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

1. Revokes the certificate of Medical Assessor Ankur Gupta dated 14 November 2024.
2. Certifies that the following injury caused by the motor accident gives rise to a whole person impariment of 7% which is not greater than 10%:
   • Major depressive disorder.

1. Mr Danijel Jovicic (the claimant) alleges injury from a motor accident occurring on

18 November 2022. 2. He subsequently lodged a claim under the Motor Accident Injuries Act 2017 (MAI Act) upon Insurance Australia Limited t/as NRMA Insurance (the insurer), the compulsory third party insurer of the vehicle considered at fault. 3. The insurer is liable for payments of statutory benefits and/or damages under the MAI Act. 4. The subject dispute between the parties is whether any psychological injury caused by the accident gives rise to a whole person impairment (WPI) greater than 10%. 5. A medical assessment matter is determined in accordance with Division 7.5 of the MAI Act. This means that the matter is determined at first instance by a Medical Assessor. 6. The dispute the subject of these proceedings is a medical dispute, as defined by s 7.17 of the MAI Act, and is a medical assessment matter: Sch 2, cl 2(a) of the MAI Act. 7. The dispute was originally determined by Medical Assessor Ankur Gupta who issued a certificate and reasons dated 14 November 2024. The Medical Assessor certified that the claimant had suffered psychological injury caused by the accident that gives rise to a permanent impairment and is not greater than 10%.

1. The claimant sought a review of the medical assessment of Medical Assessor Gupta in accordance with s 7.26 of the MAI Act. On 13 February 2025 the President's delegate determined that there was reasonable cause to suspect the medical assessment was incorrect in a material respect. As such the review application was accepted and referred to a Review Panel (the Panel).
2. Section 7.26(5A) of the MAI Act provides that a review panel consists of two Medical Assessors and a Member assigned to the Motor Accidents Division of the Personal Injury Commission (Commission).
3. The review of the medical assessment is not limited to a review of only that aspect of the assessment that is alleged to be incorrect and is to be by way of a new assessment of all the matters with which the medical assessment is concerned: s 7.26(6) of the MAI Act.
4. Rules 127 and 130 of the Personal Injury Commission Rules 2021 (Rules) are made pursuant to Part 5 of the Personal Injury Commission Act 2020 (PIC Act). A Review Panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application: Rule 128 of the Rules.
5. The Panel met via video conference on 11 November 2024 and determined that a

re-examination of the claimant was required. A medical examination was arranged to take place on 17 December 2025 with Medical Assessor Jones and Medical Assessor Baker via Microsoft Teams. 6. The Panel reconvened via videolink for a teleconference on 10 February 2026 where the clinical examination findings were discussed along with the documentary evidence provided by the parties.

1. Sections 5D and 5E of the Civil Liability Act 2002 (CL Act) apply to the MAI Act.[1]
2. In respect of the issue of causation, Part 6 of the Guidelines includes guidance. Whilst Part 6 deals with permanent impairment, it is still relevant to the issue of causation in respect of threshold injury disputes.[2]
3. Causation of injury is addressed from cl 1.5 of the Guidelines. Whilst the clauses are set out in respect of permanent impairment they are relevant to a dispute as to threshold injury.[3] Clauses 6.6 and 6.7 provide:

"6.6 Causation is defined in the Glossary at page 316 of the AMA4 Guides as follows:

Causation means that a physical, chemical or biologic factor contributed to the occurrence of a medical condition. To decide that a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has, in fact, done so, it is necessary to verify both of the following:

1. The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination.
2. The alleged factor did cause or contribute to worsening of the impairment, which is a non-medical determination.'

This, therefore, involves a medical decision and a non-medical informed judgement.

6.7 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. In determining the issue of causation, the Panel is to also have regard to s 5D of the CL Act:[4]

(1) A determination that negligence caused particular harm comprises the following elements -

(a) that the negligence was a necessary condition of the occurrence of the harm (factual causation), and

(b) that it is appropriate for the scope of the negligent person's liability to extend to the harm so caused (scope of liability).

(2) In determining in an exceptional case, in accordance with established principles, whether negligence that cannot be established as a necessary condition of the occurrence of harm should be accepted as establishing factual causation, the court is to consider (amongst other relevant things) whether or not and why responsibility for the harm should be imposed on the negligent party.

(3) If it is relevant to the determination of factual causation to determine what the person who suffered harm would have done if the negligent person had not been negligent -

(a) the matter is to be determined subjectively in the light of all relevant circumstances, subject to paragraph (b), and

(b) any statement made by the person after suffering the harm about what he or she would have done is inadmissible except to the extent (if any) that the statement is against his or her interest.

