Review Panel assessment of the degree of permanent impairment

Certificate issued under s 63(4) of the Motor Accidents Compensation Act 1999

1. The Review Panel revokes the certificate of Medical Assessor Melissa Barrett dated

14 October 2024 and issues a new certificate as follows:

(a) The Review Panel certifies the following injury was caused by the motor accident:

(i) post-traumatic stress disorder, and

(ii) intermittent episodes of major depression.

(b) The Review Panel finds that the above injury results in a whole person impairment of 22% which is greater than 10%.

1. William Northcote (the claimant) was involved in a motor vehicle accident on 10 February 2017. He says he was hit as a pedestrian by a four-wheel drive and sustained physical and psychological injuries.
2. The claimant made a claim for personal injury benefits with Allianz Australia Insurance Limited (the insurer), the third-party insurer of the vehicle that he says caused the accident.
3. Since the accident, he has had numerous medical assessments for his alleged physical and psychological injuries at the Personal Injury Commission (Commission) and the former Dispute Resolution Service.
4. The present review proceedings concern a medical dispute about whether the degree of the claimant's whole person impairment (WPI) is greater than 10% WPI. Where there is a dispute about the degree of a claimant's WPI, damages for non-economic loss[1] cannot be awarded and disputes must be referred to a Medical Assessor/s for determination.
5. On 14 October 2024, Medical Assessor Melissa Barrett determined that the claimant's psychiatric injuries were caused by the motor accident and assessed his WPI at 17%.
6. The insurer lodged an application with the Commission seeking a review of Medical Assessor Barrett's decision. This was allowed by the President's delegate (Ms Rachel Brittliff) and this Panel was convened to conduct the review.

1. The psychiatric injuries referred to Medical Assessor Barrett was worded in the following way:
   • psychiatric condition - post-traumatic stress disorder and deterioration of psychological injuries.
2. The Medical Assessor was given a pre-accident history of social anxiety in the claimant's teens, which was related to social stigma regarding his sexual orientation. He was prescribed venlafaxine but he had side effects of sedation and ceased after a year. There was however, some inconsistency regarding whether he was using an antidepressant at the time of the motor accident.
3. In his early life, when the claimant was about 5 years old, his mother passed away from ovarian cancer. His father was an alcoholic and he was raised by his paternal grandmother.
4. He left school after completing Year 10 and in 2009 attended TAFE to complete a Seafarer course. He did not achieve his certificate as his grandmother became unwell with lung cancer and, following her surgery, the claimant was her informal carer.
5. He reported being in a relationship with his former partner, Cameron, at about 21-years-old. There was again some inconsistency with when the relationship ended - whether it was before or after the motor accident.
6. The claimant reported no apparent issues with his pre-accident functioning, with adequate self-care, enjoying social and recreational activities and being in a relationship with Cameron which had been ongoing for about six years at the time of the accident. He also reported working part time, up to 20 hours a week in Cameron's garden maintenance business.
7. He is currently single, on a disability support pension and denied any previous CTP or workers compensation claims.
8. At the time of the motor accident, the claimant alleges that he was in a verbal altercation with Cameron's ex-wife. He then set out on foot and was followed by Cameron's ex-wife in a four-wheel drive and then proceeded to intentionally hit him.
9. Following the accident, the claimant reported immediate onset of psychiatric symptoms. The Medical Assessor diagnosed post-traumatic stress disorder which was related to the motor accident. This was found to be complicated by the development of secondary psychotic features and the development of major depressive disorder.
10. The Medical Assessor accepted that while there was pre-existing vulnerability, the psychiatric diagnoses were causally related to the motor accident. It was considered that the claimant's longstanding poor relationship with the driver of the insured vehicle and his allegations that the accident was intentional made it not unreasonable for the claimant to fear that the driver was trying to inflect serious injury or death.
11. The degree of permanent impairment was assessed under the psychiatric impairment rating scale (PIRS) with scores of 2,2,2,3,4,4 which amounted to 19% WPI.
12. A pre-existing PIRS was also tabled due the claimant's social anxiety diagnosis and found to be 0% WPI. As the claimant was noted to be taking ongoing antidepressant medication which resulted in his pre-existing symptoms being in remission, it was determined that there would be a 3% WPI treatment effect.
13. The claimant was on antipsychotic medication which was determined to have a 1% WPI treatment effect.
14. No deduction was made for pre-existing or subsequent impairment because the Medical Assessor determined that the breakdown of his friendship with Cameron was caused by the impact of his psychiatric symptoms and therefore did not represent an unrelated injury.
15. The final degree of WPI found to be caused by the motor accident was therefore 17% (current impairment 19% - pre-existing treatment effect 3% + current treatment effect 1%).

