues to live with his wife. He prefers to avoid contact with former police colleagues because it reminds him of his police career. Prior to the motor accident most of his socialisation was with police colleagues.
Concentration, Persistence and Pace	3	Moderate impairment. Mr Taseski did sit through an examination lasting about 1½ hours. He struggled to answer questions and repeatedly stated he did not understand questions when asked about his symptoms. He struggled to focus on the crossword taking three hours to complete it and making mistakes. He had read several books but it appears they took months to complete, despite not working. He was easily distracted when gardening. He had difficulty concentrating and need to concentrate on a one square metre patch in the garden or else he achieved nothing.
Adaptation	5	Totally impaired. Mr Taseski officially notified the Police that he was retiring in July 2019 and was officially retired from the Police Force in March 2021. His presentation today with feeling very speeded up in his thoughts, having thoughts that he could flip a car with his ankle, feeling that he was Superman, struggling to focus and concentrate and not being able to tolerate others would make him unable to return to work as a police officer and unable to work in any other capacity.
List classes in ascending order: 1, 1, 2, 2, 3, 5
Median class value: 2
Aggregate score: 14
Whole person impairment: 7%

[2023] NSWPICMP 432

1 September 2023