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

1. The Panel revokes the certificate of Medical Assessor Abhishek Nagesh dated

1 August 2024. 2. The following injury was caused by the motor vehicle accident: * post-traumatic disorder,

1. Wayne Sonter (the claimant) is a 54-year-old man who suffered a psychological injury when attending a catastrophic motor vehicle accident in the course of his duties as a police officer on 13 November 2022. Following the motor vehicle accident the claimant lodged an application for personal injury benefits and thereafter sought a concession from the insurer that the psychological injury he sustained ought to be considered a non-threshold injury. Following a review the insurer declined to make this concession and thereafter the claimant lodged an application for assessment of threshold injury.
2. The claimant was examined by Medical Assessor Abhishek Nagesh on 18 July 2024 who, in a certificate dated 1 August 2024, certified that the claimant did not a suffer post-traumatic stress disorder as a consequence of the motor vehicle accident and consequently these injuries are a threshold injury. The claimant sought a review of this determination and, in a decision dated 30 January 2025, President's delegate Melinda Drew decided that there is a reasonable cause to suspect that the medical assessment was incorrect in a material respect. The matter was referred to this medical review panel.
3. Panel convened on 15 October 2025 and determined that it was appropriate to re-examine the claimant and thereafter schedule a further teleconference to review the examination findings and settle the certificate.
4. 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.
5. 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).
6. 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.
7. 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.
8. The review of the medical assessment is by way of a new assessment of all the matters with which the medical assessment is concerned.

1. The claimant was examined by video teleconference by Medical Assessors Paul Friend and Christopher Canaris. The examination was conducted online. The claimant was at home and was unaccompanied. His wife was at work.

1. The claimant stated that he was born in Caringbah Hospital which is probably the Sutherland Hospital. He was adopted as a baby. His mother was from New Zealand and his father was Australian. The family soon after his adoption relocated to Christchurch. His sister was later adopted. He and his sister are from different families. The family relocated to Dunedin, after three years where he completed school. He enrolled in Otago University after leaving school in a degree in Law, Psychology and Economics which he failed and left university. He then worked underground in a mine at Mount Isa for three years. He had an uncle working in Mt Isa.
2. He returned to Queenstown in New Zealand where his mother had a travel agency. He worked in the travel agency, later as a hotel porter and also driving jet boats on the river at Queenstown.
3. He left Queenstown, came to Sydney and found his birth mother. He discovered that he had three stepsisters and one stepbrother.
4. Soon afterwards he joined the New South Wales Police at aged 26 years.
5. After completing his police training, he was initially posted to Waverly Police Station and later Maroubra Police Station doing General Duties policing.
6. He next worked patrolling trains at Central Railway Station.
7. He subsequently worked as a Youth Case Manager at the Police Citizens Youth Club (PCYC) at Woolloomooloo.
8. He met his wife whilst working in the PCYC, in about 2007. She was then a primary school teacher in Woolloomooloo and dealt with a lot of Indigenous children who lived in Woolloomooloo or had been transferred there to live with kinship carers. She was running a fishing program to engage with the troubled children and she invited him to attend.
9. He through his PCYC work had realised that troubled children needed to be engaged by age 12 years and that it was very difficult after that age.
10. His job was to try to work with young offenders to prevent them reoffending.
11. Whilst working at the PCYC, he confronted a young man outside the building who was drinking alcohol and graffitiing the building. This young man called him a paedophile. It was an allegation with no dates or details of incidents. This was in about 2014.
12. This resulted in extensive investigation internally and after a period of several months he was forcibly transferred to North Sydney Police Station initially on General Duties and later in the Traffic Office.
13. There was no adverse finding from the internal investigation.
14. He worked in the Traffic Office for five to six years before the subject motor accident on

13 November 2022. 15. He was required to do random breath testing and write various reports. It was somewhat similar to Highway Patrol but he did use the same sophisticated equipment and there were fewer pursuits. 16. He achieved the rank of Senior Constable prior to the motor accident. 17. He married his wife, sometime after meeting in 2007, but could not recall the date. 18. He has three stepchildren from his wife's previous marriage. He has a daughter aged 32 and sons aged 30 and 28 years. 19. The children have all left home. His daughter is married.

