What happened: A review panel more than halved a motor accident claimant's permanent impairment rating after finding the original assessment relied on the wrong type of scan
Who's involved: Allianz Australia Insurance Limited and a claimant before the NSW Personal Injury Commission
What's at stake: The claimant's access to pain-and-suffering damages, which requires impairment above 10% under NSW's CTP scheme
Why it matters: The panel's reasoning gives CTP claims teams a clear, citable basis for challenging thoracic spine ratings built on MRI evidence alone
Where it stands: Decided - the review panel revoked the original certificate and issued a replacement at 12%
A hairdresser's car flipped several times in a high-speed T-bone collision. Five years later, a fight over which type of scan measures a spinal fracture has cut her impairment rating by more than half - and nearly cost her the right to claim pain-and-suffering damages altogether.
A NSW Personal Injury Commission review panel has slashed the claimant's whole person impairment - the percentage doctors assign to permanent harm from an accident - from 29% to 12%. Under the state's CTP laws, a claimant cannot recover damages for pain and suffering unless that number sits above 10%. She clears it now by just two points.
The entire swing turned on one question: which type of scan should be used to measure a spinal fracture.
The claimant was driving to work on April 9, 2021, when another vehicle, travelling at considerable speed, T-boned her car on the passenger side. Her vehicle flipped several times before landing upright. Ambulance records noted neck pain, thoracic spine tenderness, right shoulder pain, and tingling in her hands and feet during the 30 minutes she was trapped inside.
An MRI taken the next day at Port Macquarie Hospital reported roughly 20% loss of height at the T4 vertebra, with similar but lesser changes at T3 - suggestive of mild compression fractures. The original medical assessor leaned on those MRI findings to rate the thoracic spine at 25% impairment. Combined with 5% for the right shoulder, the total came to 29%.
Allianz applied for review within a week.
The insurer's argument was pointed: a CT scan taken about two years later found no definite fractures at T3 or T4. And the original assessor had attributed the 20% height loss to T3, when the MRI report actually described it at T4. The claimant's lawyers called that a typo and argued it made no practical difference to the rating.
The review panel sided with neither expert's overall assessment and conducted its own fresh evaluation. Its reasoning came down to a single rule in the Motor Accident Guidelines: when measuring how much a vertebra has been crushed, use a CT scan or X-ray - not an MRI.
The panel found that MRI can overstate the degree of compression because it does not clearly separate bone from surrounding tissue. The CT taken on the day of the accident had reported only a mild reduction in mid-thoracic vertebral height, without singling out any specific vertebra. The follow-up CT in April 2023 went further - the reporting radiologist said he was not convinced he could see any definite fracture of T3 or T4.
On that basis, the panel reclassified the T3 and T4 injuries as end-plate fractures - superficial damage to the top or bottom surface of the vertebra, rather than a collapse of the vertebral body itself. Under the Guidelines, that distinction dropped the thoracic spine from the second-highest severity rating to a far lower one: from 25% impairment down to 5%.
That single reclassification wiped 20 points off the total.
The panel did rate the right shoulder slightly higher than the original assessment, finding traumatic bursitis - inflammation of the cushioning sac in the joint - with an ongoing frozen shoulder. Measured range-of-motion losses in flexion, extension and abduction gave 7% impairment, up from 5%. The cervical spine soft tissue injury stayed at 0%, and the fractured rib, now fully healed, also attracted 0%.
Final tally: 12%.
Five years after the accident, the claimant - now 34, out of work since late 2024 because her shoulder will not let her hold a hairdryer at arm's length, and unable to hang washing above shoulder height - keeps her eligibility for pain-and-suffering damages. Two points lower and she would have lost it.
For CTP claims teams reviewing impairment assessments built on MRI evidence of thoracic compression fractures, the panel's reasoning is a practical, citable tool - particularly where a later CT scan tells a different story.