1. The insurer relies on submissions lodged in the present review application, submissions made in reply to the further assessment application and previous MAS 1A and 5R submissions. These are summarised collectively below.
2. The insurer takes issue with the assessment of the claimant's current functioning and impairment performed under the PIRS in the following categories:
   • Social and recreational activities - class 4;
   • Travel - class 2;
   • Social functioning - class 4;
   • Concentration, persistence and pace - class 2, and
   • Adaptation - class 3.
3. The insurer says the medical assessment must carefully consider the accuracy of the claimant's reported history, particularly concerning whether certain events occurred and the timing of those events as they are relevant to the assessment under the PIRS. Any inconsistencies in the evidence need to be addressed with the Panel noting the insurer's reference to the histories documented in various medical reports.
4. The insurer also refers to pre-accident evidence referring to anxiety and depression which, it is submitted, affected the claimant's social functioning and social and recreational activities.
5. The insurer's submissions with respect to its reply to the further application and its previous MAS 1A and 1R have been noted by the Panel. These submissions are not summarised here as they relate to a treatment dispute or the relevant gatekeeper tests for applications for further assessment or review of medical assessment.

1. The claimant submits that the medical assessment certificate under review "is correct and ought not to be interfered with".

1. On 24 June 2025, the Panel issued a direction to the parties requesting indexed and paginated bundles of the information they relied upon. The Panel advised that unless documents are uploaded to the review file, the Panel would not be able to read and consider those documents.
2. The insurer provided a bundle comprising of pages 1-751. The claimant did not provide a bundle.
3. The Panel has read the documentation relied upon by the insurer. Much of the material has been summarised in the previous medical assessments of Medical Assessor Jager (10 June 2019) and Medical Assessor Barrett (14 October 2024). The Panel notes that a significant amount of time has passed between the previous medical assessments and indeed from the time of the motor accident to the Panel re-assessment (over eight years). With the passage of time, some detail from previously obtained histories will inevitably change. Such changes are not necessarily considered inconsistencies. As the Panel is tasked with assessing the claimant as he presents currently, much of the historical material may in fact be of little weight to the assessment of the claimant's present psychiatric functioning.
4. Any relevant inconsistencies identified by the Panel and the insurer were raised with the claimant as detailed in the re-examination report below.

1. At the initial teleconference on 16 September 2025, the Panel determined that the claimant be re-examined. The re-examination report of Medical Assessors Baker and Jones is below:

The medical examination occurred on 19 November 2025. The assessment was undertaken through audiovisual link through the MS Team platform organised by PIC. The assessors were Drs John Baker and Matthew Jones, Psychiatrists. Mr Northcote was situated in his home in Gorokan. The assessment had a lengthy duration of more than two hours and twenty minutes.

Mr Northcote was informed that the assessment was not for treatment purposes and was not confidential in nature. He indicated he understood the purpose of the assessment and agreed to continue voluntarily.

Mr Northcote is a thirty-five-year-old man living in Gorokan, on the Central Coast. He has lived in this house for approximately twelve months. He has a housemate, a male friend of his sister, named Jay. He was previously living between his grandmother's house and his current abode, however stated that he needed his own space as he was finding himself getting angry and frustrated living with his grandmother. His grandmother is eighty-eight years old and is cognitively intact but has physical and medical issues. His grandmother lives at Warabrook, a suburb of Newcastle. His grandmother is currently living with Mr Northcote's sister, Destiny, who provides his grandmother with care.

Mr Northcote also has another sister, Shae, who lives in Parramatta. He has no ongoing contact with Shae. Mr Northcote also has a younger sister, the youngest of four, named Brielle. Mr Northcote reported that he does not know her whereabouts and she has her own mental health problems. He reported Brielle is suffering from PTSD and other mental health problems after being involved in a high-speed motor vehicle accident. He believes that the last time that he saw Brielle was in January, at which time she was living at their grandmother's house. He said this was part of the reason he moved out as his two sisters were living with his grandmother and the house became overcrowded.

Mr Northcote reported he is receiving the Disability Support Pension from Centrelink. He was not certain but believes he has been receiving this for five or six years.

Mr Northcote reported he is not currently in a primary relationship. The Panel Medical Assessors asked Mr Northcote about Cameron, his previous partner, mentioned in the documents. He reported that although they had had a period of separation prior to the motor vehicle accident (which occurred on 10 February 2017) they were still close, still friends, and had tried to reconcile following the accident. Mr Northcote said his outbursts of anger and experience of depression interfered with the relationship. He was also not enjoying intimacy. He said he found himself unable to feel love. He went on to say that he was having no feelings, Cameron wanted to feel loved, but Mr Northcote was unable to provide this.

Mr Northcote said that prior to the accident they had separated for four to six months, however they were still living in the same accommodation for financial reasons.