(4) For the purpose of determining the scope of liability, the court is to consider (amongst other relevant things) whether or not and why responsibility for the harm should be imposed on the negligent party."

1. The Medical Assessor examined the claimant via audiovisual link on 8 November 2024. In the certificate dated 14 November 2024 the Medical Assessor finds a 6% WPI from a major depressive disorder caused by the motor accident.
2. The claimant gave a history of continuing to suffer from pain in his back and legs. It is also stated the claimant's psychological symptoms started soon after the accident and have followed a fluctuating course.
3. The claimant gave a history of his relationship with his wife has been adversely effects with arguments occurring. Other symptoms include lack of concentration and having to be reminded regarding personal hygiene.
4. The Medical Assessor commented that a reasonable differential diagnosis is a chronic adjustment disorder, however, the duration and extent of the symptoms make a diagnosis of major depression.
5. The Medical Assessor found a class 2 impairment in all Psychiatric Impairment Rating Scale (PIRS) categories except for social and recreational activities, and adaptation where a class 1 impairment is found.

Claimant's review submissions dated 11 December 2024

1. It is asserted that the Medical Assessor was in error when assessing the claimant's impairment in accordance with the PIRS in several categories.
2. In respect of self-care and personal hygiene the submissions refer to the history provided by the claimant regarding his hygiene routine and the described deficits. It is submitted that the preferable class impairment is 3.
3. The submissions also refute the class 1 impairment found in respect of social and recreational activities. It is submitted that based on the claimant's history in respect of social activities, specifically his lack of interest that a class 3 impairment is satisfied. It is submitted the Medical Assessor failed to provide adequate reasons.
4. In respect of social functioning, the submissions refer to the history of the claimant being isolated from his wife, family and friends and spending his day in the backyard smoking alone. It is also submitted the claimant has not been able to form new friendships or restore pre-existing friendships.
5. It is submitted that a class 3 impairment in respect of social functioning is appropriate.
6. The claimant submits that in respect of concentration, persistence and pace a class 3 impairment is satisfied on the history. The history of the claimant being forgetful with difficulties concentrating has impact on the ability to maintain pre-injury friendships.

1. In respect of adaptation, the claimant submits that the Medical Assessor has fallen into error as the examination findings suggest a severe impact on employability due to the psychiatric injury. It is submitted that the claimant's pre-injury employment required him to travel to different job locations daily, a high level of concentration in performing his trade and an above average level of interacting with customers.

Insurer's review submissions in reply dated 13 January 2025

1. It is essentially submitted on behalf of the insurer that the claimant's own history demonstrates the Medical Assessor correctly assessed the impairment in each PIRS category.

1. The Panel issued interim directions requiring the parties to each lodge a single bundle of all documents relied upon. The parties have complied with such directions.
2. The Panel has considered all documents included in the bundle lodged by the claimant on or about 8 October 2025 consisting of 189 pages - "JOVICIC PIC Directions Bundle - Psych Index & Annexures" and the insurer's bundle lodged on or about 5 November 2025 consisting of 43 pages - "FOR - PIC - Insurer submissions - Medical assessment - CTP".
3. Not every document is summarised or referenced within these reasons, however, some evidence is referred to that is directly relevant to the Panel findings. However, the Panel's reasons are provided in the context of all material having been considered.

Application for personal injury benefits (claim form) dated 29 November 2022

1. The claimant describes having his vehicle side swiped on the left hand side. He records having suffered injuries to his neck, shoulder, back and right knee together with "PTSD".

1. Progress notes of Bathurst Street Medical Practice are provided by the claimant and begin on 21 November 2022. The subject accident is recorded. The claimant complained of neck and both shoulders, upper and lower back, right knee pain. Subsequent visits demonstrate ongoing complaints of pain, predominantly to the back.
2. Various certificates of capacity are provided which include diagnoses related to the physical injuries together with an inclusion of "PTSD".

1. Various reports are provided. Dr Kuljic appears to have first seen the claimant on 17 April 2023. The claimant is reported to have complained of being irritable, argumentative and impatient since the accident. The claimant is described as unhappy and feeling depressed.
2. On the basis of the presentation, the doctor stated the claimant had a major depressive disorder caused by the motor accident. A previous psychiatric history was not found.
3. Progress notes are provided which include notes of low motivation, low energy levels, poor concentration. Medication is noted to be tolerated well. He is noted to sit at home and smoke. He is also noted to be unhappy with himself, not being able to work and being depressed. He was noted to be irritable which was having an impact on his family and friendships.

