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

The Review Panel revokes the certificate of Medical Assessor Drew Dixon dated 20 May 2025 and issues a new certificate determining that:

• The following injuries caused by the motor accident give rise to a permanent impairment of 2% and IS NOT GREATER THAN 10%:
  • ­ Left shoulder - Soft tissue injury

1. Shaheer Ul-Hasan (the claimant) is a 23-year-old man who was injured in a motor vehicle accident on 1 December 2022. Following the accident, the claimant logged an application for personal injury benefits and thereafter sought a concession from the insurer that the injury sustained in the motor vehicle accident gave rise to a degree of impairment of greater than 10%. Following an internal review of the insured client to make this concession and, consequently, the claimant lodged an application for assessment of whole person impairment (WPI).
2. The claimant sought an assessment of the injury to his left hand and left shoulder.
3. The claimant was examined by Medical Assessor Drew Dixon on 14 May 2025 and issued a certificate dated 20 May 2025. Medical Assessor Dixon determined that the claimant had sustained a permanent impairment of 14% as a consequence of the injury to his left shoulder.
4. The insurer sought a review of this certificate and in a decision dated 16 July 2025 the President's delegate determined that there is a reasonable cause to suspect that the medical assessment was incorrect in a material respect. The matter has been referred to this medical panel.
5. The Review Panel was convened on 11 September 2025 and noted that all material which was before Medical Assessor Dixon has now been uploaded to the portal. It was determined that an examination of the claimant was required.
6. Clause 14F of Schedule 1 of the Personal Injury Commission Act 2020 (the PIC Act) provides that the new review provisions apply in relation to a decision of a new decision-maker. A "new decision maker" is defined in cl 14A(1) of the Schedule 1 of the PIC Act. As the medical assessment, the subject of the review, was made on or after 1 March 2021, the new review provisions apply.
7. The new review provision provide that a review panel consists of two Medical Assessors and a Member assigned by the Motor Accidents Division of the Personal Injury Commission (the Commission).
8. Part 5 of the PIC Act enables the Commission to make rules with respect to its practice and procedure including proceedings before a panel reviewing a decision of a Medical Assessor.
9. Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the PIC Act. A review panel determines how it conducts and determines the proceedings and may determine the matter solely based on the written application.
10. The review of the medical assessment is by way of a new assessment of all the matters with which the medical assessment is concerned.
11. The claimant was examined on 22 October 2024 at the Medical Suites, Personal Injury Commission by Medical Assessor Michael McGlynn and Medical Assessor Shane Moloney.

1. Mr Ul-Hasan stated that he had been in good health prior to the accident and was living with his parents. He had been undertaking a degree in exercise science which he has now graduated and is completing a master's degree at Sydney University. He had also been working as a packer at Woolworths in a casual position for about 20 hours per week. There was a history of a fracture of the right big toe but no other injuries sustained prior to the accident.

History of motor accident and subsequent treatment

1. Mr Ul-Hasan was a front seat passenger when the driver lost control and smashed the left side of the car into a tree. With the impact, he lost consciousness and the next thing he remembers is waking in Westmead Hospital the following day.
2. He sustained a seatbelt injury to his left shoulder, left hand and facial injuries which included a fracture of the left zygoma with laceration around the left ear. Initially, he had been intubated and the left ear laceration was sutured. There was no surgical intervention needed for the fractured zygoma. A CT of the left hand on 2 December 2022 reported a comminuted displaced fracture through the fifth metacarpal base with volar dislocation and a minimally displaced fracture through the fourth metacarpal base. There was also a fracture of the left little finger proximal phalanx.
3. The hand fractures were managed conservatively with a plaster of Paris cast for two months and then a splint for another two months. Physiotherapy was organised for the left shoulder and hand and later a hand physiotherapist at Mount Druitt Hospital. He was referred to a hand surgeon, Dr Bradshaw who determined that surgery was not necessary. An ENT specialist advised him that there was narrowing of the left ear canal.
4. There have been no further injuries sustained since the accident.
5. No radiological studies were available for inspection.

1. The claimant underwent a CT to his left hand on 28 February 2023. The reported findings were that there is a mildly displaced fracture of the medial aspect of the base of the fourth metacarpal with small fracture fragment seen between the proximal fourth and fifth metacarpals. The margins of the fracture demonstrate mild sclerosis suggesting that this may be long-standing.
2. The claimant underwent an MRI to his left shoulder on 14 September 2023. The report noted the lab room is intact. No labral tear. No paralabral cyst.
3. The report also noted normal rotator cuff muscle signal and bulk, sub scapularis, supraspinatus, infraspinatus and teres minor tendons are intact. The findings concluded no rotator cuff tendon tear and minor bursitis.

1. Mr Ul-Hasan stated that he has persistent left shoulder pain which increases with abduction above shoulder height and wakes him at night. He feels he has a weak left-hand grip with pain on the ulnar border of the hand.
2. He has no trouble walking or driving his car. There is some difficulty with cleaning the car or doing yard work which required bi manual tasks.
3. He attends the gym four days a week which is mainly machine based. He undertakes no sporting activity and no swimming. He continues his home exercises and states that there has been a slight improvement this year.

1. Mr Ul-Hasan takes no medications at present and has no manual therapy. He consults his GP only if needed.

1. Mr Ul-Hasan sat comfortably during the interview and stated that he was right-handed. His height was measured at 181 cm and weight of 82 kg.

1. There was a full range of right shoulder movement and slight reduction in active left shoulder movement which was measured using a goniometer and repeated.

1. On passive movement no crepitus was detected with no tenderness over the acromioclavicular joint. On resisted protraction there was no winging of the left scapula with both scapula movements being equal. This was repeated by both assessors with normal scapula-thoracic movement.
2. There was a full pain free range of movement of the elbows.

1. There was a full pain free range of movement of both wrists.

1. On inspection, there is a firm swelling between the fourth and fifth metacarpal bone with some flattening of the fifth knuckle.
2. There was a full range of movement of the fourth and fifth fingers of the left hand with no muscle wasting apparent.

1. On inspection of the cervical spine there was a normal contour and on testing range of movement, there was a full pain free range of movement of flexion/extension, side bending and rotation.
2. On neurological examination of the upper limbs reflexes were equal bilaterally with no sensory changes noted and normal power. No muscle wasting was apparent with the circumference of the upper arms 33cm bilaterally (10cm above the olecranon process) and in the upper forearms 27cm on the right and 26cm on the left (5cm below the olecranon process). This is within normal limits for a right-handed male.

1. There was documentation of the soft tissue injury sustained to the left shoulder in the subject accident. The ambulance report noted tenderness in the left shoulder as did the treating GP and physiotherapist. The Panel considers that Mr Ul-Hasan sustained a soft tissue injury to his left shoulder in the subject accident. No winging was apparent at the time of the examination by the Assessors and therefore no diagnosis of impairment of the left long thoracic nerve.
2. The impairment is assessed using range of movement with tables 38, 41 and 44 of AMA 4th edition. This gives a total of 4% UEI and converts to 2% WPI using table 3.
3. Left hand - fracture involving the fourth and fifth metacarpophalangeal joints.
4. It was reported by Westmead Hospital that Mr Ul-Hasan sustained fractures to the fourth and fifth metacarpals in the subject accident with follow-up treatment. The Panel accepts that these injuries were sustained in the subject accident. The impairment was assessed using range of movement and at the time of the examination by the Panel there was a normal range of movement of the left wrist and fourth and fifth fingers. This gives an impairment of 0% WPI.

1. The Review Panel has assessed the referred injuries being an injury to the left hand and left shoulder to give rise to a permanent impairment of 2% WPI.