WHETHER THE INJURED PERSON'S DEGREE OF PERMANENT IMPAIRMENT AS A RESULT OF THE INJURY CAUSED BY THE MOTOR ACCIDENT IS GREATER THAN 10%

THE REVIEW PANEL'S ASSESSMENT UNDER S 7.23(1) OF THE MOTOR ACCIDENT INJURIES ACT 2017 IS:

1. The Review Panel revokes Medical Assessor Michael Hong's certificate dated 6 September 2023, which found that the psychological injuries arising from the accident gave rise to permanent impairment of 13%.
2. The Review Panel certifies that Mr Lever's permanent impairment resulting from the injury caused by the accident is 10% permanent impairment arising from posttraumatic stress disorder in partial remission and alcohol use disorder in substantial remission, which is not greater than 10%.

1. The claimant Peter Lever was injured in a motor accident on 23 July 2020.
2. He was employed as a police officer for NSW Police Force at the time of the accident.
3. The accident occurred at Murwillumbah between the insured Landcruiser and the claimant's motorcycle.
4. The claimant alleges that the accident caused right ankle, toes and right leg and psychological injuries.
5. IAG Ltd t/as NRMA Insurance (the insurer) is responsible for loss arising from the claimant's injuries from the accident under the Motor Accident Injuries Act 2017 (MAI Act)
6. The insurer and the claimant are in a dispute about the degree of permanent impairment from injuries caused by the accident.
7. The claimant applied to the Personal Injury Commission (the Commission) to resolve this dispute.
8. On 3 September 2024 Medical Assessor Michael Hong (Medical Assessor) assessed the claimant and issued a certificate dated 6 September 2023, which found that the injuries arising from the motor accident gave rise to whole person impairment of 13%.
9. The insurer applied for review on the basis the assessment was incorrect in a material respect.
10. On 7 November 2024, the President of the Commission's delegate constituted this Review Panel (the Panel) to review the original certificate (the Review).
11. Following rule 128(1) of the Personal Injury Commission Rules, 2021 (the PIC Rules) the Panel 'is to conduct and determine the proceedings in accordance with procedures determined by the panel'.
12. The Panel met on 5 September 2025 to discuss how this matter will proceed.
13. The Panel discussed the claimant's exposure to various stressors before the accident and the necessity to resolve causation and whether there was sufficient objective evidence to assess permanent impairment existing before the accident and from the accident.
14. The Panel requires up-to-date clinical notes in order to resolve these issues. The Panel noted that the most recent clinical notes dated back to 2022.
15. The Panel considered re-examination was required and Medical Assessors Canaris and Verma re-examined the claimant on behalf of the Panel. The details of the examination appointment are as follows:
16. The teleconference was arranged to occur on 19 November 2025

"...the degree of permanent impairment of the injured person that has resulted from the injury caused by the accident (including whether the degree of permanent impairment is greater than a particular percentage) is a medical assessment matter."

1. If there is a dispute about the degree of permanent impairment of an injured person being sufficient to award non-economic loss damages i.e. greater than 10%, then those damages may not be awarded unless the degree of permanent impairment has been assessed by a Medical Assessor under Division 7.5: s 4.12(1) MAI Act.
2. Division 7.5 of the MAI Act provides for the Commission to assess declared medical disputes including provisions relevant to an original medical assessment and for appointing Panels to review those medical assessments.[1]
3. Parties may apply to the President of the Commission for review of a medical assessment on grounds that the assessment "was incorrect in a material respect (sub-s (1))." If the President, or his delegate is satisfied "there is a reasonable cause to suspect that the medical assessment was incorrect in a material respect" then the President refers the application to a review panel consisting of a member of the Commission and two Medical Assessors (sub-ss (2) and (2B)) to reassess the dispute.
4. The review is not confined to the issues raised in the application (or the reply) but is "a new assessment of all the matters with which the medical assessment is concerned (sub-s 3A)."
5. Rule 128 of the PIC Rules permits the Panel to determine its own proceedings and the rules of evidence do not bind the Panel, which may inquire into relevant matters as it thinks fit, while observing procedural fairness.
6. The method of assessing the degree of impairment is dealt with in s 7.21, which is in the following terms:

"7.21 Assessment of degree of permanent impairment

(1) The assessment of the degree of permanent impairment of an injured person for the purposes of this Act is to be made in accordance with the Motor Accident Guidelines.[2] The assessed degree of permanent impairment is to be expressed as a percentage.

(2) Impairments that result from more than one injury arising out of the same accident are to be assessed together to assess the degree of permanent impairment of the injured person.

(3) In assessing the degree of permanent impairment, regard must not be had to any psychiatric or psychological injury, impairment, or symptoms, unless the assessment of the degree of permanent impairment is made solely with respect to the result of a psychiatric or psychological injury.

(4) A medical assessor may decline to make an assessment of the degree of permanent impairment of an injured person until the assessor is satisfied that the impairment caused by the injury has become permanent."

1. Pre-existing impairment is addressed in cls 6.31-6.33 of the Guidelines. Clause 6.34 deals with subsequent injuries.
2. The Guidelines state as follows with respect to causation of injury:

6.5 An assessment of the degree of permanent impairment is a medical assessment matter under clause 2(a) of Schedule 2 of the Act. The assessment must determine the degree of permanent impairment of the injured person as a result of the injury caused by the accident. A determination as to whether the injured person's impairment is related to the accident in question is therefore implied in all such assessments. Medical assessors must be aware of the relevant provisions of the AMA4 Guides, as well as the common law principles that would be applied by a court (or the Personal Injury Commission) in considering such issues.

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 accident. The 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. It is necessary for the Panel to consider whether the accident caused or contributed to the diagnosed psychiatric condition: Briggs v IAG Limited t/a NRMA Insurance [2022] NSWSC 372 at [75]. The accident does not have to be the sole cause as long as it is a contributing cause, which is more than negligible: Owen v Motor Accidents Authority of NSW [2012] NSWSC 650 at [50]. Further, the provisions of the Civil Liability Act 2002 apply, in particular

ss 5D and 5E.