1. The doctor is the claimant's treating psychiatrist. Dr Kuljic's report of 4 May 2024 and is provided in a medico-legal context. The doctor notes the claimant was treated after the accident with sertraline which was later changed to mirtazapine. The medication was later changed to duloxetine.
2. A history was taken of the claimant no longer finding joy in life, a loss of appetite and insomnia. He is noted to struggle with energy levels, and he felt worthless because he cannot work and earn money for his family.
3. The doctor diagnosed a major depressive disorder. Applying the PIRS, the doctor assessed a 19% WPI.
4. The insurer relies on a report of Dr Synnott dated 24 July 2024.
5. Dr Synnott takes a history from the claimant, which he describes as being consistent with a diagnosis of major depressive disorder with prominent anxiety. However, in his opinion the report of Dr Keller raises questions as to the credibility of the claimant's account. In this regard, Dr Keller has opined that the claimant's physical injuries should have resolved with no ongoing physical restrictions. Dr Synnott then states: "given the questions about the credibility of his account, one can have no confidence in offering an opinion regarding the psychiatric impact of the MVA...". He also opines that the claimant's comment about being psychiatrically unable to work "...will prove a self-fulfilling prophecy".

1. The below are the clinical examination findings of Medical Assessor Jones and Senior Medical Assessor Baker.
2. The medical examination took place via audio-visual link through the Teams platform organised by the Commission.
3. Present were Mr Jovicic, a Serbian interpreter, Zelijka Mariani, and Medical Assessors, John Baker and Matthew Jones.

1. Mr Jovicic was provided with the appropriate explanation and cautions with respect to the purpose of the assessment, the non-confidential nature of the assessment and the inability of the Medical Assessor to provide treatment and advice. Mr Jovicic indicated that he understood these cautions. He consented to continue with the assessment.

1. Mr Jovicic is a 44-year-old man living in Mount Pritchard, where he has lived since 2014. He lives there with his wife, Branka, who works as a manager for the NSW Correctional Service. Also living there with them are her parents. Mr Jovicic's parents-in-law own the home. His mother-in-law still works and his father-in-law is retired. He reported that they are both generally well but not perfect in their health. Mr Jovicic was not entirely sure of his wife's role in NSW Corrections but stated he knows that she completed some form of education to work there. He reported that prior to working in Corrections, his wife worked in a hotel, but this was a long time ago.
2. Mr Jovicic reported that he is not currently working. He has an income source which he said is provided by the insurance company. He reported he is not sure how they have calculated the amount he receives. Mr Jovicic reported he started receiving income after he made a claim for the accident.
3. Mr Jovicic last worked prior to the subject motor vehicle accident (18 November 2022). When asked if he had attempted to work since that time, he said he had, and only on a few occasions. When asked what occurred with these attempts, Mr Jovicic reported that he was unable to physically perform his work due to pain in his shoulder and back. Mr Jovicic reported that he was attempting to return to work as a tiler. His previous work involved primarily residential work including bathrooms, laundries and floors in homes. He said he did some commercial work. For most of his career he worked for himself as a sole trader or subcontractor, utilising his Australian Business Number (ABN). When he did work, he worked predominantly by himself on jobs. He said that he had been a tiler for approximately 20 years, both in Australia and in Serbia.
4. Mr Jovicic came to Australia in 2014. He reported he does not have Australian citizenship. He said that Branka had previously been in Australia and they met in Serbia. They have been married for 11 years. He reported they have no children.
5. Mr Jovicic reported he has no other family members present in Australia, however his wife has several family members here.
6. With respect to family, Mr Jovicic reported his mother, father and sister, as well as three uncles and an aunt still reside in Serbia. He maintains contact with his father, mother and sister but rarely has contact with his uncles and aunt.
7. Mr Jovicic reported he has visited his family home in Serbia twice since coming to Australia. The last time he travelled there was in 2024, for approximately a month. He confirmed he had travelled after the accident in 2022. When asked how this trip was, he said that he was glad to see his parents however they are getting unwell and are elderly. He said he appreciated being able to "touch them physically."

