1. The Medical Assessor determined that the motor accident caused a post-traumatic stress disorder and persistent depressive disorder.
2. The Medical Assessor concluded that the motor accident caused minor impairment (class 1) in self-care and personal hygiene and travel and moderate impairment (class 3) in the categories of social and recreational activities, social functioning, concentration, persistence and pace and adaptation.
3. The Medical Assessor diagnosed a major depressive disorder as a pre-existing condition but found no pre-existing impairment.

1. The insurer provided a bundle of documents. The claimant provided a letter dated

5 June 2025 setting out her circumstances. 2. The Panel advised the parties that we would include the claimant's bundle filed in the original assessment as part of the material before us.

1. A certificate of capacity dated 3 February 2020 noted the motor accident and review for pain management.[9]
2. On 6 February 2020 the claimant completed a claim form describing the motor accident and her physical injuries.[10]
3. A certificate of capacity dated 11 March 2020 noted fractured spine at L1, L2 and L3.[11]
4. A report of Dr Rao, neurosurgeon, dated 8 April 2020 noted the MRI scan showed a minor crush fracture at L1.[12] On 13 July 2020 Dr Rao noted discogenic back pain with potential left L4 radiculopathy.[13]
5. A certificate of capacity dated 14 November 2020 noted ongoing lower back pain and psychological trauma from the motor accident.[14]
6. An Allied health recovery request dated 4 February 2021 noted the claimant presented with symptoms suggesting a provisional diagnosis of post-traumatic stress disorder and depression. Symptoms included severe anxiety, nightmares, sleep disturbances, intrusive memories, flashbacks, hypervigilance, avoidance of driving, chronic pain, difficulty concentrating and feelings of frustration and anger.[15]

1. Dr Tim Hwang, occupational physician, was qualified by the insurer and provided a report dated 28 March 2022.[16] The doctor noted a history that the motorbike accident caused lumbar spine fractures.
2. Dr Hwang described the radiology as inconclusive and was unable to confirm any lumbar spine fractures. The doctor assessed impairment of the lumbar spine based on a best fit as DRE lumbar spine category 2.
3. Dr Dayalan, psychiatrist, was qualified by the insurer and provided a report dated

26 May 2022.[17] The doctor opined that the claimant's mental health condition did not impact on her capacity to attend to personal hygiene although physical injury impacted on some functioning. He noted that driving was affected by both the physical and mental health. The relationship with the daughter and granddaughter was reported as good. 4. The doctor noted childhood experiences with unresolved trauma and depressive symptoms following her father's death for which the claimant received both psychological and psychiatric treatment. 5. Dr Dayalan diagnosed post-traumatic stress disorder caused by the motor accident. He noted that there had been an improvement in the claimant's condition three months prior to the assessment and the psychological condition had not stabilised. The doctor opined that there was a clear need for future treatment with a potential trial of psychiatric medications. 6. Dr Dayalan provided a further report dated 10 August 2023.[18] The doctor noted that the claimant indicated there had been a significant improvement in her mental state since the previous assessment. The claimant reported that consultations with a psychologist and returning to work had greatly assisted with her mental state and felt supported by her daughter and her family. 7. The claimant reported no problems with personal hygiene, was able to do household chores and lived on her own and did not require any assistance. The leisure activities included watching television, reading books and spending time with her grandchildren. The claimant did not engage in regular social activities and believed that interactions with her work colleagues was her social outlet. Ms Hicks reported a good relationship with her colleagues occasionally attending sporting events involving her grandchildren. 8. The claimant reported that the relationship with her partner ended, and she had taken an apprehended violence order out against him some 12 months previously. The claimant reported an improvement in her concentration, and the work required her to focus, and she was able to sustain attention when she read books. 9. The claimant denied any mental health problems affecting her capacity for work and remarked that she experienced back pain after a full day at work and the physical pain appeared to be the barrier to increasing hours at work. 10. Dr Dayalan noted that the claimant presented as well-kept during the assessment maintain good eye contact and rapport was established. The doctor opined that the claimant did not present with any obvious impairment in her cognition. 11. Dr Dayalan noted that the claimant denied that most of the symptoms from the initial assessment continued and any residual impairment in functioning was largely attributable to ongoing physical pain. The doctor opined that based on the presentation and history provided, he regarded the claimant's post-traumatic stress disorder to be in remission. 12. Dr Dayalan opined that the psychiatric condition had resolved and there was no ongoing incapacity for work due to the psychiatric condition. There was no whole person impairment as the psychiatric injury had resolved.

