//
austlii:nsw/NSWPICMP/2025/616
General information, not legal advice.
NSWPICMP
2025-08-18
Original judgment source is linked above.
We have considered the documents provided in the application.
Ms Matti was born in Iraq and says that she suffered a lot during the Iran-Iraq war and then the Gulf War. She did not want to answer questions about the trauma that she endured in the war. She did not answer the question regarding sexual and physical abuse. She completed a degree in pure mathematics from the University of Baghdad and 'escaped' to Lebanon in 1994. She says that Saddam Hussein had decreed that anyone with a degree could not leave. She had to pay and get forged papers to escape. She had to travel with her father to Jordan and from there to Lebanon. Her father was stopped in Jordan and was not allowed to enter Lebanon. She stayed in Lebanon with her mother's family and studied drafting. She moved to Australia in May 1995 as a refugee. Her father passed away in Iraq in a motor vehicle accident in 1996. She denies any history of mental illness in her family. Her mother moved to Australia in January 1998. Her younger brother followed six months later. Her older brother came over one year later, while her remaining sister migrated in 2005/06.
Ms Matti was married but separated in 2007. She has been single since 2007. She describes financial and emotional abuse in the marriage as her husband was a "gambler". She has a daughter who is 25 and her son is 17 years old. She lives with her daughter and her son. She says that her mother is with her "90% of the time".
According to documentation, she was involved in an MVA on 08 June 2000, but could not remember the details.
She was then injured in an MVA on 05 Oct 10 and received 4% WPI. She was able to remember details of the accident. She says that she recovered fully from that accident. It took time but she became 'normal' with driving eventually.
She worked as a secondary school maths teacher for twenty years. Her last appointment was at Liverpool High School, three days per week.
She says that her last day at work was on 18 March 2020 and she was deemed to be totally and permanently incapacitated (TPD) to work from then on. She says that she nearly lost her life to COVID owing to asthma and had to stop working after that. She says that she was 'really unwell with asthma' that year, and her lung function was down to 20%. She says that she was also 'really stressed' because of not working and financial uncertainty.
She was referred on July 22 to psychiatrist Dr Richa Rastogi, who prescribed her antidepressant medication, but she did not continue for a long time.
She says that she has had PTSD from asthma and the war. She says that she is much better in that regard. She says that she does not cry because of those issues.
She says that she was off all the antidepressant medications at the time of the accident. She says that she was seeing psychologist Ms Mariel Gadia for a long time for issues such as depression related to the loss of her job and her asthma. She says that she was depressed but not severely when she suffered the accident. She describes herself as the 'best that she ever was'. She says that she was feeling happy and used to walk every day. She denies any pre-existing impairment.
Ms Matti was driving her Toyota Camry, 2011 model on 12 May 23. She was driving her son to school, who was fifteen years old and was sitting in the front passenger seat. She stopped at a red light, and the vehicle behind her failed to stop, rear-ending her car. She says that it was a 60 kmph or a 70 kmph zone. The impact was sudden, and she was unaware of any car behind her. She says that the driver tried to avoid her car by steering right and hit her car on the right (driver's) side, towards the back. Her vehicle was pushed forward, but did not hit any other car. Her airbags did not deploy and she did not suffer any head injury or loss of consciousness. She says that she was in shock and was unable to make a phone call. Her son was fine and took the phone from her to call his uncle. She says that she was worried about her son, thinking that he had hurt his back. His son kept on telling her that he was fine, but she was worried nevertheless. Her son helped her out of the car but was shaking. The other driver came over to check on her. Her brother arrived and 'took over'. She did not have to go to the hospital that day but did seek help one week later. Her son did not need any medical attention. He missed school that day, which was a Friday, and returned after the weekend. Her car was written off. She says that she has suffered from neck and back pain. She also has pain in left shoulder and numbness in her hands bilaterally.
Ms Matti says that she was in 'great pain' after the accident and attended with a physiotherapist for a year, which was helpful. She then attended with a chiropractor, which was also beneficial. She has had two injections in her lower back as well. However, her back pain has increased recently as the injections have 'worn off'. She is awaiting surgery on her lower back at the end of this year.
She says that her emotional symptoms started the day of the accident and have persisted since.
She says that she has improved. She is sleeping better and has stopped suffering from nightmares.
Ms Matti says that her mood is better. She says that she does not care about anything but manages to look after her mother. She says that 'nothing has taste' and nothing gives her pleasure. Her daughter asks her repeatedly if she is happy but she does not feels that emotion. She says that she feels anxious 'a lot of the time'. She did not describe panic attacks. She says that she is always thinking that 'death is around a corner'. She says that she thinks about dying but not suicide. She is a Christian and thinks that it is a 'sin to be suicidal'. She does not think it would matter if she passed away. She says that her sleep has improved but she still wakes up 'multiple times a night'. She sleeps on her couch in the afternoons and says that she can have a good sleep then. Her nightmares have become much less frequent.