1. The claimant injured himself when he was about 10 years old. He was in his parents' warehouse and climbed up on top of a safe and fell off it. He landed on the edge of the safe, causing a laceration to his back.
2. He was involved in a motor accident in a police car when he was a passenger and hit his head on the seat in front despite wearing a seatbelt at aged 29-30 years but fully recovered.
3. In 2017 he fell off the roof at home when he was trying to clear the moss of the roof and fractured his left wrist. He attended Royal North Shore Hospital where his hand was put in a cast.
4. His only other physical health problem is gout for which he continues to take prophylactic medication.
5. He had contacted the New South Police Employee Assistance Program, several times during his police career, when he felt under stress but he cannot remember the details.
6. The most stressful incident before the motor accident was being called a paedophile in 2014.
7. The distress from that allegation and consequent investigation has resolved well before the motor accident.
8. He, very occasionally when he worked in General Duties, had transient thoughts that if he became too stressed, that he would kill himself by shooting himself, but had not planned or attempted to do so.
9. He felt well and happy prior to the motor accident.

1. The claimant ceased smoking cigarettes when he joined the police.
2. Before the motor accident he was drinking two beers and two double bourbons every night which increased to three beers and three double bourbons every night and sometimes as much as three to four beers and three double bourbons, after the motor accident.
3. He has now reduced his alcohol intake to three beers and two double bourbons but has an alcohol-free day every Sunday and on a Tuesday night every one to two weeks.
4. He has never used illegal substances.
5. He has one cup of tea each day. He drinks caffeine-free cola drinks but previously drank normal cola drinks.
6. He has an energy drink about once every one to two weeks, more likely in Summer.

1. The claimant was on duty at North Sydney Police Station. He was talking to his Supervisor who was listening to a radio broadcast about a police pursuit. His supervisor told him to help the police in the pursuit. He and his partner drove to the area where the pursuit was occurring. They saw that the vehicle being pursued had collided with a tree. The scene was chaotic. The vehicle later caught on fire. He believes there were four or five young people car who were being hurriedly removed from the vehicle. He assessed them as being all under the age of 18 years. At least some of them were being resuscitated. All of them looked to be deceased. He believes one was pronounced deceased at the accident site but later "came back to life".
2. He was particularly upset because he was wondering if his next door neighbour, who was aged 15 years and who been had involvement with crime and the police was one of the young people in the vehicle.
3. He believes that one young person later died in hospital and that one or more have significant brain damage.

History of symptoms and treatment following the motor accident

1. The claimant returned to the scene of the motor accident about two days later to look at the flowers and the cross that had put at the site. Various news media were present. He cried uncontrollably.
2. He had recurring intrusive memories and images of the scene of the motor accident and of people administering cardiopulmonary resuscitation from soon after the motor accident. He had nightmares two to three times each week of "horrible" work-related motor accidents which were probably fictitious, but very similar to what he had experienced as police officer.
3. He had difficulty falling asleep, not being able to do so for one to two hours.
4. He was easily startled by any sudden unexpected event including his stepdaughter and her husband who were living at home, at that time, coming into the room, in the house where he was sitting or standing.
5. He avoided leaving home and avoided socialising because he wanted to avoid interacting with others. He became very anxious. He described he felt alone and was having more frequent thoughts of shooting himself.
6. He had a poor memory. At least several times, he wrote two tickets for the same offence, which led to complaints.
7. He became generally irritable and argumentative.
8. He could become enraged when driving if he saw another driver doing risky or dangerous manoeuvres on the road and needed to deliberately calm himself down. He never acted on his anger.
9. He had more arguments with his wife and became more distant from his stepchildren.
10. He almost separated from his wife several times. He left home eight to nine months ago and relocated to Cairns for a month, where he and his wife owned an apartment. He felt that his wife and children did not understand how he felt.
11. He only left home, if accompanied by his wife, because he just did not want to deal with others.
12. The claimant sought treatment from his general practitioner who prescribed medication to help him sleep which appears to be Imovane, and prior to that, melatonin. He was later prescribed mirtazapine. The various entries in August 2023, the clinical notes of Our Medical Crows Nest Practice, record that he was having better sleep with a combination of melatonin and Imovane.
13. In July 2023, his Supervisor or immediate manager took him to see the Area Commander at Chatswood apparently in response to complaints about his forgetfulness and conduct. He was told that there were two types of management plans. One was purely a performance management plan and the other was a conduct plan. He was told by the Area Commander that it was believed that he had a conduct problem and that it was deliberate. He was told that he would be put into General Duties and be put on a conduct plan.
14. He became very tearful and "broke down" in the Commander's office. He returned to the North Sydney Police Station with his immediate manager or supervisor. He remembers going downstairs to the basement in the carpark and having the thought to shoot himself. His supervisor, Sergeant Edwards, came down and told him to come back upstairs. They had a discussion. That was his last day at work.
15. His gun was put in the safe at work.
16. He was medically retired from New South Wales Police in March 2024.
17. He reported that prior to the medical retirement, he would frequently think about throwing himself under a train.
18. He had, prior to the motor accident had a strong work ethos, telling himself to keep going and not give up. He tried to do that for about eight months after the motor accident, but just felt unable to continue working, once he was put back on General Duties which was generally seen as a punishment in the police.
19. He described his work in the police as generally stressful, felt that he was not allowed to make a mistake and felt repeatedly picked on.
20. He remembered that a police officer who was about 20 years his junior and had previously worked in the same police station, subsequently was transferred back to North Sydney Police Station as his Supervisor. This occurred before the motor accident. This person subsequently made lots of complaints about him. One of his Supervisors watched the vision from his body-worn camera and then asked him why he had made so many mistakes.
21. The claimant commenced consulting Ana Nikibin, psychologist, at the Our Medical Crows Nest Medical Practice.
22. He believes he initially consulted her every month which gradually increased to six weekly intervals.
23. He also consulted Dr Geoffrey Lee Ingram, psychiatrist, who was at the same medical practice. There are entries in the clinical notes of that practice by Dr Ingram dated

