Review Panel: Principal Member John Harris, Dr Wayne Mason and Dr Michael Hong

Important takeaways: 

• The Review Panel applied the findings in Lynch v AAI Limited t/as AAMI [2022] NSW PICMP 6 as to the timing of the diagnosis.
   
• The Review Panel did not diagnose PTSD as the accident was not experienced as a threat of serious injury or death.

Facts

The Claimant in Cho v Insurance Australia Limited t/as NRMA Insurance [2022] NSWPICMP 107 was involved in a rear end collision on 27 June 2020.  At first instance, Medical Assessor Jones diagnosed a chronic adjustment disorder with depressed mood and mixed anxiety which is a minor injury for the purposes of the Motor Accident Injuries Act 2017 (‘MAI Act’).

His determination was the subject of a Review. There was a history of excessive alcohol consumption prior to the accident.

The Claimant relied on his psychiatrist’s diagnosis of PTSD, as well as his psychologists diagnoses of Major Depression and Co-Morbid Substance Abuse, and submitted that this was evidence of a non-minor injury following the accident.

The Review Panel Examination

At assessment, the Claimant described the onset of anxiety immediately following the accident - and reported some driving anxiety which had improved. He described the onset of severe depression 3-4 months following the accident, when he also increased his alcohol intake. This was in the context of him being unable to perform overtime work due to being on medication.

In the 8 weeks prior to assessment, the Claimant reported drinking 8 standard drinks per day on average. He described ongoing nightmares, reduced enjoyment, poor concentration and pervasively depressed mood. He also described fatigue, suicidal thoughts, anger and distress.

The Claimant presented with a tired appearance, and it was noted that he exhibited difficulties regulating his emotions and appeared depressed. He was also consistently restricted in his affect range and reactivity.

The Panel Decision

The Panel diagnosed Major Depressive Disorder and Alcohol Use Disorder, and accepted both that these conditions were caused by the subject accident, and that they were “non-minor” injuries for the purposes of the MAI Act.

Although the Panel recognised that there was a pre-accident history of excessive alcohol consumption, they found that this was not impacting the Claimant’s functioning prior to the accident.

The Panel noted that the Claimant’s psychologist had previously made the above diagnoses in November 2021, and in accordance with the reasoning in Lynch v AAI Limited t/as AAMI [2022] NSWPICMP 6, found it was evidence that the Claimant had sustained a non-minor injury.

They did not accept that the Claimant was suffering from PTSD as the subject accident was not experienced as a threat of serious injury or death which they noted was an essential element for the purposes of diagnosing PTSD.

If you have a query relating to any of the information in this case note, or would like to speak with someone in Holman Webb’s Insurance Group in relation to a matter of your own, please don’t hesitate to get in touch with Partner Stephanie Davis today.