Degree of psychiatric impairment rating scale (PIRS)

1. Impairment is assessed following the Guidelines which include a chapter entitled "Mental and behavioural disorders." The assessment is to be undertaken in accordance with the PIRS and the Medical Association's Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA 4 Guides) are to be used as "background or reference only."[3]
2. The Medical Assessor must obtain a psychiatric diagnosis before assessing PIRS in accordance with the current editions of either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Statistical Classification of Diseases and Related Health Problems (ICD).[4]
3. The PIRS provides[5] for the consideration of any psychiatric condition present before the accident in question:

"In order to measure impairment caused by a specific event, the medical assessor must, in the case of an injured person with a pre-existing psychiatric diagnosis or diagnosable condition, estimate the overall pre-existing impairment using precisely the method set out in this part of the Guidelines, and subtract this value from the current impairment rating."

1. The PIRS provides in cl 6.219 for six areas of function:

(a) self-care and personal hygiene;

(b) social and recreational activities;

(c) travel;

(d) social functioning (relationships);

(e) concentration persistence and pace, and

(f) adaptation.

1. The PIRS then provides at cl 6.220 for five classes of impairment with a descriptor for each which is "illustrative rather than literal criteria" and which is based on:

"... a history of the injured person's pre-accident lifestyle, activities and habits, and then [an assessment of] the extent to which these have changed as a result of the psychiatric injury."

1. The impairment may be adjusted for treatment,[6] that is treatment such as medication being taken to treat the psychiatric condition.
2. Once all six areas of function have been categorised into a particular class, the median class score is determined, the aggregate score is determined and the median and aggregate is converted to provide a WPI percentage.[7]

1. On 3 September 2024 Medical Assessor Michael Hong (Medical Assessor) assessed the claimant and issued a certificate dated 6 September 2023, which found that the injuries arising from the motor accident gave rise to whole person impairment of 13%.
2. He had assessed Mr Lever earlier to produce a certificate dated 13 Feb 2024.
3. He has high cholesterol and a lower back injury from police work.
4. Mr Lever had no psychiatric problems when he joined the police in 2002. He last worked in late 2021. He had been medically retired from the police force in August 2022.
5. He worked in general duties for six years, which included attending fatalities.
6. In 2014 he was transferred to Tweed Heads in 2014 in general duties. In 2015, he took time off and saw a psychiatrist, He took Effexor 275mg, which was helpful and stopped in 2018. He was diagnosed with alcohol use disorder and post-traumatic stress disorder.
7. He was assessed by the police medical officer (MO) and went back full-time to pre-injury duties without psychiatric restrictions.
8. Medical Assessor Hong considered Mr Lever's last period of psychological symptoms occurred around 23 April 2019.
9. Before the subject accident Mr Lever had no problems with self-care, socialising, concentration, or memory. He worked full time, played golf, rode his motorcycle for fun, met friends, visited cafes. He had abstained from drinking for about two and a half years.
10. He returned to police work after the subject accident but he struggled with pain. There were several operations. He resumed drinking.
11. When Medical Assessor Hong saw Mr Lever, he was drinking about 12 beers a week. He had gained 15kg since Medical Assessor Hong saw him early in 2024 due to inactivity. He was having nightmares and he was medicated. He was seeing a psychiatrist regularly.
12. The Medical Assessor acknowledged that the claimant's past psychiatric history and his work-related psychological injury (post-traumatic stress disorder with anxiety and depression and alcohol use disorder), had resolved before the subject accident, although there was a brief episode in 2019. He did not identify psychiatric impairment before the accident.
13. The Medical Assessor found the claimant developed post-traumatic stress disorder and alcohol use disorder as a result of the accident.
14. The Medical Assessor concluded there was more than a negligible contribution from the accident to Mr Lever's psychological injury, as his injury had not resolved over time with treatment.
15. The Medical Assessor did not assess the claimant's PIRS before the accident.
16. The impairment rating was on the basis that Mr Lever's social functioning, concentration, persistence and pace and adaptability for employment were the greatest deficits. The claimant can drive, but only close by and never on a motor bike as before the accident. He sees less of his friends and avoid large gatherings. He is not impaired in self-care.

1. The documentary evidence before the Panel consists of material in the insurer's bundle of 1,657 pages filed in accordance with the Panel's directions and the claimant's brief additional panel of 11 pages. The Panel has considered the relevant material.

1. An Incident Reporting Form claims that a subsequent psychological injury occurred on 16 July 2021. The report refers to workplace post-traumatic stress disorder re-occurring.
2. Certificate of capacity dated 20 July 2021, re-occurrence of post-traumatic stress disorder following the 5 February 2015 gunfight incident. Dr Stephen Lennon at King Street Medical Centre reports he is experiencing increased anxiety, hypervigilance, poor concentration, and focus.
3. Total and permanent disability (TPD) outcome report dated 2 September 2022 determined he meets the criteria of TPD as of 11 November 2021. The reasons for this decision refer to treatment with Dr James Whan, Kelly Bisgrove, and Dr Stephen Lennon.
4. Psychiatrist Dr Prior reported on 12 October 2022 that the claimant described the onset of his index symptomatology in 2010 where he stated, "I started going downhill then". He described more prominent symptomatology beginning in 2012/2013.
5. Dr Prior diagnosed chronic post-traumatic stress disorder with; comorbid persistent depressive disorder with associated generalised anxiety phenomena and panic/agoraphobic phenomena and alcohol use disorder. His chronic post-traumatic stress disorder was due to exposure to multiple and serial and cumulative traumatic scenarios during his police service stop the cause of his comorbid persistent depressive disorder with associated generalised anxiety and panic/agoraphobic symptomatology is that persistent depressive disorder is a common complicating and comorbid condition to associated post-traumatic stress disorder. The cause of his alcohol use disorder was a secondary disorder to his post-traumatic stress disorder and comorbid persistent depressive disorder.
6. Dr Peter Young, independent medical examiner (IME) psychiatrist report dated 7/3/23, noted Mr Lever's psychological symptoms from between 2007 and 2014 at Woodburn, highway patrol and experienced post-traumatic stress disorder and had psychologist treatment, cognitive behaviour therapy (CBT), and eye movement desensitization and reprocessing (EMDR), then psychiatrist and antidepressant. He has withdrawn from all social and recreational activities, rarely leaves home and almost no friends, poor concentration, and memory. The claimant drinks two cartoons of beer a week, or nine a day. The claimant is on Fluoxetine, Agomelatine, Diazepam PRN. His symptoms began around 2013 and has not had post injury employment. He provided a PIRS 232 335, the total permanent impairment was 22% for post-traumatic stress disorder and Major depressive disorder and Alcohol use disorder.
7. Psychiatrist Dr Young's report dated 7 March 2023 refers to psychological symptoms at work between 2007 and 2014 in Woodburn, and after his return to work experiencing a gradual recurrence of symptoms increasing in severity in the context of further trauma exposures such that by May 2021, he re-commenced seeing a psychologist. His symptoms continued to deteriorate through to November 2021 when he was certified as having no work capacity.
8. Since this time, he continued treatment with his psychiatrist and psychologist, including behavioural therapy (BT) based therapy and anti-depressant medications. The benefit was limited.
9. Dr Young reports that he continues to experience frequent repeated disturbing thoughts and memories of trauma experiences as well as frequent disturbing dreams related to work occurring several times per week. He continues to feel significant distress including strong physical reactions, increased heart rate and trouble breathing or sweating when reminded of these experiences and these symptoms may last from 30-60 minutes.
10. Dr Young concludes that the claimant presents a history of gradual onset symptoms of post-traumatic stress and mood disturbance accompanied by alcohol abuse. There was some initial response to treatment, but his symptoms continued to deteriorate and resulted in significant ongoing functional impairments. His prognosis is guarded but he could improve if he moderated his alcohol intake.

