austlii:nsw/NSWPIC/2025/186
General information, not legal advice.
NSWPIC
2025-05-05
Original judgment source is linked above.
AAI Limited t/as AAMI v Simpraga [2025] NSWPIC 186
MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; motor vehicle accident; claims assessment; damages for economic loss; damages for future economic loss; most likely future circumstances; pre-existing condition; 70-year-old claimant was injured in a motor vehicle on 2 January 2022; injuries to cervical, thoracic and lumbar spine, both shoulders, left knee; both hips, anxiety and depression; prior accidents; following 2016 accident compensated on basis no past or future work capacity until age 67 years; - no capacity to maintain longer term employment where not fully recovered and given age; buffer of $20,000 for impairment past earning capacity; no change in most likely future circumstances.
**Issued under s 7.36(1) of the Motor Accident Injuries Act 2017
Assessment of Claim for Damages made in accordance with s 7.36 of the Act**
I specify the amount of damages for this claim as $20,000. 3. The amount of the claimant's costs, taking into account the amount of damages assessed in respect of this claim, assessed in accordance with the MAI Act is $12,541.10 inclusive of GST. 4. Attached to this certificate are reasons for my assessment.
(a) injury to the neck;
(b) injury to the thoracic spine;
(c) injury to the lumbar spine;
(d) injury to both shoulders;
(e) injury to hips;
(f) injury to the left knee, and
(g) anxiety and depression, symptoms consistent with post-traumatic stress disorder.
(a) past economic loss, and
(b) future economic loss.
Mr Simpraga states he had a claim which was settled in his favour. 2. Mr Simpraga denied he was injured in a car accident in 2003 or that he fell off a ladder in 2009. 3. In terms of his general health Mr Simpraga reported he had Type II diabetes which is controlled by medication. 4. The accident on 3 January 2022 occurred when he was a front seat passenger in a vehicle hit from behind. He stated he has been suffering anxiety and depression since the accident with flashbacks and disturbed sleep. He also described severe physical injuries. 5. He states he consulted his general practitioner Dr Tomka the following day, although it should be noted Dr Wong asserts the first consultation following the accident was on
10 January 2022. Certainly, the clinical notes of Dr Tomka disclose a consultation on
10 January 2022, although the claimant's wife Bozana Simpraga states she took her husband to see Dr Tomka the day after the accident. 6. Mr Simpraga states he had not worked since the 2016 accident other than a trial he says he completed with a formwork carpenter Sasha Uzelac in about April or May 2021 which lasted for a couple of days and for which he was paid $50 per hour. He states the business then went into lockdown due to the COVID-19 pandemic but had that not occurred he would have continued working. Mr Simpraga asserts it was his intention to work until at least 70 years of age. Mr Simpraga asserts he would have earnt $1,500 net per week if he had been able to undertake work as a formwork carpenter and gyprocker. 7. Mr Simpraga states as a result of the accident he is totally incapacitated for work. 8. Mr Simpraga provided a supplementary statement dated 26 March 2025. He stated the agreement he had with Mr Uzelac was he would be paid $50 per hour under an ABN. He stated:
"I had worked for Mr Uzelac in the past and he was aware of my capabilities but he told me that due to my previous injuries he wished to observe my work to ensure I could work to the same standard as before."
...I do recall being paid for the gyprocking work I performed for Mr Uzelac. I recall being paid in cash."
"The claimant understands there is an allegation that he was involved in another motor vehicle accident in 2003. He denies this."
