Certificate issued under s 7.23 (1) of the Motor Accident Injuries Act 2017 (the Act)

1. The Medical Review Panel revokes the certificate of Medical Assessor Robin Mitchell dated 21 August 2025 and issues a new certificate determining that the following injuries caused by the motor accident give rise to a degree of permanent impairment of 10% and is not greater than 10%:
   • cervical spine soft tissue injury 0%;
   • lumbar spine soft tissue injury 5%;
   • right shoulder soft tissue injury 4%, and
   • right wrist soft tissue injury 1%.

1. Mamoon Ahmed (the claimant) is a 35-year-old man who was injured in a motor vehicle accident on 24 May 2022. Following the accident the claimant lodged an application for personal injury benefits and thereafter it was agreed that the claimant had sustained non-threshold injuries.
2. The claimant sought a concession from the insurer that the injuries he sustained in the accident have left him with a degree of permanent impairment of in excess of 10%. Following an internal review, the insurer declined to make this concession and consequently the claimant lodged an application for assessment of degree of permanent impairment in respect to both physical and psychiatric injuries.
3. In respect to his physical injuries the claimant was examined by Medical Assessor Robin Mitchell who, in a certificate dated 21 August 2025, determined that the injuries caused by the motor accident gave rise to a permanent impairment of 2%. The claimant lodged an application for a review of this determination and, in a decision dated 14 October 2024, President's delegate Rachel Brittliff decided that there is a reasonable cause to suspect that the medical assessment was incorrect in a material respect and, consequently, the matter was referred to this Medical Review Panel (the Panel).
4. Directions were issued to the parties to upload the originating application and reply for assessment of whole person impairment and this material is now before the Panel.

1. Clause 14F of Schedule 1 of the Personal Injury Commission Act 2020 (the PIC Act) provides that the new review provisions apply in relation to a decision of a new decision-maker. A "new decision maker" is defined in cl 14A(1) of the Schedule 1 of the PIC Act. As the medical assessment, the subject of the review, was made on or after 1 March 2021, the new review provisions apply.
2. The new review provisions provide that a review panel consists of two Medical Assessors and a Member assigned by the Motor Accidents Division of the Commission.
3. Part 5 of the PIC Act enables the Commission to make rules with respect to its practice and procedure including proceedings before a panel reviewing a decision of a Medical Assessor.
4. Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the PIC Act. A review panel determines how it conducts and determines the proceedings and may determine the matter solely based on the written application.
5. The review of the medical assessment is by way of a new assessment of all the matters with which the medical assessment is concerned.
6. Section 17 of the Motor Accident Injuries Act 2017 (MAI Act) defines a "medical dispute" as
   • a dispute between a claimant and an insurer about a medical assessment matter, or
   • an issue arising about a medical assessment matter in proceedings before a court for damages or in connection with the assessment of a claim by the Commission.

1. The claimant was examined by Medical Assessor David Gorman on 14 January 2026at

1 Oxford Street Darlinghurst. He attended with his wife.

1. The claimant is a 35-year-old man who was working as a Trainer and Assessor and Traffic Controller at the time of his motor accident. In the past he has had other jobs including as a tyre fitter. He is married with two children aged 3 and 5 years. He smokes more than a packet of cigarettes per day now since the accident. He does not drink alcohol.
2. He is not working now and receives insurance payments. He said that he has not worked since the accident.
3. In 2013 he had back pain. He was a tyre fitter and his pain arose after lifting a tyre. His pain was significant. He was on opioids.
4. He had continuing pain and attended Westmead Pain Clinic on 30 January 2015. When asked about this he said "to be honest I can't recall going there".
5. On 6 March 2016 he had a car accident. Dr Medhat Guirgis diagnosed him as having a WPI of 11% after these injuries.
6. In 2016 he had a recurrence of back pain.
7. On 10 November 2017 he had a consultation which he could not recall.

1. On 24 January 2022 he was riding his motor cycle when a car ran a stop sign into his path. He hit the driver's side door.

1. He was taken to Westmead Hospital with neck, shoulder, right leg and right wrist pain. He, in particular, recalled his right arm and leg pain were most severe.
2. His top and bottom lip were split and required 14 stitches he recalls. He was discharged that day.

1. He had physiotherapy. He saw Dr Simon McKechnie (neurosurgeon) who suggested either surgery or cortisone injection for his spinal pain. He had in injection but reported that the insurance declined surgery.
2. He saw Dr Danesh (pain specialist). He saw a psychologist.

1. He has pain in the right shoulder radiating down the right arm. He was certain that it came from the shoulder, not from the neck, down the arm. He holds his head stiffly. He described this as a "habit" since the accident.
2. He has right leg pain which is worse in cold weather. It radiates to his foot. This is associated with back pain but his leg pain is worse than the back pain. He tries not to do things which aggravate his back.
3. Even slight bending forward when he is cooking can aggravate his pain. He said shopping is "touch and go" - sometimes he has trouble walking any distance. He is still depressed he said. He still sees a psychologist.

1. He still sees a psychologist, not physiotherapist. He is on Lyrica 300mg bd and takes Nurofen as needed.
2. He could not recall the name of another stronger medication he takes only occasionally. He does not want opioids. He was on these in 2015 and he said that it affected him mentally.