Mr Northcote also explained that Cameron was having a lot of difficulties with his daughter and her mother (Kylie.) Mr Northcote said he would return to live with his grandmother during the week that Cameron had care of his daughter. Mr Northcote, as an aside, said before the accident happened he was a very compassionate, empathic person and he remembers that he and Cameron loved each other. Mr Northcote concedes that he tended to blame Cameron for what had happened, as the driver of the vehicle in his accident was Cameron's ex-partner. He remembers that Cameron's ex-partner, Kylie, was causing difficulties, harassing him and Cameron, and 'ruining her daughter's life.' He said this was all because she did not want her daughter to have a gay father. He commented that the separation prior to the accident was amicable, but they still loved each other and were there for each other. Mr Northcote reported he has no ongoing contact with Cameron for an extended period before this re-examination.

With respect to employment, Mr Northcote reported that he 'tried to go back to work' around December 2023. He said he had worked on ships from a young age, commencing with cleaning ships from the age of seventeen to nineteen. He said this was in Newcastle and Carrington. From the age of nineteen, he studied to be a seafarer and around 2018/2019 he was qualified to work on smaller offshore vessels. He worked for a couple of years in this capacity. Early on, he remembers working for Atlas Marine which was initially in Victoria but now they are in Western Australia.

He said that seafaring was a passion of his. He said he stopped this work after about two years because his grandmother was diagnosed with lung cancer. At the time he was living with her. She had a lung removed as part of treatment. He said that his grandmother had brought him and his sisters up after their mother died, so he felt honourably obliged to care for her. He was caring for his grandmother for quite a period, about seven years. He remembers receiving a carer's payment from Centrelink for this. Mr Northcote remembers that he was on Jobseeker payments between receiving the Carer's Pension and the Disability Support Pension.

He said the next work he did was not actually employment, but he considered it a hobby and enjoyed it. He said it was volunteering in a capacity working for Cameron. Mr Northcote said that the last time he did any work like that was in 2016. He went on to say that Cameron no longer needed help. After this, he started helping with his grandmother and grandfather. He commented his grandfather is in a nursing home, aged ninety-four, and has dementia. He was put into the nursing home because he started wandering. He said as an aside he still has the passion for being a seafarer.

The Panel Medical Assessors asked about his relationship with Cameron's daughter, Hayley. He remembers being close to her and that Cameron, Hayley, and he, were very happy. He was heavily involved in Hayley's life from when she was aged six until she was ten. He said this was when it turned bad. He had trouble remembering her birthdate, but the Panel Medical Assessors ascertained she was born in February 2004, therefore would now be twenty-one. He said that she reached out to him about a year before the re-examination however he changed his number and ignored it. He went on to say that he does not want to talk to people and that he finds it very hard to make or hold friendships. He said that he had lost all of the friends that he had ever had. He said he only undertakes small talk with his flatmate, Jay.

Mr Northcote reported he has had a considerable struggle with various side-effects from medication. He said he has tried medicinal cannabis. He currently has a new GP, Dr Cantlay in Warnervale. He asked Dr Cantlay for a prescription for Quetiapine, however stopped this about nine to ten months before the re-examination. When asked why he ceased this medication, he said he does not 'have the fight in [him] anymore.' He said he feels like he is in a losing battle. He said he had asked for some antidepressants from his GP, and he was put on Citalopram in approximately May 2025. He said he had commenced this medication. He went from 20mg to 40mg however developed side-effects of strong suicidal ideas. He said he also developed panicky feelings and had a lot of gastrointestinal problems. He commented that he had been on many tablets since the accident and said that his vision was affected. He said now he takes CBD oil and St John's Wort (a natural antidepressant treatment) as well as Panadol and Ibuprofen. He told the Panel he has a lot of neck pain and his knee pain flares up. With respect to the St John's Wort, he said he finds it provides 'a bit of relief' in the evening and he also tries to have it in the daytime. He said when he wakes up is the worse time for him. He said he does not sleep well and feels exhausted in the morning. Mr Northcote reported he is taking no other medications.

The Panel Medical Assessors asked if Mr Northcote was seeing any health professionals regarding his injuries from the motor vehicle accident and he said that he had been seeing a psychologist, Geoff Bowser, who is situated in Hamilton (Newcastle). He has been seeing Geoff for seven or eight years and sees him every month via audiovisual link. He said for a long time initially it was every fortnight so. On clarification, he said he had probably seen him more than one-hundred times.

Mr Northcote sees him free of charge through Medicare funding.

Mr Northcote saw a psychiatrist, Dr Stuart Saker, but only three or four times in total. He has not seen him for four years. Dr Saker trialled a few medications on

Mr Northcote. He saw Dr Saker in Toronto around 2018/2019. He remembers having to save up money to see him as he was quite expensive. He commented that it was $600 in total and the out-of-pocket cost was close to $400. He commented that he had begged the insurer, Allianz, to help him pay for it. He found seeing Dr Saker helpful and said that seeing Geoff Bowser, "can be helpful." He said there are times when he attends Geoff that he does not feel particularly present, he has a numb feeling, and he has nothing to say.

Mr Northcote does not have a particularly remarkable medical history. He said in 2025 he had four wisdom teeth removed at Belmont Hospital under anaesthetic. He said he recovered well from this. As an aside he said his oral hygiene is not very good and he had infected gums around that area.