11 December 2023 and 25 January 2024. 24. Dr Ingram subsequently left the practice. 25. He has had one appointment with Dr Sarah Jane Spencer who is at the Ramsay Clinic, 2 Frederick Street Artarmon. He will see her again when EML, the insurer, makes an appointment.

Details of any relevant injuries or conditions sustained since the motor accident

1. The claimant has not been exposed to any subsequent trauma of any kind, has not sustained any fractures or undergone any surgery.
2. He believes that he attended several minor motor accidents after the subject motor accident and before he was medically retired. None of them had any ongoing emotional impact on him.

1. The claimant describes himself as improved. He continues to feel anxious and on edge.
2. He continues to be easily angered by minor adversity.
3. The nightmares occur about once each week and have the same content.
4. He more easily gets back to sleep if he wakes up, which occurs about once every two weeks.
5. It is easier to get to sleep even though he has ceased the sleeping tablet.
6. He continues to feel very angry when other drivers cut him off or he sees them doing risky or dangerous manoeuvres on the road and needs to deliberately calm himself down. He has never acted on his anger.
7. Sometimes he realises that he had made the mistake.
8. He continues to have arguments with his wife and had one the night before this examination.
9. His wife and stepchildren want him to go back to work. He feels that they do not understand how he feels unable to do so.
10. He and his wife now have a seven-month-old border collie cross miniature poodle puppy which he takes out walking with each day. He started walking sometime after stopping work but cannot recall exactly when. This has been helpful and has obliged to engage with others when he is working with the dog.

1. The claimant continues to take mirtazapine at night but has ceased the sleeping tablets.
2. He continues to consult Ana Nikibin about every six weeks.
3. His only other medication is prophylactic medication for gout which appears to be allopurinol.

1. The claimant was on time, alert, orientated and provided a reasonable account of the motor accident and his previous history.
2. He initially struggled to describe his symptoms, following the motor accident, as outlined above, but eventually was able to do so.
3. He was not involved in the motor accident, but he witnessed the chaotic scene from the collision with the tree.
4. It had increased emotional impact on him because he thought that his 15-year-old neighbour could have been one of the victims.
5. He is easily angered in response to minor adversity. He has repeated arguments with his wife.
6. He is very angry, if other drivers cut him off or he sees them doing risky or dangerous manoeuvres on the road and needs to deliberately calm himself down.
7. He is generally more anxious and on edge, although that has improved.
8. He has nightmares, about once each week, related to motor accidents which he has experienced the content is generally fictitious.
9. He wakes from sleep about once every two weeks.
10. He initially avoided leaving home except with his wife but now takes his dog walking each day.