1. The claimant provided the Panel with a letter in response to the request for documents. In that letter the claimant said that she no longer had the mental or physical capacity to be able to get back to her pre-accident life and noted she could not collect her daughter or grandchildren or do their home duties for them. The claimant was unable to drive and would have panic attacks.
2. The claimant stated that she does not leave the house, does not interact with people and has become reclusive.
3. The claimant stated that the accident affected her relationship with her partner as she became disconnected from him and made a life changing decision to move from her life in New South Wales and return to her family in Adelaide.
4. The claimant stated that it has been a slow process with the improvement of quality of life. She stated that apart from being back with the family she does not socialise anymore. The claimant said she started working as a retail assistant which had helped her to interact with people, but it has been very challenging. She said she does not have the same ability now to do the work she used to do before and that she has not been able to get into another relationship as physically and mentally she has been compromised.
5. The claimant said that she does not go out socialising outside of work and does not have any close friendships. Her day-to-day functioning has slowed, and she still gets anxiety when she leaves the house and drives anywhere.
6. The claimant stated that she is in pain and moving is difficult and she is otherwise agitated that she can no longer do the same things that she could do before the accident.

Insurer's submission dated 2 May 2024[19]

1. The insured noted that there was no evidence that the claimant suffered any pre-existing injuries or medical conditions.
2. The insurer referred to the treating evidence in relation to the claimant's physical injuries.
3. The insurer noted the report of Dr Dayalan, psychiatrist, dated 26 May 2022 who diagnosed post-traumatic stress disorder and opined that the psychological injury had not reached maximum medical improvement for the purposes of whole person impairment assessment.
4. The insurer referred to the updated report of Dr Dayalan dated 10 August 2023 which reported a diagnosis of post-traumatic stress disorder in remission and that the claimant had made considerable progress in her mental state. The doctor reported that any residual impairment in functioning was largely attributed to the ongoing physical pain and opined that the psychiatric condition had resolved.
5. The insurer referred to the Allied health recovery request report dated 3 November 2022 where the psychologist noted improvements in the claimant's mood, energy, level, motivation, ability to undertake daily activities, self-confidence, decision-making and reductions in anxiety symptoms.
6. The insurer noted the claimant developed psychological symptoms requiring treatment and was diagnosed with post-traumatic stress disorder caused by the accident. The insurer submitted that the findings of Dr Dayalan should be preferred on the basis of a most recent examination and submitted that the psychological condition had resolved with the passage of time and no permanent impairment was assessable.

Insurer's submissions dated 2 October 2024[20]

1. These submissions sought leave to review the medical assessment.
2. The insurer submitted that the Medical Assessor recorded contradictory information in the assessment in relation to histories of watching television and failed to put these inconsistencies to the claimant. It was submitted that this breached paragraph 6.41 of the Guidelines.
3. The insurer submitted that the assessment of class 3 for social and recreational activities, was dependent on being unable to go out without a support person and was inconsistent with histories recorded elsewhere that the applicant travelled independently and worked 20 hours per week as a retail assistant.
4. The insurer submitted that the history was that the claimant could drive up to an hour and work 20 hours per week was consistent with a conclusion that the claimant had an ability to concentrate for more than 15 minutes.
5. The insurer submitted that a reason for the class 3 assessment for social functioning was that the claimant was not able to be a pillion rider and not ride bikes which was an irrelevant consideration for that category.