Mr Northcote was also diagnosed with obstructive sleep apnoea in 2018. He said at one period, about three or four years ago, he had lost considerable weight, about 30kg. He stated that this was stress related because he was not looking after himself. He said his highest weight was around 133kg. He said that before the accident he was around 100-105kg. He increased weight after this which he attributed to depression. He said 'things all got too much,' he was smoking cigarettes and 'starving' himself. He said he then lost the considerable amount of weight. He said his weight has been stable since around 2020, between 90 and 100kg. His current weight he estimated was around 96 or 97kg. He spontaneously added that he generally eats only one thing a day and that he 'can't be bothered.' He went on to say that he was previously cooking for his family and would make meals for himself and Cameron. He said his current barriers to cooking include motivation and pain.

The Panel Medical Assessors asked Mr Northcote to talk about his pain. He has pain in his lower back, neck and right knee. He said he is unable to stand for too long. His knee hurts after he has had too much activity, for example walking. He also said he has been told he has problems with his sacroiliac joint. He is unable to stand for more than five to seven minutes as this effects his legs and he gets pins and needles. He reported if he sits for too long his neck is bothered and he starts to get dizzy. He reported lying down is somewhat of a relief. He tries not to spend every day in bed but spends a lot of time during the day sitting around, constantly shifting positions. He said his pain comes and goes depending on what he does and the quality of his sleep during the night.

Mr Northcote reported that he uses Dencorub on his pain and said that hot showers can help relieve his pain.

With respect to the limitations his pain places on his activity, he said he has trouble hanging out the washing, doing the dishes, mopping and vacuuming, and similar activities. He avoids cooking elaborate meals because it involves standing and then he needs to sit often. He said his difficulties standing for long mainly involve his neck and his back. He said that his knee is generally okay until he tries to crouch, or walk he walks too far, after which his knee has a burning sensation. He commented that his local shopping mall is quite long and that his knee will start burning whilst walking around that.

Mr Northcote has no remarkable criminal history although stated that he had a double demerit speeding ticket four years before the assessment. He was with Cameron at the time and he had wanted to try and drive. He denied any other major motor vehicle accidents. He reported he had had one work-related injury in November 2023 when he had gone back to work in Gladstone as a steward on a cargo ship. He said this work involved cleaning accommodations and dealing with some waste management. He said he did this work because he wanted to do something meaningful in his life. He offered, in a mildly confused manner, that he was in a dissociated state of mind when he attempted to try that work. The dissociated state of mind meant that he felt and believed that he was functioning better than he actually was. He said he was in a state of mind that he 'could do it' and he 'did do it'. He went on to say, however, that he, in that dissociated state, tends to be accident prone. He said the actual work injury involved him being in a stairwell, cleaning it, he became a bit dizzy and disorientated from leaning down cleaning and mopping, went over to another flight of stairs, slipped, put his hand out and incurred a hand and wrist injury. He remembers being put on light duties for a week or so.

He denied any involvement in any other compensation or litigation processes.

Mr Northcote reported that he grew up with experiencing symptoms of anxiety and depression in his teens. He said at one point he was taking an antidepressant, which he thought may have been Effexor (Venlafaxine), but on crosschecking with the documents was likely Pristiq (Duloxetine). He said this was in his twenties and for a couple of years. He did not remember other details about this. The Panel Medical Assessors crosschecked with the documents and informed Mr Northcote this was up until 2017 and was prescribed by Dr David Jones (no relation) at Charleston. He conceded that it likely was Pristiq. He added that he had 'quite a few after,' referring to other trials of medications.

Mr Northcote reported that he saw a counsellor in his teens which he thinks was for one session. He said at the time he 'didn't understand [him]self.' He described himself as a young man and having to deal with life and being confused about his sexuality. He said he did not feel like he fitted in. He concedes that he had anxiety, but it was not severe. He said it caused no barriers to his functioning back them. He described himself as being 'free and had the world.' He said he 'enjoyed life.' He said he would go on adventures with friends and have occasional beers on Fridays or Saturdays.

Next, Mr Northcote met Cameron. He said that they were initially just friends. It was Mr Northcote's first relationship, and he was around the age of twenty when he met Cameron. He said Cameron and his partner, Kylie, separated and after that, he and Cameron formed a relationship and they ended up living together for a couple of years. He said he developed anxiety about being in a same sex relationship and he had problems generally feeling accepted.

The Panel Medical Assessors asked Mr Northcote about any psychiatric admissions or involvement in community mental health teams, and he said that he had attended Mater Hospital a couple of times. He said he had 'had enough and didn't know what to do.' The last time he went was his birthday two or three years ago and he remembers that he stayed for a few hours. He believes he was prescribed Quetiapine on that occasion.