1. He was very "flat" in affect answering questions slowly. His depression was severe he said.
2. He took his "hoody" off over his head. There were pain behaviours with groaning and grimacing.
3. His height was 166cm with his weight being 87.7kg.
4. His neck was held stiffly as he moved into the consultation but was somewhat more mobile as the consultation proceeded. He said holding his neck stiff had become a "habit".

1. In the cervical spine flexion was 2/3 normal and extension was 2/3 normal. Rotation to the right was 2/3 normal and to the left 2/3 normal. Lateral flexion was similarly restricted. There was no dysmetria.
2. There were normal power, sensation and reflexes in the upper limbs. There was no wasting. Cervical compression testing was negative.

1. In the lumbar spine, there was no dysmetria. The range of motion in all planes was 1/2 normal.
2. He indicated pain radiating to the right foot laterally involving all of the toes.
3. There was no abnormality however of power, objective sensation or reflexes in the lower limbs. There was no wasting. Sciatic stretch testing was negative.

1. He could touch the occiput with both hands. On the right he could only reach back to the spinous process of T10. On the left he could reach T7. He indicated pain and was tender across his anterior right shoulder.
2. The range of motion on formal testing using a goniometer is outlined below:

1. In the wrists, the range of motion is outlined below. There is mild restriction in wrist extension.

1. The lip scarring was well healed and barely perceptible.

1. The following reports were reviewed:
   • CT lumbosacral spine 2 January 2014 - lumbar spondylosis particularly at L4/5 where there is a foraminal/extraforaminal nerve root compression on the right;
   • CT scan lumbar spine 14 June 2022 - at L4/5 a right disc protrusion causing some foraminal compression;
   • MRI lumbar spine dated 25 July 2022 - at L4/5, a right foraminal, extraforaminal disc protrusion with an annular tear compressing the right L4 nerve root;
   • MRI right shoulder dated 25 July 2022 - mild subacromial bursitis. Cuff tendinopathy involving the bursal supraspinatus and articular infraspinatus fibres. More focal area of tendinopathy is seen in the posterior mid supraspinatus corresponding to the recent sonographic finding but does not indicate tear. AC joint arthropathy is noted, and
   • MRI right wrist dated 25 July 2022 - no fracture. There is mild synovitis in the mid carpal level particularly on radial side dorsally.

1. Cervical spine - soft tissue injury - caused by the motor accident - there were symptoms present from the time of the accident and they remain.
2. Lumbar spine - soft tissue injury - caused by the motor accident - there were symptoms present at the time of the accident and they persist. This was on the background of significant lumbar pain previously.
3. Right shoulder - soft tissue injury - caused by the motor accident - the pain and restriction in movement of the right shoulder has persisted since the accident.
4. Right wrist - soft tissue injury - caused by the accident - his wrist was painful at the time of the accident and it remains symptomatic.

1. It is now more than three years since the subject accident. He is not having specific treatment for his physical injuries. His symptoms have not changed significantly for more than 12 months. His condition is stable for the assessment of permanent impairment.
2. Cervical spine - soft tissue injury - there is no dysmetria, radiating pain nor any radiculopathy - he is DRE category I with WPI of 0% based on Table 73 on page 110 of the American Medical Association's Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA 4 Guides).
3. Lumbar spine - soft tissue injury - there are persistent non-verifiable radicular symptoms to the right leg. There is no radiculopathy - the reflex abnormality noted by Medical Assessor Mitchell was not present. The WPI is therefore 5% based on Table 72 on page 110 of the AMA 4 Guides.
4. This was on the background of significant lumbar pain previously with scans showing L4/5 disc protrusion to the right compressing the L4 nerve root. It had however settled by the time of the subject accident. He was back at work and was off opioids. Therefore, there was no definite quantifiable impairment at the time of the accident, and no deduction can be made.
5. Right shoulder - soft tissue injury - there is restriction in range of motion which has persisted since the accident. Using Figures 38, 41 and 44 on pages 43, 44 and 45 of the AMA 4 Guides, the restriction in flexion gives 3% upper extremity impairment (UEI), the limitation in extension gives 1% UEI, the limitation in adduction 1% UEI, the limitation in abduction a 2% UEI and the limitation in internal rotation a 1% UEI. The total UEI is therefore 8%.
6. However, both Medical Assessor Gorman and Medical Assessor Mitchell noted restrictions on the uninjured left side compared to normal. This needs to be subtracted from the assessed impairment according to the NSW Guidelines. Using the same Figures from AMA 4 Guides, the limitation in in flexion gives 1% UEI and limitation in abduction a 1% UEI. This 2% for the uninjured left side is subtracted from the right side giving UEI of 6% as an effect of the injury (which equates to 4% WPI).
7. Right wrist - soft tissue injury - there is mild discomfort with mild persisting restriction in extension. Using Figures 26 and 29 on pages 36 and 38 the restriction in extension gives 2% UEI (which equates to 1% WPI using Table 3 on page 20).
8. Scarring was not referred for assessment of impairment. Please note however that based on the section in AMA 4 Guides pages 229-230 (Table 4) the WPI is 0% for the well healed almost imperceptible scarring after lip laceration.
9. Total impairment - the upper extremity impairments combine to 8%. This is equivalent to 5% WPI. This is combined with 5% for the lumbar spine giving a 10% WPI.

1. The degree of whole person impairment caused by the subject accident is assessed at 10%.