Material Contribution Revisited

In Brief

• The onus is on the Claimant to demonstrate that the motor accident made a more than negligible contribution to their injuries.
• The onus is also on the Claimant to demonstrate that any injuries cause by the accident are non-threshold injuries.

Facts

The Personal Injury Commission (PIC) published its decision in Rim v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPICMP 64 on 21 February 2025.

The Claimant had a documented workplace injury to her cervical spine and right shoulder in 2020.

The Claimant was involved in a motor accident on 4 May 2021 when she was rear-ended on the M4 motorway.

The Claimant alleged a number of injuries to her cervical spine, right shoulder, right foot, lumbar spine and right hand as a result of the motor accident.

The original Medical Assessor determined none of the injuries were caused by the motor accident.

The Claimant sought a review of the medical assessment.

The Review Panel’s Decision

The Review Panel agreed with the original decision for the following reasons:

• The pre-existing work injuries to the Claimant’s cervical spine and right shoulder were well documented by the Claimant seeking regular treatment under the workers compensation scheme.
• Imaging both before and after the motor accident demonstrated the injuries to the cervical spine and right shoulder were directly related to the workplace injury.
• The accident had, at most, a negligible effect on the pre-existing conditions in the Claimant’s cervical spine and right shoulder.
• There were no objective findings, such as swelling or bruising, documented in the initial contemporaneous evidence immediately after the motor accident and there was no clinical evidence or any observance of symptoms of any injury to the Claimant’s right hand as a result of the motor accident.
• The documented evidence demonstrates the Claimant’s lumbar spine injury was addressed under her prior workers compensation claim even though she complained of this lumbar symptoms six months after the motor accident. The evidence demonstrated the subsequent reporting was purely related to the workplace accident.
• The ultrasound of the right foot performed nearly 12 months post-accident, which revealed mild plantar fasciitis, was not consistent with a non-traumatic condition, making it improbable the motor accident caused any injury to the right foot.

The Review Panel determined the injuries to the cervical spine, right shoulder, right hand, lumbar spine and right foot all qualify as soft tissue injuries under the Act.

However, the overwhelming evidence demonstrates the injuries to the cervical spine and right shoulder were related to the previous 2020 workplace injury, with the motor accident having a negligible impact.

The other injuries lack sufficient evidence to establish causation from the accident and are due to unrelated factors or pre-existing conditions.

As a result, the Review Panel did not disturb the original decision and the Claimant is not entitled to pursue ongoing statutory benefits or pursue a common law damages claim because she did not sustain any injuries as a result of the motor accident.

Why This Case is Important

This decision reminds us:

• The Claimant bears the burden of proving their injuries meet the requisite threshold for causation and classification as non-threshold injuries under the Act.
• The duty lies solely with the Claimant to present compelling and corroborative evidence to support their claim.

If you have a query relating to any of the information in this case note please don’t hesitate to get in touch with CTP Insurance Special Counsel Helen Huang today.

Additional McCabes Resources

• MC PIC Decision of the Week
• MC MAIA Toolkit
• The Proper Lookout Podcast
• MC Ready Reckoner