Dr Habib he replied "possible". Mr Simpraga also agreed it was possible he complained about neck pain down his arms to Dr Reid in September 2004. Mr Simpraga initially stated he continued working after the 2003 accident although he subsequently agreed he may had stopped working for a short time. 4. I suggested there were, in fact, two motor vehicle accidents in 2003. Mr Simpraga agreed there was another accident which occurred in Mascot. When asked if he had pain after the first two accidents Mr Simpraga replied, "very little". When asked where he experienced pain Mr Simpraga said he did not remember, and he agreed he did not have a good recollection of those two accidents. 5. Mr Simpraga was questioned about the 2009 workplace accident. He stated he had a little pain; he took sick leave, got better and went back to work. When he was reminded, he was off work for about three years Ms Simpraga said his absence was also because there was not much work at that time. Mr Simpraga denied he returned to work on light duties because he was unfit for heavy lifting, suggesting he would not have returned to work if he had big injuries. 6. In relation to the 2016 accident Mr Simpraga agreed it was a heavy collision, and he had neck pain, headaches, and pain to both shoulders. He also agreed his hips hurt after the 2016 accident, he had low back pain and problems with his left knee. 7. Mr Simpraga agreed he was anxious in traffic after the 2016 accident, and he experienced nightmares. However, he did not agree he was drinking more than a bottle of wine a night as recorded by Dr Kuljic. He stated he never drank wine. 8. Mr Simpraga agreed he applied for the Disability Support Pension (DSP) in 2016 because of the injuries to his knee, hip and back. He stated he was still on sick leave at that time but did not agree he had no intention of returning to work. 9. Mr Simpraga was asked about the evidence he gave at the assessment conference in 2018 in respect of his claim arising out of the 2016 accident. When asked whether he said that his symptoms were not getting better Mr Simpraga said he was scared they would not get better, but then stated his symptoms were getting better at that stage. However, when it was put to him that he did not say his symptoms were getting better at the hearing in 2018 he stated, "that was in 2018, but in 2019 and 2020 getting better". 10. Mr Simpraga stated he returned to work in 2021. He said he worked at Mr Druitt Westfield in March in gyprocking and carpentry work. He said he worked three days and then Corona occurred. 11. Mr Simpraga said he knew the boss, Sasha Uzelac. He said he worked with him about 10 years ago on other jobs including at Hornsby and at Nowra Airport. He said he knew
Mr Uzelac now had his own company. Mr Simpraga described the work with Mr Uzelac as a work trial to see if he could work because he had been off work. 12. Mr Simpraga said he and Mr Uzelac were not friends, but he had seen him between 2015 and 2021 in Liverpool, at parties and socially "a little" outside work. 13. In relation to domestic chores Mr Simpraga stated up until 2016 he undertook chores with his wife but after 2016, he was restricted. Mr Simpraga conceded that he was not doing heavy housework at the time of the accident, only light tasks. When asked how he could return to formwork if he was not able to do house chores Mr Simpraga stated he had recovered 90%. 14. Mr Simpraga stated he was paid cash for the work trial. He worked eight hours a day for two or three days. When asked what work he did Mr Simpraga replied "everything, gyprock, carpentry" and noted the boss was happy he had all the tools. 15. When asked whether he looked for any other work after the work trial in March 2021 and before the accident in January 2022, Mr Simpraga replied "I don't remember I did".
Mr Simpraga had not worked between 2016 and 2021. 5. Mr Uzelac said he did not work alongside the claimant, but he walked around the site to check the work. 6. Mr Uzelac said he paid the claimant by cash, a cash cheque, or payment by EFT. He said he only worked two or three days, and he probably gave him cash on the day. He said he would have paid him $45 to $50 per hour. 7. Mr Uzelac said the construction industry totally shut down in March 2021. Mr Uzelac said he had been happy with the claimant's work. 8. Mr Uzelac did not contact the claimant after the restrictions were lifted to offer him work.
"On the way from Goulburn to Sydney near Moss Vale on Hume Highway I was a front seat passenger in a car driven by a friend. Because of a heavy rain condition we had to stop aside the road as many other vehicles did in order to avoid any dangers with driving in poor visibilities. While stationary another car coming from behind and with high speed hit our car from behind. From the impact our car was displaced app 10 metres."