1. Mr Jovicic reported he takes some medications. He takes Mersyndol for pain, Panadol for pain, and an antidepressant, Brintellix (Vortioxetine) an antidepressant medication. This was prescribed by psychiatrist, Dr Blagoje Kuljic. He is not sure how long he has been taking this medication but said this was for approximately two or three months. He said he has seen Dr Kuljic approximately every month but is not sure of how many times he has seen him. He said he started seeing Dr Kuljic a few months after the accident.
2. Mr Jovicic also sees a psychologist, Daniella Savic, on average two times a month. He started seeing Ms Savic around the same time he started seeing Dr Kuljic.
3. The Medical Assessors asked Mr Jovicic what he talks about when he sees the psychologist and psychiatrist and he said he talks about what to do and what his future will hold. He said a lot of the discussions are about the future and how his condition can be improved. He said he is taking medication and hoping his condition will improve. He said they also talk "about life" and what could be good for him. An example of this was that he is encouraged to socialise more with people, and he said he is trying to do that. He gave an example of going out to coffee with friends. He said when he does this, physically he is present but mentally he is not. He said his friends call him to go and he goes, but not often.
4. With respect to future treatment, Mr Jovicic reported he is anticipating having knee surgery. He said the insurance company did not approve this and he seemed somewhat unclear of his circumstance, but he said there was another decision about the knee surgery which questioned the need. He is not sure about the insurance company's current stance on whether he needs surgery. He said that there were questions about whether the accident was the cause of the meniscus injury or not. He is still awaiting the decision about approval for surgery.

1. Mr Jovicic reported he had never seen a psychologist or a psychiatrist before the accident. He reported he had never been prescribed psychiatric medications previously. He declared that he had "no experience of anxiety or depression" before the accident.
2. The Medical Assessors asked Mr Jovicic about his situation prior to the motor vehicle accident. He said he was living in the same house and "life was good." He said he went to work and had the "satisfaction of doing something and making plans." He worked "every day", which generally meant six days per week. On his day off he would sometimes rest or go and have a coffee with his wife. When asked about other interests he said he enjoyed fishing and hunting. Hunting would involve camping and pursuing deer in Victoria with his friends. He would go when he did not have as much work on. Hunting usually involved the same group of people. He met these people through a hunting group when he first arrived in Australia. When asked, he declared that he had a sporting shooter's firearms licence. With respect to fishing, Mr Jovicic would fish for trout when hunting, in the high country of Victoria. He said he was successful in catching trout, and this was usually stream fishing.

1. Mr Jovicic confirmed the date of accident was 18 November 2022, approximately three years before the Panel examination. He reported he was in his car, sitting at a traffic light, on his way to his home. He was only at 150 to 200 metres from home. He said, all of a sudden, a car came and crashed into the back of his vehicle. He was alone in his vehicle which was his work van. The accident occurred around 5.00 or 5.30pm. The Medical Assessors clarified whether Mr Jovicic was hit from behind. He said that the car that struck him was in the next lane, crashed into the side of his van and then it hit the car in front.
2. Mr Jovicic reported initially "there was a shock as to what happened." He got out of his car and sat on the side of the road. He discovered that there were in fact four cars involved altogether. He said he does not know what happened with, the fourth car. He said emergency vehicles arrived including ambulance, a fire engine and police. He said he was not the person who called for them. Between the accident and the emergency services arriving, Mr Jovicic reported he was sitting on a footpath.
3. Mr Jovicic said that he had pain in his shoulder, back and knees. He was asked by ambulance officers if he was all right and if he wanted to go to the hospital. He said he did not want to go, he was close to home, and he thought that perhaps if he rested his pain would go away.
4. Mr Jovicic said that after this his father-in-law arrived and they walked home together. He said a tow-truck took his vehicle away and it was ultimately written-off.
5. After he got home, Mr Jovicic reported he felt pain which he still thought would go away. He said he started feeling panic about what had happened or what could have happened.

