Transport Accident Commission v Harris

DETERMINATION OF REVIEW PANEL
CITATION:	Transport Accident Commission v Harris [2025] NSWPICMP 435
CLAIMANT:	Harris
INSURER:	Transport Accident Commission
REVIEW PANEL
MEMBER:	John Harris
MEDICAL ASSESSOR:	Dr Matthew Jones
MEDICAL ASSESSOR:	Dr Christopher Canaris
DATE OF DECISION:	19 June 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); motor accident on 17 October 2019; assessment of whole person impairment (WPI) for psychiatric impairment; significant motor accident-causing post-traumatic stress disorder (PTSD); observations that adaptation affected despite pre-accident cessation of employment; no other relevant principles in assessment of impairment. Held – claimant’s degree of permanent impairment assessed at not greater than 10%; original assessment revoked; MAC revoked; new certificate issued.
DETERMINATIONS MADE:	*THE ASSESSMENT MADE BY THE REVIEW PANEL UNDER S 7.23(1) OF THE MOTOR ACCIDENT INJURIES ACT 2017* IS AS FOLLOWS:** 1. The Panel revokes the certificate dated 15 March 2024 and issues a new certificate determining that the following injuries caused by the motor accident give rise to a whole person impairment that is NOT GREATER THAN 10%: · specific phobia related to driving, and · post-traumatic stress disorder.

PERSONAL INJURY COMMISSION

MOTOR ACCIDENTS DIVISION

STATEMENT OF REASONS FOR DECISION OF THE REVIEW PANEL IN RELATION TO A MEDICAL ASSESSMENT

Matter Number:	R-M21329/24
Claimant:	Lesley Harris
Insurer:	Transport Accident Commission
Review Panel:
Principal Member:	John Harris
Medical Assessor:	Matthew Jones
Medical Assessor: Date of Decision:	Christopher Canaris 19 June 2025

Medical Assessment – Permanent Impairment

WHETHER THE DEGREE OF PERMANENT IMPAIRMENT OF THE INJURED PERSON AS A RESULT OF THE INJURY CAUSED BY THE MOTOR ACCIDENT IS GREATER THAN 10%

THE ASSESSMENT MADE BY THE REVIEW PANEL UNDER S 7.23(1) OF THE MOTOR ACCIDENT INJURIES ACT 2017 IS AS FOLLOWS:

The Panel revokes the certificate dated 15 March 2024 and issues a new certificate determining that the following injuries caused by the motor accident give rise to a whole person impairment that is NOT GREATER THAN 10%:
· specific phobia related to driving, and
· post-traumatic stress disorder.

REASONS
BACKGROUND

Ms Lesley Harris (the claimant) suffered injury on 17 October 2019. The claimant was a passenger in a vehicle travelling straight when it was T-boned by the insured vehicle which had entered the intersection from the left.[1]
[1] Claimant’s bundle, p 7.
The Transport Accident Commission (the insurer) insured the owner and/or driver of the motor vehicle for liability to pay to Ms Harris any damages and/or statutory benefits under the Motor Accident Injuries Act 2017 (the MAI Act).
The present dispute is whether the claimant’s “degree of permanent impairment as a result of the injury caused by the motor accident is greater than 10%”. This constitutes a medical dispute within the meaning of the MAI Act.[2]
[2] See Division 7.5 and Schedule 2 cl 2 of the MAI Act.
Section 7.21 of the MAI Act provides that the degree of permanent impairment of an injured person is to be made in accordance with the Motor Accident Guidelines (the Guidelines).
The Guidelines are issued pursuant to s 10.2 of the MAI Act. The Guidelines adopt the fourth edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment, fourth edition (AMA 4). Where there is any difference between AMA 4 and the Guidelines, the Guidelines are definitive.[3]
[3] Clause 6.2 of the Guidelines.
This is a review of a medical assessment pursuant to s 7.26 of the MAI Act. The medical assessment the subject of this review was conducted by Medical Assessor Roberts and dated 15 March 2024. The Medical Assessor concluded that the motor accident caused a post-traumatic stress disorder, and assessed the degree of permanent impairment at 17%.
The details of that medical assessment certificate are set out later in these Reasons.

THE REVIEW

The application for referral of the medical assessment to a Review Panel (the Panel) was made by the insurer within 28 days after the parties were issued with the original certificate for the medical assessment for which the review is sought.[4]
[4] Section 7.26(10) of the MAI Act.
The delegate of the President referred the medical assessment to the Panel as they were 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.[5]
[5] Section 7.26(5) of the MAI Act.
Pursuant to s 7.26(5A) of the MAI Act and Schedule 1, cl 14F(2) of the Personal Injury Commission Act 2020 (the PIC Act), the Panel consists of two Medical Assessors and a Member of the Motor Accidents Division of the Personal Injury Commission (Commission).
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 Merit Reviewer or a Medical Assessor.[6]
[6] 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 Review Panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application.[7]
[7] Rule 128 of the PIC Rules.
The review is by way of new assessment of all matters with which the medical assessment is concerned.[8]

ASSESSMENT UNDER REVIEW
[8] Section 7.26(6) of the MAI Act.

The Medical Assessor provided a medical assessment certificate determining that the motor accident caused a post-traumatic stress disorder and persistent depressive disorder.
The Medical Assessor concluded that the motor accident caused serious functional restrictions in travel, social and recreational activities and adaptation.

MATERIAL BEFORE THE REVIEW PANEL

The parties provided separate bundle of documents.

PRE-ACCIDENT RECORDS

The pre-accident clinical records of the general practitioner (GP) note a past medical history of Protein S deficiency diagnosed in 2004, lumbar spine symptoms and complaints of leg pain at work from long-standing in 2017.[9]

POST MOTOR ACCIDENT

[9] Claimant’s bundle, p 49.