1. The insurer's bundle contains the accident details including photos of the accident scene.
2. The claimant applied TAL for total and permanent disability under his superannuation. The medical evidence supported a finding that the claimant was unlikely to be able to return to any of his police duties, nor any other roles within his experience, education, or training in the foreseeable future. TAL determined that he was unlikely to return to a suitable occupation, and that this had been so since 1 September 2020.

1. There is an extensive history about the claimant's psychological symptoms after the accident, which are attributed solely to the claimant's police duties. The claimant's claim and award for TPD is based on psychological symptoms that do not refer to the accident.
2. The insurer disagrees that the claimant's work-related psychological symptoms had abated 15 months before the accident based on the TPD determination. Medical Hong did not address the conflicting history and found the accident was the cause of his current symptoms as opposed to the claimant's 20 years in the police
3. The insurer submits that Medical Assessor Hong's history about the claimant's work-related psychological symptoms abating is inconsistent because he found that the claimant recovered after the work incidents resulting in post-traumatic stress disorder and alcohol use disorder with anxiety and depressive symptoms, and he was fit to return to full-time duties and he was well until the accident on 23 July 2020, which resulted mainly in a foot injury, led to increasing alcohol intake and increased anxiety and depressive symptoms, which led him to stop work.
4. After the accident, he worked in non-operational police work. He was not drinking much alcohol when he went back to work.
5. He was to return to general duties when his foot healed (he was never actually certified fit to return to general duties physically). He became more depressed though, increased his alcohol because he could not do things, such as kick a football with his children.
6. The only reasoning provided for the Medical Assessor's diagnosis is the incorrect history that the claimant's work-related psychological symptoms abated around 15 months before the accident.
7. This reasoning ignores the NSW Police and TAL documents demonstrating that the claimant only complained of psychological symptoms referable to his police work.
8. Medical Assessor Hong has incorrectly noted that the claimant's psychological symptoms had ceased before this accident. Under "Pre MVA psychiatric history" he noted: [The Claimant] reported that the first sign of a psychological problem was when he was in Woodburn. He had attended many fatalities and felt he had to transfer out of general there, after working there for six years.
9. The insurer submits Medical Assessor Hong made an error assessing Concentration, Persistence and Pace as Class 3. He stated: "Mr Lever described having poor concentration. He cannot engage in intellectually demanding tasks for 30 minutes. He can do woodwork but not use a building plan".
10. That is inconsistent because the claimant goes to the gym three times per week, sometimes for one hour. He also reported that he drove to Noosa with his family for a holiday early in 2024, which took about two and a half hours, and he did most of the driving. The claimant has reported visiting the golf range about every two weeks. The insurer submits that demonstrates that the claimant can concentrate and persist for prolonged period of time so he should be classified as Class 2.
11. The insurer submits Medical Assessor Hong made a further error assessing Adaptation based on a finding that the claimant is productive "less than 20 hours per week".
12. Medical Assessor Hong was not clear as to whether the claimant could perform the same position for no more than 20 hours per week (Class 2) or in a different position for less than 20 hours per week (Class 3). Earlier in his certificate, Medical Assessor Hong states "In terms of adaptation (as opposed to employability), he described contribution at home and being productive, e.g. making a kitchenette, and this is consistent with productive age appropriate life roles at around 20 hours per week. Therefore, I rated 3".
13. Medical Assessor Hong should have assessed the claimant's ability to return to his pre-injury role. Considering the claimant's current capacity and applying the relevant deductions and apportionments pursuant to clause 6.31 of the Guidelines for pre-accident psychiatric injuries, it is submitted that the claimant's psychological whole person impairment will be assessed as below the threshold.

1. The claimant submits that the TAL TPD findings that the claimant was unfit for work due to reasons unrelated to the accident does not carry weight on the question of causation, because the process under the TPD scheme does not require a finding on causation only on work capacity.