History of symptoms and treatment following the accident

1. Mr Jovicic reported he went to see his usual GP a few days later. He was given some painkillers and later sent to have some imaging done. He said the imaging showed he had injuries in his neck, back and knees. When asked to clarify this, he said he could not really say except that he had injuries and that he had nerves that were compressed. He saw a specialist who was a back and shoulder specialist had recommended surgery. He saw a different doctor regarding his knee, who also recommended surgery.
2. Mr Jovicic reported he has undergone no surgery and when asked why, given the recommendations, he said that he had asked what the percentage chance of improvement was and one surgeon told him that no one was able to say that. He said he does however want to have knee surgery however he finds it difficult to make a decision. He said his knee, at times, gets stuck and does not move and this is why he wants to get surgery. He said this can occur two or three times a day or not for a few days. The Medical Assessors asked what this experience interfered with and he said it sometimes gets stuck, the moment he tries to rise from his bed in the morning. He said it is hard to predict when it would happen and he cannot move because of severe pain. He said however he has learned to fix it with a manoeuvre with his hands. The Medical Assessors asked how long this locking experience persisted and he said it depends on how long it takes to fix it. He said sometimes he can fix it immediately and sometimes he will have to attempt to move his leg until it sets itself in place. He said it could take a minute or so. He said that the problem has to do with his meniscus in his knee. He believes there are small broken bits or cracks which interfere with the movement of his knee. He said once his knee is put back in place he is okay.
3. The Medical Assessors asked Mr Jovicic about his experience of pain. He said his knee hurts every day, particularly when he does movement or even when he sits. He said the pain is worse when his knee is stuck.
4. The Medical Assessors asked about his back and neck. He said that his shoulder pain is a consequence of his neck injury. He said his back also gets stuck and he is unable to move. When this happens, he has to hold himself up against a wall if he wants to move. When asked how often this occurs, he said it is hard to tell but it does not happen that frequently, perhaps every four to six days. Between these episodes of his back getting stuck, Mr Jovicic has pain in his back and legs. He said it is always there and he cannot find a position that is comfortable. He said it occurs in all different positions including lying, standing, walking or sitting. When asked how bad the pain was, Mr Jovicic simply repeated that it was "a lot."
5. The Medical Assessors asked what limitations his back pain placed on his activity, and he said he is unable to go to the toilet without needing to hold himself up against a wall and he cannot put his socks on. The pain interferes with his ability to work, and he is unable to drive for long periods because of it. He said when it gets too bad, he is unable to drive at all. The Medical Assessors asked how long Mr Jovicic could drive before it hurts and he said that he can only drive short distances, for example to his doctors. He may be able to drive 20 to 30 minutes or at a maximum 40 minutes. If he drives for 30 minutes, and has to stop, it is because of pain in his back and pressure in his legs, which go numb. He said both legs can be affected but it is usually the left more than the right leg.
6. The Medical Assessors asked if Mr Jovicic's back pain interfered with his activities such as showering and he said he is not showering particularly frequently. He said the reason for this is that he is not doing any work around the house. He said pain interferes with his ability to shower but he also has a lack of motivation to shower and says that he is "not going anywhere." He reported that his wife is an office manager and goes to work regularly so he is often at home alone, or with his parents-in-law.
7. The Medical Assessors asked Mr Jovicic about any psychological, emotional or mental health problems emanating from the motor vehicle accident. He said he "lost interest" in things and lost his "zest for things." He feels that he is "not connecting" or feels like there has been "something lost." He said this started a few months after the accident when he realised that his injuries were not going to get any better.
8. Mr Jovicic reported that he often stops and thinks what will happen next. He said he sees that nothing is going to get better and then he worries. With respect to his mood patterns, he said what worries him most is his future. He said he does not know any other job that he can do other than the one that he knows. He said he also worries about his health and worries about whether his condition will improve or get worse. He said he is hopeful for improvement in his condition and also hopeful for the relationship with his wife.

1. Mr Jovicic reported he spends his time sitting at home. He sometimes goes out to have a coffee or will sit and smoke cigarettes. He will sometimes spend all day in bed. He said he lies there, falls asleep, wakes up, then lies down somewhere else and said, "that's it."
2. With respect to sleep, Mr Jovicic reported he will wake in the middle of the night sweating and experiencing fear. When asked what time he goes to sleep he said it depends on how much sleep he has had during the day. He said he will go to bed at 9.00 or 10.00pm if he does not sleep in the day. He said on a recent evening he went to bed at 8.00pm but said he does not remember if he slept during that day. If he does not sleep during the day he will sit and smoke in an outdoor area or go for a walk in the yard.