1. The claimant usually wakes 7.30-8.00am whereas previously when he was taking sleeping tablets, it was about 8.00-8.30am. He will watch television and then he will go for a walk for one and a half hours with his dog is helpful, distracting and obliges him to talk to others.
2. He showers and gets dressed after walking. He cleans up what is required at home and goes to the shops if necessary to buy groceries.
3. His wife arrives home at about 5.00pm.
4. He cooks two to three nights each week and they go to bed 9.30-10.00pm. Closer to the time of the motor accident, it was very difficult to cook. It was difficult to plan and organise to cook the evening meal. This caused him to feel angry and become aggressive towards his wife.
5. He now plans what he wants to cook 24 hours ahead, so he feels prepared on the day he will be cooking. He previously enjoyed cooking and had no difficulty doing so.
6. He usually has a cup of tea for breakfast and will have leftovers for lunch or buy lunch.
7. He purchases the groceries during the week and his wife purchases whatever else they need at weekends.
8. He does the laundry and the gardening, including mowing the lawn. He likes to be outdoors.
9. Prior to the motor accident he and his wife would meet with their children, on a Wednesday evening, at a local boutique brewery which has a café/restaurant and where one of his sons works. They had done this for many years, for about one and a half hours.
10. He continues to do so, but has less enjoyment and sometimes avoids going, feeling too stressed to do so.
11. Before the motor accident he and his wife would have lunch with her parents about once each week but now do not do so.
12. He does not do any other social activities.
13. He has lost contact with most of his police colleagues because initially he withdrew from contact with them and now they do not respond to his text messages or other contact.
14. He has contact with one retired police friend who lives near his mother at Port Macquarie whom he will contact if he is feeling particularly unwell.
15. The claimant becomes very angry when other drivers cut him off or he sees them doing risky or dangerous manoeuvres on the road and needs to deliberately calm himself down.
16. He has driven as far as Port Macquarie where his birth mother lives.
17. On one occasion closer to the time of the motor accident, he was driving to Port Macquarie through an area in shadow which caused him to think intensely about the motor accident.
18. He thinks about and has images and memories of the motor accident if he drives past, or his wife drives him past, the scene of the motor accident. He also thinks of the cross on the tree and the flowers, that he observed after the motor accident.
19. He previously thought a lot about the motor accident when he started walking, in the morning, but now deliberately stops himself from doing so.
20. Walking the dog is distracting.
21. The claimant's relationship with his wife was very strained and there was a period of separation as described above. He feels it is good 90% of the time but he thinks his wife might say its good 65% of the time.
22. He has always had a difficult relationship with his daughter but this has improved since she has had a baby.
23. He had difficulty relating to one of his sons when he was aged 14-15 years when he had bulimia but that has resolved.
24. The claimant describes his concentration and memory as improved.
25. Closer the motor accident he would read a sentence and not remember it.
26. He would forget what he was doing such as turning off his mobile telephone, issuing two tickets for one offence and forgetting to do up the fly on his trousers.
27. He now takes more time to do tasks and activities and do them more deliberately, which means he is less forgetful. He continues to be very forgetful about dates of events.
28. He read news articles on websites but only reads short articles, being unable to read longer articles.
29. The claimant has not tried to return to work since ceasing work in July 2023.
30. He could not work as a police officer because he would be very stressed and distressed by seeing deceased people, the general pressure and bullying culture in the police, his memory problems and the likely increased sleep disturbance because of work experiences.
31. He was asked what work he might do and believes he eventually could work mowing lawns but would need assistance to learn how to run a small business.
32. The claimant has received $100,000 payout from some source into his superannuation fund.
33. His wife has suggested that work as a bus driver but feels he could not cope with the general public in such a situation. He remains wary of dealing with others in public situations.

1. The application for personal injury benefits dated 21 July 2023, states that the claimant, a police officer, has difficulty sleeping, nightmares and flashbacks when hearing sirens, etc., after attending a motor accident in the course of his duties. The vehicle was on fire, when he arrived at the scene. Five youths were involved and the ones that he saw looked to be dead.
2. A female had major facial injuries and was being treated by an off-duty doctor or other medical person.
3. The Certificate of Capacity/Certificate of Fitness dated 16 October 2023 states he has a stress reaction from a critical incident that occurred on 13 November 2022.
4. The report by Dr Yajuvendra Bisht, psychiatrist dated 19 January 2024 states that during the course of his work as a police officer, he had attended many traumatic scenes, including deaths and situations where his safety was under threat. He did not develop persistent symptoms until an event in which he was involved on 20 November 2022.
5. This was a motor accident in which a vehicle with "five kids in the car" hit a tree and one of the girl's faces was quite battered. The vehicle was on fire when he arrived at the scene.
6. The symptoms included:
   • daily recollections of that and previous traumatic events during the course of his police service in the form of nightmares and flashbacks;
   • hypervigilance about his own safety and the safety of his family;
   • anxiety accompanying the recollections and the hypervigilance;
   • sleep difficulties on most nights;
   • difficulty sustaining concentration for long periods and making complex decisions;
   • being easily startled;
   • feeling distant from family and friends;
   • being more irritable;
   • being prone to getting anxious in day-to-day situations, such as being in crowded places;
   • obsessive urges about hurting others and also about cleanliness, and
   • being triggered by sirens or loud banging noises.
7. He has increased his alcohol consumption up to 10 drinks each night.
8. He ceased working in July 2023 because of increasing severity of symptoms.
9. He has consulted a psychiatrist since July 2023 and has been treated with various psychological strategies.
10. He has been a member of the New South Wales Police for 25 years, having joined at age 26 years.
11. He has been based in Sydney for almost the entire duration of his career.
12. He and his wife have been together since 1998.
13. He has stepchildren aged 26, 28 and 30 years.
14. Dr Bisht makes a diagnosis of post-traumatic stress disorder.
15. The police report dated 10 May 2023 regarding the motor accident on 13 November 2022 states that the vehicle was being driven by an unlicensed 17-year-old female driver who accelerated onto the wrong side of the road towards the oncoming traffic, then over-corrected, clipped a curb with the near side front wheel, mounted the gutter and collided with a tree.
16. One person was deceased at the scene. Four people were conveyed to Royal North Shore Hospital.
17. The clinical notes from Our Medical Crows Nest for consultations from 12 August 2022 and

