If you’ve been injured in a motor accident or at work in New South Wales, you may come across the term “Personal Injury Commission” in a letter from your insurer. It might appear in a notice stating that your weekly payments are being reduced, that your injury has been assessed as a “threshold injury”, or that liability for your workers compensation claim is disputed. You may also hear about the PIC during an internal review process or when your lawyer advises that a formal dispute needs to be lodged.
For many injured people, this is the point where the claim shifts from routine administration to formal dispute resolution.
Below is a clear, practical guide to understanding the Personal Injury Commission (PIC), why it becomes involved in claims, and how it may affect your entitlements.
What Is the Personal Injury Commission?
The Personal Injury Commission (PIC) is an independent tribunal in New South Wales that resolves certain types of personal injury disputes. It was established in 2021 to replace the former Dispute Resolution Service (DRS) and Workers Compensation Commission.
The PIC deals primarily with disputes arising from:
- Motor accident injuries
- Workers compensation claims
It does not handle public liability claims (such as slips and falls in shopping centres) or medical negligence matters. Those cases are usually dealt with in the court system.
The Commission’s purpose is to provide a forum for resolving injury disputes without the need for lengthy court proceedings.
The PIC is a tribunal, not a court. However, its decisions are legally binding. It has decision-makers called Members and Medical Assessors who determine disputes based on legislation, medical evidence, and submissions from the parties.
While the process is generally less formal than court proceedings, it still involves structured legal procedures, evidence, and statutory interpretation.
What Types of Cases Does the PIC Handle?
The PIC has two main divisions:
Motor Accidents Division
This division handles disputes under the NSW compulsory third party (CTP) scheme. These can include disagreements about:
- Whether someone was at fault
- Whether injuries are classified as “threshold” injuries
- Weekly income payments
- Medical and treatment expenses
- Permanent impairment assessments
Workers Compensation Division
This division manages disputes between injured workers and insurers, including issues relating to:
- Weekly payments
- Medical expenses
- Whole person impairment
- Work capacity decisions
- Liability disputes
If your insurer disputes your entitlement to benefits, your matter may be referred to the PIC for determination.
How Does a Matter Get to the PIC?
A dispute usually reaches the PIC after:
- An insurer makes a decision about a claim.
- The injured person disagrees with that decision.
- Internal review processes are completed (where required).
- A formal application is lodged with the Commission.
Strict time limits apply. Missing a deadline can affect your rights, so obtaining legal advice early is important.
What Happens During the PIC Process?
The process depends on the type of dispute, but may include:
- Written submissions from both sides
- Review of medical reports
- Teleconferences or conciliation conferences
- Referral to a Medical Assessor
- A formal determination by a Member
Some matters resolve at conciliation. Others proceed to a binding decision.
In medical disputes, the Commission may appoint an independent Medical Assessor whose opinion can be decisive, particularly in permanent impairment assessments.
Why Does the PIC Matter for Injured People?
The PIC plays a central role in determining entitlements under NSW’s statutory compensation schemes.
For injured people, this can directly affect:
- Access to weekly income payments
- Ongoing medical treatment
- Lump sum compensation for permanent impairment
- Whether injuries are classified in a way that limits benefits
Decisions made at the Commission can significantly impact the overall value and trajectory of a claim.
Understanding the PIC’s function helps injured individuals appreciate why evidence, medical documentation, and procedural compliance are so important from the outset of a claim.
Can You Appeal a PIC Decision?
Appeal rights are limited and depend on the type of decision.
In some circumstances, a party may seek a review or appeal within the Commission. In more restricted cases, judicial review through the Supreme Court of New South Wales may be available, but this generally focuses on legal error rather than simply disagreeing with the outcome.
Because appeal pathways are technical and time-sensitive, professional legal advice is critical.
How Can A Compensation Lawyer Assist with a PIC Matter?
Navigating the PIC process requires more than simply lodging an application. Strategic preparation, properly framed submissions, and carefully selected medical evidence often determine whether a dispute is resolved successfully.
Our team of compensation lawyers regularly act for injured people in both motor accident and workers compensation disputes before the PIC. They assist clients by:
- Reviewing insurer decisions and identifying grounds for dispute
- Advising on time limits and procedural requirements
- Preparing detailed legal submissions
- Arranging appropriate medical assessments
- Representing clients in conciliation conferences and hearings
- Advising on review or appeal options where necessary
Importantly, they understand how insurers assess risk and evidence, and how PIC decision-makers approach statutory interpretation and impairment disputes. This experience allows them to position a claim clearly and strategically.
For injured individuals, the PIC process can feel overwhelming, particularly when income, treatment access, or lump sum compensation is at stake. Having experienced representation can help ensure that your entitlements are properly argued and supported with the right evidence.