1. Mr Jovicic reported if he wakes in the middle of the night he will either go back to sleep or sometimes he will get up and sit in the outdoor area for a couple of hours. He said after he feels tired, he will go back to sleep. With respect to his morning wake time, he sometimes wakes up early and sometimes later, depending on what is happening. He said his sleep is sometimes better and sometimes worse. Mr Jovicic reported he believes his sleep problems are due to his "condition" and his "thoughts." He said that pain definitively interferes with his sleep, but he also has thoughts, for example worrying about the next day and worried about what the future will hold. He lamented that he is, "not contributing in any way" at home. He finds this very frustrating as he has always been a worker. He said he did not mind working and loved his job and considered that he "did a really good job." Mr Jovicic reminded the Medical Assessors that he went back to try and work and stated that if his neck, back, legs and knee were all fixed he would definitively go back to work.
2. Mr Jovicic reported he is no longer going hunting or fishing. He said he is still in contact with his friends with whom he enjoyed these activities, but this contact is not frequent. He said this group of friends is his main group of friends.
3. The Medical Assessors asked Mr Jovicic about the quality of relationships with his parents-in-law and his wife. He said that he has arguments with his wife, but he is "trying to respect" his parents-in-law. He said he thought his relationship with them was "okay." The Medical Assessors asked Mr Jovicic about the nature of the arguments with his wife, and he said that it depends on his mood. He said the argument can be about something as simple as why his wife moved his cup to another place. He said that he finds himself easily becoming cranky and said that small things can get him out of his normal mood.
4. Mr Jovicic reported he is "not watching television at all." When asked why, he said he cannot concentrate for a long time, even when he is watching things on his phone.
5. Mr Jovicic reported his mother-in-law cooks every day and is a good cook, (even better than his wife). He said that he will usually eat food that has already been prepared. He will sometimes make himself a sandwich. He commented that he has never been one to be able to cook anything complex.
6. Mr Jovicic maintains his driver's licence and has a vehicle, his own car, separate from his wife's car.
7. The Medical Assessors asked about Mr Jovicic's reference to going out for coffee. He said that the coffee shop is close, about 10 to 15 minutes away, and he will usually attend there with his wife on Sundays or Saturdays.
8. The Medical Assessors asked Mr Jovicic about his overseas travel. He said he went to Serbia last year by himself from around the end of September to the end of October. Mr Jovicic flew alone via Dubai where there was a two-or three-hour stopover. He was picked up from the airport in Europe by his sister and travelled by car from there. Over there he spent time with his parents and his siblings, and his sister's daughters. He did not go on any tours or travel much and spent this time mainly at his parents' home.
9. Mr Jovicic estimated his current weight to be around 100kg. He said his height was between 185 and 190cm. (Current body mass index (BMI) around 28 which is considered mildly overweight.) Mr Jovicic estimated that his weight at the time of the accident was around 107kg, stating that he had lost some weight. Mr Jovicic reported he is happy with his current weight.
10. The Medical Assessors asked Mr Jovicic what his future holds for him and he said he does not see a future and that is his problem.

1. Mr Jovicic reported no recreational drug history apart from a small amount of marijuana when he was younger. He said he no longer drinks alcohol and estimated he has had one beer in three years. He said he has always been a smoker of cigarettes. He has never been addicted to prescription medications and has never had any problematic gambling behaviour. He will drink a considerable amount of caffeine, up to six coffees a day. The last one he has in the evening may be at midnight when he wakes up. He said he has no problems falling asleep after this, however his sleep is unpredictable and disturbed. He said he does not think his sleep problems are due to his coffee intake as he used to drink a considerable amount of coffee even prior to the accident.

1. Mr Jovicic was seen by audio-visual link. He had long, wavy, dark hair, a moustache and a short beard. He wore a light-grey t-shirt with a US flag motif. This appeared to be a Tommy Hilfiger brand t-shirt. There were tattoos covering most of his left arm. He was smoking often throughout the assessment and wore a small leather bracelet. He was polite, cooperative and attentive and displayed no abnormal movements. His speech was normal in rate, volume and tone; he spoke predominantly through the interpreter. There was no evidence of formal thought disorder or delusional thought processes. There were no expressed thoughts of self-harm or thoughts of harm to others. His mood was described in frustrated and dysphoric terms. His affect (expressed emotion) was somewhat flat, bland and deflated. He was otherwise reactive, congruent and appropriate. He brightened in his affect when talking about pleasurable topics such as hunting and fishing. There was no evidence of any perceptual abnormalities consistent with psychosis. His cognition, insight and judgement appeared grossly intact in the context of the assessment. His concentration, memory and attention were quite good at assessment. Rapport was limited but established sufficiently to facilitate the assessment.
2. The examination had a duration approximately 1 hour and 45 minutes.

1. Mr Jovicic's family was originally living in Bosnia. He said he was not himself a witness of war or war trauma. He said his parents had jobs and he grew up with sufficient basic necessities. He reported his father is currently 74 and his mother is currently 72 and his sister is two and a half years older than him.
2. Mr Jovicic attended school in Bosnia for the first four years, up until approximately the age of 9 or 10. He then moved to Serbia with his mother, father and sister. They stayed with their aunt in a small town in the countryside for about six months and then the family moved to a town which was bigger than the village. They rented an apartment there. He underwent further schooling including four years in primary school and three years in secondary school. He then studied and attained metalwork qualifications over three years, working on machines and with mechanical equipment. He said he was able to work in the town where he lived.
3. Mr Jovicic reported he did not undergo any national service in the military as this was not compulsory for them as refugees. He came to Australia at the age of 33.
4. Mr Jovicic denied being victimised as a refugee in Serbia. He is not sure through which organisation he travelled as a refugee, but said it was not the United Nations High Commissioner for Refugees (UNHCR). He said he had never seen a psychologist prior to coming to Australia.
5. Mr Jovicic came to Australia on a tourist visa, around which time his application for another visa was in process. When he was here on a tourist visa his other visa was approved.

