austlii:nsw/NSWPIC/2025/160
General information, not legal advice.
NSWPIC
2025-04-20
Original judgment source is linked above.
Fakhreddine v Allianz Australia Insurance Limited [2025] NSWPIC 160
MOTOR ACCIDENTS - Motor Accidents Compensation Act 1999; claims assessment dispute; amount of damages to be paid to the claimant under ; self-employed concreter; driver of a motor vehicle involved in a collision with the insured vehicle; claimant suffered soft tissue injuries to cervical spine, right limb and left shoulder; lumbar spine also suffered from a persistent depressive disorder; claimant also involved in a subsequent motor vehicle accident in May 2018 where he sustained injuries to his right shoulder and right wrist; no common law claim for damages made in respect of this later accident as the injuries were non threshold; submitted since the accident he suffered a diminution in earning capacity; liability admitted; claim for past and future economic loss; past and future treatment; past and future care; - claimant is entitled to damages for past economic loss and past treatment expenses.
Issued under section 94(5) of the Motor Accidents Compensation Act 1999
Assessment of Claim for Damages made in accordance with section 94 of the Act.
Issued under Section 94(5) of the Motor Accidents Compensation Act 1999.
12. The main issues requiring my determination are as follows
a. To what extent, if at all, have the claimant's injuries and ongoing disabilities resulted in the claimant suffering a diminution in his ability to earn an income from the date of the accident up until the present time and for the remainder of his working life.
b. To what extent, if at all, have the claimant's care needs increased as a result of the injuries caused by the accident and,
c. What is the entitlement to damages which flow from the findings of the above issues.
13.I have considered the documents provided in the application and reply, and any further information provided by the parties.
14.At the assessment conference, the claimant stated, prior to the accident, he had never received treatment from a psychiatrist or psychologist and had never suffered panic attacks. He first joined a gymnasium in 2004 but had only attended the gymnasium on 4 occasions after the accident. He confirmed prior to the accident, he had injured his right knee, but he stated his issues with his back had resolved. On occasions, he now suffers from panic attacks, which he states places pressure on his heart and results in shortness of breath. These attacks can last between 5-6 hours which render him incapacitated for at least three days. He spends most of his work, at the present time, on computer and tendering. He suffers from bad pain in the right shoulder. He is no longer a" hands on "concreter" and he further stated he now feels disabled. When questioned by counsel for the insurer, he denied any back problems prior to the accident
"12. After I incorporated, Concrete Blitz Pty Ltd, I started to engage more and more subcontractors, as my business had grown over time, and I felt that I couldn't keep up with the demands of the work myself. I had always used subcontractors on occasion, but I felt like I needed to do this more and more. I continued the work which I was doing as a sole trader. After, I was still doing the physical work as well as being responsible for getting the jobs I was carrying out. I would then determine whether I needed help for a job or part of a job.
13. In the 2 years preceding the accident (2015 and 2016) I drew monies from the company through a debt shareholder loan account (in lieu of wages}.
15. At the time of the accident, I was running my own company Concrete Blitz Services Pty Ltd. I incorporated this entity on 9 May 2017. I was the sole director and shareholder. I did phone work, concreting work, steel fixing and I was involved in plant operations such as driving a bobcat and excavators. I worked on average 6 days per week 70- 80 hours per week. I did heavy physical work such as lifting and moving heavy constructions materials weighing in excess of 25-30 kg my work included repetitive bending and twisting of my lower and upper back, use of hand tools and power tools, repetitive heavy pulling and pushing, frequent overhead work and walking on uneven ground. I would drive anywhere the work site was. These were the duties I had always carried out in my work since I started as a sole trader. It was only after the accident, that I ceased working in the physical role and commenced a more hands off role. At times I have continued to work in the physical role, however, I experienced quite severe pain my right shoulder when I do so. I find it flares up after I attempt to do a long day's work, as such. since the accident, I have had to mostly refer the jobs that I've been able to obtain to other contractors and try and take a small percentage of the profit margin of the job."
16. From September 2023 Concrete Blitz services was able to get on to the vendor panel with the Waverley Council. That has resulted in Concrete Blitz Services, obtaining tender by tender jobs. This has taken me some years to achieve, and although I performed the work from time to time physically, mostly I have subcontractors to do the work. Again, I still persist persevere to try and work physically, but it is difficult, both as a result of my right shoulder and my neck, although my neck is more painful. When I sleep, I find that when I do work physically, I have flare ups
17. I have also found that I become lethargic and lack the motivation and discipline to network and obtain work like I was able to before the accident. I have explained how I felt and become as a person as result of the accident further below. I do feel like the changes in me from the accident have affected my ability to carry out the business side of the job, as well as the physical side.
32. Since the accident, I have returned to work on a limited basis usually about one to two days per week. I work up to 10 hours per week I can engage in very limited physical work and my role is predominantly that of a supervisor.
41. I was also involved in a motor vehicle accident in 2018. I never made a claim for this accident. My wife was in the car at the time of the accident, and to the best of my knowledge, she has never made a claim either. I did not make a claim because I did not suffer any injuries as a result of this accident.
