What happened: A NSW review panel slashed a CTP claimant's psychiatric impairment from 17% to 7% after surveillance showed him working full days at construction sites.
Who's involved: QBE Insurance (Australia) Limited and a CTP claimant, reviewed by a Personal Injury Commission panel.
What's at stake: The claimant's whole person impairment rating - cut from 17% to 7% - which under the Motor Accident Injuries Act 2017 affects his entitlements and access to damages.
Why it matters: The decision shows how sustained surveillance evidence can overturn a psychiatric certification and narrow the path to PTSD claims from low-speed collisions.
Where it stands: Decided. The review panel revoked the original medical certificate.
Paint-splattered work clothes and a 6.45am start at a construction site are not what you would expect from someone assessed at 17% whole person impairment for post-traumatic stress disorder.
But that is what QBE Insurance (Australia) Limited's surveillance investigators captured when they filmed a CTP claimant over several months in 2025 - footage that prompted a NSW Personal Injury Commission review panel to reject a PTSD diagnosis entirely, substitute an adjustment disorder, and cut the man's psychiatric impairment rating to 7%.
The case goes back to a rear-end collision on July 13, 2023. The claimant was stationary at a traffic light when his car was hit from behind and pushed into the vehicle in front. Three vehicles were involved. Airbags did not deploy. His partner drove him home, and he did not seek medical treatment that day - he did not think there were any major problems at the time, according to the panel's account.
In the months that followed, the claimant's mental health became the centre of a drawn-out dispute. His treating psychologist referred him for counselling for an adjustment disorder with anxiety symptoms. A psychiatrist engaged by the claimant, Dr Nagesh, later diagnosed PTSD and major depressive disorder and assessed his whole person impairment at 17%. A medical assessor appointed through the Personal Injury Commission, Dr Shen, also diagnosed PTSD and persistent depressive disorder at 17%.
QBE challenged the assessments across the board.
The insurer engaged ProCare Investigations to conduct surveillance across several months in 2025, covering days in February, April, May, June, July, and September.
On June 20, 2025, investigators observed the claimant arriving at a building site at 6.45am. He left at nearly 3pm in dirty clothing. When he pulled off his jumper, he was wearing a T-shirt bearing what investigators reported was a painting company brand. Three days later, he left home at 5.20am and turned up at a construction site at Castle Hill, where he stayed until close to 5pm in painting clothes and work boots. The pattern repeated: day after day, he returned to the same site carrying a hard hat and bag.
The review panel catalogued what the footage showed in detail. The claimant was observed painting above shoulder height with a roller, climbing multiple flights of stairs at a worksite without difficulty, squatting and returning to full height, carrying a fully laden shopping basket and swapping it between hands. He was seen talking and laughing with people on site and moving without any apparent physical restriction.
All of this while his certificates of capacity - signed by his GP - certified him as having no work capacity at all.
The claimant told the panel his psychologist had recommended attending the worksite to connect with people rather than remaining isolated at home. He said he received no payment and had not returned to work "in any meaningful sense." When workers asked him to help with duties, he said he felt uncomfortable refusing and assisted with their tasks.
The panel rejected this explanation outright. It found it implausible that a site operator would allow a non-worker onto an active construction site for the entire working day - from 7am to 3pm - purely for social purposes. Safety considerations alone would normally prevent that kind of access, the panel said, and the reasons the claimant gave were "not plausible."
One earlier detail added a further wrinkle. The claimant had previously told a medical assessor that he had stopped smoking after the accident because he could not afford it. The panel noted that the insurer's surveillance footage suggested otherwise.
Beyond the surveillance, the panel took issue with the PTSD diagnosis itself. Under the DSM-5-TR - the diagnostic manual used by psychiatrists - a PTSD diagnosis requires that the person was exposed to actual or threatened death, serious injury, or sexual violence. The panel found this rear-end collision, where airbags did not deploy and the claimant declined hospital treatment, did not meet that bar.
The original medical assessor had certified PTSD on the basis that the claimant met the relevant diagnostic criterion "via his involvement in the subject accident." The panel said this was not the proper test. Citing a 2022 NSW Court of Appeal decision, it drew a distinction between an event that feels traumatic and one that objectively exposes a person to death or serious injury.
Instead, the panel diagnosed an adjustment disorder with anxiety and depressive symptoms. Under the Motor Accident Injuries Act 2017, an adjustment disorder is classified as a threshold injury - a distinction that affects what the claimant can claim.
The panel's revised assessment dropped the claimant's ratings in nearly every category. Social functioning fell from class 4 (severe) to class 3 (moderate). Social and recreational activities dropped from class 3 to class 2. Travel went from class 2 to class 1 - effectively no deficit - after the panel found the claimant could drive everywhere, for up to an hour or longer, as the surveillance showed. The capacity to adapt fell from class 3 to class 2, with the panel noting the claimant could handle quotation work for painting jobs at familiar work sites.
The final figure: 6% whole person impairment, plus 1% for the effect of treatment, totalling 7%. The original 17% certificate was revoked.
The decision is a sharp reminder that sustained, well-timed surveillance - paired with a rigorous challenge to the diagnostic criteria underpinning a psychiatric claim - can fundamentally reshape the outcome of a CTP impairment dispute.
The panel's determination reflects its own clinical assessment and the evidence before it. The claimant's psychiatric condition was reassessed on review, and the original certificate was revoked. The determination may be subject to further proceedings.