The Panel Medical Assessors crosschecked with Mr Northcote about any experience of psychotic symptoms. He said that he 'did feel very paranoid and on edge' and that Cameron took him to the hospital the first time he went, and the second time he took himself. With respect to the symptoms at the time, he said he felt like everybody was conspiring against him, police were conspiring, and he did not trust anybody at that stage. He said this sensation occurred a few times in a one-year period and he remembers that it also occurred for a period soon after the accident. He said after he was commenced on Quetiapine he 'could deal with it a bit better.' He remembered the Quetiapine as being the slow-release formulation, 50mg, once a day, and the quick release formulation 25mg, when required.

Mr Northcote denied any recreational drug history. With respect to alcohol, he said that since he finished working more recently on the ship, he had been drinking quite a bit. Initially he said he did not know when he stopped working but from the documents it appears to have been from around November 2023. He remembered with prompting that there was a reason he stopped working and that was that he would get in his head that feeling of paranoia, and think that people may know Kylie, or that something very bad would happen. He said that he had hoped that the feelings would go away but they persisted. He commented that he remembers, in response, he tended to lock himself in his cabin on the ship and changed his phone number.

The Panel Medical Assessors crosschecked with Mr Northcote documents related to his employment on ships. This was around November 2023. He worked around three weeks with one ship. The next job was with the same company but a different role. He said his second job was as a deckhand for a few months. Following November 2023, he spent three weeks involved with one boat, two to three months involved with another boat and stopped work again around March/April 2024. He commented that he had started drinking at work, a few beers a day, which he said had helped his mental state.

With respect to his current alcohol consumption, he said on three to four occasions a week he will drink up to a litre and a half of wine. He said he is unable to afford beer and will buy cheap wine in a two-litre cask. He reported he feels intoxicated when he drinks a litre and a half of wine, and he said it takes away the pain and his anxiety. He said he had previously never drunk like that before. He said he had never had a big relationship with alcohol, including after he had initially started working and also whilst he was looking after his grandmother.

With respect to prescription medications, Mr Northcote reported that for about five years after 2017, he took regular painkillers including eight Panadeine Forte a day and up to two Targin tablets a day. He said he took himself off the painkillers and said he went 'cold turkey' and this did not cause any problems (that is, there was no particular withdrawal syndrome).

Mr Northcote reported he has never been a big gambler. He is currently not smoking and not vaping. He said he had quit smoking for a long time and said he took up smoking on and off, but he was not sure of the timelines of this.

Very early life history was not explored due to time constraints. The Panel Medical Assessors relied on available documents for an understanding of this.

Mr Northcote attended high school at Waratah. He finished Year 9 and then started Year 10 around the age of sixteen or seventeen. He then had the opportunity to go to sea and he started working on the wharves and went on to study seafaring. This was his first job after school. He attended a TAFE course for seafaring, which involved four months in the classroom and one-hundred and eighty days at sea. He also had to complete five training modules in the written component. Prior to going back to sea in November 2023 he did a three-day safety course at TAFE which was at the Ultimo campus, in person. He completed an Integrated Rating Qualification allowing him to be part of a deck crew, an engine room assistant or a watchkeeper. He said it also is a Steering Certificate. For his original qualifications he did the majority of his sea time in 2008.

Summarising his work career, Mr Northcote reported that he started as a painter and docker when he was around seventeen to nineteen for an engineering company at Carrington. This was a maritime industrial island on the Hunter River. He was then a seafarer for Atlas for about twelve months until the age of twenty or twenty-one, then looked after his grandmother following her lung cancer diagnosis for seven or eight years. Mr Northcote more recently went back to working on ships, for about 6 months in late 2023 - early 2024.

The date of accident was confirmed as 10 February 2017. Mr Northcote referred to there being, 'a lead up of events.' He said that Cameron was being alienated from his daughter, Hayley, by her mother, Kylie. He said Kylie was 'starting a lot of dramas' and that he and Cameron did not see Hayley for an extended period. He said Hayley reached out by phone on 10 February 2017 and was crying, in distress, and stating that her mother was not being nice to her. Mr Northcote recalled that he was 'like a father to her.' He said he had organised to meet her where she was living in Shortland.

Mr Northcote paused and said it was difficult to remember all of the details, however he does remember being verbally abused by Kylie in the driveway of Hayley's grandmother. Mr Northcote told Kylie to leave the premises, he went inside, gave it a few minutes and then when he went outside to make his way to the car he saw Kylie in her car. He said that she sped down the road and Mr Northcote walked across the road. He remembers Kylie was in her car shaking her steering wheel. Mr Northcote was standing near somebody else's car, he turned his back and she struck him on the right side with her car. He said he was struck just above his pelvis, he fell over, hit his right knee first and then fell on his right arm.

He said that she was driving a Toyota Kluger and he commented that this was another trigger and that if he sees a Kluger parked somewhere 'it, takes [him] back.' He said that Kylie did not drive away but manoeuvred her car and Mr Northcote walked across the road again. He said he heard her tyres screech, she went up on the gutter and he feels like she tried to hit him again, however she was unsuccessful. He remembers trying to get the attention of someone by hitting a fence. He said that Hayley's grandfather, Theodore, came out and helped him. He said Kylie then drove off. He said Theodore called an ambulance and the next thing he remembers is the ambulance was there and he remembers that they took his jeans off.