General practitioner and treating records

The ambulance records refer to a vehicle pulling out in front of a Kombi van travelling at approximately 85 kmph with the patient trapped and complaining of central chest pain radiating into the thoracic region of the spine and pain in the left lower leg.[10]
[10] Claimant’s bundle, p 34.
The claimant was discharged from hospital on 22 October 2019 with a fractured sternum and neck haematoma.[11]
[11] Claimant’s bundle, p 39.
Ms Wendy van Praag, psychologist, provided a report dated 15 May 2021 following an initial consultation three days earlier.[12] Ms van Praag noted a 20-year history of chronic pain due to a genetically inherited disorder which caused blood clots which were continually painful and prevented the claimant from sleeping.
[12] Claimant’s bundle, p 44.
Symptoms included an inability to sleep, tearfulness, loss of concentration and motivation and heightened anxiety. There are reports of some suicidal ideation, feelings of helplessness and hopelessness, inability to maintain concentration and loss of motivation, loss of sleep and heightened anxiety.
Ms van Praag opined that the claimant had no work capacity and was unlikely to develop work capacity given the underlying pain and severe symptoms of depression.
Ms Sorley, psychologist, provided a report dated 1 June 2021 following sessions with the claimant in April and May 2021.[13] The psychologist noted symptoms consistent with a generalised anxiety and specific phobia – driving, with the psychological symptoms compounded by the ongoing physical symptoms both her and her husband experienced as a result of the motor accident.
[13] Claimant’s bundle, p 45.
On 4 June 2021 the GP wrote to Centrelink in the following terms:[14]
“I am the regular GP of Leslie Harris.
She has left iliofemoral DVT, which was first diagnosed in 2003 when she was diagnosed with Protein S deficiency. She was commenced on Warfarin, then Xarelto, but developed a new left superficial venous thrombosis in the left antecubital fossa in April 2018 despite being on Xarelto. She has been suffering chronic pain in her left thigh up to the groin and left arm which are hindering her from work and cause significant impairment of her quality of life and day to day function and prevent her from sleep. She has been referred to chronic pain specialist for opinion on chronic regional pain syndrome but there was little to offer her as a service, and it was not helpful. over the years she has been reviewed by PA Hospital vascular surgeons Dr Peter Hansen, Dr Tim McGahan and Dr Andrew McCann. Surgery was not an option because of her Protein S deficiency and there was nothing further that could be done for her. Her condition is inoperable, permanent & deteriorating. She is in significant pain.
She was injured with her husband in a MVA in October 2019, and she is caring for her husband who had severe injuries and had 3 surgeries due to his injuries, the last one was 5 weeks ago. Lesley has been severely depressed, anxious and stressed and is receiving psychological counselling with Ms. Wendy Van Praage, Psychologist (report attached).
In my opinion, Lesley has no work capacity and is unlikely to develop any work capacity for more than 24 months as her condition is permanent and because of her chronic pain and severe depression. She is not able to cope with any added stress which aggravates her anxiety & depression.”
[14] Claimant’s bundle were restricted, p 51.
In a report dated 26 July 2021, Dr Vivekananda, vascular surgeon, noted ongoing pain in the left lower limb with standing tolerances limited to 30 minutes.

Qualified opinions

Dr Parsonage, psychiatrist was qualified by the claimant and provided a report dated
[15] Claimant’s bundle, p 11.
5 July 2022.[15] The doctor noted that the claimant was on a disability support pension because of an inherited blood clotting disorder and depression and had last worked in December 2018.
Dr Parsonage noted that prior to the motor accident the claimant managed self-care within the limits of physical restrictions such as not cooking because of difficulties with prolonged standing. However, the claimant enjoyed going for walks with friends and going on motorbike rides, enjoy going out with friends on boats and attending trivia nights, having meals with friends and going with her husband on trips to the city. She had no difficulty travelling independently.
Dr Parsonage noted the physical injuries from the motor accident had largely resolved and the only residual physical problems was that she cannot lie on the side, cannot tolerate her husband’s arm on her chest when she is asleep and had difficulty hanging out washing.
Psychological problem since the motor accident included hypervigilance whilst driving especially when driving towards or at an intersection. Social life had been affected as the claimant and her husband have been restricted in their ability to drive to places.
Dr Parsonage opined that the claimant suffered from an adjustment disorder with depressed mood prior to the motor accident which was clinically significant because the claimant experienced suicidal thoughts secondary to her chronic pain. The doctor assessed permanent impairment at 17% with significant adjustments for adaptation, concentration persistence and pace, travel, and social and recreational activities.
An Activities of Daily Living Assessment report dated 12 December 2019[16] noted an onset of symptoms 15 years previously due to Protein S deficiency with a deterioration in 2017 where the condition progressed to an occlusion. Employment ceased in 2017 due to the underlying health problems.
The claimant advised that she was independent with respect to personal care. Difficulty with respect to some activates was due to pain. Other home activities were restricted due to significantly restricted walking and standing tolerances.
The claimant reported and was observed to experience low moods since the accident when discussing her symptoms and her concerns for her husband.
Dr Murphy, psychiatrist, was qualified by the insurer and provided a report dated
23 August 2022. The doctor noted that the claimant exhibited intrusion, arousal, avoidance and mood symptoms relating to the accident.
The doctor assessed Class three for social and recreational activities and travel noted that adaptation was a Class one due to loss of work for the underlying Protein S deficiency in 2018. The assessment of whole person impairment was 6% with a 1/10th deduction for a pre-existing condition.

Claimant’s statement

The claimant provided a statement dated 14 October 2022. The claimant was employed by Michael Hill Jeweller and oversaw the warehouse but left work prior to the accident because of Protein S deficiency and claimed a benefit from Centrelink along with an income protection payment.
The pre-accident work required the claimant to stand for long periods. On ceasing work and with assistance from pain management, the claimant was able to reduce her pain.
The claimant’s pre-accident activities included spending time with her family and friends and regularly meeting the children for dinner. She enjoyed short walks with her husband which was limited due to leg pain. Other activities included motor bike rides with the Ulysses club, socialising with friends on the boats and going on trips into the city and other activities such as trivia nights.
The claimant enjoyed sedentary activity such as reading puzzles. She also had purchased a Kombi van which her husband largely restored but she assisted with the finer details.
The claimant described the manner of the accident which, when happening, thought she could not possibly survive and at the time thought she had died and came back to life.
The claimant described the physical trauma caused by the motor accident including a fracture of the sternum and multiple rib fractures and multiple contusions and bruising. The claimant was advised by her daughter that following the accident she yelled and thrashed while sleeping and she frequently relives the accident occurring. The claimant became anxious and hypervigilant about the actions of other drivers and found it worse if there were cars on the left-hand side when she was a passenger.
The claimant stated that she was referred to a psychologist due to ongoing psychological symptoms which she initially found helpful but did not notice an improvement in symptoms.
The claimant stated that she continued to suffer from physical and psychological symptoms caused by the motor accident including chest pain and a dull ache in the chest when she leaned on the right side. She also noticed a different sensation over the left ankle where an ulcer had healed.
The claimant stated that she continued to experience anxiety and hypervigilance when travelling by car and no longer had the confidence to drive by herself, so her husband drove. She said that if her husband could not drive then they would not make trips to visit family members or socialise with friends.
The claimant stated that she no longer rode her motorbike or drove freely around the area where she lived because of how she felt whilst driving.
The claimant stated that she would awaken in the early hours for no reason and would have difficulty getting back to sleep for a period which made her tired. Her personal self-care and hygiene were affected because she had difficulty motivating herself to complete the tasks around the home.
The claimant stated that she no longer socialises with friends like she did before the accident because of anxiety in going out to activities. The claimant stated that she was particularly affected if it was raining, and she could not face driving in those conditions.
The claimant stated that she had difficulty concentrating and would readily start reading a book but found that she did not understand what was being read. She otherwise took much longer to complete puzzles than before the accident.
The claimant stated that she had been married for a long time prior to the accident and there was no strain on the relationship. Since the accident there has been a significant strain on the relationship with the negative impact from the ongoing symptoms. They no longer have made plans to travel and no longer have the carefree approach to enjoying life such as they did before the motor accident.