1. Medical Assessors Canaris and Verma interviewed the claimant via MS Teams on

19 November 2025. After explaining the purpose of the examination, they obtained the following history.

Psychosocial history and pre-accident history

1. The claimant is a 51-year-old married former police officer who was medically discharged and is a father of four children aged 19, 17-year-old twins, and 16.
2. He began experiencing mental health difficulties around 2010 while working in Woodburn in general duties as the lockup keeper on a stretch of road known for numerous fatalities. He attended to many incidents, including suicides and murders. He started drinking excessively, which negatively affected his relationship with his wife. He was "short with the kids" and very irritable, stating he drank "every night," up to "18 beers a day at my worst."
3. Although he did not seek treatment initially, he approached his superiors about struggling with his situation and transferred to Tweed Heads, where things initially went better. His job was less stressful, and he was "not picking up dead bodies." He drank less, swapping heavy beers for non-alcoholic ones, and managed to stop drinking after two years.
4. In February 2015, he encountered trouble during a pursuit, resulting in a shootout on the highway. The offender fled on foot across lanes of traffic, but he did not shoot back. The offender was apprehended later along with a companion. This incident triggered old habits; he resumed drinking, though less than before, and his anxiety surged. He started seeing a psychologist and psychiatrist, being prescribed Efexor XR, which he took for 18 months to two years, experiencing side effects like "head zaps" and feeling emotionally numb and sexually unresponsive. He reduced his Efexor dose from 275mg daily to nothing and abstained from alcohol for about two years.
5. During this period, he was involved in a workers' compensation claim. He reports that he was doing well and seeking a promotion. He eventually ceased seeing his psychologist and psychiatrist and was off medication when returning to full duties, with treatment including EMDR.
6. From 2017 to 2020, he remained well, with general practitioner (GP) notes indicating some post-traumatic stress disorder symptoms. He said he was working full-time, socialising, and living his life. His previous health issues were limited to a back injury around 2007 and a broken right knuckle in his first year of policing, though he now contends with additional issues such as improved high cholesterol, coronary artery disease evidenced by high calcium, some liver issues, and an ankle injury from a motor vehicle accident.
7. Alcohol was not an issue before 2010; he does not smoke, use drugs, or gamble. He denied any legal problems or a family history of psychiatric issues. He has three older sisters, and his parents are in good health, living nearby independently. His parents formerly owned a cleaning company. He grew up in Murwillumbah and reported a happy childhood.
8. He completed Year 10 and undertook an apprenticeship as a carpenter, working as a "chippy" from 1991 until 2001, when he joined the police. He always aspired to join the police, noting that Year 11, 12, or a trade were requirements. He has always been based on the North Coast. He married in 2000; his wife is self-employed as an exercise physiologist.

1. On the day of the accident, he was riding his motorbike (a Yamaha, which looks like a Harley). He had hopped on his bike to go to the gym, did a workout, and was on his way home. He was riding up an incline, "and I saw this Land Cruiser coming straight up at me." He had an embankment on his left, "and I was right on the embankment when she hit me - I'd tried to squeeze between the car and a telegraph pole - there was no room - I remember thinking to myself, I'm gone." He was terrified ("To be blunt, I was shitting myself - the most scared I'd been ever... I'd been through some moments in my work but I thought that this is it"). He thinks his bike was dragged under the car - he can "remember seeing under the car and the tyres" and "I just jumped to my feet and then basically collapsed" in a lot of pain. Several people came up to him. Someone turned off his bike and he asked someone to get his phone. Police and ambulance attended, and he was taken to Murwillumbah Base Hospital.
2. He remained in Murwillumbah Hospital for several hours and was sent home. He was given a moon boot.

History of symptoms and treatment following the accident

1. He continued in constant pain. His pain was initially attributed to his skin being scraped off. He was observed to have a broken toe. He had four weeks of sick leave, with his feet up, and "I started going backwards, I suppose, sitting around drinking."
2. At that stage, he was consuming a six-pack of beer a day. This led to some conflict at home - his wife's workload tripled because he was no longer contributing to household chores
3. He returned to work on light duties managing exhibits.
4. He had continuing pain in his right ankle. He "demanded an MRI nearly 9 months later". The MRI showed a range of avulsion fractures and ligament tears. He was sent to see a surgeon who hospitalised him to reattach ligaments and to strengthen his muscles and ligaments.
5. He had further time off work and he returned to restricted duties a couple of weeks later.
6. He had further toe surgery.
7. He has continued to experience pain and swelling in his ankle and has never returned to full duties. He was never deemed fit to return to operational duties, and non-operational roles were unavailable.
8. He kept working in exhibits, saying:

"I wasn't coping - my foot was hurting all the time - I was drinking again - you'd sit there and listen to people talking - you'd hear about guns - I got depressed - I'd come home and I wasn't a happy person - you couldn't kick a ball with my kids - I started to get more and more depressed and I slowly fell down that rabbit hole again."

He stated, "My family life got shit again - I wasn't playing with my kids," and admitted to feeling quite sad, saying, "I was feeling like crap and treating everybody like crap - I wasn't enjoying anything - I was a miserable person."

1. He never felt as though his life was not worth living ("I never got that low - close but not that low").
2. He went back to see his psychologist and started seeing another psychiatrist.

Details of any relevant injuries or conditions sustained since the accident

1. He had not sustained any further injuries or conditions.

1. He would "sometimes" relive police experiences for example when watching TV and "have a bit of a flashback" but on the whole feels he is in control of these.
2. He would experience intrusive thoughts of the accident for example when he sees a motorbike.
3. His mood these days is "good and bad - if everything is going to plan - but it doesn't take much to flip me back."
4. He is "pretty good" now with regard to alcohol and keeps non-alcoholic beverages at home though when he goes out, he might have "a couple of beers." He said in relation to this, "I want to be around for the kids... with the cardiologist and that... I've had to man up."

1. He sees his psychiatrist (Dr Whan) every four to six weeks and his psychologist (Kelly Bisgrove) fortnightly. He would "talk over things" with his psychologist addressing "what am I doing to improve" and "giving me a sounding post." His medication includes topiramate, agomelatine, and fluoxetine as well as diazepam "every now and again."

1. The Medical Assessors interviewed the claimant on Microsoft Teams with a good audiovisual connection. He was at his home in Murwillumbah. Medical Assessors Canaris and Verma were in their respective offices. He became very distressed when the possibility of a further appointment was raised because Medical Assessor Canaris had to leave to attend to another matter. He said he just wanted to finish it. Consequently, Medical Assessor Verma concluded the assessment over a period of 20 minutes.
2. The claimant's wife, Natalie Lever, was present for much of the assessment. She did not interfere with the assessment.
3. He presented as a bespectacled balding man with salt-and-pepper hair and beard. He looked reasonably groomed. He provided the account documented above. His narrative was coherent and internally consistent. His demeanour was depleted and as noted above at one point he became very distressed.
4. There was no evidence of psychosis or cognitive impairment.