"There was full pain free range of movement in both right and left shoulders, elbows and forearms."
"Mr Fakhreddine suffered mechanical strain injury to the neck with radiating pain into the right trapezius and shoulder as well as secondary aggravation of pre-existing low back condition in a motor vehicle accident on 10 February 2017. Treatment has been conservative and although rather sporadic, has been appropriate. He does, however, continue to experience disability and impairment which have diminished his functional and work capacities".
22.. The claimant was examined on a medical legal basis by Dr Nagesh, psychiatrist and I refer to his report dated 12 May 2023. I note the following on page 3 of his report
"In terms of his current routine, Sam works one to two days per week averaging around 10 hours per week in construction management. Before the motor vehicle accident, he could be hands on. He now just supervises at the moment. The rest of the days, he sits at home. He has become a complete social recluse. He has lost contact with the majority of his friends he doesn't attend any weddings, dinner parties, anniversaries, BBQ events. He struggles to live independently where he relies on his wife for cooking, cleaning and shopping. His parents support him financially. He relies on outside people for lawnmowing his ability to concentrate has diminished, he cannot read a book, cannot read a newspaper article, or browse the Internet. His ability to drive and travel has been affected where he cannot drive and travel for more than 20 minutes which makes him anxious. His relationship with his wife is up and down, where they do have frequent arguments and there is a loss of intimacy "
23... Dr Nagesh opined the claimant had no capacity to work more than 10 hours per week. He stated the claimant met the criteria for persistent depressive disorder (major depressive episode of moderate degree with anxious distress}.
24.. I refer to the ambulance report dated 25 May 2018 regarding the claimant's accident on that date. It records, inter alia, the claimant complained of mild right shoulder pain and anterior right wrist.
25.. The clinical notes of Dr Vo record on the 20 March 2019, the claimant as consequence of the accident, on 25 May 2018, developed left shoulder pains, which since then, have been getting worse,,, left sided headaches.
26. The insurer, inter alia, submits the causal relationship between the subject accident and the claimant's neck, right deltoid and numbness in his hands is tenuous, as found by Dr Keller in 2018, due to the very late onset of complaints. This is especially so, given he was fit for pre-injury duties which were already restricted in any event by reason of the long-standing lower back symptoms, pre-existing right knee symptoms and pre-existing cervical spine symptoms. In all these circumstances, the insurer denies there were injuries sustained in the accident and submits, if anything at all is accepted as causally related, the claimant sustained a short-lived soft tissue aggravation to the cervical spine and down his arms right and allows a closed period of damages of 4 months consistent with the presentation to Dr Chung in May 2017,and improvement of symptoms in his neck and arms as reported to OZ physiotherapy on 8 May 2017 with the last complaint of left arm symptoms on 7 June 2017. The continuing right shoulder symptoms after onset of 8 May 2017 were not causally related to the accident. The insurer submits the claimant's last accident-related medical treatment was with GP Dr Chung in May 2017. He only saw Dr Chung on one further occasion in July 2017, to obtain the personal injury claim form medical certificate.
27. The insurer arranged for him to be seen on a medico legal basis by Dr Keller, and I refer to his report dated 6 April 2018. On page 2 of his report. Dr Keller records the following
"Mr Fakhreddine reports no head injury or loss of consciousness. He was able to stand and walk at the scene of the accident. He reports no immediate pain or injuries and went home after the accident. Mr Fakhreddine continued working as normal. After around one month, he reports the development of pain in his neck associated with pins and needles and all of the fingers of the left and right hand to the level of the mid forearm. In late March, he also developed lower back pain that was interfering with his sleep and headaches."
At the assessment conference the claimant said he did not recall making these statements to Dr Keller.
28. Dr Keller recorded he was suffering from intermittent pain in the neck. The claimant's self-stated capacities included sitting for 60 minutes, standing and walking unrestricted lifting up to 40 kg and driving automatic vehicle for up to 70 minutes. Dr Keller also recorded the following on page 4 of his report
"Mr Fakhreddine is independent is self-care tasks. He is able to assist with cooking and cleaning at home and also mows his own lawns. He has no paid cleaning or yard services it has no such services prior to the accident. He states he has never received any medical disability benefits"
29. Dr Keller examined the claimant and found the range of movement in both shoulders and elbows was full and symmetrical. He also notes on page 8 of his report he appears to have never been certified unfit for work and noted on 4 May 2017 Dr Chung certified him fit for unrestricted work. Dr Keller opined he suffered possible soft tissue strains to the cervical and lumbar spine, but with an unusually delayed presentation. The insurer also arranged a refresher medical examination with Dr Keller, and I refer to his report dated 19 May 2023. In summary, he was of the opinion the claimant should have experienced a full physical recovery from the effects of the accident within 3 or 4 weeks, and he was also unable to find objective evidence for lasting physical injuries attributable to the accident that required current or future treatments. He also noted the following on page 7 of his report,
"It is reasonable that Mr Fakhreddinne received up to three months of physiotherapy this relates to neck and back pain .it is however not clear to me that this is directly attributable to the subject accident. In my opinion Mr Fakhreddine is unlikely to receive lasting benefit from ongoing passive physical therapies. there are no current medical indications for any surgery or injections.