8 March 2024, include the following. 18. Current medications: * Allopurinol 150 mg daily; * Mirtazapine 45 mg, one tablet at night , and * Imovane 7.5 mg 1/2 -1 at night as required 19. The list of prescriptions includes Melatonin MR 2 mg prescribed on 21 November 2022,

2 July 2023, Imovane 7.5 mg was prescribed on 28 September 2023, 6 November 2023,

9 November 2023, and Mirtazapine 45 mg was prescribed on 6 November 2023. 20. The entry dated 21 November 2022 states, he went to a car crash site recently, where possibly five teenagers were involved and one died in hospital. The car was on fire. 21. He is still feeling impact and talking to a police counsellor. 22. His sleep is disturbed, waking at 2.00-4.00am. 23. He used to work at the PCYC. There was a false allegation by a 14 or 15-year-old boy, and it took him seven years to clear his name. 24. The entry dated 15 June 2023 states he was referred to a psychologist under a mental health care plan. He is feeling stressed and overwhelmed and is being bullied by the boss at work. 25. The entry dated 21 June 2023 states that there are ongoing police duty incidents, perceived bullying and ongoing stress regarding a specific critical incident. His gun has been removed by the police. 26. The report by Ana Nikibin dated 3 July 2023, in the Our Medical Crows Nest clinical notes, states this was the initial consultation with the claimant. It appears to state that he was advised that he has post-traumatic stress disorder and work-related bullying/stress. 27. He has had a decline in mental health and absence from work over the past few weeks. He works as a police officer. He attended a critical incident a few weeks ago, which has led to flashbacks and trauma-related symptoms. 28. He is no longer able to tolerate stresses in the same way and becomes more emotional and triggered by incidences. 29. There are stresses in relation to dealing with his boss. He felt that the complaints made against him in the conduct plan are unjust and believes he is being bullied, leading to additional symptoms of stress and anxiety. 30. He currently has sleep disturbance with flashbacks. He is triggered by loud noises such as sirens. There are ongoing ruminations associated with current conduct and conversations with the commander related to his behaviour and conduct. 31. The entry by Ana Nikibin dated 10 July 2023 repeats many of the previous symptoms and states that he completed the depression, anxiety and stress scale 21 item, which had moderate scores for depression and anxiety. He was asked about the low scores and replied that he was not at work and therefore his stresses were minimal and that these scores would be significantly higher if he was at work. 32. The entry by Ana Nikibin, psychologist, dated 17 July 2023 states he has OCD tendencies in the home with urges to clean or straighten items in the home. He is concerned that he does not know how to fill in his time with activities. 33. The GP mental health treatment plan by Dr Nyan Lin Fio Phyo dated 15 June 2023 states he is tearful, has anxiety, insomnia, is difficult to focus, and flashbacks from recent trauma. 34. He is stressed at work and feels bullied at work. 35. The scores on the depression, anxiety and stress scale, 21 item, dated 10 July 2020 are as follows: * depression - 5 - mild; * anxiety - 0 - normal, and * stress - 6 - normal. 36. The entry by Ana Nikibin, psychologist, dated 27 July 2023 states, this is the fourth consultation. He has an unstable mood and ongoing rumination and worry but has continued to work through the safe care practices and grounding techniques. 37. He has a flat affect, especially when recalling/recounting past events and early morning awakening. Flashbacks, nightmares, and some suicidal ideation. He put through a complaint regarding his conduct plan and received correspondence that this was rejected and his mental health deteriorated. 38. The entry by Ana Nikibin, psychologist, dated 31 July 2023, states that he has ongoing trauma related symptoms of nightmares, flashbacks and rumination. He has sleep disturbance, flashbacks, irritability and poor attention span. He has ongoing worry and rumination. 39. The entry by Ana Nikibin, psychologist dated 24 August 2023 states he has a flat affect. He is anxious, teary, fidgety, has suicidal ideation, panic, nightmares and early morning awakening. He has had a decline in his mental health due to stressors in personal life and meeting with the psychiatrist, which he felt did not capture his mental state and issues. His memory impacts his ability to respond accurately. His drinking has increased due to the decline in his mental health and sleep. He has difficulties with winding down and falling asleep. It is recommended he try Zoloft or Lexapro. 40. The entry, by Dr Mark Ferrier dated 28 August 2023, states there was a discussion regarding ongoing post-traumatic stress disorder. He wakes early in the morning when the alcohol wears off, and his intake has become higher over time. It recommends three alcohol-free days each week. Small doses of Imovane can be used as melatonin is not effective. Alcohol will produce dysphoria, over time. 41. He had a head-on collision as a backseat passenger 20 years ago and dealt with this event by always being the driver in a police vehicle. In more recent event, it has not been as easily mitigated. He has felt persecuted at work for many years. There are some suicidal thoughts at irregular intervals, especially regarding the perceived bullying at work. 42. The entry by Dr Mark Ferrier dated 5 September 2023 states he is having a good sleep with small doses of Imovane. 43. The entry by Aana Nikibin, psychologist, dated 9 November 2023 states that there has been mild improvement in sleep with mirtazapine, suicidal ideation, sleep disturbance, nightmares, flashbacks, but no self-harm, and has alcohol use. He has ongoing difficulties of leaving the house, has uncontrollable thoughts and social withdrawal. He has not left the house over the past two weeks except for necessities such as grocery shopping and one social event with his wife. He gets anxious and has concerns around his safety. 44. Alcohol intake remains high, and he is consuming it most nights this week, except for one night. 