For the reasons set out in Medical Assessor Assem's examination report the Panel found that the accident caused injuries to all the referred body parts, except for a nexus between restricted shoulder range of motion and the cervical spine injury.

The following injuries were not caused by the accident:

bilateral shoulders - supraspinatus tendinosis with overlying subacromial bursitis and bursal impingement on abduction. Full-thickness incomplete tear of the anterior and mid supraspinatus tendon.

The following injuries were caused by the accident:
- right elbow - partial tear common extensor tendon on background of diffuse tendinosis;
- lumbar spine - soft tissue injury;
- left elbow, and
- cervical spine.
The following injuries that have been caused by the accident have resolved:
- cervical spine - soft tissue injury, and
- left elbow.
The Panel found that the following injuries caused by the 26 March 2021 accident gave rise to permanent impairment:
- lumbar spine, and
- right elbow.

MAA Guidelines, paragraph 6.24,p 88 and AMA4, Table 4, 3/20

* %WPI = percentage whole person impairment or permanent impairment

All of the calculated impairment is the outcome of the accident.

Permanent impairment is defined in the American Medical Association's Guides to the Evaluation of Permanent Impairment (Fourth Edition) (AMA 4 Guides) (p 315) as follows:

"Permanent impairment is impairment that has become static or well stabilised with or without medical treatment and is not likely to remit despite medical treatment.

A permanent impairment is considered to be unlikely to change substantially and by more than 3% in the next year with or without medical treatment."

The entire Panel has considered Medical Assessor Assem's examination report, evidence relating to the claimant's condition and the parties' submissions on this point.
The Panel has also considered the earlier certificates, the claimant's treating doctors' opinions and the claimant's IME.
The Panel has given weight to its medical Members' opinion and clinical judgment who, following a thorough consideration of the claimant's medical history concluded that there was insufficient objective evidence to calculate any existing impairment at the date of the accident, which could be deducted in accordance with the relevant Guidelines.
The Panel is satisfied that the claimant suffered physical injury as a result of the accident, including rendering any referred asymptomatic conditions symptomatic, because the accident mechanism was capable of causing such injuries, and there were sufficiently contemporaneous complaints regarding the referred body parts.

The Panel has found that the degree of permanent impairment of the claimant that has resulted from the referred injuries caused by the accident is 6%.
Accordingly, the Panel revokes Medical Assessor Truskett's certificate dated 11 June 2024 and issues a new certificate certifying that the degree of permanent impairment of the claimant resulting from the injuries caused by the accident is not greater than 10%.

Accident Injuries Act 2017

Accidents Injuries Act 2017

Personal Injury Commission Rules 2021

Younes v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 710; (15 September 2025)

It is necessary for the Panel to consider whether the accident caused or contributed to the diagnosed condition: Briggs v IAG Limited t/a NRMA Insurance [2022] NSWSC 372 at [75]. The accident does not have to be the sole cause as long as it is a contributing cause, which is more than negligible: Owen v Motor Accidents Authority of NSW [2012] NSWSC 650 at [50]. Further, the provisions of the Civil Liability Act 2002 apply, in particular s 5D and s 5E.

Mr Younes denied any prior history of shoulder injury, and there is no contemporaneous documentation of direct trauma to the shoulders in relation to the accident.
Although shoulder symptoms were mentioned in the Claim Form, there were no recorded complaints involving the shoulders in the early clinical records, including those of his general practitioner, physiotherapist, or treating orthopaedic surgeon, Dr Maniam.
Bilateral shoulder pain was first reported retrospectively during subsequent medicolegal assessments. Mr Younes was unable to consistently localise his symptoms to the shoulder joints or describe a pattern consistent with intrinsic shoulder pathology. Notably, the shoulder movement demonstrated during clinical examination was variable on repeated testing and appeared to arise from global upper limb discomfort, rather than a definable shoulder disorder or mechanical restriction secondary to cervical spine pain.
While he reported that neck symptoms occasionally radiated into the shoulders, clinical findings did not support a diagnosis of referred pain severe enough to cause functional limitation. There was no evidence of cervical muscle guarding or spasm, and both Medical Assessors Woo and Truskett had previously documented full, symmetrical shoulder range of motion.
Accordingly, the Nguyen principle (Nguyen v Motor Accidents Authority of NSW & Zurich Australian Insurance Ltd [2011] NSWSC 351) does not apply. There is no clinical basis to assess shoulder impairment as a consequence of cervical spine injury, as there is no objective evidence that the neck pathology is functionally limiting shoulder motion.

Younes v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 710;

At a glance

Court

Decision date

Catchwords

Source

Catchwords

Judgment (14 paragraphs)

Parties

Legislation Cited (4)

Cases Cited (3)

Younes v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 710; (15 September 2025)