Peter Hunt
Principal
CTP Insurance, Insurance
Understanding PTSD Criteria in Non-Severe Accidents
5 March, 2025
In Brief
- An exposure to actual or threatened death or serious injury is a criterion for post-traumatic stress disorder (PTSD), as per the DSM V.
- For psychological injuries, any recognised condition under the DSM-V is considered a non-threshold injury, except for Acute Stress Disorder or Adjustment Disorder.
Facts
The Personal Injury Commission (PIC) published its decision in Ozucargil v QBE Insurance (Australia) Limited [2025] NSWPICMP 102 on 19 February 2025.
A Claimant was involved in a motor vehicle accident on 26 September 2022. He was making a lefthand turn when a vehicle travelling at approximately 50 kph collided with the rear left side of his vehicle. The Claimant did not experience any immediate pain and he was able to drive the vehicle following the accident. No police nor ambulance attended the scene.
The Claimant alleged he developed PTSD, a non-threshold psychological injury, as a result of the accident. He reported some trauma symptoms such as nightmares and flashbacks about the accident.
At first instance, a PIC Medical Assessor agreed that the psychiatric injury sustained is a non-threshold injury.
The Insurers sought a review of the medical assessment.
Relevant Definitions
In Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) Diagnostic Criteria for PTSD, Criterion A outlines that there must be:
- ‘Exposure to actual or threatened death, serious injury, or sexual violence’.
The Review Panel’s Decision
The Review Panel found that the Claimant did not meet the necessary criteria for PTSD, particularly in the absence of exposure to trauma threatening serious injury or death (as per Criterion A of DSM V). Absent the establishment of Criterion A there cannot be a finding of PTSD.
Instead, the Panel found that the claimant had suffered an initial adjustment disorder, which was considered a threshold injury under the Motor Accident Injuries Act 2017.
Why This Case is Important
This case clarifies the criteria for diagnosing PTSD, emphasising the need for exposure to actual or threatened death or serious injury (Criterion A) as required by the DSM-V.
It highlights the distinction between PTSD and other psychological conditions, like adjustment disorder, which may qualify as threshold injuries.
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 Principal Peter Hunt today.
Co-author
Shannon Chan, Lawyer