45. The entry by Geoffrey Lee Ingram dated 11 December 2023 states he is a police officer and has been off work for five months. He was a senior constable in traffic for five years and he has been in the police force for 25 years. 46. He has noticed emotional symptoms, particularly in the last one to two years. There has been bullying in Sydney. His boss is very pedantic and he has had clashes with staff. Someone he used to work with, with whom he had personality clashes, became his boss a few years ago. 47. He had increased anxiety and stress as a result, but had a significant incident a year ago when he attended a motor accident where a group of kids hit a tree and he was one of the senior officers. It was one of the worst jobs he had ever attended. The car was on fire and they were pulling bodies out. 48. He is having problems with insomnia and nightmares of the other horrific scenes of police work. He has intrusive memories about the incident and is concentrating at work. He went with his boss to talk to the big boss. The meeting was to go about going back on general duties on a conduct plan for three months. He was told that if he did not improve his conduct, he would be sacked. 49. Putting people on general duties is a punishment and a form of bullying. He was only just four weeks into general duties. 50. He was making a lot of mistakes at work and this is why he was put on a conduct plan. 51. One of the reasons he was making mistakes was because he worked harder than everyone else, but on reflection, thought that it be due to problems with concentration and anxiety. 52. He before this incident had been crying a few times in front of his boss. This is in front of the duty officer who was critical of him. 53. On the day he went to Chatswood, he had thoughts of shooting himself, which were not new. His boss returned after explaining to him how he is feeling. He was put off work. 54. In the last five months, he has been taking sleeping tablets on and off because of insomnia. He also has over-the-counter sleeping tablets and Zopiclone, and was recently commenced on mirtazapine. Mirtazapine has improved the symptoms, especially regarding rumination and replaying of the incident and he is less irritable. 55. His sleep is much better up to 12 hours each night, but he has nightmares one to two days each week. His mood is currently not too bad. 56. He has avoided watching the news because it triggers intrusive memories. He has had weight loss in the last five months, which has now stabilised. 57. He has hypervigilance and is startled easily. 58. His concentration is poor and he cannot read. He avoids leaving the house. 59. There is some obsessive cleaning, but no clear features of OCD. 60. He can leave the house and go to the shops, which he still avoids. 61. He denied significant mental health problems, longitudinally in spite of his long career in the police. 62. He did have a depressive episode 10 years ago when he was accused of being a paedophile, which was very stressful. He was tearful and emotional when discussing this event today. 63. He is drinking up to 10 standard drinks each day, but appears to say he is having two alcohol-free days. He is not getting withdrawal symptoms and does not have cravings for alcohol. 64. Before the incident, a year ago, he was drinking six to eight standard drinks a day or less. 65. He was adopted and has never known his biological father. 66. There is a history of anxiety in his biological father, including two sisters with severe anxiety and his mother. 67. He was born in Australia but moved to New Zealand when he was aged three years. 68. He lived in Christchurch for two years before living in Dunedin. His parents were great. He has one adopted younger sister. He went to a good school but was bullied a bit. 69. He did a year of a law and psychology degree at university but dropped out because he failed. 70. He worked in Mount Isa for three years in the mines then worked with his mother at a tourist agency in Queenstown. 71. He came to Sydney at age 25 years to find his birth father and join the police force. His life in the police force has been pretty bad. 72. The relationship with his wife has been up and down. It has been more strained the past year, because he has been quite negative. 73. He has symptoms consistent with post-traumatic stress disorder, which developed following an incident a year ago when he witnessed a horrific motor accident. His symptoms are related to various traumas he experienced in his 25 years as a police officer. He had some symptoms of anxiety related to workplace bullying in the last one to two years which contribute to this condition. 74. The entry by Dr Geoffrey Lee Ingram, dated 26 February 2024, states that in a phone call he discussed the possibility of return to work in non-operational duties. He felt he could not face it. He has had significant problems with bullying. He is not currently thinking about returning to work in any paid employment and is unable to consider whether he could return to work in the future. He is trying to get a medical discharge. 75. The entry by Ana Nikibin, psychologist, dated 20 February 2024 states he has had improvement in mood and sleep. There has been a reduction in anxiety. He still has flashbacks and nightmares, but only one nightmare in the past month, and his sleep has improved. 76. He is walking daily. He is doing more physical activity, including weight exercises. He is losing weight and building strength. 77. This has been helpful for his mental state and mood. 78. There's been improvement in relationship with his wife. He has had a few outings with his wife to art galleries and libraries in the city. 79. He has continued to try to reduce his alcohol intake. 80. He continues to be triggered by watching news programs. 81. The New South Wales Police Incident Reporting Form by Evan Gray Turner, supervisor, dated 14 November 2022 regarding Wayne Sonter states he attended a major single vehicle motor accident as a result of police pursuit, which resulted in a critical incident. Multiple victims within the vehicle at the scene, which were pulled from their vehicle. Exposure to hazardous smoke from the vehicle in a traumatic scene. There is no treatment loss and no medical review or treatment required. 82. The clinical notes from the Willoughby Medical Practice for attendances from