Mr Northcote was taken to John Hunter Hospital and he was there for a few hours. He commented that they only assessed his knee. He said he went back the next day with problems with his neck, shoulder and back.

An AVO was put in place after this, however he believes that Kylie was never charged for the offence. He had been told by Kylie's father that the family has relatives in the police. He said he kept pushing and pushing for something to happen and he remembers that he was often chasing up with the police where the case was. He remembers at one stage he was called into Waratah Police Station. He also attended with the police straight after he got out of the hospital. He was told that the case was going to some other team. He gave the impression that he felt that there was interference with the case, and he rhetorically asked, 'Where does the truth lie.' He said he made many efforts about this including subpoenaing the police file but, in the end, he does not believe Kylie was charged with any violent offence (despite the serious nature of what Mr Northcote reported happened).

The Panel Medical Assessors enquired about Mr Northcote's sleep. He said he tried to get to bed around 12 midnight and sometimes will toss or turn for an hour or two, 'with negative thoughts.' He said he thinks about 'whatever has triggered [him] through the day.' He said sometimes when he cannot sleep, he will get onto his phone and watch some YouTube videos. He said it may be 3.00am or 4.00am when he finally falls asleep. He said he will wake-up and get out of bed at 8.00am or 9.00am, after the sunlight comes into his bedroom. He added that he sometimes has some bad nightmares and finds himself fully awake after them.

The Panel Medical Assessors asked him what type of triggers encourage negative thoughts, and he said that if he has to leave the house, he feels on edge straight away. He feels like something bad is going to happen to him. He said he goes to get things from the shops only once or twice a fortnight and goes with Jay, his housemate. He goes to the local Aldi. He finds that he gets triggers having to walk near cars in a carpark. He said he does not know what other specific triggers he has. He reported he avoids a lot of television because he 'can't deal with hateful or violent stuff.'

Mr Northcote reported that he does not trust people and he has 'limited emotions.' He said initially after the accident he was having anxiety and what he would call panic attacks. He said he would have some heart palpitations and have this feeling of having to get to safety. He said there was a period when he was very overwhelmed by symptoms including suicidal thoughts, feeling worthless and hopeless, and also feeling paranoid. He said he was feeling that everyone was out to get him. He said he does not like people anymore. He said he feels like someone wants to hurt him and he said these feelings stop him leaving the house.

He commented, as an aside, that the insurance process is a reminder. The Panel Medical Assessors asked Mr Northcote why he thought that the process was ongoing and he said, 'it's a broken system.' He said that it was still processing 'because of liability.' The Panel Medical Assessors clarified with Mr Northcote that the insurance company had accepted liability for the case, however his frustration seemed to focus on them not approving treatment to see Dr Saker, which he thought would have been particularly helpful.

Mr Northcote concedes that sometimes he does have good days, however when he has bad days, "it's a struggle." He said everything comes back to PTSD-type symptoms of avoiding things and being worried. He said he has nightmares, usually about Kylie, but not always the same. He reported the nightmares were not as frequent as they used to be and now, they occur every two weeks or so, however they 'set [him] back.'

The Panel Medical Assessors asked Mr Northcote what his daily routine was and he said he 'take[s] it easy.' He said he will go for a walk with Jay and Jay's dogs. He commented that he does not get to see his grandmother as it is too far to travel. He said he pretty much spends most of his time at home and a lot of time on YouTube. He said he has tried reading, however he finds this very difficult with his problems with concentration and he has challenges 'retaining the words.' He said he does some light housework. He implored that he does not 'want to be like this.' He thinks that he would have been different if he 'could have got to Dr Saker.'

Mr Northcote reported he tries to meditate during the day. He said when he is around people, he tends to get very frustrated and angry and he feels that he has pushed many people away from him.

Mr Northcote reported in the evenings he will put his earphones and watch YouTube. He will tend to watch car repair videos and sometimes cooking shows. He said that he tends to rely a bit upon meditation, which he does under his own steam. He also said that "binaural" frequencies and tunes 'resonate' with him.

When the Panel Medical Assessors pointed out that he worked for approximately six months from November 2023, he stated that at the time he 'felt really good.' He said that his ability to be able to work on the two ships was because he 'had a mask on.' He said this was related to his description of dissociation. He said however he got to the point where he felt trapped and in danger and he stated he is now 'not mentally well enough to have a job like that.' He commented that in general he was better than he was at his worst since the accident and remembers that he was very suicidal at one point because of his psychological injury sustained in the accident.

With respect to his plan or hopes for the future, Mr Northcote said he is hopeful to get some 'proper help.' He remembers he underwent some Transcranial Magnetic Stimulation, funded by the insurance company, which he said very much helped him. He had this every day for about two weeks. He remembers it particularly helped with his feeling of panic."

