For the reasons above, the cervical and lumbar spines are DRE I (0% WPI). The right shoulder is 4% WPI and the left shoulder 1% WPI by measured range of motion. The right knee attracts 2% WPI for patellofemoral pain/crepitus (Table 62 footnote). The combined WPI is 7%.
[2]
The claimant has requested that the published reasons be de-identified.
The insurer has informed the Panel that it neither consents or objects to the de-identification of the published reasons.
These reasons contain sensitive personal information.
The reasons for de-identification relate to the claimant's physical and psychiatric condition which, it has been submitted to the Panel, will as a result of this determination, unnecessarily affect the claimants mental health if reasons are published and which identify the claimant. The Panel does consider that it is possible that publication of the reasons will cause the claimant further trauma.
Having weighed the matters referred to in of the including the safety, health and wellbeing of the claimant, and whether the public interest in giving the direction significantly outweighs the public interest in open justice, the Panel are satisfied that the decision should be deidentified before it is published.
Pursuant to Rule 132 of the Rules, the decision is to be de-identified prior to publication to include, at least, a pseudonym for the claimant.
[3]
This certificate and reasons replace the certificate and reasons of 24 November 2025
The Panel agrees that reference to the claimant should be deidentified.
The Panel revokes the certificate of Medical Assessor Home dated 14 April 2025.
The Panel finds that the claimant has a whole person impairment assessment of 7%.
Parties
Applicant/Plaintiff:
FNA
Respondent/Defendant:
AAI Limited t/as AAMI [2025] NSWPICMP 923;
Legislation Cited (1)
Accident Injuries Act 2017
Cases Cited (3)
FNA v AAI Limited t/as AAMI [2025] NSWPICMP 923; (24 November 2025)
The parties have each presented their respective bundles of documents upon which they rely. The Panel have read all the documentation. If a particular document is not referred to by the Panel, this does not mean that the Panel or a Panel Member has not read it, in much the same manner as parties not referring to or not specifically relying on a document in their own bundle and submissions.
The fact that evidence is not referred to in these reasons does not mean it has been overlooked and nor is it required that each piece of evidence be mentioned - see WAEE v Minister forImmigration and Citizenship (2003) 75 ALO 630 at [46].The Panel is not required to "analyse every piece of information from every opinion contained in a document with which he [it] was provided" - see Farr v Insurance Australia Limited t/as NRMA Insurance Ltd[2014] NSWSC 1435 at [46]. The Panel has come to its own conclusion and has taken its own history.
The Panel notes the High Court judgment in Gamestar Pty Ltd v Lockhart[1993] HCA 79. The Court observed in the absence of submissions referring to specific documents that a tribunal is not required to search for references within documents where the submissions do not specifically address the materials. The Panel also notes the comments of Bellew J in Bevan v Bingham[2023] NSWSC 19 concerning the obligation of legal practitioners to place only the necessary evidence before the decision-maker.
The claimant submits that the Medical Assessor's findings are inaccurate, inconsistent with the preponderance of the evidence presented by both parties, and are also internally inconsistent, and have been assessed in breach of the requirements of both the AMA4 Guides and the Medical Assessment Guidelines (the Guidelines)
The claimant says that the Medical Assessor has made speculative and unscientific findings in relation to his assessment of the claimant's lumbar spine injury and impairments, and has made causation findings in relation to this that breach the assessment requirements that are contained in the Motor Accident Guidelines, and which breach the principles enunciated in the authority of Insurance Australia Limited trading as NRMA Insurance v Brown[2019] NSWSC 1236;
The claimant submits that the Medical Assessor's overall assessment of 6% WPI was not open to him on the evidence, and which has resulted in an untenable and outlying opinion that is inexplicably outside of the range of WPI assessments available to him on the evidence.
The claimant submits that with respect to the lumbar spine assessment, the Medical Assessor has inexplicably and wrongly concluded that "...A 5% WPI rating arises for that condition. However, I find that this arises due to a subsequent lumbar spine condition, a new right sided disc protrusion that developed in early 2024", noting, the claimant submits, that the claimant's post-accident lumbar spine and radicular complaints of pain into his lower limbs occurred before 2024 and which the claimant submits is confirmed in the report of his treating specialist Dr Steele.