SUBMISSIONS

Claimant’s submissions dated 24 April 2024[17]

These submissions opposed leave to review the medical assessment certificate on the basis that the insurer had not shown that the assessment was incorrect in a material respect.
The claimant submitted that the Medical Assessor had regard to the medical evidence before him and was required to form his own opinion. The Medical Assessor was not required to refer to every piece of medical evidence and otherwise referred to the claimant’s previous symptoms and provided reasoning as to how he arrived at the assessment.
The claimant rejected that there were inconsistencies between the history recorded in the claimant’s pre-accident medical evidence and the history provided to the Medical Assessor. The Medical Assessor recorded a pre-accident history of symptoms which can be summarised as pain, low mood and physical restrictions.

Insurer’s submission dated 30 November 2022[18]

The insurer noted that the claimant’s attendances at the Victoria Point Medical and Dental Centre (GP) since July 2007. The records showed a history of Protein S deficiency and thrombosis including chronic DVT to the left renal vein. In 2016 the claimant complained of left thigh pain and an ultrasound showed a DVT from the common femoral vein.
In December 2017 the claimant complained of weakness in the left leg and difficulty walking. There were complaints of pain in the right groin and left thigh at that time and in January 2018.
In February 2018 the GP completed a total permanent disablement benefits claim with the superannuation fund relating to the claimant’s blood clotting disorder. It was then noted that the claimant was unable to walk to the car and was experiencing chronic pain conditions which were permanent, and no treatment was available, and that the claimant would not be able to return to work in any capacity in the future.
In April 2018 the claimant complained of back pain and that the leg pain was getting worse and she is unable to walk long distances. In August 2018 it was recorded that the claimant had clotting, was not coping and was unable to work.
In early 2019 the claimant was treated for benign paroxysmal positional vertigo.
On 11 March 2019 the GP completed a statement for the income protection claim when he noted that the claimant’s physical restrictions would be permanent, the claimant was suffering from frequent panic attacks, her motivation and social interaction were reduced due to pain and she was easily fatigued. It was further noted that the claimant was depressed, cried a lot and was frustrated.
On 28 August 2019 the GP noted further complaints of right inguinal pain and left leg pain.
Centrelink records reveal that the claimant underwent a job capacity assessment on
29 August 2019 when the claimant described chronic pain in the left leg and left arm due to the blood clotting disorder, reported very limited standing tolerances, was reliant upon a mobility walker and was unable to attend most domestic tasks. The claimant advised that she had stop driving due to pain and slept during the day due to fatigue.
The claimant was considered to have a baseline work capacity of 8 to 14 hours per week and a temporary capacity of 0 to 7 hours per week. The claimant advised Centrelink that she had resigned from employment at the end of 2017 due to health conditions and had been in receipt of a total and permanent disablement benefit which had now ceased.

On 10 October 2019 the GP noted the claimant experienced difficulty breathing even at rest for the past two months. The CT venogram of the left lower leg dated 11 October 2019 noted a three-year history leg pain in the context of Protein S deficiency and a chronic DVT in the femoral vein.
The insurer referred to the records from the ambulance service and Coffs Harbour Hospital. On discharge it was recorded that the claimant was mobilising independently.
An ADL assessment conducted by rehab management dated 12 December 2019 confirmed the history of a blood clot in the left leg with subsequent pain symptoms and limited standing and walking capacity.
The GP records up till 8 April 2021 show complaints unrelated to the motor accident until the claimant sought a referral to a psychologist. The GP noted physical and psychological symptoms due to the motor accident.
On 5 May 2021 the GP recorded that the claimant was very distressed about being unable to stand due to pain in the legs and a mental health care plan was created noting the claimant was suffering from depression due to persistent left leg pain causing an ability to work.
Ms van Praag, psychologist, noted the pain condition disturbed the claimant’s sleep. The psychologist noted the claimant did not have any work capacity relating to the underlying chronic pain and severe symptoms of depression.
The claimant was examined by Dr Parsonage on 30 June 2022 who noted that the claimant last worked in December 2018 and was in receipt of the disability support pension for a blood clotting disorder and secondary depression as a result of pain and restrictions caused by that condition.
Dr Parsonage considered that the claimant had a pre-accident adjustment disorder with depressed mood secondary to chronic painful blood clotting disorder which had been further exacerbated by the subject accident. Whilst he acknowledged the pre-accident functioning and lifestyles were restricted prior to the motor vehicle accident, the doctor considered that the pre-existing psychological condition gave rise to a 0% whole person impairment.
Dr Murphy, psychiatrist, was qualified by the insurer and provided a report dated
23 August 2022.
Dr Murphy found the claimant to be a credible historian and observed a range of emotions including that she became visibly distressed when speaking about the motor accident and consequences.
Dr Murphy said that there was a clear deterioration in the claimant’s mental health following the motor accident with the onset of intrusive thoughts, arousal, avoidance and mood symptoms. The doctor diagnosed post-traumatic stress disorder and noted the claimant had engaged well with treatment and no longer demonstrated any dysfunctional cognitions, typical depression or post-traumatic stress disorder.
Dr Murphy opined that the claimant’s earning capacity had not been changed by the motor accident and considered that she remained totally and permanently disabled due to the chronic pain and severe depression. He assessed whole person impairment at 6% and deducted 1/10 due to the pre-existing major depressive disorder. The insurer noted that the deduction for the pre-existing condition did not accord with the Guidelines.
The insurer submitted that the assessment provided by Dr Parsonage was inconsistent with the pre-accident medical records or the fact that the claimant was not working at the time of the accident and reported feeling suicidal.

