The report by Navin Gooniah, psychologist, dated 27 February 2023, states Ms. Webb has symptoms consistent with an adjustment disorder and post-traumatic stress disorder.

Her anxiety symptoms have been aggravated by having a severe car accident in Wentworthville and observing the wreckage.

The report by Navin Gooniah, psychologist, dated 9 May 2023, states Ms Webb first attended on 6 June 2022, and the last appointment was on 23 March 2021.

At the time of the accident she was going well and had purchased a property in Queensland and a new vehicle.

Following the accident 2021 she was unable to exit the vehicle. She experienced pain in the neck and lower back and anxiety about a shoulder.

She developed symptoms consistent with post-traumatic stress disorder.

It states during the course of the sessions she was making progress. She informed me in the session of 27 February 2023, she was at the pool in Wentworthville, when she heard a motor vehicle crash. She exited the pool and observed the wreckage, which triggered anxiety, as she questioned, "what if it was me?"

She was improving until the session on 27 February 2023.

There are no restrictions on her capacity to work, short of not working in a role related to motor accidents. She has a diagnosis of post-traumatic stress disorder.

The clinical notes of Navin Gooniah, only some of which are dated, contains a typed entry which is undated, states she's still working at Winning Appliances. She is working part-time. She has anxiety in regard to driving and does not drive too far. She won a steam oven. It is not a stressful job. She has ongoing anxiety about having an accident.

The handwritten clinical notes dated 28 February 2019, apparently of Navin Gooniah, states she was involved in a motor accident two years ago. She was doing a Certificate III in travel and was doing job interviews.

She had a rear end accident with a lower back injury and increased pain.

She had right rotator cuff bursitis and no improvement with physiotherapy. She had tears on an MRI scan.

She had tendonitis with right muscle right hand symptoms.

She is unemployed and a single mother. She has an 18-year-old son.

She has a frozen right shoulder with chronic pain, which impacts on her daily functioning.

The report of Dr. Gary McKay Colorectal surgeon, dated 2 September 2020, states her irritable bowel symptoms have been exacerbated by stress since a motor accident in May 2017, when she sustained a rotator cuff injury and wrist injury. She has been off work for some time.

It was recommended she stop the Somac and try Nexium.

She had a normal gastroscopy and colonoscopy on 15 March 2019.

She has five to seven loose bowel motions each day, which is usually triggered by stressful events.

She's gained weight from 65 to 82 kg in the last 10 years. She has been trying to lose weight with taking Optifast.

She has had two episodes of urge incontinence last year.

There is no evidence of progressive weakening of the anal sphincter or rapid deterioration.

The report by Navin Gooniah dated 14 March 2020, states Ms. Webb has diagnoses consistent with an adjustment disorder. She has anxiety and depressive symptoms.

The GP mental health treatment plan by Dr Zaid Ali dated 28 August 2019, states she has depression.

The insurer's reply submissions state the assessor considered the previous diagnosis. The assessor determined the claimant did not reach criteria for a diagnosis of pos-ttraumatic stress disorder.

The GP mental health treatment plan by Dr Zaid Ali, dated 14 February 2022, makes a diagnosis of Generalised Anxiety and Adjustment Disorder.

The clinical notes from the Wentworthville Medical Centre from 26 May 2022 to 21 July 2023 include the following.

The entry dated 26 May 2022 by the physiotherapist CY Ernest Kwan states she was rear-ended by another vehicle. Her vehicle hit the vehicle in front. She is unemployed and had been travelling to Queensland as her son has moved there. She can currently drives for 20-30 minutes, whereas pre-injury could drive for 60 minutes.

She has neck pain with headache, lower back pain, right shoulder pain, and secondary left shoulder pain due to overuse post-motor accident.

There is a past history of right cuff and biceps repair by Dr Gupta from a previous motor accident, 2017, and De Dequervains release by Dr Simon Chan. She had a cortisone injection in December 2021 to relieve the pain from this motor accident.

She has been approved for physiotherapy and psychology sessions and may also get cleaners too as she lives alone.

The entry dated 20 June 2022 states she has been doing physiotherapy. She is taking Nexium 20mg in the morning, and Duromine 30mg in the morning.

The entry dated 18 July 2022 states she is continued her physiotherapy and has consulted the psychologist. She uses Duromine every third day or so, but has not lost weight.