22 May 2012 to 24 April 2017 include the following. 83. The entry dated 5 May 2014 states there have been problems at work over 12 months ago with allegations of paedophilia and was moved from case management to police beat in North Sydney. It states there is a history of porn addiction affecting relationship with his partner. He was prescribed Effexor 37.5 mg one daily. 84. These comments are repeated on 10 May 2014. 85. The entry dated 14 May 2014 states he is feeling slightly better and will have a trial return to work. 86. The entry dated 25 June 2014 states he had gout in his right big toe and with the previous episode six months ago, was prescribed Indocid. 87. The entry dated 10 September 2015 states he is doing a psychology degree while in police force. 88. The entries dated 18 December 2015 and 19 December 2015 states he has had pain and weakness in his right arm for three to four weeks and is unable to flex his arm. Ultrasound examination showed intramuscular substance tear of the distal biceps with effusion and cyst on the elbow joint. 89. The entry dated 28 January 2017 states he fell off a roof on 21 January 2017, was taken to Royal North Shore Hospital, where he was determined to have a fractured left wrist and his left arm is in a cast. 90. The entries dated 6 February 2017 and 7 February 2017 states there is a persistent swelling in the left medial thigh following a recent fall from height. Ultrasound examination showed a large fluid collection consistent with a haematoma, and he was referred for ultrasound guided aspiration. 91. The list of prescriptions states he is prescribed Effexor XR 37.5 mg one daily on 5 May 2014. There are no repeats on the prescription as per PBS requirements. 92. The report by Dr Ming-Ywei Lin, clinical immunologist, Allergy Clinic Royal North Shore Hospital, dated 18 March 2018, states that he is predominantly grass allergic. He is prescribed Nasonex nasal spray. 93. The report by Dr David Wood, orthopaedic surgeon, dated 29 August 2011, states he has pain in the medial aspect of the right knee. This is most likely an isolated medial ligament tear. 94. The discharge referral from Royal North Shore Hospital for the presentation on 11 May 2017 states he has a past history of gout and classic migraine with visual auras. 95. He presented this morning with light-headedness and confusion on arrival at work. 96. He gets classic migraines with aura and feels this was similar without the visual changes. 97. He took indomethacin and paracetamol for knee pain this morning. 98. He has recently had patella bursitis for which he has received two courses of Keflex. 99. The investigations are unremarkable. He was commenced on Augmentin Duo Forte five-day course. 100. The presentation to Royal North Shore Hospital on 12 May 2017, states he has a generalised erythematous rash after being prescribed Augmentin Duo Forte twice daily for five days for a community-acquired pneumonia but has a penicillin allergy. 101. He was prescribed loratadine and prednisolone 50 mg. He is to take doxycycline 100 mg daily for five days. He would also take prednisone 40 mg daily for three days, and loratadine daily. 102. The insurer's submissions from McInnes-Wilson Lawyers, dated 9 May 2024, states the claimant is unable to demonstrate that his reported psychological symptoms are causally related to the motor accident or he has suffered a recognised psychiatric illness as direct result of the accident. 103. The report of Dr Geoffrey Ingram, psychiatrist, dated 11 December 2023, states the claimant reported a history of emotional symptoms for the past one to two years, following clashes with colleagues, and particularly his supervisor. There were also past years of allegations against him whilst working at the PCYC. 104. He reports symptoms, insomnia and nightmares, along with rumination of other scenes attended during police work. The events were compounded by disciplinary actions, including transfer of the claimant to general duties. The condition was said to improve following use of psychotropic medication. 105. The insurer submits the diagnosis of post-traumatic stress disorder cannot be attributed to the subject accident.