Insurer’s submissions dated 4 April 2024[19]

These submissions sought leave to review the medical assessment.
The insurer submitted that the Medical Assessor failed to have due regard to the claimant’s pre and post-accident medical history as contained within the medical records and failed to address inconsistencies between the medical evidence and the history provided by the claimant as required by cl 6.41 of the Guidelines.
The insurer referred to the records from Victoria Point Medical and Dental Centre (GP) which recorded significant complaints of pain and physical restrictions relating to the claimant’s Protein and S deficiency and thrombosis prior to the motor accident. A statement by the GP dated 11 March 2019 reported that the claimant’s physical restrictions were permanent, she suffered from frequent panic attacks, her motivation and social interaction were reduced, and she was easily fatigued. The report noted that the claimant was depressed, cried a lot and was frustrated.
A Job Capacity Assessment of the claimant dated 29 August 2019 described chronic pain in the left leg and left arm relating to the blood clotting disorder, very limited standing tolerances, was reliant on a mobility walker and unable to attend to most domestic tasks. The claimant advised that should stop driving due to pain and slept during the day due to fatigue and had been referred to a pain specialist for an opinion on chronic regional pain syndrome.
An ADL assessment dated 12 December 2019 reported the effects of the motor accident, the claimant’s husband was a full-time carer and was in receipt of Centrelink benefits.
The Medical Assessor attributed all the post-accident psychological complaints to the motor accident included the reported significant ongoing anxiety with respect to travel, social withdrawal, loss of confidence and self-doubt.
The insurer noted the post-accident records which attributed at least some of the claimant’s psychological symptoms to her pre-accident condition. It referred to:
(a)    Report of Dr Nick Aitcheson. Pain and Rehabilitation Registrar at Metro South Persistent Pain Management Service. The doctor noted the history of left leg pain, her mood was not too bad and had failed to engage with physiotherapy or psychology.
(b)    Record with the GP on 5 May 2021 when the claimant reported being very distressed about being unable to stand due to pain in the legs. The GP completed a mental health care plan noting that the claimant suffered from depression due to persistent left leg pain causing an inability to work.
(c)    Report of Ms van Praag, psychologist, dated 15 May 2021 which referred to a 20-year history of chronic pain due to a blood clotting disorder which caused painful clots in the legs and disturbed the claimant’s sleep. The psychologist concluded that the claimant did not have any work capacity due to her chronic pain and severe symptoms of depression.
(d)    Report of Dr Parsonage dated 5 July 2022 which noted the claimant last worked in December 2018 would was in receipt of the disability support pension for a blood clotting disorder and secondary depression because of that condition. The doctor diagnosed post-traumatic stress disorder caused by the motor accident and considered that prior to the accident the claimant was suffering from an adjustment disorder with depressed mood secondary to the chronic painful blood clotting disorder which had also been exacerbated by the motor accident.
(e)    Report of Dr Murphy dated 23 August 2022 which recorded that the claimant had retired due to persistent pain in 2018 and was at that time suffering from severe depression and felt suicidal.
The insurer submitted that the Medical Assessor did not consider the GP records and did not address that some of the symptoms were unrelated to the motor accident. It was also submitted that the Medical Assessor failed the inconsistencies from the pre-accident medical records which referred to significant psychological symptoms and associated functional limitations with the history provided by the claimant.