1. The Panel determined that the claimant be re-examined by both Medical Assessors. The examination report is as follows,

"The claimant was re-examined by Senior Medical Assessor Baker and Medical Assessor Canaris (Medical Assessors) by MS Teams on 24 September 2025. What follows are the findings of the Medical Assessors following the re-examination.

The claimant was born in Hindmarsh Women's Hospital (closed) in South Australia. She was raised with her mother, father, and an elder brother and younger sister. Her father was a truck driver. He died at 59 years of age - about 26 years ago. Her mother worked at Clipsal a manufacturing company. She was 68 years of age when she died in 2013 from cancer.

The claimant had an elder brother aged 63 years with whom she had last contact in about 2013. She also had a younger sister who was 57 years of age. She would have regular conversations with her younger sister. Her younger sister had suffered from meningitis when she was aged about 20 years. The claimant stating her sister 'was not changed' by the illness.

The claimant had one daughter aged 37 years of age. The claimant was married in 1986 and the marriage was dissolved after 30 years in 2016. She had no contact with the father of her daughter since. Her daughter had two children aged 10 and 8 years. The claimant said none of her immediate family were suffering from any psychological condition or disability.

The claimant said she attended Mansfield Catholic Primary School and then progress to Park Community College in Angle Park, SA. She completed Year 9 of school. Her father separated from her mother about this time.

The claimant commenced her career as a cashier for Cole's supermarkets in Kilkenny, SA. She worked this role from the age of 15 years to 18 years. She then found employment at Clipsal and was a worker on the factory assembly line for about 2 years.

The claimant married in 1986, and she had one child to this union. She said that she would work

part-time in the Strathalbyn meat works for about five years, before transferring to Foodland Supermarket in Strathalbyn. She said she would also do part time work in cafes and later found employment in the retail clothing industry working for popular brands including Suzanne's, and Millers. Whilst working for Millers the claimant was promoted to work as a store manager. She said she then found employment with Black Pepper and Rockman's fashion stores.

The claimant divorced after about 30 years of marriage. She said that her daughter moved to NSW and the claimant left South Australia to work closer to her daughter.

In 2016 the claimant moved to Wollongong as a single person and found employment with Black Pepper at Shellharbour and then Rockman's in Wollongong. Before the accident the claimant moved to work in Goulburn at Rockman's. She moved to Black Butt near Marulan, NSW with her partner. She was living with her partner and she would drive about one hour to work in her own car most days before the accident.

The claimant said she had never suffered from any diagnosed psychological conditions as a child. She said she had not suffered from any fractured bones. She had not had any surgical treatment. She said she had a natural birth of her daughter. She reported that she did not suffer from any post-natal depression. She said at age 30 years she suffered from an allergic reaction to penicillin. She had stopped using this medication. She said she smoked about 10 cigarettes daily. She said she would drink alcohol if she was socialising with friends at an event. She said she did not drink alcohol daily. She would drink beer if she was at a celebration. The claimant reported not gambling.

The claimant did not report any pre-existing psychiatric or psychological injury or conditions before the accident. There is no family history of psychiatric or psychological conditions. There was no history of driving offences or any other legal matters. The divorce was settled without attending court. There was no forensic history.

The claimant was working fulltime 38 hours per week. She would socialise with a community of friends who would gather at the Robertson Pie Shop for coffee and cakes. She would ride as a pillion passenger on her partner's motorcycles on the weekend as they would take day tours along the south coast of NSW. The claimant held a Class C (car) licence but had never held a Class R (rider licence.)

The claimant was safety aware and she wore a full-face helmet, full riding protective clothing, gloves, Kevlar reinforced riding jack and heavy riding boots. She said she had never been in an accident before this accident on 1 February 2020.