1. The Medical Assessors considered all the information available to them including the supplied documents and the information supplied at the re-examination.
2. They determined that the claimant reaches criteria for the diagnosis of post-traumatic stress disorder.
3. He meets criteria as follows.

1. The claimant witnessed the results of a particularly severe motor accident which was very traumatic for him which became very personal because he thought his next-door neighbour might have been involved in the motor accident. He thought that all of the occupants of the vehicle were dead at the scene of the motor accident.

1. The claimant has recurrent involuntary intrusive memories and images of the motor accident. He has recurrent nightmares with content related to the accident although not of the actual accident.
2. He is distressed and experiences images and memories of the motor accident and subsequently the cross and flowers at the motor accident site with re-exposure to the site of the motor accident.

1. The claimant withdrew from contact with others and did not want to talk about the accident. He generally avoided talking to others.

1. The claimant initially had a very negative emotional state and described himself as very down although that has improved somewhat. He remains wary of the general public.
2. He has lost interest in various pre-accident activities.
3. His relationship with his wife deteriorated and there is emotional distancing from his wife and children.
4. He initially avoided contact with former police colleagues and now only has contact, when he feels the need, with one retired police officer.

1. Mr Sonder is angry or easily angered, after the motor accident, especially if other drivers cut him off or he sees them doing risky or dangerous manoeuvres on the road.
2. He becomes angry in response to minor adversity and has repeated arguments with his wife and needs to deliberately calm himself down. He has never acted on his anger.
3. He has an exaggerated startle response, has problems with concentration and sleep disturbance.

1. The disturbance has been present for more than a month.

1. The disturbance has caused clinically significant distress and impairment in social and occupational functioning and general day to day functioning.

1. The disturbance is not attributable to the physiological effects of a substance or another medication.
2. The claimant was drinking seven days each week prior to the motor accident. His alcohol intake initially increased but he has now reduced to the pre-accident level, with one and sometimes two alcohol free days each week.
3. The heavy alcohol consumption does not appear to have any adverse effect on his symptoms.

1. The claimant did not have any of the aforementioned post-trauma symptoms prior to the motor accident although he did feel stressed from time to time because of the pressure in the Police Force and sometimes the difficulties with dealing with superiors.
2. He did contact the Employees Assistance Program from time to time but did not undergo any therapy for his symptoms prior to the motor accident.
3. Mr Sonter despite the pre-accident difficulties dealing with superiors and the pressure of working as a police officer had no impairment of his pre-accident functioning and did not meet criterion for any psychiatric condition at the time of the motor accident.
4. Working as a police officer dealing with the public and motor accidents, is a challenging work role.
5. He has not been involved in any subsequent traumatic experiences of any kind. He did attend several minor motor accidents before ceasing work in July 2023, but they had no ongoing emotional impact on him.
6. The condition of post-traumatic stress disorder arises from the injuries sustained in the motor accident and there is no other event in his life that would explain them.

1. The following injury WAS caused by the motor accident:
   • post-traumatic stress disorder.

"For the purposes of this Act, a threshold injury is, subject to this section, one or more of the following -

(b) a psychological or psychiatric injury that is not a recognised psychiatric illness."

"A Threshold psychological or psychiatric injury is a psychological or psychiatric injury that is not a recognised psychiatric illness."

"2) Each of the following injuries is included as a threshold psychological or psychiatric injury for the purposes of the Act

3. In this clause, acute stress disorder and adjustment disorder have the same meanings as in the document entitled Diagnostic and Statistical Manual of Mental Disorders (DSM-5)"

1. The condition of post-traumatic stress disorder is not an acute stress disorder and not an adjustment disorder and is therefore not a threshold injury.

1. The panel has determined that the injury sustained by the claimant in the motor vehicle accident, post-traumatic stress disorder, is not a threshold injury.