RE-EXAMINATION

The Panel determined that the claimant be re-examined by both Medical Assessors. The examination report is as follows.
THE EXAMINATION
Ms Harris was assessed via audio-visual link through the MS Teams platform, organised by PIC. The Panel members were Dr Christopher Canaris and Dr Matthew Jones, who were in their respective rooms. Ms Harris was in her mother’s house in Wyee Point on the Central Coast. Ms Harris’ husband, Lance, was present for the majority of the assessment as a support person. He did not materially contribute to the assessment. Ms Harris was identified using her NSW Driver’s Licence. The assessment had a duration of one-hundred and ten minutes.
CONSENT AND CONFIDENTIALITY
The Panel informed Ms Harris that the examination was not confidential, that the certificate would be read by others and that no treatment advice could be provided. Ms Harris indicated that she understood the limits of confidentiality and continued with the assessment voluntarily.
INTRODUCTION
Ms Harris is a sixty-eight-year-old woman who normally lives with her husband, Lance, in Thorneside, a suburb in the Redlands Shire in Queensland. She has lived there for eleven years. Currently she is staying at her eighty-eight-year-old mother’s house in Wyee Point as her mother has taken ill recently and been admitted to Gosford Hospital.
Ms Harris’ income is in the form of the Old Age Pension through Centrelink. She does not currently work. She was previously a carer for Lance, receiving a carer’s payment for a period, until she became eligible for the Old Age Pension, which she believes was at the age of sixty-six and a half. Following retirement, Ms Harris said she received no benefit from income protection but did receive TPD benefits for about two years after she retired. She retired at sixty-one or sixty-two, therefore received this money until sixty-three or sixty-four.
With respect to Lance’s health, Ms Harris described it as “up and down.” She reported he will ultimately require a knee replacement. He has developed hip problems compensating for his knee, his walk is affected, and he does not wish to have further surgery. Lance required four operations following the motor vehicle accident.
Ms Harris reported that she was working prior to the accident for Michael Hill Jewellers as a safekeeper. She said she was “very responsible” and “very social”. She said that she was working full-time. The Panel asked if this was just preceding the motor vehicle accident and she then responded that she had retired perhaps the Christmas before the accident, therefore about ten months prior to the accident. Ms Harris was asked the reason she retired, and she said that she had a blood clotting problem which was affecting her legs. She said her job involved standing a lot. She said she had had her bike trip with her husband and then retired.
The Panel asked Ms Harris what her life was like for the ten months between retiring from Michael Hill and the accident, and she said that she and Lance had started to travel and that they had both retired. They had two Kombi vans, one of which was yellow and was involved in the accident. The other one was being restored. She said that the two of them were “going up and down the coast.” She said that they were very social, and they belonged to a Kombi club and a motorbike club, Ulysses. She commented they had a great social life, for example going to Old Bar for the comedy festival. She said it was nothing to get in the car with Lance and go for a drive. She said there was no fear and that “our life had become our own life.”
TREATMENT
Ms Harris reported she is taking Xarelto, a blood thinning medication. She also takes an anti-cholesterol medication. She takes Somac for reflux and also Lyrica for nerve pain.
With respect to regular clinicians whom Ms Harris attends, she sees a psychologist, Joanne, when she feels the need. The last appointment she had was approximately two weeks before the assessment. This is paid through iCare. She reported that soon after the motor vehicle accident she saw another psychologist, however during COVID she was not allowed to attend. She then lapsed a little with treatment and then returned to seeing the psychologist through iCare. She estimated she had seen the psychologist three or four times in the last three years. She finds that psychology is “not helpful’, however the psychologist suggests things that she should do.
With respect to physiotherapy, Ms Harris reported she is allowed five free sessions of physiotherapy in 2025, through her general practitioner. She has been attending this year and has been performing exercises. In 2024 she attended physiotherapy, but treatment was more in the form of manipulations for her chest.
HISTORY OF SYMPTOMS AND TREATMENT FOLLOWING THE MOTOR VEHICLE ACCIDENT
Ms Harris reported that the accident was “the end of the road for us.” She said that her sixteen-year-old grandson was in the backseat of the Kombi that they were driving. She said, recounting the story, “Do you know I actually died?”. She said that her son came to the front window of the Kombi attending the scene and was crying. They had been travelling to a family reunion at Nambucca, and she said that they “should have been able to go.” When the Panel asked Ms Harris how she knew that she “actually died”, she responded that people were saying that the occupants of her car had passed away and that other people thought that she was dead. Ms Harris reported she also believes she died at the accident as she saw an exceedingly bright light that overtook her visual field and then went away. Ms Harris went on to say that her life from that point is not her life. She said when she was sixty, she was riding a motorbike for six months around Europe. She said her life has changed. She said she worked up until the accident and that her “garden is just grass.” Near the end of the assessment, Ms Harris provided a detailed account of the itinerary that she and Lance followed on their bike tour around Europe.
With respect to physical injuries, Ms Harris reported that she fractured her sternum and also developed haematomas from a seatbelt injury. She said her leg was also caught in the door well. Her leg developed a haematoma but also ulcerated after the accident. With respect to her ribs and sternum, she was told there was physical overlap when the bones were healing. She said they still give her trouble. She said when she is stressed her pain is worse and she takes Lyrica for that pain.
Ms Harris reported that the main impact from the accident was the anxiety that she experienced. She informed us that her anxiety came from “the trauma of the accident.” She said now when she gets into a car she has to know exactly where she is going and can only travel to her “safe places.” She gave an example of being at her local shops. She said if the car deviates from the course, for example on the navigation map, an argument will start between her and her husband. She said she tends to “not move from [her] safe spot.”
Ms Harris reported she has a “huge fear of being in the car.” She said that she finds this terrifying and said that “people are crazy drivers.” She said that there is a particular place that they go past when driving and she notices that people place the nose of their car over the stop line, and it causes her anxiety.
Ms Harris reported that she had not developed any anxiety about any other particular stimuli.
PSYCHIATRIC HISTORY
The Panel enquired after Ms Harris’ psychiatric history. She said she experienced, “a bit of depression” because of pain in her legs. She said this was “all fine once [she] stopped working.” She said when the pain went away, her depression went away. She commented that “life couldn’t have been any better.” She denied having any treatment back then and denied any thoughts of self-harm.
CURRENT SYMPTOMS
Ms Harris reported that she does not “sleep of a night.” Her problem, she stated, was that she goes to bed around 10.00pm or 11.00pm and she is lucky to get two- or three-hours’ sleep. She said this is because she keeps re-living the car accident. She rhetorically asked, “How can a person be on holiday, not look to the right, and try to kill us?” She commented that she had been to Europe eighteen months prior to the accident and that she and Lance had shipped their motorbikes over there for a tour. She commented that she “didn’t kill a person.” She was frustrated and asked, why can’t hire car companies put warnings for overseas drivers. The other driver was looking to the wrong side, talking to his partner, and they drove into the back of their vehicle which had pulled out in front of them.
The Panel asked Ms Harris how her legs were currently, and she said that she is able to move when she wants to and can sit when she wants to. She said that movement was not the problem, but standing still was, which made her nauseous. She gave an example that if she is talking to people in shops, she is not able to stand for more than five or ten minutes.
Ms Harris reported she relives the accident every night she goes to bed, and it always goes through her mind. She said she blames herself for the accident because it was her family reunion they were attending.
The Panel asked Ms Harris to describe her experience of reliving the accident and she reported that if she sees a white sheet, it takes her back to driving into the back of the other car. She said then her “brain starts to go back into it.” She said her “brain doesn’t stop.” She said her concentration is lacking and she needs to concentrate to get back to sleep. She said her sleep pattern is unusual in that she can be in bed by 10.00pm or 10.30pm and tends to wake, she has noticed on a number of occasions, at 11.37pm. She will either not go back to sleep and will see 1.00am, 2.00am and 3.00am and by 4.00am she may go back to sleep after a struggle. She commented that she could previously sleep whilst travelling in the car, but now she has to be alert and awake. She said she needs “to be the other set of eyes.”
The Panel asked Ms Harris about her appetite, and she responded that she does not really bother too much with food. She will eat toast, sandwiches or “little box meals.” She reported that her weight before the accident was around 68kg and she is now 83kg. Her height is 5’7 or 8”. (Estimated current BMI of around 28 which is considered mildly overweight.)
With respect to daytime energy, Ms Harris reported she does not sleep in the daytime but will watch television. She said she previously would read a lot and previously sew a lot, but now does neither of these activities. She said she has trouble concentrating and said she also used to love crosswords and has trouble with these. She said she is unable to garden because it is painful.
Ms Harris reported that she loves her children and grandchildren “to pieces.” She reported she feels she is missing out on their lives. She described a “real sense of loss” and said that she was not like this before. She said she used to be “the fun girl.”
Ms Harris reiterated that she had “a huge fear of travel.” She told the Panel that she was only depressed if, or because, she is thinking that she is missing out on things.
CURRENT FUNCTIONING
Ms Harris reported that she and Lance no longer drive up and down the coast and are no longer “social”. She reported that she will watch television, for example the Black Mirror series. She said that she had rewatched Lord of the Rings and also watches Star Wars shows. She tends to watch television with Lance.
The Panel asked Ms Harris how else she spent time, and she said she may go to the shops to buy groceries once or twice a week. She said that she does not travel in the car very well and that nobody wishes to have her in the car. She described herself as “a nightmare” and that her nickname is “Mrs Bucket.” She reiterated that she was “not very good in the car.”
Ms Harris has a driver’s licence but said she had not driven. She corrected this and said she would be lucky to have driven two-hundred kilometres in total since the accident. She commented that Lance had a heart attack in October 2024 and Ms Harris was unable to drive to the hospital. She would walk a kilometre and a half to the train and catch the train to Brisbane. He was in RPA (Brisbane) Hospital for two weeks. She said on one occasion, the train stopped, and the passengers were put on buses, but she was unable to do this. She recalls sitting in the gutter and ringing her son. She said because of the confusion she felt she was unable to change from the train to buses. She ultimately did travel to the hospital with her son. Lance ended up having coronary artery bypass grafting, which at the time was very concerning, but Ms Harris said he is now “perfect.”
Ms Harris and Lance do not receive any aged care assistance. She said that iCare provides some house cleaning every two weeks, and some lawnmowing and periodic gutter clearing and window cleaning.