1. The assessment of the degree of permanent impairment is to be made in accordance with the Motor Accident Permanent Impairment Guidelines (the Guidelines).[2]
2. The Guidelines (effective from 1 June 2018) applies to the Review. Psychiatric impairment is assessed under the heading "Mental and behavioural disorders" and commence from page 44. These Guidelines apply to motor accidents that occurred between 5 October 1999 and 30 November 2017.

1. It is necessary for the Panel to consider whether the accident caused or contributed to the diagnosed psychological or psychiatric condition.
2. Causation is dealt with at cls 1.5-1.7 of the Guidelines. An abridged form of the requirements is contained in cl 1.7 which states:

"1.7 There is no simple common test of causation that is applicable to all cases, but the accepted approach involves determining whether the injury (and the associated impairment) was caused or materially contributed to by the motor accident. The motor accident does not have to be a sole cause as long as it is a contributing cause, which is more than negligible. Considering the question 'Would this injury (or impairment) have occurred if not for the accident?' may be useful in some cases, although this is not a definitive test and may be inapplicable in circumstances where there are multiple contributing causes."

1. Further, the provisions of the Civil Liability Act 2002 apply, in particular s 5D and 5E.

1. The Review is a new assessment of all matters with which the medical assessment is concerned.
2. The evaluation should only consider the impairment as it is at the time of the assessment.[3]
3. 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[4] and Insurance Australia Ltd v Marsh.[5]
4. The Panel may confirm the certificate of assessment or revoke that certificate and issue a new certificate as to the matters concerned.[6]
5. The Panel refers to the above joint re-examination report of Medical Assessors Baker and Jones. The Panel reconvened on 3 December 2025 and discussed the re-examination report findings before collectively making the below determinations.

1. Mr Northcote reported a narrative, and presented at assessment, and this is consistent with the history available to the Panel, that he had an ongoing post-traumatic stress disorder related to the motor vehicle accident. Although the subject accident appears to have been essentially intentional behaviour by his partner's ex-partner, it involved the use or operation of a motor vehicle which collided with him as a pedestrian causing injury. The Panel was of the opinion that the incident satisfied criterion A under DSM-5-TR for post-traumatic stress disorder, being an incident which threatened serious injury or death.
2. Mr Northcote also described intrusive symptoms including recurrent involuntary and intrusive distressing memories of the event, distressing dreams with content related to the accident, and other traumatic symptoms (satisfying criterion B).
3. Mr Northcote described behaviour replete with avoidance, including of people in general, his friends, going outside, motivated by feelings and fear of a lack of safety (satisfying criterion C).
4. Mr Northcote had some gaps in his memory of the incident, he had significantly persistent and exaggerated negative beliefs such as the world being unsafe, him being worthless and useless, markedly diminished interest or participation in many activities, marked feelings of detachment and estrangement from others, and a fairly persistent inability to experience positive emotions (satisfying criterion D).
5. Mr Northcote reported irritable behaviour and angry outbursts at times around others (including interfering with his relationship with Cameron and even his relationship with his elderly grandmother), a high degree of hypervigilance about others and the general safety of the world, sleep disturbance, and problems with concentration (satisfying criterion E).
6. Mr Northcote's symptoms from his post-traumatic stress disorder have been present since soon after the accident. They have waxed and waned to some extent but have never been absent. The duration of symptoms has been well in excess of one month given that the accident was approximately eight and a half years ago (satisfying criterion F).
7. Mr Northcote's symptoms have caused clinically significant distress as well as significant impairment in important areas of functioning including socially and occupationally (satisfying criterion G).
8. Mr Northcote's symptoms are not attributable to the physiological effects of a substance or another medical condition (satisfying criterion H).
9. From the information available to the Panel, it is highly likely that Mr Northcote also experienced intermittent major depressive episodes. He spoke of periods when his mood was markedly disturbed, including suicidal periods, and a period of substantial weight loss. He also had a period of treatment with Transcranial Magnetic Stimulation (generally a treatment for depression).
10. The Panel considered that there was likely a current alcohol use disorder, given his level of reported consumption of alcohol recently, and that this was more secondary to his mental health symptoms and not a primary cause of his mental health problems, or level of functioning.
11. The Panel also considered the presence of pain in Mr Northcote's clinical presentation.

Mr Northcote reported that it limited much of his functioning, however the reported narrative and clinical picture was not consistent with pain being the primary reason for his ongoing impairment in activities. Although pain has been considered with respect to his overall function, his assessment of psychiatric impairment has been undertaken on psychiatric grounds alone.

1. The diagnoses found to be caused by the motor accident are:
   • post-traumatic stress disorder, and
   • intermittent episodes of major depression.