The entry dated 7 August 2022 states she is feeling better and has nearly finished the oral antibiotics. She is travelling to Queensland tomorrow.

The entry dated 30 August 2022 states she has recently returned from Queensland and is willing to start a new sales job, which she will trial next week.

The entry dated 9 October 2022 states her new job requires tasting food to sell appliances and she has gained weight.

The entry dated 25 October 2022 states she has increasing pain in the right shoulder, which is very stiff and she has shoulder capsulitis. She was referred for an ultrasound, plus or minus cortisone injection.

The entry dated 1 January 2023 is a telehealth appointment. She has laryngitis and is in Queensland. She has cough and asthma and sore throat. She was prescribed Augmentin Duo Forte and prednisolone 25mg if required.

The entry dated 9 January 2023 states she has returned from Queensland and there are a few issues. The sore throat and cough are worse.

The entry dated 6 March 2023 states she has tried swimming to help with her shoulder. She is having physiotherapy. She has attended the Sydney Eye Hospital regarding glaucoma.

Navin Gooniah states she has some anxiety issues with flashbacks of the car accident December 2021 after she came across another car accident. She became nervous and had some difficulty.

The entry dated 25 June 2023, which is the last medical entry, states the right hand ultrasound showed tendinitis with thickening. It states she may need to see a hand physiotherapist

The Review Panel considered all the available evidence including the information provided by Ms Webb and in the supplied documents. The Review Panel determined that Ms Webb had a diagnosis of a specific phobia of driving.

She has a marked fear and anxiety about the specific object or situation which is driving.

The phobic situation is actively avoided or induces intense fear or anxiety.

The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation.

The fear or anxiety and avoidance is persistent and has lasted more than six months.

The fear or anxiety and avoidance causes significant distress and impairment into social and day to day functioning, particularly travel.

The disturbance is not better explained by the symptoms of another mental disorder and is not associated with avoidance for panic because of panic like symptoms. She does not have agoraphobia or obsessive compulsive disorder.

Ms Webb mostly described symptoms specific to driving which are outside the criteria for an Adjustment Disorder with mixed Anxiety and Depressed Mood.

Ms Webb did not describe sufficient symptoms to reach criterion for a diagnosis of Posttraumatic Stress Disorder.

The Review Panel determine that the condition of a Specific Phobia of Driving arises from the injuries sustained in the motor accident.

The Review Panel noted that Ms Webb had some symptoms in regard to driving but was able to drive in Sydney but not into the City but required someone to accompany her if she drove outside of the city such as to Gosford or Wollongong

She did not have the intense fear or anxiety when driving prior to the subject motor accident.

The Review Panel considered that she had a pre-existing Adjustment Disorder and Anxiety.

1. The following injuries WERE caused by the motor accident:
   • Specific Phobia of Driving.

The condition of a Specific Phobia of Driving is not an acute stress disorder and is not an adjustment disorder so it is not a threshold injury.

The assessment of whether the injury is a 'threshold injury' is not a direct measure of symptoms or disability. A finding that the injury is a 'threshold injury' indicates that there was an injury caused by the motor accident and that there may be continuing symptoms, however the injury satisfies the definition of a threshold injury under the Act and the Regulation.

1. The following injuries are not threshold injuries:
   • Specific Phobia of Driving.
2. The Panel met on 21 August 2025 to discuss the Medical Assessors findings on examination. The legal Member of this Panel did not participate in the medical examination but prior to the Panel meeting on 21 August 2025, the legal Member has had the benefit of reading and considering the Medical Assessors examination report. On 21 August 2025 the Panel met and all discussed the examination findings and the issues going to causation. It is from this teleconference of the Panel that the Panel has agreed and reached its final conclusion and determination.
3. The Panel adopts the examination report of Medical Assessor Friend and Medical Assessor Doris.