Ms Harris reported that she is independent with respect to her self-care and personal hygiene but offered that she had “become very lazy with it.” She said she no longer irons clothes and no longer cares if she showers each day. She said she washes her hair every one or two weeks and does not bother combing it. She said she had previously never had long hair. She said she does not put make-up on and implied she used to take care with her hair having been a hairdresser for thirty years prior to working for Michael Hill. She said she is not going out anymore and there is no point in grooming.
The Panel asked Ms Harris what she did for meals, and she said she usually eats “a box meal” which she informed us was a prepared meal bought from the supermarket and kept in the freezer. They are prepared by microwave. She described them as “really nice.” Otherwise, she will have toast and vegemite. She said she does not bother to cook from scratch and said she does not particularly care, and it is only Lance and her.
With respect to family members, Ms Harris reported she and Lance have three children, two live in Brisbane and from these two children there are eight grandchildren. The other child lives in Proserpine and has three children. In total, there are eleven grandchildren. Ms Harris reported that she used to see her grandchildren and children regularly but not since the accident. She said she does not “really travel to see them.” She said her children and grandchildren do not travel because they are busy in their own lives. Ms Harris and Lance used to be more involved in their grandchildren’s lives. She reiterated that these days she does not tend to get in the car and referred to “the unknown factor, the risk factor, the people on the road who don’t care.” One son lives in Eagleby, which is thirty to forty minutes’ drive away, and another son, Matthew, lives at Camp Hill, which is twenty to thirty minutes’ drive away. She said that Matthew is very busy at the moment with a young child.
Ms Harris reported that if she is asked, she will look after the grandchildren, however “it has to be really important.” She commented that her granddaughter had turned twenty-one and Ms Harris could not bring herself to attend her birthday celebrations. This was two years ago. She added that she was unable to come down for Mother’s Day, Christmas or her mother’s birthday. She reiterated that she needs to work herself up to get into the car. She said Lance is “pretty fine” when it comes to driving, however it is Ms Harris who is “his nightmare.”
Ms Harris reported that her siblings live on the Central Coast, and she has a sense of loss about these relationships because she does not get in the car and travel to see them (although she was currently on the Central Coast and had travelled there because of her mother’s failing health).
Ms Harris reported that her “social life has gone.” She said she does not have coffee with friends anymore, even though she does want to do this. She also no longer socialises with the bike club. She said that she sits at home, and it is her “safe place.” Other than being at home, she will travel to her doctors, the shops and also travel to get fish and chips with Lance, which is in Cleveland.
With respect to her friends, Ms Harris said they used to come and visit, however they are now “sort of not interested.” She said that she herself has “just become unsociable.” She reiterated the theme that she gets a lot of anxiety getting in the car to go places. She said if someone visits, she will not answer the front door if she is not dressed properly, because she can be in her pyjamas in the middle of the day. She reported she has no phone contact with friends and said that she does not really need to know what they are doing. She said she does not want the feeling of missing out. She said she is not on any social media, but her husband has Facebook, essentially to look at Kombis.
Ms Harris has phone contact with her children and grandchildren and her brother and sister. She said when she and Lance do come down to the Central Coast, they will come to her mother’s house. The last time was in October 2024. They had intended to come down for Christmas, however they stayed at home for Christmas. When they are at her mother’s, the other family members will come to her mother’s to socialise.
Ms Harris reported that she and Lance have an Isuzu Ute with a large bull-bar. Ms Harris reported that she will not let Lance travel by himself. If he goes to hospital for a blood test, she will always be in the car with him. She said wherever he is, she is.
Ms Harris reported that she had not been to her local Woolworths since the accident, however travels to another set of shops because she prefers the carpark there.
The Panel asked about future treatment, and Ms Harris reported she is intending to continue seeing Joanne, the psychologist. Ms Harris reported the plan is to see her at least every month. She believes that iCare will allow her six or eight sessions at a time. Ms Harris told the Panel that she “really want[s] to get over it.” She said she knows that Lance gets frustrated and said the two of them should be doing more than they are doing. She believes that she holds them back. She reiterated that she “can’t get in a car.” She reported that she feels a bit safer in a bus and does not feel anxiety in trains, because they are “simply on rails and you get there and then you hop off them”.
Ms Harris has been recommended psychiatric medications on many occasions; however, she does not want to take them. She said the reason for this was that she had “been a hairdresser” and seen how medications affect people. She said that compared to taking medication, she would rather be the person that she is and sit on the couch and stay at home and be safe. She said she would like to be there for her grandchildren’s twenty-first birthdays and then said that she would like to have her life back to how it was.
CONSISTENCY
The Panel attempted to cross-check some details of documented history with Ms Harris’ reported narrative. The Panel referred to presentations with the symptoms of depression following her retirement and predating the accident, and Ms Harris clarified that her depression became much more under control when she was able to manage her pain levels. She reported she tended to differentiate the depression she was experiencing due to her leg pain and her work, from her anxiety and “trauma” related to the motor vehicle accident. She said she is able to “separate the two.”
The Panel pointed out that in March 2019, Ms Harris was reporting frequent panic attacks, decreased motivation, being easily tired, crying a lot, amongst other symptoms, and Ms Harris simply responded that she did not cry a lot, and that she was happy watching television. She reported that the pain in her legs was very intense and that she has “post thrombotic syndrome.”
The Panel asked Ms Harris what changed in her life after being as depressed as she appeared to be historically, and she said that she “started doing stuff.” She said she “had a social life, started travelling and had the Kombi club.” Ms Harris confirmed that she was receiving the Disability Support Pension before the Old Age Pension. When the Panel pointed out there was an ADL assessment on 23 December 2019, with reference to Ms Harris being driving independently, she responded that perhaps she did not understand the question back then. She reminded the Panel of how difficult she was as a passenger and said that she is “a nightmare” and that she and Lance “end up in a fight”, when in a car.
MENTAL STATE EXAMINATION
Ms Harris was assessed through audio-visual link. She appeared of Caucasian origin, wore spectacles and had longish grey hair which was tied back. She had rings on her fingers and wore a pink top. She was polite, cooperative and attentive and displayed no abnormal movements. Her speech was normal and there was no evidence of formal thought disorder or delusional thought processes. She denied any thoughts of self-harm or suicide, but said she has “no care factor about living or dying.” There was no evidence of thoughts of harm to others. Her mood was restricted and appeared fearful and agitated. Her affect (expressed emotion) was mildly irritable, but otherwise reactive, congruent and appropriate. Her cognition, insight and judgement appeared intact in the context of the assessment. Rapport was limited but sufficient to facilitate the assessment.
DIAGNOSIS
The Medical Assessors came to the opinion that Ms Harris had longstanding mental health problems prior to the motor vehicle accident and that these would be best described, particularly in the period leading up to the motor vehicle accident, as a chronic Adjustment Disorder with mixed anxiety and depressed mood. It would appear from the available documentation and Ms Harris’ reported narrative, that her symptoms, at least in the substantial period leading up to the motor vehicle accident, were a response to her pain and frustrations with her medical conditions. The severity of her Adjustment Disorder appears to have been mild, as she was able to continue to function in multiple domains of daily living activities.
With respect to psychiatric illness caused by the motor vehicle accident, the Medical Assessors agreed that an injury had indeed occurred. There is evidence for a Post-traumatic Stress Disorder having developed, given the intensity and traumatic nature of the accident (criterion A under DSM-5-TR), the reported experience of intrusive and distressing memories of the accident which are ongoing (criterion B), Ms Harris’ general avoidance of travel in a motor vehicle, which is a reminder of the motor vehicle accident (criterion C), various negative alterations in cognition and mood including that Ms Harris is no longer the person she was, that her and her husband’s life had “come to the end of the road”, guilt about the accident, a stated belief that the other driver had tried to kill them, and reduction in significant activities, particularly socially (criterion D). Ms Harris also reported considerable hypervigilance, particularly when in a motor vehicle, some reduction in her ability to concentrate, and sleep disturbance (criterion E). It is apparent that Ms Harris has, or had experienced, these symptoms for more than a month, symptoms have caused clinically significant distress and impairment, particularly in areas of social functioning, and that her symptoms were not the effects of a substance or another medical condition (criteria F, G and H).
Of more prominence clinically at the time of the assessment (although absolutely consistent with her experience of Post Traumatic Stress Disorder) was that Ms Harris would satisfy diagnostic criteria for a Specific Phobia, related to driving and car travel.
She satisfies DSM 5-TR diagnostic criteria in the following ways. Ms Harris has a marked fear and anxiety about the specific situation of driving or being a passenger in a car (this was a predominant theme of her interaction with the medical assessors). This satisfies criterion A. The thought of, or reality of, travelling in a motor vehicle reportedly always provokes the experience of anxiety and fear (criterion B). Ms Harris’ fear and anxiety appear to be out of proportion to the actual danger posed by driving or travelling in a car (criterion C), and driving or travelling in a car is actively avoided by Ms Harris, however when it occurs it is endured with intense fear or anxiety (criterion D). Ms Harris’ fear, anxiety and avoidance regarding driving and travelling as a passenger causes her clinically significant distress and impairment, particularly with respect to social functioning (criterion E). Ms Harris’ fear, anxiety and avoidance are persistent and have had a duration of several years (criterion F). As mentioned above, this significant overlap with Ms Harris’ experience of Post Traumatic Stress Disorder, however Ms Harris’ symptoms and experience would satisfy standalone diagnosis (criterion F has been considered). This is essentially an academic and somewhat moot point, particularly given the purpose of the review.
IMPAIRMENT
The medical assessors considered that there was likely a pre-existing psychiatric illness, the most apt diagnosis under DSM 5-TR being an Adjustment Disorder with Mixed Anxiety and Depressed Mood, and that there was some degree of low-grade permanent impairment associated with this. The Panel has assessed the pre-existing whole person impairment as 0%, considering that there was no evidence of functional impairment with respect to self-care and personal hygiene (Class 1). There was also no evidence of impairment in functioning with respect to social and recreational activities (Class 1). Ms Harris reported that she was driving and travelling freely and independently prior to the motor vehicle accident (Class 1 for travel). Ms Harris had an intact marriage, ongoing social relationships with friends, and close contact with her extended family (Class 1 for social functioning). There is no evidence to suggest there was any functional impairment with respect to concentration, persistence and pace from a psychiatric point of view (Class 1). Although Ms Harris had retired and had some physical problems leading to this, the Panel formed the view that Ms Harris would have had reasonable adaptive functioning from a mental health point of view (Class 1). The medical assessors concluded that there was a 0% whole person impairment for pre-existing impairment.