The claimant said that it was the day after her birthday, and she had organised with her partner to travel to Wollongong to purchase a new pair of riding gloves as her current pair were wearing out. She and her partner rode to their favourite motorcycle shop in the industrial area of Wollongong. The trip took about one hour.

After purchasing the new gloves, the pair chose to return home via Old Jamberoo Mountain Road. The claimant said that the couple had been riding this route many times and the nature of the road was known to both the driver of the motorcycle and the claimant who travelled as a pillion passenger.

The claimant said she had been attending to the road as the pair progressed up the mountain. She said that she remembers that the bike slid left and the rear wheel was the first to lose traction.

The claimant said that her next memory was a of a heavy force hitting her back. She said she was dazed by the accident. She found herself sitting on the road with the motorcycle behind her. She said that bystanders called for an ambulance. She could not remember whether NSW Police attended the scene of the accident.

The claimant said that both she and her partner were transferred in the same ambulance. She was placed on the stretcher and her partner sat whilst being transferred to hospital.

History of symptoms and treatment following the motor accident

The claimant attended Wollongong Hospital emergency room. She was investigated for injuries. She was diagnosed with a fractured left 12th rib. She said she had injuried her lower back. She said she thought she might had fractured L1, L2, L3, however she was not provided with any speficic treatment so after her overnight stay at hospital she purchased a back bace and wore it until her pain improved.

The claimant had her abrasions cleaned and dresssed and she was discharged for follow up by her general medical practitioner. Both she and her partener went home via taxi from Wollongong as neither had family to assist them.

The claimant said that she had attended her general medical practitoiner on the second or third day after discharge from hospital. She was refered for physiotherapy. She was also refered for review by a surgeon in Bowal. She said she had a cortisone injection in her back to relieve pain however the tretment was only partly beneficial as her pain represented a few weeks after the injection. She said that her main physical difficulty was bending her back to reach the floor which made dressing, lifting and other activties of living difficult.

The claimant said her general practitioner dressed her skin lacerations. She said she had wore through her Kelvar protective clothing and had laceractions on her knees. These skin injuries healed. She said that she also became aware that she had pain in her left gluetal muscle and she thought she had susatined a haematoma in this muscle.

The claimant said she was refered to a psychologist for treatment. She said she had to wait for about six weeks for access to the psychological service. She said that she had attended the psychologist a few times in person - however most of the treatment was provided over the telephone. This treatment stopped when she left NSW and returned to SA.

The claimant said she began experiencing increasing depressive symptoms, saying she felt isolated in her home and was becoming depressed, sad and unhappy as she was unable to work. She said that her daughter attended her home and assisted her during the claimant's first week out of hospital. The claimant began to experience feelings of loss of hope and low energy with rapid fatigue. She said her sleep was poor and she would wake frequently each night and be slow to return to sleep.

The claimant developed a depressive distressing ruminiation, 'If the accident did not happen my life would be different!' She quickly added, 'I do not blame him...the accident did change everthing.' The claimant described increasing verbal arguments between her and her partner. She said that her relationshsip with her partner failed. She said she became increasingly fearful of her partner. She became so depressed in her mood that she felt she was a burden to everyone. She felt worthless and she resigned from her role with Rockman's in Goulburn.

The claimant moved to live with her mother in Lewistown, SA. She separted from her partner. Her partner followed her to SA. She applied for a domestic violence order through the Elizabeth Local Court, to restrain her partner from having any conatct with her.

The claimant moved to her current location and she said that her partner had stopped trying to contact her and it was about 2 years since his last attempt.

The claimant said that initally her sleep was disrupted by pain, waking her every two hours. She said would also wake and be startled by the sound of a motorcyle driving past her home. She said that she still experienced pain. She said she managed her pain and she was able to attempt a return to work.