1. He sees himself as unable to get back to work because of his depression and post-traumatic stress disorder. He is not physically fit to return to police saying he can't run, and he has difficulties with uneven surfaces. His ankle would flare up with periods of overactivity.
2. He has "good days - bad days - I try not to load myself up."
3. On a typical day, he wakes up at 6.30am and then makes himself coffee and gets his kids up to get ready and dressed. He will drop them to school on some mornings when they miss the bus, but often they take a bus or ride their push bikes. He then returns home and cleans or otherwise potters around the house. His dad comes about a couple of times a week as he stores all his stuff in the shed. He will accompany him if they need to get parts for tyres and do a few errands. He then sits until his wife returns home at 1.00pm and then he annoys her as he doesn't have any other interaction, and his kids return at 3.00pm. He will then work on the barbeque at the back.
4. He is "fine - never been a problem" with regard to showering or changing his clothes. He tends to eat "once a day" and often eats "crap" and "not the healthier option." He does clean around the house but does not often cook though he can manage a home-made pizza. He finds cleaning and hanging out the washing gives him a sense of purpose.
5. He goes out at his wife's prompting and he would "man up" for her sake and go to a barbeque with friends ("I don't initiate it but if I didn't do it, it would be the last nail in the coffin"). He added he might take a Valium before going out on such an occasion which might be twice a month if he is likely to face "a bit more of a crowd." He has been out three times in the last three months and last weekend had stayed at an Airbnb owned by his sister-in-law. Sometimes he goes to play golf with his mate and would play nine holes every three weeks, and he has friends over for BBQ; most of them are divorced and single. He said that he will sit at the back and talk to them when they are at home, and he socialises with them. One of them is a paramedic who understands him, and he listens to that friend about their ex-husband. He is otherwise reluctant to go out socially and tends to get "peopled out."
6. He does not ride his bike at all. He is sometimes nervous and anxious behind the wheel of a car saying, "I don't have the confidence I once had" and restricts himself to local journeys. He would not make a longer journey on his own because of his anxiety.
7. He would "snap at the kids" but apologises for this subsequently and "they're pretty understanding." He and Natalie "have our problems - she has to put up with a lot" because of his irritability "but she's still here." There has been no violence though there had been separations "a few times" when his wife has gone to stay with her sister including "nearly a month" and 2 weeks" apart earlier this year. He has lost a lot of his friends, as many of them rode motorbikes.
8. His concentration is "shocking." He can manage to watch a movie "but if you said to me at the end of the movie, what was the name of the main villain, I wouldn't remember unless it was something iconic like Batman... I can watch a show to the end but I couldn't tell you half the characters were." He tends to watch whatever his wife likes because he then doesn't have to think too much. He does not read managing no more than half a page saying he does not take it in.
9. He has not worked since his medical discharge from the police in August 2022. However, in addition to cleaning and other household chores, he does some work around the house and has painted bedrooms and has a back area he is doing and is able to put his carpentry experience to reasonable use. Thus far, he has painted three bedrooms, hung photographs, and added shelves. He sometimes makes mistakes when doing so.
10. Pain is an ongoing problem for him. He had been "in a very bad place" before his accident and riding his motorbike with his friend had been his "medicine." This was no longer possible after the accident and he said life "went pear-shaped" afterwards. He said that had the accident not happened, his life would have been very different.

1. His attention was drawn to documentation indicating in the post-accident period that he had work-related post-traumatic stress disorder and the lack of mention of the accident including the Bisgrove treatment notes. He explained that the accident removed his coping mechanisms, including his motorcycle, his work, and he regressed "into my old ways." He said he had told all his doctors that the accident had "removed my coping mechanism."
2. His wife interjected for the only time in the interview, confirming that this had been the case, as she had been to many of his appointments. The Medical Assessors accepted this explanation noting that reports relating to income protection would not have addressed causation.

1. The police report dated 12 August 2020 was noted. The accident was classified as a major traffic crash.
2. The NSW Ambulance report was noted.
3. The report of M & A Investigations dated 25 September 2020 was noted.
4. Reports of Dr Frank Machart, IME orthopaedic surgeon, dated 29 April 2022 and 16 August 2022 were noted.
5. Reports of Moore Rehab dated 9 September 2020 and 7 October 2020 were noted. In addition to physical issues, he was administered the Depression, Anxiety, and Stress Scales - 21 (DASS 21) yielding scores consistent with mild depression, moderate anxiety, and mild stress.
6. Sundry certificates of capacity related to the subject motor vehicle accident were noted.
7. Clinical records of King Street Medical Centre were noted. An entry on 5 November 2015 records a "long discussion" regarding post-traumatic stress disorder following a shooting in the previous February with recurrent and intrusive thoughts of the event, being unhappy at work, needing time off work, and seeing a psychologist. There are multiple entries relating to his workers compensation injury described at one point as arising from a "gunfight" in 2015 with prescriptions for various antidepressants, documentation of post-traumatic stress disorder symptoms, excessive alcohol use, and a range of physical problems including liver disease, hypercholesterolaemia, elevated calcium scores (a marker for coronary artery disease), and obesity. There are passing mentions of his motor vehicle accident and attendant injuries but clinical documentation appears to refer to physical aspects of his injuries and on 7 December 2022 he is noted to have been in a CAM boot for nine months and to have had multiple surgeries and procedures.
8. On 27 September 2024, he is noted to have "PTSD" which is described as a "chronic, permanent, severe condition" with symptoms including:

"...sleep disruption, muscle tension, irritability, anger, waking with dread, panic, concentration/attention issues, memory problems, hypervigilance, avoidance, reduced social interactions, racing heart, worry, rumination, reduced engagement in pleasurable activities, low energy/motivation, reduced confidence, vivid distressing memories, flashbacks".