DEGREE OF PERMANENT IMPAIRMENT

Pre-existing Whole Person Impairment:

Psychiatric diagnoses	1. Adjustment Disorder with Mixed Anxiety and Depressed Mood	2.
Psychiatric diagnoses	3.	4.
Psychiatric treatment description	Nil

Category	Class	Reason for Decision
1. Self Care and Personal Hygiene	1	No deficit. There was no evidence of functional impairment with respect to self-care and personal hygiene.
2. Social and Recreational Activities	1	No deficit. There was no evidence of impairment in functioning with respect to social and recreational activities.
3. Travel	1	No deficit. Ms Harris reported that she was driving and travelling freely and independently prior to the motor vehicle accident.
4. Social Functioning	1	No deficit. Ms Harris had an intact marriage, ongoing social relationships with friends, and close contact with her extended family.
5. Concentration, Persistence and Pace	1	No deficit. There is no evidence to suggest there was any functional impairment with respect to concentration, persistence and pace from a psychiatric point of view.
6. Adaptation	1	No deficit. Although Ms Harris had retired and had some physical problems leading up to this, the Panel formed the view that Ms Harris would have had reasonable adaptive functioning from a mental health point of view.
List classes in ascending order: 1,1,1,1,1,1,
Median Class Value: 1
Aggregate Score: 6
Pre-existing % Whole Person Impairment: 0 %

With respect to current whole person impairment, the Panel’s opinion is as follows:
Current Whole Person Impairment:

Psychiatric diagnoses	1. Specific Phobia related to driving, and a second diagnosis of Post Traumatic Stress Disorder.	2.
Psychiatric diagnoses	3.	4.
Psychiatric treatment description	Infrequent psychological therapy