The claimant had stopped attending her general medical practitioner about two years ago. She said she had been refered to a psychiatrist in Gawler, SA. She attended for a short time only. She was recommended to commence an antidepressant. The claimant said that she chose not to use this medication. She said she was prescribed diazepam 5 mg should she become agitated. The claimant said she had stopped attending her psychologist about two years ago. She was treated with cognitive-behavioural therapy, relaxation skills training and mindfulness.

The claimant was not treated as an inpatient of a psychiatric hospital. The claimant was not referred for repetetive transcranial magnetic stimulation (rTMS) for her depressive disorder.

The claimant treated her pain with paracetamol 500 mg tablets, two tablets three times daily.

Details of any relevant injuries or conditions sustained since the motor accident

There are no relevant subsequent conditions or injuries sustained since the accident.

The claimant presented as a woman who was neatly groomed at the time of the re-examination. She spoke in soft tones, and the volume of her speech was low. She spoke at a normal rate and had a normal rhythm to her speech. Rapport was developed and sustained throughout the re-examination. She was able to provide a coherent and logical history of her psychological injury sustained in the accident. Her social behaviour was appropriate and polite. Her mood was reported as sad and depressed and her effect was reactive and congruent with the content of her speech. She was tearful when talking about her lost lifestyle since the accident.

The claimant was orientated in time, place and person. She was able to provide a coherent narrative of her psychological condition before and after the accident without prompting. She did require brief pauses during the re-examination, and she was able to continue in a logical and straight forward manner whilst describing her emotional state.

The claimant did not report delusional ideas or psychotic symptoms. She spoke about her loss of hope of returning to her prior lifestyle she had enjoyed in NSW before the accident.

The claimant did not report any suicidal thoughts or plans. Her judgement was normal, and she was insightful into her condition.

The claimant currently lives at home in Tanunda, SA alone. She is able to care for herself independently. She reported a diminished appetite. She said she would suffer from poor motivation and a low mood when thinking about the accident and her injuries. She could shower, clean, buy groceries and launder her clothes. She was less interesting her deportment and her self-care than before the accident.

The claimant lives independently but has made adjustments to her lifestyle because of pain. She restricted the weight of laundry she lifted. She reduced the weight of groceries she would lift in a single bag. These changes in her functioning were not included in the assessment of whole person impairment caused by the accident in compliance with guidelines, that exclude pain and associated loss of functioning. Loss of function due to pain is not included in the PIRS assessment.

The claimant has limited social and recreational activities but she did read novels for pleasure. She enjoyed authors such as Mary Lou Stevenson, fiction and historical fiction based on real stories. The claimant also enjoyed knitting bonnets. She said she was knitting in expectation of a new grandchild in the future.

The claimant did not report any loss of social and recreational activities due to pain at the re-examination. Loss of function due to pain is not included in the PIRS assessment.

The claimant said she could drive in her car alone to local or familiar locations like her daughter's home which was about one hour away. She said she could leave her home to attend her workplace without difficulty. She could leave her home and walk in her local area.

Assessment of pain The claimant cannot drive more than 30 minutes by car due to pain in her back. She reported her pain was exacerbated by sitting. She would take a brief pause to stand and stretch before moving on. She said her daughter's home was the longest distance she could routinely travel and pain would not prevent her attendance. Loss of function due to pain is not included in the PIRS assessment.

The claimant is separated from her partner who was the driver of the motorcycle in the accident. She said he had followed her to South Australia and that he had wanted to continue the relationship. After many attempts to explain to her partner that the relationship was permanently ceased, the continued contact resulted in the claimant successfully seeking a domestic violence order (DVO) from the Elizabeth Local Court.

The claimant said that her relationship with her daughter and her grandchildren remained supportive and understanding of her condition.

The claimant did not report any loss of social functioning due to pain at the re-examination. Loss of function due to pain is not included in the PIRS assessment.

The claimant can read for up to 20 minutes before stopping for a brief pause. She could concentrate up to 30 minutes at the time of this re-examination. She said she could knit and would not make many errors. She said she kept the pattern to what she knew. She would not knit new patterns as the acquisition of this new skill was slow and frustrating. She was able to perform her complex duties at work where she was required to perform various tasks and attend customers in her retail sales role.