1. Mr Jovicic was generally consistent in his presentation and narrative provided to the Medical Assessors during the examination. The Medical Assessors asked him about the reference to physical inconsistencies in his assessment with Dr Keller (as this appears to have been highlighted as relevant in his case). We asked Mr Jovicic if he had anything to say about that and he said all he can say is that he does not understand how someone can say that he is not injured when sometimes he cannot move at all. He also added that there is evidence in the imaging of his injuries. He said that he knows that his injury is going to go away but he does not know when it will.

1. From the information available to the Medical Assessors, there does not appear to have been a pre-existing psychiatric condition or pre-existing psychiatric impairment. Mr Jovicic was involved in a car accident from which he reported he incurred various injuries that caused him pain and physical limitation including to his back, neck (and shoulder) and knee. Pain and physical limitation from these injuries have interfered with Mr Jovicic's day-to-day functioning including his ability to work, drive for long distances, sleep, and general day-to-day activities. As his pain and physical injuries were not improving, Mr Jovicic developed significant problems with his mood including worry about his future, his ability to work, and whether or not he would recover from his physical injuries. He has received psychological and psychiatric treatment since several months after the accident and these continue. He is currently taking an antidepressant medication.
2. From a diagnostic perspective, Mr Jovicic reported a narrative and presented at assessment as consistent with having the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) diagnosis of Major Depressive Disorder which was in partial remission. There is a predominance of pain in his clinical presentation that interferes with his day-to-day functioning and also contributes to perpetuating his mood disorder.
3. Mr Jovicic satisfies diagnostic criteria under DSM-5-TR for Major Depressive Disorder in partial remission in the following ways:
   • Mr Jovicic has depressed mood, loss of interest or pleasure in most activities, sleep disturbance, tiredness, fatigue and low energy, sense of worthlessness, subjective difficulties in thinking and concentration (satisfying criterion A).
   • Mr Jovicic's symptoms are causing clinically significant distress and impairment in other important areas of functioning, for example socially (criterion B).
   • His symptoms are not the direct physiological effect of a substance or a medical condition (criterion C).
   • There has never been a manic episode or hypomanic episode (criterion D).
   • Mr Jovicic's experience and symptoms is not better explained by a psychotic disorder (criterion E).
4. Mr Jovicic has experienced his depressive symptoms well in excess of two weeks. He does not appear to have been symptom-free since he developed his Major Depressive Disorder. His current experience would therefore be considered a prolonged major depressive episode. The Medical Assessors consider he is in partial remission as there has been some improvement compared to when he was at his worst.

1. Mr Jovicic has stabilised in his psychiatric status and is unlikely to change in his level of whole person impairment in the upcoming 12 months. The Medical Assessors' opinion is that Mr Jovicic has a permanent psychiatric impairment. He has received regular psychiatric and psychological treatment for a prolonged period with only mild improvement over time.
2. Given the predominance of pain and physical limitation in Mr Jovicic's clinical picture, these are significant reasons for limitations in Mr Jovicic's day-to-day functioning. The Medical Assessors have taken this into account when assessing WPI, noting that impairments due to pain and physical injury are not included in measurement of WPI measurement when utilising the PIRS. As such, the assessment of WPI below takes into account psychiatric impairment only and not impairment caused by pain or physical dysfunction in compliance with clauses 6.214 and 6.215 of the Guidelines.

1. Major Depressive Disorder (major depressive episode) in partial remission.

Approximately fortnightly psychological therapy and approximately monthly psychiatric review.

Mr Jovicic is able to undertake tasks relevant to self-care and personal hygiene such as showering, dressing and grooming. He is able to feed himself, make simple meals such as sandwiches or reheating leftover food. He reported he has never been one to cook. He reported some decrease in frequency with respect to his showering and grooming, however noted that he was not doing much and therefore had less need. He did report some decrease in motivation. The Assessors considered that Mr Jovicic would be able to live independently, if required, however might look unkempt occasionally, occasionally miss a meal or rely on take-away food, in that circumstance.

Utilising clinical judgement, there is a class 2, mild impairment.