1. The Panel accepted that Mr Northcote had some pre-existing mental health problems, which, in essence, were symptoms of anxiety and depression from his early teens onwards, initially related to anxiety about fitting in in society and some issues related to his sexuality. He was commenced on an antidepressant in his twenties which he was taking at the time of the motor vehicle accident.
2. On review of all of the information, it appears that there was no evidence for any active diagnosis, or active permanent impairment at the time of the motor vehicle accident.

Mr Northcote reported no problems with self-care and personal hygiene, no problems with his ability to travel independently, no problems associated with any social or recreational activities, some degree of relationship discord, being an amicable separation and problems secondary to the behaviour of his previous partner's ex-partner, but no other dysfunction in his social relationships. (It should be noted that he and his ex-partner made attempts to reconcile, in the context of an amicable separation, however this was unsuccessful due to symptoms Mr Northcote developed following the motor vehicle accident.) Although

Mr Northcote was not working full-time (in the Panel Medical Assessors' understanding) leading up to the motor vehicle accident, there was no psychiatric impairment to working. That being said, the claimant managed the workload of being a full time carer of his grandparents in the lead up to the motor vehicle accident and working part-time in a pressure cleaning business with his ex-partner Cameron (Certificate of Medical Assessor Castle-Burton). The Panel was of the view that there was no active pre-existing diagnosis or WPI prior to the motor vehicle accident.

Mr Northcote is independent with respect to his showering and dressing. He would be able to live independently if required. He reported minimal interaction with his housemate. He does small domestic chores around the house. He is able to prepare food for himself. He takes less care with his grooming and has a tendency to look unkempt. Utilising clinical judgement, there is a class 2, mild impairment, here.

Mr Northcote is able to leave his place of residence, although usually in the company of others such as his housemate on dog walks. He spoke of little in the way of recreational activities, however, tends to spend his time watching YouTube videos. He reported little in the way of social interaction with others. Utilising clinical judgement, there is a class 3, moderate impairment.

The Panel had to consider this category in depth. Mr Northcote demonstrated the ability to travel independently for a period of about six months when he was working on ships. This, if it were his current level of functioning, would be consistent with a class 1 impairment. His current description of his traveling repertoire is significantly more impaired. It appears that he is able to walk in his local area although most times either with his housemate Jay whilst walking the dogs, or in his company and going to the local shopping centre. There appears to be considerable avoidance and anxiety associated with limitations on his travelling. His social avoidance and limits in partaking of activities tends to imply a limitation in ability to travel freely, however does not automatically indicate a lack of ability in this area. After much consideration the Panel considered that a class 2, mild impairment was appropriate as a hybrid assessment of his best and worst functioning over the last one to two years, such that he would likely have the psychiatric capacity to walk alone in his local area such as to the local shops.

Mr Northcote referred to being unable to form or keep any long-term friendships. He lost his partner and close friend. With his current mental health problems, he would be unable to care for children or his elderly parent. He reported that he had been unable to care for his elderly grandmother, a role he previously had for about seven years. Utilising clinical judgement, there is a class 4, severe impairment here. Gets along with Jay, room-mate. Small talk only.

Although Mr Northcote endured a prolonged assessment, there were times when he required breaks to allow him to focus. There were also gaps in his memory and he appeared to get mildly confused at times. He reported he can watch YouTube videos but is unable to retain meaning when he attempts to read. He would be unable to follow complex instructions due to his mental health problems. The Panel noted Mr Northcote's completion of a three-day safety course at TAFE and the obtaining of a Steering Certificate in late 2023, however the Panel accepts that his condition has since deteriorated. Utilising clinical judgement, there is a class 3, moderate impairment here.

Mr Northcote is receiving the Disability Support Pension. He was able to work for a period of six months starting approximately two years ago, however developed difficulties during this. The Panel's overall opinion was that his ability to work in some sort of suitable appropriate employment was not consistent with zero capacity, but at the very lower end such that he would be erratic and unreliable, which is consistent with a class 4, severe impairment, utilising clinical judgement.

1. As detailed above, the Panel assessed that there was no diagnosable psychiatric condition before the motor vehicle accident which would warrant any adjustment for pre-existing impairment.
2. The Panel found no separate or discrete insult or injury or a subsequent aggravating event such that there would be any adjustment for subsequent impairment.

1. Mr Northcote has received treatment over the years since the accident, from which, at times, he reported some benefit. He reported he is currently seeing a psychologist in a supportive fashion, every month, however this is not providing any particular psychiatric benefit. There is no particular benefit to his symptoms, given his ongoing reported problems. The Panel concluded that there was no adjustment for treatment effect.

1. The degree of permanent impairment caused by the motor accident is 22% which is greater than 10%.
2. The change in psychiatric diagnoses and impairment percentage assessed means that the certificate issued by Medical Assessor Melissa Barrett dated 14 October 2024 is revoked. A new certificate is issued at the front of this determination.

[1] Section 131 of the Motor Accidents Compensation Act 1999.

[2] See s 44 of the Motor Accidents Compensation Act 1999.

[4] [2021] NSWCA 287.

[5] [2021] NSWSC 619.