The claimant reported that she was able to knit and concentrate to perform her work and work-like activities without making errors at the time of this re-examination. Loss of function due to pain is not included in the PIRS assessment.

The claimant was able to make a slow and sustained return to work in a lesser role that that which she held prior to the accident. She worked causal hours, selling furniture in a well-known shop close to her home. She had increased her hours from initially about 15 hours per week to now 32 hours per week. She said she worked about 32 hours per week over 5 days. She said that she had met the necessary sales and activities with completion of tasks required by her employer without complaint regarding her capacity to work.

The claimant said that her pain was managed by her restricting how long she sat. She said that she preferred to stand mainly and she would reduce her sitting time so not to experience increased pain. Loss of function due to pain is not included in the PIRS assessment.

The interview was consistent. She was able to provide a coherent and consistent history that was similar to the record in documents forwarded with this referral. She did not overemphasise her incapacity at work in a new format with a new employer since the accident. She could explain how she was impaired by pain and how she managed her pain.

The medical panel considers that the diagnosis defined by DSM-5-TR F 32.0 major depressive disorder - single episode of mild severity is the most appropriate diagnosis that describes the claimant's primary psychological injury.

The following DSM-5-TR criteria for major depressive disorder are as follows - the claimant reported the current symptoms at the time of the re-examination:

Criterion A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

• Depressed mood most of the day, nearly every day as indicated by the claimant reporting daily sadness most days since the accident.
• Markedly diminished interest and pleasure in all or almost all activities nearly every day as demonstrated by her loss of interest in social motorcycle touring, and loss of her friendship circle in NSW.
• Poor sleep with difficulty initiating sleep with the claimant having initial and middle insomnia.
• Fatigue and loss of energy nearly every day with the claimant not been able to socialise within her new community with her not making any friends since the accident.
• Persistent feelings of worthlessness every day since the accident as she had not fully recovered from her psychological injury.
• Diminished ability to concentrate with marked indecisiveness whilst making simple everyday decisions about her personal life and career

Criterion B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

This criterion is met because the claimant has lost her senior retail career which she was performing in NSW before the accident. She had lost the relationship she had formed before the accident whilst living in NSW. She had lost her lifestyle where she enjoyed day-touring in Southern NSW.

Criterion C. The episode is not attributable to the physiological effects of a substance or to another medical condition.

This criterion is met because the claimant does not drink daily alcohol, use substances or suffer from a medical condition that may cause depressive symptoms.

Criterion D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified an unspecified schizophrenia spectrum and other psychotic disorders.

This criterion is met because the claimant does not suffer from any of the above conditions.

Criterion E. There has never been a manic episode or a hypomanic episode.

This criterion is met because the claimant does not suffer from any of the above conditions.

The claimant suffered from pain, which caused her to have some restriction in her capacity to function. The claimant was able to self-manage her pain and she used paracetamol in the advised dosage to treat her pain. The components of functioning attributed to pain by the claimant was separated from the accessible psychological condition causing the psychological injury.

The Medical Assessors noted that the claimant reported other symptoms consistent with post-traumatic stress disorder, including nightmares, poor concentration and poor sleep. She did not report avoidance of driving after the accident. She did not have sufficient symptoms to meet all the criteria for a diagnosis of posttraumatic stress disorder and for these reasons this diagnosis was not made.

Considering the nature of the accident it was concluded that the accident did not satisfy Criterion A for post-traumatic stress disorder. The claimant did not fear for her life at the time of the accident. She was investigated and treated for her physical injuries sustained in the accident. She did stop riding as a pillion passenger - however she was able to return to 32 hours of employment after the accident and continue her career in a lesser role with significant lifestyle changes adapted to her circumstances at the time of the re-examination. For these reasons, the claimant did not meet DSM-5-TR criteria for F43.1 post-traumatic stress disorder.