She says that she is 'so scared' when she travels as a passenger in a car. She is better as a driver. She says that she can drive 'normally' but does get anxious at traffic lights. She takes her mother with her for long distance driving but has also done it independently. She says that she finds long drives stressful. She says that her appetite is maintained. She is on Ozempic to manage her weight. She says that she drives her son to the school, using the same route and passes the site of the accident. She says that she gets anxious every time. She says that she has flashbacks but 'very minor'. They usually occur on days that she is feeling stressed. She says that she had become angry but has settled since she has been on medication. She says that she is 'very patient' with her mother. She says that part of her depression is related to not working. Work gave her happiness and she would return to work if her back surgery is successful. She says that her self esteem is "zero". She says that that is related to not working, financial issues and the impact of the accident. She was asked about pre-existing back pain but she stated that her 'back was good and she did not have pain'. Her asthma is under control now and she is unable to work because of the back injury, related to the claimed injury.
Ms Matti is on injections for asthma along with Flutiform and Ventolin inhalers. She is also on Fluoxetine 20mg. She had been seeing a counsellor for a year until the insurance stopped paying, around July 2024.
Ms Matti presented as a casually dressed lady who maintained adequate eye contact over videoconferencing. She answered all the questions and did not come across as guarded. She appeared adequately nourished and reasonably kempt. Her mood appeared euthymic, and her affect was reactive. Her speech was normal in rate, rhythm, tone and volume. Her thought content revealed that she has become fearful of driving. She was not suffering from any perceptual abnormalities but describes occasional nightmares and flashbacks. She appeared to be well-orientated to time, place and person. She could focus for the entire duration of the assessment. She was able to remember dates of events such as the last day of work.
Ms Matti bought a new car after receiving money for her car. She is a carer for her mother who suffers from dementia. She remains her mother's main carer but there has been an increase in external carer hours since the accident as she is not able to do as much physically. Her mother's care needs have increased as well. She says that she is a 'very clean person: and manages her activities of daily living appropriately. She cooks regularly for her family. Her son is in year twelve and she looks after him as well. She has lost 12 kilograms with Ozempic. She has learned to make easy meals to suit her physical needs. She says that she is unable to concentrate 'very well'. She says that she struggles to understand things. She tried to learn about chat GPT but struggled to understand the information on the internet. She listens to YouTube videos but does not understand the content like she used to. She has also become forgetful. She says that she could work as a teacher but is limited by her back injury. She says that she could manage to teach maths despite her concentration problems. She manages her mother's medications and finances as well.
She has not worked since March 2020 because of asthma. She is on carer allowance for looking after her mother and disability payments. She says that it is hard but manages her expenses on her payments. She does not have to pay for her daughter and her son works for his 'pocket money'. She can budget for things and pays her bills on time.
She gets on well with her mother and children. She is close to her siblings as well. She does not meet them very often. She is visited by her siblings every week who come to check on their mother. She partakes in family celebrations and says that she visited her brother for his birthday in June. She says that she manages her grocery shopping independently. She goes to Coles daily and buys a coffee on her way back. She says that she has one very good friend whom she goes out with occasionally. She has managed to form friendships with her mother's friends and her mother's carers. She buys clothes for her mother and looks after her mother's house as well.
She can drive to new places if needed. She could use public transport if needed. She takes her mother to the shopping centre every week.
The Medical Assessors noted documentation from My Family Health Medical Centre dated 4 Oct 2023 when it was noted that Ms Matti's depression and anxiety were worse since the motor vehicle accident.
The Medical Assessors noted a certificate from Medical Assessor Allen Doris dated 5 Aug 2024 in which her injury was described as a recurrence of PTSD and a recurrence of major depressive disorder.