14 December 2000 to 2 September 2010. The claimant complained of back pain, neck pain, bilateral foot pain, left knee pain and left shoulder pain. The records record the claimant was involved in a motor vehicle accident on 22 February 2003. 2. A discharge summary of Prince of Wales Hospital dated 15 December 2009 refers to the claimant's attendance following a fall. He fell landing on his left knee with a metal frame hitting his back. He reported pain in the thoracic and lumbar spine as well as the left knee. 3. In a report dated 6 April 2010 Dr Matthew Giblin advised that a bone scan showed degenerative arthritis at L4 and in both AC joints and both greater trochanters. An X-ray of his right shoulder confirmed arthritic change of the AC join. An MRI scan of the whole spine showed a small right disc protrusion at C5/6 with no significant nerve root pressure and minor disc bulging in the lumbar spine at L4/5 and L5/S1. An MRI scan of the left knee confirmed an old ACL injury and a small peripheral horizontal tear of the body of the medial meniscus. 4. On 26 August 2010 Associate Professor John Ireland, orthopaedic specialist noted that the claimant injured his back and right shoulder in the workplace injury on 14 December 2009. He also had pain and swelling of the left knee. He thought the claimant had sustained a tear of the meniscus but also noted an old ACL (anterior cruciate ligament) injury. A/Prof Ireland performed an arthroscopy of the claimant's left knee. 5. In a report dated 8 November 2010 Dr Henry Lam, pain medicine specialist, opined that the claimant suffered from a chronic persistent pain condition. 6. On 15 December 2010 Dr Giblin noted that the claimant underwent a left knee arthroscopy with some benefit. The claimant was complaining of bilateral shoulder discomfort. 7. Following a motor vehicle accident on 16 March 2016 (the 2016 accident) the claimant underwent physiotherapy with Holistic Physiotherapy for injuries to his neck, shoulders, back, left elbow, left knee and left hip. 8. An MRI of the cervical spine of 18 May 2016 noted cervical spondylosis with degenerative changes at C5/6. 9. An MRI of the right shoulder of 18 May 2016 reported:
"hypertrophic AC joint arthropathy. Minimal subacromial bursitis. Mild subscapularis and supraspinatus tendinopathy. Posteroinferior as well as superior labral tear."
9 August 2021 Dr Tomka reported the low back pain was better.
2 January 2022. Dr Tomka reported Mr Simpraga complained of pain in his neck, both shoulders, the upper and lower back and the left knee. He also complained of dizziness and headaches. On examination Dr Tomka noted limited range of motion in the neck and both shoulders and muscle spasm in the upper and lower back. He reported the left knee was swollen and tender. 2. An ultrasound of the shoulders on 17 February 2022 revealed bilateral supraspinatus tendinosis, without a tear and subacromial bursitis. 3. An MRI of the whole spine on 17 February 2022 revealed a posterior central/right paracentral disc protrusion at C5/C6 causing mild canal stenosis and potential impingement of the right C6 nerve root. In the thoracic spine there was a Schmorl's node at T8 with no structural abnormality. In the lumbar spine there was a minimal disc bulge at L1/2 without stenosis, facet arthrosis at L3/4 and at L4/5 a broad disc bulge with mild canal stenosis and indentation of the right thecal sick with slight lateral recess stenosis. There was no abnormality at L5/S1. 4. In a report dated 3 December 2024 Dr Tomka reported he has continued to treat
Mr Simpraga every month from 2022 to 2024. Dr Tomka diagnosed the following injuries as a result of the accident: * post-traumatic mechanical derangement of the cervical, thoracic, and lumbar spine due to musculo-ligamentous sprain associated with pain, stiffness and muscle spasms; * chronic pain and restricted range of movement in both shoulders; * post-traumatic symptoms secondary to contusion in both hips; * post-traumatic tenderness and swelling with chronic pain in the left knee, and * vertigo symptoms that developed post-accident. 5. Dr Tomka reported there were no pre-existing injuries that could explain the current symptoms, notwithstanding he has been the claimant's treating general practitioner since January 2015. He reported medical imaging confirmed findings compatible with the clinical presentation including aggravation of underlying age-appropriate degenerative changes. 6. Dr Tomka concluded, considering the claimant's persistent pain and physical limitations, his age and his limited capacity for retraining he was permanently unfit for work. 7. Clinical notes of Holistic Physiotherapy show the claimant underwent physiotherapy treatment to his neck, shoulders, upper and lower back and left knee between
"Mr Simpraga was able to gain work after arriving in Australia in 1999, He started heavy manual work as a "roofer" then moved on to heavy manual work as a Formworker ...progressing to Formwork Carpenter work on construction sites. He continued in this occupation up until the Covid-19 pandemic forced him off work then before the MVA he was offered formwork with an employer of which he was about to commence."
"At the time of the MVA he had been off work since 2019 due to Covid, however he had received an offer (verified document) to return as a Formwork Carpenter. Wanted to work to at least 72 years of age to get some superannuation."