Mr Jovicic maintains contact with his core group of hunting and fishing friends (he reported these were the main group of friends he had established since being in Australia). He will go out for a coffee by himself, or with his wife on occasion. His previous functioning in this category involved a limited repertoire of activities as he was working up to six days per week and would only go out somewhere with his wife on a Saturday or Sunday, and hunting or fishing with his friends when he had more time off. His pre-accident life was predominated by work and he indicated little, other than spending some time with his wife or hunting or fishing with friends, within his social and recreational group prior to the motor vehicle accident.

Utilising clinical judgement, there is a class 2, mild impairment in this category.

Mr Jovicic reported he is able to leave his home to travel and drive alone. He travelled alone internationally approximately twelve months before the assessment. He has a limited capacity to travel currently because of his psychological symptoms alone. He is able to travel independently. His current reported functioning is consistent with a class 2, mild impairment.

Mr Jovicic reported that there is some irritability and a tendency to have arguments with respect to his relationship with his wife. He reported he is getting on sufficiently with his parents-in-law. He maintains contact with his family of origin overseas and maintains contact with his main group of friends in Australia. His friends still ask him to go out however he is less actively involved with them because of the accident. There is no evidence of any domestic violence or periods of separation in his relationship with his wife.

Utilising clinical judgement there is a class 2, mild impairment in this category.

Mr Jovicic maintained good levels of concentration and attention throughout a prolonged assessment, utilising an interpreter over Teams, for one hour and forty-five minutes. This was indicative of reasonable capacity in this category. He described little in the way of cognitively demanding activities day-to-day. The majority of Mr Jovicic's waking hours prior to the accident appear to have been taken up by regular and sustained capacity to perform and concentrate whilst persisting at complex tasks that included laying tiles and managing his books that were required for his small business record keeping.

Utilising clinical judgement, the assessors considered that there was a class 2, mild impairment in this category.

The Assessors considered that there was some component of Mr Jovicic's mental health problems that would interfere to some degree with his return to full employment. This would be consistent with a class 2, mild impairment, given that the Assessors' opinion was that Mr Jovicic could return to his pre-accident employment from a psychiatric perspective, but perhaps not to the same level of functioning as he was capable of before the accident.

Utilising clinical judgement, this was consistent with a class 2, mild impairment.

1. The Medical Assessors considered there was no evidence of any pre-existing active psychiatric disorder or WPI. Therefore, there is no adjustment for pre-existing impairment. There is insufficient evidence for any adjustment for subsequent impairment.

1. Mr Jovicic has undergone extensive psychiatric and psychological treatment over many months, and this is ongoing. There has only been a mild (if any) improvement in his mental health over time. He reported limited ongoing effect from this treatment. Accepting the above circumstances, the Medical Assessors' opinion is that there is likely some mild ongoing treatment effect such that if this treatment were removed, Mr Jovicic would likely decline in his mental health status. The Medical Assessors considered that there is a 1% mild treatment effect applicable to Mr Jovicic.

1. Mr Jovicic's final WPI due to the motor vehicle accident is 7% (6+1%).

1. The above clinical examination findings and the material provided by the parties were discussed by the Panel at the post examination teleconference. It was collectively agreed by all three Panel members that the clinical examination findings are agreed to and would form part of these reasons.
2. The Panel finds that there is a lack of any evidence of any prior psychological disorder and any evidence of any other factor that could give rise to the diagnosis reached by the Medical Assessors. It is further observed that the diagnosis is consistent with that reached by Dr Kuljic and Medical Assessor Gupta. It is also consistent with the comments of Dr Synnott that the presentation is consistent with the diagnosis of major depressive disorder, albeit with a caveat in respect of credibility.
3. The Panel noted the suggestion of the claimant being less than credible. The Panel accepts, on the basis of the clinical judgment of the Medical Assessors, that the claimant's presentation was consistent, and it is accepted that the claimant's complaints of pain are more likely than not genuine. However, the Panel notes that the existence of any objective injury is a matter for suitably qualified medical experts.
4. The Panel agreed that the Medical Assessor's application of the PIRS is justified in the context of the expert clinical judgment of the Medical Assessors. The Panel finds the existence of impairment in each category of the PIRS, however, on the evidence, such impairment is mild in each category.
5. The Panel's findings differ in respect of the percentage of WPI and for that reason the medical certificate of 14 November 2024 is revoked. A new certificate is provided at the beginning of these reasons.

[1] See s 3B(2) of the Civil Liability Act 2002.

[2] Briggs v IAG Ltd [2022] NSWSC 372.

[3] See Briggs v IAG Limited t/as NRMA Insurance [2022] NSWSC 372 at [35].