1. Whilst the claimant has coping strategies regarding the driving of car, it is apparent from the by the history provided by her that she has continued to drive on a regular basis but in a considerably restricted form.
2. However, the Panel is satisfied that the accident has caused a specific situation phobia to driving because following the accident, she informed her physiotherapist, Mr Kwan, that she could drive for 20 to 30 minutes but pre-injury she could drive for 60 minutes. Mr Goonniah noted some anxiety issues with flashbacks of the car accident when in December 2021 she came across another car accident. She also informed Mr Goonniah as noted in his AHRR of 9 June 2022 that she had significant anxiety when driving or as a passenger when driving and avoidance of driving. The clinical notes of Mr Goonniah also record that she had anxiety in regard to driving and she does not drive too far. She has consistently reported this anxiety to other practitioners and not just to the Panel.
3. It is apparent from the reasons of the Medical Assessor that at the time of his examination of the claimant, she did not demonstrate to him a driving phobia. However, the Panel is satisfied that at other points in time, the claimant has suffered this phobia and at the time of examination by the Panel, the claimant clearly demonstrated a specific situation phobia to driving.
4. The Panel is not required to choose between competing medical opinions and is required to form its own opinion: Insurance Australia Group Ltd v Keen and Insurance Australia Ltd v Marsh [2021] NSWCA 287.
5. The claimant informed the Medical Assessors that she actively avoids driving or situations involving driving. She has stopped driving because of his distress experienced and has further anxiety whilst having to travel a long distance to visit her son in Queensland.
6. The claimant's fear, anxiety, or avoidance is persistent, having lasted for six months or more. The onset of the claimant's specific situational phobia to driving was at the time of the motor accident on 28 June 2022. The claimant remained impaired by this psychological injury at the time of her examination on 24 July 2025.
7. The Panel adopts the reasoning in Lynch v AAI Ltd [2022] NSWPICMP 6 (Lynch) that the psychological condition can be present at any time to establish that the injury is not threshold for the purposes of the Act. However, in this claim, the Panel is satisfied that a driving phobia was demonstrated at the time of examination by the Panel Medical Assessors, in any event.
8. The Panel also adopts the reasoning in Lynch that the claimant bears the onus of proof in establishing that any injury is not a threshold injury for the purposes of the Act. The Panel is satisfied, following examination of the claimant, that this onus has been satisfied.
9. The Panel must also ask itself in considering whether the accident contributed to the claimant's injuries as referred to it by the Commission, whether the claimant's condition was caused by or materially contributed to by the accident. The Panel is satisfied that this can be answered affirmatively. She has had to change her driving arrangements and routes of travel and is reliant on assistance to get from one point to another.
10. On the balance of probabilities, can it be said that the claimant suffered a recognisable psychiatric injury? For the reasons discussed above in the report of the Medical Assessors, the Panel does find that this can be answered in the affirmative.
11. Would the impairment have occurred, if not for the accident? The Panel is satisfied that the accident and impact has had a more than negligible effect on the claimant's psychiatric condition suffered by the claimant. This is because up to and at the time of the accident his driving activities were not restricted and caused her no distress. Prior to the accident the claimant was driving without restriction and without anxiety. Following the accident though, her driving was curtailed due to her anxieties arising from this such that she was not able to drive all the time and had to plan her route of travel, endeavour to avoid the accident site, and to try to avoid traffic, amongst other things.
12. The insurer has relied on the decision of Mandoukos v Allianz Australia Insurance Limited [2023] NSWSC 1023. The insurer says that the scope of the medical dispute referred to the Commission for determination is not defined by law but by the parties submissions. The insurer says that the claimant did not put before the Medical Assessor submissions alleging a differential diagnosis of specific phobia. That may be the case but this is a hearing de novo and those very issues raised before the Medical Assessor and for determination by the Panel now include consideration of a differential diagnosis of specific phobia.
13. The Panel has not "gone looking" for alternative diagnosis when the specific diagnosis of post-traumatic stress disorder had been referred to it. The Panel must examine the claimant and perform its assessment on the basis of its discussions with the claimant on the day of assessment. A psychiatric symptom might evolve over time and disappear over time for that matter. In this case, the Panel was not satisfied that the claimant had a post-traumatic stress disorder but was satisfied on the basis of the history provided by the claimant, and the clinical assessment of the Medical Assessors, that she was suffering a psychiatric disability of a specific situation phobia to driving.

1. The Panel is satisfied that consequent upon the motor accident which occurred on 28 June 2022, the claimant developed a psychiatric disability of a Specific Phobia of driving. This is a non-threshold injury

(a) revokes the certificate of Medical Assessor Canaris dated 4 June 2024;

(b) has examined the claimant and determined that she has a Specific Phobia to Driving, and

(c) determines a diagnosis of a Specific Phobia to driving is a non-threshold injury