Category	Class	Reason for Decision
1. Self Care and Personal Hygiene	2	Mild impairment Ms Harris is independent with respect to her self-care and personal hygiene. She reported that she is taking less care with her appearance and washes and grooms herself less frequently. She is able to feed herself with respect to simple meals such as prepared meals, toast and sandwiches. In the Panel’s opinion, Ms Harris would be able to live independently but may look unkempt occasionally and sometimes miss a meal or rely on take-away food. Her reported functioning was consistent with a class 2 mild impairment.
2. Social and Recreational Activities	3	Moderate impairment Ms Harris appeared to particularly enjoy watching television and spending time at home. She complained of no longer attending social events and having withdrawn somewhat from her friendships. There has been a reported decline in her social activity when compared to prior to the subject motor vehicle accident (for example, socialising with her Kombi and motorcycle clubs and visiting friends). Much of her reduction in socialising is due to her reluctance to travel by car. Even though she is capable of travelling by other forms of transport, Ms Harris has still not returned to her previous socialising. Taking into account all factors, the Panel considered that Ms Harris had a class 3 moderate impairment in this category.
3. Travel	2	Mild impairment Ms Harris has driven independently, infrequently, subsequent to the motor vehicle accident. She estimated that she had driven a motor vehicle less than two-hundred kilometres in the previous five years or so. She generally has a travel repertoire of a few familiar places, however, has travelled longer distances as a passenger when required (for example: she has recently journeyed from Queensland to the Central Coast of NSW as her mother fell ill). Ms Harris can travel as a passenger but described considerable anxiety during that process. In fact, she said that she does not allow her husband to travel anywhere by himself due to fear for his safety on the road. Outside of motor vehicles, Ms Harris has been able to travel independently on public transport but prefers not to venture out of her home or her “safe places.” She finds travelling on buses more tolerable than travelling in cars, and she reported minimal anxiety with respect to travel by train. Taking into account all factors, the Panel considered that it was a class 2 mild impairment in this category.
4. Social Functioning	2	Mild impairment Ms Harris maintains her longstanding marriage with her husband, Lance. This appears to be a close and mutually supportive relationship. Ms Harris has close emotional bonds with her children and grandchildren, however, is limited in her contact with them due to her fear and anxiety related to travelling in a car. She reported that her social network has drifted somewhat due to her lack of socialising (for example with previous club involvements). There have been no periods of separation or domestic violence associated with her marital relationship. Taking into account all factors, there is a class 2 mild impairment here.
5. Concentration, Persistence and Pace	2	Mild impairment Ms Harris presented at the examination as consistent with having a mild impairment with respect to concentration and focus. She was able to concentrate for the lengthy assessment (110 minutes), was able to recount the multi-stop itinerary of her bike tour in Europe, over five years previously, and appeared to display good memory and attention to detail with respect to her narrative. She also reported that she would happily watch television all day without any difficulties. Ms Harris also reported that when she travels in a car with her husband, she is hyperalert and hyper-focused, secondary to her hypervigilance and anxiety. On the other hand, Ms Harris reported that she lacks sufficient concentration to read for any length of time, nor partake of previous hobbies such as sewing, which required some fine concentration. Notwithstanding physical challenges (for example inability to stand for any length of time without developing pain), which were not taken into account in this assessment, the Panel considered that there were some psychological symptoms, for example anxiety, that would interfere with Ms Harris’ persistence and pace. Ultimately, taking into account the descriptors in the PIRS, Ms Harris best fits a class 2 mild impairment.
6. Adaptation	3	Moderate impairment Ms Harris was not employed prior to the motor vehicle accident and received benefits due to Total and Permanent Disability associated with her various medical and physical problems which rendered her unable to work. Her adaptive roles, with respect to this category, in the period leading up to the motor vehicle accident were more so as wife, mother, grandmother, and social community member. Ms Harris continues in these roles but is hampered by her anxiety related to travel and therefore has reduced capacity to actively participate as a grandmother, for example, however she still assists when there is an urgent need. She maintains an active and supportive role in her marriage. She maintains social connections with her children; however they are busy, and Ms Harris is less able to travel to them to visit. Ms Harris reported she is no longer an active participant of previous social clubs due to her reluctance to travel and feelings of fear outside the home. Taking into account all factors, the Panel considered there was a class 3 moderate impairment, consistent with Ms Harris being capable of fulfilling some of her previous adaptive roles, however to a lesser degree and a qualitatively different way, and with a capacity less than twenty hours per week (compared to the hypothetical forty hours per week previously).
List classes in ascending order: 2 2 2 2 3 3
Median Class Value: 2
Aggregate Score: 14
% Whole Person Impairment: 7%

*%WPI ^{= Percentage Whole Person Impairment}
Apportionment
There was a pre-existing impairment, however this was assessed as 0%.
There was no subsequent impairment, therefore no adjustment for such.
Effects of Treatment
There was no effective ongoing psychological or psychiatric treatment. Therefore, no treatment effect.
Final Whole Person Impairment
7%.

FINDINGS

The Panel conducts a new assessment of all the matters with which the medical assessment is concerned.[20]
The Panel, comprised of two specialist medical practitioners, is not required to choose between competing medical opinions and is required to form its own opinion: Insurance Australia Group Ltd v Keen[21] and Insurance Australia Ltd v Marsh.[22]
The Panel adopts the detailed examination findings made by both Medical Assessors with the additional further short observations.
Clauses 6.214 and 6.215 of the Guidelines note that the assessment of psychological injury does not include any allowance for “impairment due to physical injury” and “impairments due to somatoform disorders or pain”.
The claimant’s ongoing physical restrictions have not been considered in assessing the impairment due to psychological injury.
We note the submissions on the assessment of adaptation as the claimant was not in employment at the time of motor accident and there were pre-existing references to the claimant being totally disabled. Clause 6.220 of the Guidelines relevantly provides:
“The medical assessor should obtain a history of the injured person’s pre-accident lifestyle, activities and habits, and then assess the extent to which these have changed as a result of the psychiatric injury.”
We have considered the extent to which the claimant’s adaptation has changed due to the ongoing psychological condition.
Our assessment differs slightly from that made by the original Medical Assessor. Noting the time since the previous medical assessment and our requirement to assess at the present time, we have explained the reasons for our assessment.

CONCLUSIONS

The certificate issued by Medical Assessor Roberts dated 15 March 2024 is revoked. The new certificate is attached at the commencement of these Reasons.

[2025] NSWPICMP 435

19 June 2025