1. He is said to have reached maximum medical improvement.
2. On 24 February 2025, he is documented as reporting that his 16-year-old daughter had left home on Christmas Day with her boyfriend, that she is making allegations of abuse, assault, and inappropriate touching which he said were false claims. His daughter that previously identified as male again identified as female. He was noted to be drinking two cartons of beer a week. Overall, any mention of psychological symptoms appeared to relate to post-traumatic stress disorder related to his workers compensation claim although some entries did not make a specific reference to it. However, there was no mention of psychological issues referable to the accident. He is noted to be on fluoxetine, agomelatine, and topiramate.
3. The Panel noted the clinical notes of Kingscliff Health as printed on 24 January 2022 comprising physiotherapy notes only.
4. A Police Medical Officer report from Dr Judy Balint dated 29 May 2017 relates to the incident in February 2015 in which an offender had fired at the claimant and his colleague during a pursuit. Psychological symptoms including a perception that he was struggling, felt nauseous when going to work, and avoided going outside the station. He was noted to be irritable, emotionally labile, having difficulty sleeping and becoming socially withdrawn and avoiding the location of the incident. He was noted to be hypervigilant particularly in relation to his children's safety. He sought medical help 10 months after the incident and was referred to a psychologist and psychiatrist in early 2016. He spent six months off work before returning on a graded return to work program in July 2016. There is a comment on psychometric testing (MMPI II is contained elsewhere in the documentation) which is said to be valid with elevation in some clinical scales consistent with his presentation and interview. He was recommended to remain on restricted station duties but to resume nightshift with a view to eventual clearance for full operational duties. There are handwritten notes dated 22 May 2017 related to this assessment. These documented him to be sleeping well, to have no nightmares or irritability, and not avoiding travel in the area where the incident had occurred. He was still hypervigilant in relation to his children now able to take them places. He was said to be "socialising okay". He had recently had reduction in his dose of medication with some discontinuation effect.
5. There were sundry other documents related to this incident including a report from Lucille Reynolds, treating psychologist, dated 14 February 2017 providing a diagnosis of post-traumatic stress disorder and alcohol use disorder. The latter was related to his workplace injury and he was noted to have had cognitive behaviour therapy, EMDR, exposure therapy, and motivational interviewing related to alcohol use.
6. Correspondence of Kelly Bisgrove, treating psychologist, from 24 September 2021 related to the claimant's workers compensation injury making a diagnosis of post-traumatic stress disorder including a range of symptoms including anxiety and depressive symptoms, concentration and memory difficulty, sleep disruption, racing heart, agitation and reduced patience, worrying rumination, reduced engagement in pleasurable activities, reduced energy and motivation, and reduced self-esteem and confidence. It was recommended that he would be better able to engage in treatment whilst not in a triggering environment such as general duties policing. A range of treatments including inter alia trauma focused cognitive behaviour therapy, progressive exposure, and EMDR were mentioned. There were accompanying Allied Health Recovery Request started 26 October 2021 reiterated the diagnosis of posttraumatic stress disorder. On 10 November 2021, Ms Bisgrove reported that the claimant did not feel he could continue in his role as a police officer. There was a Medical Disengagement Report dated 4 February 2022 essentially finding him to have no work capacity because of his symptoms. A letter to TAL dated 20 July 2022 reiterated the diagnosis of posttraumatic stress disorder stating:

"Mr Lever has experience trauma-related anxiety and reactivity over many years. Current clinical symptomatology include, however are not limited to, sleep disruption, muscle tension, irritability, anger, waking with a sense of dread, panic, concentration/attention and memory issues, hypervigilance, avoidance, reduced interaction with friends, racing heart, worrying rumination, reduced engagement in pleasurable activities, reduced energy and motivation, reduced confidence, vivid and distressing memories of past workplace trauma, and flashbacks."

"...been exposed to death of others, personal threatened death, as well as fear of personal serious injury on multiple occasions stop as such, he experiences unwanted upsetting memories, nightmares, flashbacks, and emotional and physical distress. He exhibits avoidance of trauma -related thoughts and external triggers, decreased interest in activities and isolation. He is avoidant of crowded spaces and when he is exposed to such situations, he is anxious during and after exposure. He experiences significantly heighten symptoms each time he has to leave the house."

"Specific triggers include any reminders of work-related trauma, such as roads where accident occurred, sirens of policing uniform. Mr Lever experiences the above symptoms of trauma, anxiety, and depression on a daily basis. Mr Lever often feels too anxious to drive on his own and takes his father and his vehicle for reassurance. Mr Lever also experiences anxiety associated with his family safety, and reports that he feels less anxious when everyone is at home together with reduced risk for their personal safety."

Ms Bisgrove concludes, "the causation of injury is 20 years of accumulated trauma from frontline policing" and that "symptoms are directly and solely caused by his employment with NSW Police".