30.. The insurer also arranged for the claimant to be examined on a medical legal basis by Dr Rikard Bell psychiatrist and I refer to his report dated 5 December 2023. He expressed the opinion the claimant developed a panic disorder and somatic symptom disorder with dominant pain anxiety in addition to anxiety symptoms. He recommended he undergo treatment In relation to panic disorder with a clinical psychologist and would also benefit from treatment with pain management. He did not believe there was any care or rehabilitation requirements in relation to the psychological injury.
31. The claimant was examined by Medical Assessor Alan Home, and I refer to his certificate and reasons dated 21 December 2023. Assessor Home determined the claimant suffered the following injury in the subject accident
He determined the claimant had suffered a right shoulder, referred pain from the neck, trapezius muscle strain which had resolved. I note the following on page 10 of his reasons,
"The claimant reports the progression of pain at his right shoulder over the last 12 months. There is documentation of restricted right shoulder motion at the time of the examinations of Dr Bodel and Dr Dias with motion progressively restricted overtime. The range of right shoulder motion is further restricted at the current assessment.
At the current assessment there is marked restriction of external rotation motion with the elbow by the side, which is constant with a diagnosis of severe underlying glenohumeral joint arthritis, which is now causing the claimant constant pain. The diagnosis is evident from ultrasound and MRI scan imaging of the right shoulder performed in July 2023.
I do not find that the subject accident has caused the current diagnosis of severe glenohumeral joint osteoarthrosis. There is no record of immediate shoulder pain that would be anticipated if the claimant had sustained an injury to the shoulder joint articulation (glenohumeral joint) in the subject accident. Mr Fakhreddine presented with the full range of active motion of the right shoulder at two separate independent examiners, one year after the accident, indicating that there was no evidence of symptomatic osteoarthritis of the right shoulder at that stage,
32. The claimant was also examined by Medical Assessor Shen, and I refer to his certificate and reasons dated 7 March 2024. He determined the claimant suffered the following injuries caused by the subject accident.
I note the following under the heading "Causation and Reasons" on page 9,
"The subject accident has led to his physical injuries and pain, which has led to a degree of preoccupation causing the somatic symptom disorder. In conjunction with physical limitations from his injury, and somatic concerns, in turn has negatively impacted his capacity for work, leading to significant financial strain, and marital strain. A further accident in 2018 has likely compounded this anxiety, and the cumulative stressors has led to the onset of panic attacks, and hence panic disorder in 2023.
In the alternative, since the claimant drew shareholder loans, in lieu of wages in the financial years 2015 and 2016, I should find he earned $1280 nett per week in the financial year ending 2016, in the form of shareholder loans, as opposed to wages. It is submitted, I should accept this sum as being the claimant's earning capacity as at 10 February 2017. Thereafter, the claimant was paid in wages and a schedule of such wage payments is set out in paragraph 42 of the claimant's submissions. The calculations proposed for past economic loss as at 13 May 2024 total $348,400.
I determined the claimant suffered minor soft tissue injuries to his neck, back and left and right shoulders, in the subject accident, and such injuries had, to a large extent, resolved by the time he was examined by Dr Barold in March 2018.
I also accept the findings of Dr Keller as stated in his report dated 6 April 2018 and in his later report, dated 19 May 2023 when he opined the claimant should have experienced a full physical recovery from the effects of the accident within 3 or 4 weeks. Dr Keller was also unable to find objective evidence for lasting physical injuries attributable to the accident that required current or future treatments when he examined him in May 2023.
In relation to his psychological injuries, I again note he had not received any psychological treatment since the accident and the first indication he was suffering psychological injuries was when he was examined on a medico legal basis by Dr Nagesh in May 2023, I do not find the panic attacks were of such severity to cause him to suffer a diminution in earning capacity.
I therefore find the claimant suffered a minor diminution in his earning capacity since the accident, for a period of approximately 13 months, up until May 2018, and thereafter, there was no diminution in earning capacity causally related to the injuries suffered by him, both physically and psychologically.
I consider it appropriate in the circumstances to award him a sum of $25,000 for past loss of earnings.
I will allow the amounts claimed for treatment provided by OZ physiotherapy totalling $1875. I allow a Medicare charge in the sum of $200. I allow $610 for treatment from Kookdang traditional medicine centre.
The total amount allowed for past treatment expenses is $2685.
f. I accept the opinion of Dr Keller regarding the claimant's need for future domestic assistance and accordingly, I make no allowance.
Total of economic losses and non-economic loss $27,685
a. Section 83 payments $ nil
This determination takes effect on 22 April 2025. .
The amount of the claimant's costs assessed in accordance with the Motor Accidents Compensation Regulation 2015 are the regulated costs.
In making my decision I have considered the following legislation and guidelines
Fakhreddine
Allianz Australia Insurance Limited [2025] NSWPIC 160