A Review Panel has blocked an insurer's attempt to sidestep a psychological injury assessment by classifying a claimant's depression as secondary to somatic symptom disorder.
The Personal Injury Commission of New South Wales, in a decision handed down on January 27, 2026, revoked a Medical Assessor's certificate and found that claimant BLP's psychological impairment from a 2017 motor vehicle accident exceeded the critical 10% threshold for non-economic loss damages.
The ruling in Allianz Australia Insurance Limited v BLP [2026] NSWPICMP 52 reinforces how insurers must approach psychological injury claims, particularly those arising from physical injuries and chronic pain.
The dispute traces back to a rear-end collision at North Ryde on May 30, 2017. BLP was stationary at a red traffic light when another vehicle collided with her car. She developed injuries to her cervical and lumbar spine, and over time, her psychological state deteriorated. She experienced depression, anxiety, sleep problems, and a persistent fear of paralysis after doctors warned her about her spinal condition.
When Medical Assessor Mason examined the claimant in September 2024, he acknowledged she had major depressive disorder with anxiety. However, he determined the condition was "secondary to a Somatic Symptom Disorder (Pain)" and concluded that no impairment assessment was required. In effect, the classification meant the claimant's psychological injuries would not be measured against the statutory threshold.
The claimant pushed back, arguing that a psychological injury need not be "primary" to qualify for assessment—it simply needs to be causally connected to the accident.
A three-member Review Panel agreed. Senior Member Brett Williams, alongside Medical Assessors Christopher Canaris and Paul Friend, re-examined the claimant on October 1, 2025, and again on December 10, 2025. Their conclusion was clear: the somatic symptom disorder diagnosis did not hold up.
The Panel found that while BLP showed significant concern about her physical symptoms and the risks of spinal surgery, her worry was not "manifestly excessive" given her documented degenerative spinal disease and multiple surgical recommendations. She simply did not meet the diagnostic criteria for somatic symptom disorder.
What she did have, the Panel determined, was persistent depressive disorder with anxious distress - a condition that is entirely assessable under the Psychiatric Impairment Rating Scale.
The numbers told the story. The Panel found moderate impairment in social and recreational activities, social functioning, and adaptation, with mild impairment in travel and concentration. The final tally came to 13% whole person impairment, comfortably above the 10% threshold that unlocks non-economic loss damages under the Motor Accidents Compensation Act 1999.
The Panel also rejected any deduction for pre-existing conditions, finding that BLP's earlier generalised anxiety disorder had fully resolved before the accident.
For insurers, the message is pointed: psychological conditions that emerge from physical injuries and chronic pain cannot be reclassified out of existence. If a claimant meets the diagnostic criteria for depression or anxiety, the condition must be assessed on its merits - regardless of its origins.