1. Correspondence from Dr James Whan, treating psychiatrist, was noted. Dr Whan in letter dated 3 December 2021 confirms the diagnosis of post-traumatic stress disorder listing symptoms including his involvement in a gunfight in 2015 and exposure to a more recent critical incident. Excess alcohol was a problem. He was noted to be reluctant to have a trial of medication. Subsequent correspondence of Dr Whan recommends attendance at a veterans/emergency services group at the Currumbin Clinic as an outpatient. On 5 August 2022, he was noted to have worsening depression despite being on fluoxetine (an antidepressant) 60mg daily and seeing his psychologist weekly. He was to be weaned off fluoxetine and to start on agomelatine (another antidepressant). On 12 August 2022, Dr Whan noted the presence of depression with low mood, tearfulness, fatigue, poor concentration, and intermittent suicidal ideation with symptoms of the post-traumatic stress disorder including irritability, hypervigilance, nightmares, and feelings of guilt. His symptoms were considered stable, stationary, and permanent and he was deemed to be never able to return to NSW Police or to any other work employment.
2. Progress notes of Dr James Whan were noted from 3 December 2021 to 2 September 2022. Medication included Valdoxan (agomelatine), fluoxetine, and Topamax (topiramate). There is reference to excessive drinking. Symptoms noted included nightmare and sleep disturbance with rumination. However, the notes are non-specific in relation to the questions concerning the Medical Assessors.
3. Correspondence from Dr Whan to TAL superannuation dated 12 August 2022 relates to his functioning and his symptoms and impairments but does not provide further specific information to assist with the Medical Assessors.
4. Sundry correspondence from TAL to Aware Super dated to September 2022 was noted summarising much of the preceding documentation and determining that he was totally and permanently incapacitated.
5. The report of Dr Maxwell Katz, IME psychiatrist, dated 20 March 2017 was noted. Dr Katz documented that the claimant had for the first time in his life thought he was going to die at the time of the 2015 incident. He was noted to have mild residual symptoms of post-traumatic stress disorder and to be on Efexor (venlafaxine - an antidepressant) although earlier he had had "a full hand" of post-traumatic symptoms including flashbacks, nightmares, intrusive thoughts, increased startle response, hypervigilance, generally increased nervous sensitivity manifested in being on edge, agitated, irritable, anxious, fearful, and overreacting to day-to-day pressures and stressors. He was noted to be on a graded return to work plan, to be highly motivated to getting back to work, and to be contemplating a return to full operational duties. Symptoms included increased sensitivity to situations that were confrontational, anticipatory anxiety, some hypervigilance, and some issues with emotional modulation in relation to triggers relating to the armed pursuit. There was no indication of secondary depressive processes although there was some "raised sensitivity."
6. An attending doctor's statement dated 11 November 2021 for income protection insurance notes the claimant to have post-traumatic stress disorder as well as a range of other physical issues, to be on fluoxetine with regular input from a psychologist and psychiatrist and to be not fit to return to work.
7. An NSW Police Force incident reporting form dated 19 July 2021 states, "Re-occurring issues with PTSD. Started seeing Psycologist [sic] in late 2019 due to a number of incidents that have triggered my PTSD I have been getting the sessions through EAP".
8. Sundry documents related to a TPD application were noted.
9. The panel noted the certificate of Medical Assessor Michael Hong dated 6 September 2024. Dr Hong made a diagnosis of post-traumatic stress disorder with anxiety and depressive symptoms together with an alcohol use disorder giving rise to a permanent impairment of 13%. Dr Hong noted his prior diagnosis of post-traumatic stress disorder with anxiety and depression and alcohol use disorder which he said had resolved before the subject accident apart from a brief episode of unwellness in 2019. He considered that there was no identified impairment prior to the subject accident. He rated him as Class I for self-care and personal hygiene, Class 2 for social and recreational activities and travel, Class 3 for social functioning and concentration, persistence, and pace, and Class 3 for adaptation. He made no adjustment for treatment effects.
10. The report of Dr Michael Prior, IME psychiatrist, dated 12 October 2022 was noted. Dr Prior took a history of a deterioration in the claimant's mental health from 2010 onward in response to multiple, serial, and cumulative traumatic scenarios such as attending a deceased suicide whose body had decomposed found hanging in a state forest. The worst traumatic incident involving a fatal car accident involving two girls while his most recent traumatic scenario involved a police pursuit in which the driver and passenger of the pursuit car had jumped out of the vehicle and fired a gun at the claimant in his partner. He was noted to have seen psychologists and psychiatrists and to have been started on fluoxetine and agomelatine as well as Topamax (topiramate - an anticonvulsant use this a mood stabiliser). He was noted to have last worked in November 2021 and have been medically discharged in August 2022. He had not returned to work because of poor concentration, memory problems, lack of motivation, avoidance of people, low mood, anxiety, panic symptoms, and avoidance of leaving home. Dr Prior diagnosed chronic post-traumatic stress disorder with comorbid persistent depressive disorder with associated generalized anxiety phenomena and panic/agoraphobic phenomena as well as alcohol use disorder which he attributed to his exposure to multiple, serial, and cumulative trauma exposure over the course of his police career. He assessed him with 24% whole person impairment with no deduction for pre-existing impairment or adjustment for treatment effects. He assessed him as Class 2 for travel, Class 3 for self-care and personal hygiene, social and recreational activities, social functioning, and concentration, persistence, and pace, and Class 5 for employability.
11. The Panel noted that Dr Prior's report is under workers compensation guidelines. Dr Prior's report mentions the subject motor vehicle accident and notes that the claimant denied any psychological sequelae of that event. Additionally, Dr Prior's report was prepared over three years ago.
12. The report of Dr Peter Young, IME psychiatrist, dated 7 March 2023 was noted. Dr Young took a history of psychological symptoms emerging between 2007 and 2014 involving attendances at multiple fatal car accidents. He was drinking nine standard drinks per day. Treatment had included seeing a psychologist, undergoing CBT and EMDR, and taking antidepressants, and he was noted to be on topiramate, fluoxetine, agomelatine, and diazepam. There was a reference to a physical injury claim in 2020 (presumably the subject motor vehicle accident). He was diagnosed with posttraumatic stress disorder with alcohol abuse.
13. Dr Young assessed him with 22% whole person impairment with no deduction for pre-existing impairment or adjustment for treatment effects rating him as Class 2 for self-care and personal hygiene and travel, Class 3 for social and recreational activities, social functioning, and concentration, persistence, and pace, and Class 5 for employability.
14. Dr Young's report was also under workers' compensation guidelines. That report did not mention psychological sequelae of this motor accident. Additionally, Dr Young's report was prepared two years and nine months ago.

1. The claimant's presentation is consistent with a diagnosis of post-traumatic stress disorder and alcohol use disorder. His post-traumatic stress disorder is in partial remission, while his alcohol use disorder appears to be in substantial remission.
2. In terms of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria, the claimant's symptoms of post-traumatic stress disorder arose as a consequence of direct exposure to actual or threatened death and serious injury (Criterion A). There is evidence of intrusion symptoms comprising recurrent, involuntary, and intrusive recall of traumatic events, nightmares, and distress when exposed to reminders of trauma (Criterion B). There was evidence of persistent avoidance of stimuli associated with traumatic events manifested in his eventual departure from policing in the face of increasing reluctance to be at work (Criterion C). There was evidence of negative alterations in cognitions and mood associated with traumatic events manifested in low mood and withdrawal from family life (Criterion D). He gave a history of marked alterations and arousal and reactivity manifest in irritability, hypervigilance, problems with concentration, and sleep disturbance (Criterion E). His symptoms had been continually present for many years (Criterion F), caused him clinically significant distress and psychosocial impairment as manifested in his departure from work, his social withdrawal, and a strain on his marriage (Criterion G), and were not attributable to the physiological effects of a substance or to another medical condition (Criterion H).
3. In relation to Criterion H, the Medical Assessors noted his history of drinking which had emerged as a response to rather than a cause of his symptoms.
4. In relation to DSM-5-TR criteria for diagnosis of alcohol use disorder, there was evidence of manifestly excessive alcohol consumption with evidence of tolerance with an adverse impact upon his marriage. He fulfilled 3 out of the 11 symptoms specified of which a minimum of 2 during a 12-month period was needed to make the diagnosis.