Dr Rosenthal noted that the claimant's prognosis in 2017 was poor. He concluded it was not clear the claimant had made a sudden recovery from chronic pain symptoms and based on the assessments of Dr Dixon and Medical Assessor Wijetunga he was unfit for work. Accordingly, he concluded the accident had not impacted on the claimant's fitness for work. 2. He concluded Mr Simpraga may have developed soft tissue injuries to the cervical spine, thoracic spine and lumbar spine, and possibly the bilateral shoulders, bilateral hips and left knee caused by the accident. However, he considered those injuries had resolved and any ongoing complaints were due to the pre-existing conditions and pre-existing degenerative changes. 3. Dr Rosenthal found the claimant was unfit for manual work prior to the accident and that the accident had not impacted his fitness for work.
Mr Uzelac that he was not aware the claimant had not worked since 2016 or that he had sustained serious injury in a motor vehicle accident in 2016. 10. I am satisfied having regard to the corroborative evidence of Mr Uzelac and Ms Simpraga that the claimant was keen to return to work and that the work trial he undertook with
Mr Uzelac in March 2021 was to establish whether he had the capacity to maintain full time employment as a formwork carpenter and/or gyprocker. 11. I find the evidence of the claimant is unreliable and should be treated with caution.
Dr Tomka I am satisfied having regard to the aggravation of his pre-existing condition caused by the accident that the claimant is now and has been since the accident unfit for work.
"He last worked in 2017 as a formwork carpenter and went on the old age pension in 2022. He had intended to return to some form of employment in the building industry as a formwork carpenter but because of the accident the subject of this claim, he was unable to do so.
Further he was not able to work from February 2020 because of the Corona Virus in any event, however, he now makes a claim for loss of earning capacity as a formwork carpenter. Formwork carpenters earn on average $2.000 per week clear. He claims a loss of $50,000 for economic loss and so amends his claim. He also says that he would have worked to at least age 72.
$2,000 per week from 3 January 2022 for 2.5 years to 1 July 2024 = 130 weeks: $260,000."
Dr Dave, orthopaedic surgeon in February 2021, one month before the work trial, in relation to both hips. Dr Dave diagnosed left trochanteric bursitis. 13. I do not propose to make any allowance for future economic loss having regard to the provisions of s 4.7 of the MAI Act which states no allowance may be made for future loss of earning capacity unless the claimant establishes that the accident has caused a change in his most likely future circumstances. The claimant is now 70 years of age. Even if the accident had not occurred, I am not satisfied having regard to the claimant's underlying health conditions there was any likelihood he would still have been undertaking heavy work as a formwork carpenter or gyprocker. I am not satisfied the accident has caused a change in the claimant's most likely future circumstances. 14. In cases such as Medlin v State Government Insurance Commission[3] and Husher v Husher,[4] the High Court confirmed that the fundamental questions to be determined in a case such as this, are whether the claimant has sustained a loss or diminution in her earning capacity and, if so, whether that loss or diminution will result in economic loss. 15. I consider a small buffer to be appropriate where I am satisfied the claimant engaged in a work trial and demonstrated an intention to attempt a return to work. However, having worked only two or three days it is uncertain how long Mr Simpraga would have been able to maintain full time consistent employment. Mr Simpraga was already 66 years of age, his wife indicated it was a trial to see how he coped with full time work, and even Mr Simpraga conceded he had not returned to the heavy domestic chores he undertook before the 2016 accident. It is also clear from the evidence of Ms Simpraga that Mr Simpraga's English skills precluded the possibility of light duties, meaning he was limited to the only work he was qualified to perform by reason of his experience and that is the heavy manual work of a formwork carpenter or gyprocker. Significantly, Mr Simpraga had already been compensated based on total incapacity for work until age 67 following the 2016 accident. 16. Where it is difficult to assess the impact of the injury upon the claimant's earning capacity but where I find he might have otherwise undertaken work for a limited period of time I consider it appropriate to award a buffer of $20,000 for the impairment of his earning capacity, inclusive of loss of superannuation benefits.
Past loss of earnings (including superannuation) $20,000
[1] Mason v Demasi [2009] NSWCA 227.
[2] Penrith City Council v Parks [2004] NSWCA 201.
[3] Medlin v State Government Insurance Commission (1995) 185 CLR.
[4] Husher v Husher [1999] HCA 47; (1999) 197 CLR 138.
AAI Limited t/as AAMI
Simpraga [2025] NSWPIC 186
(1999) 197 CLR 138