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

The Review Panel revokes the certificate of Medical Assessor Geoffrey Paul Curtin dated

30 November 2024 and issues a new certificate determining that:

• The following injuries caused by the motor accident give rise to a permanent impairment of 4% and IS NOT GREATER THAN 10%:
  • - Facial scarring

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 an injury to his face being zygomatic arch fracture and left-sided periauricular laceration.
3. The claimant was examined by Medical Assessor Geoffrey Paul Curtin on 29 November 2024 who, in a certificate dated 30 November 2024 determined that the claimant has sustained a permanent impairment of 12% consequent on facial scarring and deformity as well as mastication difficulty.
4. The insurer sought a review of this certificate and, in a decision dated 16 July 2025, President's Delegate Tarjan Baba determined that there was a reasonable cause to suspect that the medical assessment was incorrect in a material respect. Accordingly, the matter was referred to this Medical Review Panel (the Panel).
5. The Panel issued directions on the parties to upload the application and reply to the assessment of WPI, together with all annexures and this material is now before the panel.
6. The Panel convened on 11 September 2025 and determined that it was appropriate that the claimant be re-examined.
7. 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.
8. 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).

1. 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.
2. 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.
3. The review of the medical assessment is by way of a new assessment of all the matters with which the medical assessment is concerned.
4. 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.

Pre-accident medical history and relevant personal details

1. The claimant was in good health prior to the motor vehicle accident with no prior facial injury or scarring. At the time of the accident he was a student and working part time in the retail industry.

1. The claimant was a front passenger in a vehicle which left the road and struck a tree. He was wearing a seatbelt. There were no airbags in the motor vehicle and consequently no airbags were deployed. Following the motor vehicle accident the claimant was taken, by ambulance, to Westmead hospital.

1. Shaheer Ul-Hasan stated following the motor vehicle accident he was conscious of swelling of his left mid face. This resolved.
2. He is conscious of visible scarring of his left cheek immediately in front of the ear and scarring and deformity of left earlobe. He said the tragus of left ear is missing. He is concerned about indentation of skin immediately below the left earlobe and said this is difficult to keep clean.
3. He had no concerns about facial sensation. He stated he gets episodic stinging discomfort in the left ear scar and feels "heaviness" in the left ear. He has left sided tinnitus which is most prominent at night.
4. He did not describe restriction of diet to soft and semisolid food. He can chew meat without discomfort. He said when biting very hard food his bite feels "weak". He did not describe jaw or facial pain caused by eating. He had no temporomandibular joint pain.

1. Shaheer Ul-Hasan was examined on 22 October 2025 at PIC Medical Suites, Darlinghurst.
2. He was 180cm tall and weighed 80kg.
3. He had a lightly pigmented facial skin colour.
4. There was no visible or palpable facial skeletal deformity or asymmetry.
5. There was visible scarring on the left lateral cheek and junction of ear and cheek. There was scarring in deformity of the left earlobe.
6. There was a transverse scar on the lateral left cheek 30mm x 5mm.
7. The transverse left cheek scar joined a vertical pre-auricular scar that ran from upper third of left ear at the level of root of helix, down to and across the earlobe, then halfway up the back of the ear at junction of ear and side of head to level with the external auditory canal. This scar was 80mm in length and between 2mm and 5mm in width.
8. The left ear tragus was flattened or partially missing. The left external auditory canal was patent.
9. The scar crossed the lower third of the left ear lobe. Scar contracture at this site caused a deep readily visible notch in the edge of the earlobe and a deep indent in the cheek skin immediately anterior to the earlobe due to adjacent skin contracture.
10. There was normal facial sensation and normal spontaneous movement of face.
11. His mouth opened easily to 48mm between the anterior teeth, a normal distance. He had excellent dentition and dental hygiene. There was no apparent discomfort with jaw movement and no palpable joint crepitus.

1. The medical records of NSW Ambulance describe a head injury with laceration to left ear with minimal active bleeding "Blood from lac or from ear canal unable to determine".
2. The clinical notes of his admission to Westmead Hospital identify that the claimant sustained laceration to his left ear and a haematoma in the right occiput. He sustained a fracture of the left zygomatic arch. The laceration to his left ear was sutured.