1. His posttraumatic stress disorder arose as a direct consequence of extensive trauma exposure in the course of his police career, and his comorbid alcohol use disorder appears to have been predominantly an attempt to self-medicate his traumatic symptoms. However, there was evidence from the history provided that his post-traumatic stress disorder had worsened in the aftermath of the motor accident, as had his alcohol use disorder. The Medical Assessors noted in this context that he had returned to regular duties before this accident after he had been cleared psychologically.
2. The accident itself was traumatic in that it caused him a significant physical injury. Moreover, he reports that at the time of the accident, he thought he would be killed. His subsequent chronic pain and physical limitations, include loss of outlets that had managed his existing trauma, with the frustrations that this entailed, also would have contributed to an aggravation of his posttraumatic stress disorder and hence his alcohol use disorder.
3. The Medical Assessors were mindful of Ms Bisgrove's opinion on causation. They also noted the TPD application evidence which did not mention the motor accident. However, they noted also that this evidence did not concern itself with causation but with his capacity for employment. They consequently concluded that these did not suffice to exclude the contribution of the subject accident to his injury and impairment.

1. The subject accident occurred well over five years ago. Over that time, he has had access to a psychologist and a psychiatrist. He has been on an appropriate psychotropic regimen. Consequently, his level of impairment is unlikely to change substantially or by more than 3% over the next year.

Degree Of permanent impairment psychiatric impairment rating scale

1. Post-traumatic stress disorder in partial remission

He sees a psychiatrist and a psychologist and is on an antidepressant regime.

He is "fine - never been a problem" with regard to showering or changing his clothes. He tends to eat "once a day" and often eats "crap" and "not the healthier option." He does clean around the house but does not often cook though he can manage a home-made pizza. He finds cleaning and hanging out the washing gives him a sense of purpose.

He goes out at his wife's prompting and he would "man up" for her sake and go to a barbeque with friends ("I don't initiate it but if I didn't do it, it would be the last nail in the coffin"). He added he might take a Valium before going out on such an occasion which might be twice a months if he is likely to face "a bit more of a crowd." He has been out 3 times in the last 3 months and last weekend had stayed at an Airbnb owned by his sister-in-law. Sometimes he goes to play golf with his mate and would play 9 holes every 3 weeks., and he has friends over for BBQ; most of them are divorced and single. He said that he will sit at the back and talk to them when they are at home, and he socialises with them. One of them is a paramedic who understands him, and he listens to them about their ex-husband. He is otherwise reluctant to go out socially and tends to get "peopled out."

He does not ride his bike at all. He is sometimes nervous and anxious behind the wheel of a car saying, "I don't have the confidence I once had" and restricts himself to local journeys. He would not make a longer journey on his own because of his anxiety.

He would "snap at the kids" but apologises for this subsequently and "they're pretty understanding." He and "Natalie "have our problems - she has to put up with a lot" because of his irritability "but she's still here." There has been no violence though there had been separations "a few times" when his wife has gone to stay with her sister including "nearly a month" and 2 weeks" apart earlier this year. He has lost a lot of his friends as many of them rode motorbikes.

His concentration is "shocking." He can manage to watch a movie:

"but if you said to me at the end of the movie, what was the name of the main villain, I wouldn't remember unless it was something iconic like Batman... I can watch a show to the end but I couldn't tell you half the characters were."

He tends to watch whatever his wife likes because he then doesn't have to think too much. He does not read managing no more than half a page saying he does not take it in.

Comment: The Medical Assessors noted his capacity to perform repairs around the house such as painting, hanging up pictures, and putting up shelves. They noted that he admitted to making mistakes when doing so. Nevertheless, these are tasks requiring significant focus. Using clinical judgement, they determined him to have Class 2 impairment in this category.

He has not worked since his medical discharge from the police in August 2022. However, in addition to cleaning and other household chores, he does some work around the house and has painted bedrooms and has a back area he is doing and is able to put his carpentry experience to reasonable use. Thus far, he has painted 3 bedrooms, hung photographs, and added shelves. He sometimes makes mistakes when doing so. Noting opinions expressed in the medical evidence the Panel decided this would probably not translate into being able to attend meaningful levels of employment.

1. The Medical Assessors considered the claimant's impairment before the subject motor vehicle. He had post-traumatic stress disorder and alcohol use disorder related to extensive workplace trauma exposure. This had remitted as best as could be discerned from the documentation on hand.

He had seen a psychologist and had cognitive behaviour therapy with EMDR. He had also seen a psychiatrist but was not on psychotropic medication.

There was no evidence of impairment in the documentation of impairment at the time of the motor vehicle accident.

There was no evidence of impairment in the documentation of impairment at the time of the motor vehicle accident.

There was no evidence of impairment in the documentation of impairment at the time of the motor vehicle accident.

There was no evidence of impairment in the documentation of impairment at the time of the motor vehicle accident.

There was no evidence of impairment in the documentation of impairment at the time of the motor vehicle accident.

He had returned to full duties as a police officer.

Apportionment - pre-existing/subsequent impairment

1. Of his total permanent impairment of 8%, 0% was attributable to pre-accident psychiatric injury.

1. He had improved significantly with treatment. Consequently, the Medical Assessors considered that a 2% uplift for treatment effects was appropriate.

Degree of permanent impairment caused by the accident

1. The Panel agrees with and adopts the reasons given by its medical members in their re-examination report in support of this finding.
2. The Panel has considered the evidence relating to the claimant's pre-accident psychological history and his inconsistencies.
3. The Panel has given weight to its medical members' opinions who, following a thorough examination of the claimant's pre-existing functioning, were satisfied that while there were pre-existing psychiatric conditions at the time of the accident, the accident aggravated the referred conditions.
4. There is a plausible mechanism of injury from the circumstances of this accident and the development of these psychiatric injuries, and there is a temporal and thematic association with the psychiatric symptoms becoming more prominent and the accident, which maintains a nexus between this accident and the psychiatric injuries.
5. There was no other cause for these conditions being exacerbated other than the accident.

1. The Panel revokes Medical Assessor Michael Hong's certificate dated 6 September 2023, which found that the psychological injuries arising from the accident gave rise to permanent impairment of 13%.
2. The Panel certifies that Mr Lever's permanent impairment resulting from the injury caused by the accident is 10% permanent impairment arising from posttraumatic stress disorder in partial remission and alcohol use disorder in substantial remission, which is not greater than 10%.

[2] Version 10 since 15 September 2025. Referred to as the Guidelines

[6] See clauses 6.222 - 6.223 of the Guidelines.

[7] See clauses 6.225 - 6.228 and table 17.