ADMINISTRATIVE LAW — judicial review — Personal Injury Commission — medical assessment under Motor Accident Injuries Act 2017(NSW)
Quick Take
1A medical assessor satisfies the obligation to respond to a substantial and clearly articulated argument regarding inconsistencies in a claimant's reporting where the assessor acknowledges the inconsistencies, notes differing medical opinions, and explains why no major inconsistencies were found — the assessor is not obliged to accept the argument or analyse every individual inconsistency, particularly where the claimant has a complex psychiatric history and the assessor forms an independent clinical opinion based on contemporaneous records and examination.
2Whether a motor accident satisfies Criterion A of the DSM-5 for PTSD (exposure to actual or threatened death or serious injury) is a question of clinical judgment and fact exclusively for the medical assessor; a finding based on the claimant's subjective perception of the accident as potentially life-threatening is within the assessor's competence and does not constitute a misapplication of the DSM-5.
3A Delegate exercising the s 7.26 gatekeeper function does not exceed that function by reviewing the Medical Assessor's reasoning to determine whether there is reasonable cause to suspect material error, provided the Delegate does not purport to determine the correctness of the assessment or exercise medical expertise the Delegate does not possess.