1. CT Brain, Cv Spine, Chest, Abdomen, Pelvis 1/12/2022 (trauma series) - Endotracheal tube at the level of a sternal notch. Left-sided zygomatic arch fractures. No acute intracranial or cervical spine pathology detected. A ligamentous injury within the spine cannot be excluded. If there is ongoing concern, an MRI should be obtained. No traumatic abnormality within the thorax or abdomen. No fractures in the visualised in the axial or appendicular skeleton.
2. CT Petrous Temporal 3/08/2022 - Comment: No definite evidence of left-sided ossicular chain disruption. No inflammatory change is seen on either side. No temporal bone fractures are identified.

1. Shaheer Ul-Hasan has visible facial scarring and deformity of left outer ear.

1. When assessing facial scarring/disfigurement, MAA Permanent Impairment Guidelines Version 9.1 paragraph 6.189 to 6.191 states, facial scarring and disfigurement are assessed separately to scarring elsewhere on the body. This scarring is combined with any other assessment of scarring and/or other permanent impairment assessments. Assessment of permanent impairment involving scarring of the face may be undertaken using Chapter 13 'The Skin' pages 279-280 AMA 4 Guides and/or section 9.2 'The Face' pages 229-280 AMA4 Guides.
2. AMA4 Section 9.2 pages 229-290 describes Class 1 Facial Impairment to be facial abnormality limited to a disorder of the cutaneous structures, such as visible scars or abnormal pigmentation. The impairment range is 0-5% WPI.
3. Paragraph 6.259 of the MAA Guidelines states, the assessment of permanent impairment involving scarring of the face may be undertaken using Chapter 13 'The skin' (pages 279-280, AMA4 Guides) and/or Section 9.2 'The face' (pages 229-230, AMA4 Guides). Criteria for facial impairment are listed on page 229 of the AMA4 Guides. Specific facial disfigurements may also be assessed by reference to Table 4 (page 230, AMA4 Guides).
4. MAA Permanent Impairment Guidelines Version 9.1 paragraph 6.177 states, "Chapter 9 of the AMA4 Guides (pages 223-234) provides guidance on methods of assessing permanent impairment involving the ear, nose and throat, and related structures, including the face." AMA4 Table 4, page 230 states loss or deformity of the outer ear causes impairment with a range of 0-5%WPI.
5. Shaheer Ul-Hasan as visible scarring of his left cheek and left ear. He has deformity of the ear. He does not have loss of skeletal support for part of the face. He has Class 1 Facial Disfigurement with an impairment range of 0-5% WPI. His condition is not the worst possible for Class 1. In my opinion his facial scarring and left ear deformity cause 4% WPI**.**

1. Shaheer Ul-Hasan does not have restriction of diet to soft and semisolid food.
2. MAA Guidelines Version 9.1 paragraph 6.195 states "damage to the teeth can only be assessed when there is a permanent impact on mastication and deglutition (page 231, AMA4 Guides) and/or loss of structural integrity of the face (pages 229-230, AMA4 Guides). Paragraph 6.197 directs use of AMA4 Table 6 on page 231 with the first category, diet limited to semisolid or soft food, to be 0-19%, not 5-19%. By analogy, restricted mastication due to other facial injuries could be assessed using AMA4 Table 6 on page 231."
3. Shaheer Ul-Hasan sustained a fracture of left zygomatic arch that did not require surgical treatment and has resolved with no residual facial deformity. There is no imaging evidence of temporomandibular joint injury, and no dental injury.
4. There is no restriction of diet to soft and semi-solid food and no assessable impairment due to mastication difficulty. There is 0% WPI due restricted mastication.

1. The left face scarring and left earlobe deformity could be improved with surgical scar revision and Z-plasty release of earlobe scar contracture. The best outcome would be scars with improved contour. They would still be residual permanent impairment.
2. Maximum medical improvement has been reached as his condition is stable and is unlikely to change by more than 3% WPI with or without further treatment.

1. At today's assessment the ear canal was not blocked and I note the examination finding of Medical Assessor Robert Payton, ENT surgeon, in his Medical Assessment Certificate dated 2 April 2025. Medical Assessor Payton reported the left canal was smaller than the opening of the right with scar extending from left tragus towards the opening of the air canal. He was able to view the tympanic membrane which was normal.
2. The left earlobe is not missing; it is deformed by scar contractures from laceration injury sustained in the motor vehicle accident.
3. The left earlobe deformity and facial scarring both fit Class 1 Facial Disfigurement with an impairment range of 0-5% WPI.
4. The Panel finds that the claimant has sustained whole WPI of 4% because of the facial scarring.