The Medical Assessors noted documentation from Greenfield Medical Centre. According to this documentation, Ms Matti was noted to be suffering from ongoing depression and was referred to a psychotherapist on 19 Jun 2018. She continued to present with symptoms of depression through 2018 and on 3 Oct 2018 she was prescribed agomelatine. Ongoing symptoms of depression were noted through 2019 and on 5 Mar 2020, she was noted to be on agomelatine 25 mg. A mental health care plan was completed for her on 27 Apr 2020. On 30 Sep 2020, it was considered that her diagnosis was PTSD and depression. Her medication at that time was agomelatine 25 mg and fluoxetine 20 mg. She was referred to psychiatrist Dr. Richa Rastogi on 18 Dec 2020 for depression, anxiety and PTSD. A mental health care plan was completed for her on 15 Mar 2021 for PTSD and depression. On 30 Apr 2021, it was noted that she had been considered to be totally and permanently disabled to work. Her medication was agomelatine 25 mg and fluoxetine 20 mg. She presented with anxiety over 2021 and 2022. On 28 Mar 2022 it was noted that she wanted to come off medication and the dose of fluoxetine was reduced to 10 mg. She was again referred to Dr. Rastogi on 11 2022 for depression and anxiety. On 26 Aug 2022 it was noted that she had stopped medication two months previously but was suffering from pervasive low mood and continuing to see a psychologist. She was re-prescribed fluoxetine 20 mg on 1 Dec 2022. She presented with depression and anxiety in Feb 2023 and a mental health care plan was completed for her for depression and anxiety. She next presented with mental health symptoms after the motor vehicle accident.
The Medical Assessors noted documentation from Edensor Park Medical Centre which describes a history of motor vehicle accident dated 8 Jun 2000. Ms Matti was noted to be depressed on 14 Dec 2002 and was taking venlafaxine 75 to 150 mg per day. On 12 Aug 2013, it was noted that she was having problems with her husband, which was due to his gambling habits and was stressful. Her antidepressants was stopped on 26 Aug 2013. On 24 Nov 2014, it was noted that she had suffered sexual harassment at work, which had caused her stress. Her depression was noted to have worsened by 28 Nov 2014 and she was referred to a psychologist. She was switched to duloxetine for ongoing depression on 13 May 2015.
The Medical Assessors noted a report from treating psychologist Ms Mariel Gadia dated 12 Jul 2023, which describes previous treatment for PTSD related to her time in Iraq.
The Medical Assessors noted documentation dated 13 Oct 2023 from treating general practitioner Dr. Benjamin Touma, which describes long-term PTSD, depression, and anxiety. The dose of agomelatine was increased to 50 mg.
The Medical Assessors further noted a history of motor vehicle accident dated 5 Oct 2010, following which the patient was diagnosed with a chronic adjustment disorder with mixed anxiety and depressed mood. She was assessed to have 4% impairment of the whole person on 12 Feb 2024 because of that accident.
The Medical Assessors noted a file review report by psychiatrist Dr. Kerry Neville, which describes pre-existing PTSD, depression, and anxiety in relation to the current injury. It was noted that she was not medicated when she suffered the motor vehicle accident in May 2023.
The Medical Assessors noted a report by psychiatrist Dr. Abhishek Nagesh dated 5 Mar 2024, which did not describe any previous episodes of mental illness apart from depression, anxiety and PTSD 10 years ago, which was considered to be in remission. Dr. Nagesh diagnosed Ms Matti with major depressive disorder with anxious distress and assessed her to have 15% impairment of the whole person.
The Medical Assessors noted that in an allied health recovery request dated 12 July 2023, treating psychologist Mariel Gedia described a history of war trauma.
The Medical Assessors opines that Ms Matti's diagnosis is Major Depressive Disorder with anxious distress, as an aggravation of pre-existing symptoms. She also suffered an aggravation of underlying Post Traumatic Stress Disorder but that has resolved.
Ms Matti meets the diagnostic criteria for Major Depressive Disorder (MDD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as follows:
She continues to care for her mother, but she describes a lack of emotional engagement and expresses a wish for death,
Her depressive symptoms are an aggravation of pre-existing symptoms which predate the back pain.
Ms Matti has a long and complex history of trauma, both from her early life in Iraq and subsequently from the severe nature of her Asthma, marital difficulties and two previous motor vehicle accidents. She has suffered from symptoms of PTSD, Depression and Anxiety for most of her adult life. She was symptomatic with depression and anxiety owing to the loss of ability to work and financial distress when she was injured on 12 March 23. She also had subclinical symptoms of PTSD. The accident would not have caused PTSD in a person of normal fortitude, but Ms Matti was especially vulnerable owing to her psychiatric history and suffered an aggravation of underlying symptoms of PTSD. The accident also led her to suffer from chronic back pain, which is now the main barrier to her returning to work. That has led to an aggravation of pre-existing symptoms of depression. The aggravation of PTSD has resolved, but her Depressive Disorder has persisted.
Major Depressive Disorder is not a threshold injury.
[5] Insurance Australia Group Limited v Keen [2021] NSWCA 287 and Insurance Australia Group Limited v Marsh [2021] NSWCA 31.
QBE Insurance (Australia) Limited
Matti [2025] NSWPICMP 616;