DSM-5-TR F 32.0 Major depressive disorder of mild severity

The claimant had received psychological treatment for her psychological injury caused by the accident. She had also used diazepam 5 mg orally at night if agitated. She had been treated by her general medical practitioner and a psychiatrist. She elected not to use antidepressant medication for this psychological injury.

The claimant currently lives at home in Tanunda, SA alone. She is able to care for herself independently. She reported a diminished appetite. She said she would suffer from poor motivation and a low mood when thinking about the accident and her injuries. She could shower, clean, buy groceries and launder her clothes. She was less interested in her deportment and her self-care than before the accident.

The claimant has limited social and recreational activities, but she did read novels for pleasure. She enjoyed authors such as Mary Lou Stevenson, fiction and historical fiction based on real stories. The claimant also enjoyed knitting bonnets. She said she was knitting in expectation of a new grandchild in the future.

The claimant said she could drive in her car alone to local or familiar locations like her daughter's home which was about one hour away. She said she could leave her home to attend her workplace without difficulty. She could leave her home and walk in her local area.

The claimant is separated from her partner who was the driver of the motorcycle in the accident. She said he had followed her to South Australia and that he wanted to continue the relationship. After many attempts to explain to her partner that the relationship was permanently ceased, he continued contact resulted in the claimant successfully seeking a domestic violence order (DVO) from the Elizabeth Local Court.

The claimant said that her relationship with her daughter and her grandchildren remained supportive and understanding of her condition.

The claimant can read for up to 20 minutes before stopping for a brief pause. She could concentrate up to 30 minutes at the time of this re-examination. She said she could knit and would not make many errors. She said she kept the pattern to what she knew. She would not knit new patterns as the acquisition of this new skill was slow and frustrating. She was able to perform her complex duties at work where she was required to perform various tasks and attend customers in her retail sales role.

The claimant was able to make a slow and sustained return to work in a lesser role that that which she held prior to the accident. She worked casual hours, selling furniture in a well-known shop close to her home. She had increased her hours from initially about 15 hours per week to now 32 hours per week. She said she worked about 32 hours per week over 5 days. She said that she had met the necessary sales and activities with completion of tasks required by her employer without complaint regarding her capacity to work.

With respect to current whole person impairment, the Medical Assessors' opinion is as follows:

There was no pre-existing impairment, and this apportionment was assessed as 0%.

There was no subsequent impairment, therefore no adjustment for this apportionment.

There was no effective ongoing psychological or psychiatric treatment. Therefore, no treatment effect.

1. The Panel conducts a new assessment of all the matters with which the medical assessment is concerned.[21]
2. 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[22] and Insurance Australia Ltd v Marsh.[23]
3. The Panel adopts the detailed examination findings made by both Medical Assessors with the additional further short observations.
4. Clauses 6.214 and 6.215 of the Guidelines note that the assessment of psychological injury does not include any allowance for "impairment due to physical injury" and "impairments due to somatoform disorders or pain".
5. The claimant's ongoing physical restrictions and pain have not been considered in assessing the impairment due to psychological injury.
6. We confirm that the impairment is based on the evaluation at the time of the medical assessment (cl 6.21 of the Guidelines) and we have relied on the combined clinical expertise of the Medical Assessors when examining the claimant.
7. We are satisfied, particularly based on the clinical expertise of the Medical Assessors, that the impairment is permanent within the meaning of cls 6.19 and 6.20 of the Guidelines because the condition is well stabilised and is unlikely to change by more than 3% within the next 12 months with or without treatment.

1. The certificate issued by Medical Assessor Nagesh dated 9 September 2024 is revoked. The new certificate is attached at the commencement of these Reasons.

[2] See Division 7.5 and Schedule 2 cl 2 of the MAI Act.

[20] Insurer's bundle, p 3.[21]