What happened: A NSW review panel overturned an Allianz threshold injury finding, ruling a crash claimant has major depressive disorder, not just an adjustment disorder.
Who's involved: Allianz Australia Insurance Limited and a self-employed disability support worker injured in a roundabout collision.
What's at stake: Access to non-economic loss damages, which require permanent impairment above 10% - blocked while the injury was classified as threshold.
Why it matters: The panel's symptom-by-symptom reasoning shows claims teams exactly where the original assessor's adjustment disorder diagnosis fell short.
Where it stands: The review panel has revoked the original certificate and substituted its own determination. The injury is no longer classified as a threshold injury.
Bags of rubbish accumulated in her apartment. She stopped cooking. She closed her own business after her irritability drove away clients. And the medical assessor who first examined her called it an adjustment disorder - a classification under New South Wales CTP law that would have capped her entitlements at 52 weeks of statutory benefits.
A review panel of the Personal Injury Commission disagreed.
The case involves a self-employed disability support worker who was driving through a congested roundabout on December 10, 2024 when another vehicle struck her car on the left-hand side. Her vehicle was later written off. No emergency services attended. After pain started flashing through both arms and her right ribs - a sensation that reminded her of a serious crash three years earlier that had fractured her hip, shoulder and rib - she hired a car and drove herself to hospital.
The original medical assessor examined the claimant in August 2025 and diagnosed adjustment disorder with mixed anxiety and depressed mood. Under the Motor Accident Injuries Act 2017, that counts as a "threshold injury" - the Act's term for a psychological injury that is not a recognised psychiatric illness. Threshold classification caps a claimant's statutory benefits at 52 weeks and blocks access to damages for non-economic loss.
The assessor also rejected a post-traumatic stress disorder diagnosis, finding the claimant did not perceive there was significant injury at the time of the accident and therefore did not meet the DSM-5 severity requirement (the diagnostic manual's gateway test for PTSD, which requires exposure to actual or threatened death or serious injury).
The claimant sought a review, arguing the assessor had not properly applied the diagnostic criteria and had not engaged with treating evidence - including psychometric testing that showed elevated scores for avoidance, intrusion and hyperarousal.
The review panel re-examined the claimant in August 2026 and took a markedly more detailed history. What emerged was a picture of functional collapse in the months after the crash.
Within days, the claimant reported the world felt "really foggy." She became irritable with her disability support clients, damaging those relationships. She stopped taking out her rubbish - bags of it piled up. She was barely eating. She felt "disconnected from people" and experienced panic while driving.
At her worst, she developed suicidal ideation, though that has since abated. She ultimately closed her business and took an office-based coordination role.
The panel identified six depressive symptoms meeting the DSM-5-TR criteria for a major depressive episode (the threshold a clinician must reach before making that diagnosis): markedly diminished interest or pleasure, reduced appetite, sleep disturbance, fatigue, diminished concentration and suicidal ideation.
That symptom count mattered. The panel noted that an adjustment disorder diagnosis specifically requires that symptoms do not meet criteria for another psychiatric disorder such as major depressive disorder. Once the symptom count crossed that line, the original diagnosis could not stand.
The panel agreed with the original assessor on one point: the roundabout collision, as described, was not severe enough to meet the DSM-5 severity requirement for a PTSD diagnosis. That finding held even though the claimant's treating psychologist had assessed all PTSD criteria as met.
The panel's final diagnosis was major depressive disorder with anxious distress, single episode, in partial remission. That is not a threshold injury under the Act - it is a recognised psychiatric illness, which falls outside the threshold definition.
The practical consequence: the claimant's path to non-economic loss damages is no longer blocked. Under the Act, those damages require permanent impairment exceeding 10%, a question that may now proceed to assessment.
The panel also confirmed the motor accident caused the psychiatric injury, noting the claimant had experienced a prolonged period of psychological stability before the December 2024 crash despite earlier episodes following a previous motor vehicle accident and a 2010 workplace incident.
For claims teams assessing psychiatric injuries under the NSW CTP scheme, the decision is a pointed reminder that adjustment disorder is a diagnosis of exclusion. If the symptom count reaches major depressive disorder territory, the threshold classification cannot hold.
