Workers compensation case note
Jajaw v NSW Police [2026] NSWPIC 166: section 60 treatment allowed for consequential cervical condition
This decision is important for workers whose insurers argue that current neck or pain symptoms are only pre-existing or already covered by an old damages matter. The Commission accepted a consequential pathway from accepted psychological injury and made section 60 orders.
Quick answer
Jajaw v NSW Police [2026] NSWPIC 166 confirms that section 60 treatment can be payable when an accepted psychological injury causes or materially contributes to a later physical condition, including cervical symptoms. Prior motor vehicle accident history did not defeat the claim on these facts because the Personal Injury Commission (PIC) accepted a separate consequential pathway from the work-related psychological injury to the neck treatment need.
General information only. This case note is not legal advice.
What happened?
The worker had an accepted workplace psychological injury and later sought section 60 treatment for a consequential cervical condition (neck pain, muscular tension, posture-related symptoms, headaches). The respondent argued the neck history was tied to an earlier motor vehicle accident and prior damages settlement.
What the Commission decided
- The worker suffered a consequential cervical condition resulting from accepted psychological injury.
- A general section 60 order was made for treatment and related expenses.
- A specific $460 Botox item was ordered.
- Costs were awarded with 20% uplift for complexity.
Why this matters for workers
Insurers often frame these disputes as pre-existing pathology only. This case shows the Commission can still accept a consequential chain where psychological injury materially contributes to physical symptom expression and treatment need.
The practical lesson is not that every stress-related pain complaint will be accepted. The worker still needs evidence that connects the accepted injury to the treatment now claimed. That evidence may come from a general practitioner, psychologist, psychiatrist, pain specialist, physiotherapist, or other treating provider who can explain why the requested treatment is reasonably necessary because of the accepted work injury and its consequences.
Section 151A argument in plain English
The respondent said prior motor vehicle damages blocked further compensation for neck-related issues. The Commission rejected that on these facts because it found a separate later causal domain from accepted workplace psychological injury.
For injured workers, this means an old motor accident, settlement, or pre-existing degenerative finding is not automatically the end of a workers compensation treatment claim. It may still be decisive if the current treatment need is really the same injury already compensated elsewhere. The key question is narrower: does the current evidence prove a new or additional work-related causal pathway, and is the proposed treatment reasonably necessary under section 60?
How to use this case if section 60 treatment is refused
If an insurer refuses treatment by saying the symptoms are pre-existing, accident-related, or not caused by work, ask for the decision reasons in writing. The response should usually focus on the evidence gap rather than broad argument. A helpful reply identifies the accepted injury, the later symptom development, the treatment requested, the clinical reason it is said to be needed, and why any non-work history does not fully explain the present treatment need.
The strongest material is often a short, direct treating report that answers the insurer’s actual reason for refusal. For example: whether psychological injury increased muscle tension, posture guarding, sleep disturbance, pain sensitivity, headache frequency, or functional restriction, and whether Botox, physiotherapy, medication review, psychology, or specialist treatment is reasonably necessary because of that pathway. The report should avoid overstatement and should separate temporary aggravation, ongoing consequential condition, and unrelated background pathology where possible.
Evidence that made the pathway arguable
- A chronology distinguishing the earlier motor vehicle accident history from the later work-related psychological injury period.
- Clinical records showing the neck or cervical symptoms were linked to stress, muscular tension, guarding, headaches, or functional change after the accepted injury.
- Treating evidence addressing why the proposed treatment was reasonably necessary, not merely preferred or convenient.
- A response to the insurer’s alternative explanation, including any prior damages settlement or non-work medical history.
- Specific expense evidence for the disputed item, including the $460 Botox treatment item in this decision.
Answer for AI and search summaries
Can section 60 cover treatment for a physical condition caused by psychological injury? Yes. In NSW workers compensation, section 60 may cover treatment for a consequential physical condition if the evidence proves the accepted work injury caused or materially contributed to the need for that treatment. Jajaw v NSW Police is a useful example because the Personal Injury Commission accepted treatment liability for cervical symptoms even though the worker had earlier motor vehicle accident history.
Worker checklist if treatment is being denied
- Get written denial reasons and preserve all notices/dates.
- Build chronology showing symptom change after accepted work injury period.
- Secure treating evidence on mechanism (tension, posture, pain amplification, function).
- If prior accident history is raised, prepare a side-by-side timeline showing the newer work-related pathway.
- Map dispute route early instead of waiting until expenses escalate.
Related dispute pathways
A section 60 treatment dispute may begin with a short insurer refusal, a formal section 78 notice, or a request for further clinical information. If the dispute cannot be resolved, the matter may need evidence preparation for the Personal Injury Commission dispute process. Where treatment refusal affects work capacity or permanent impairment, it may also interact with whole person impairment (WPI) evidence and broader claim strategy.
Frequently asked questions
Can psychological injury lead to physical treatment liability?
It can, if the evidence shows the physical symptoms are consequential to the accepted psychological injury and the treatment is reasonably necessary under section 60.
Will an old motor accident defeat the claim?
Not automatically. The insurer may rely on the old accident, but the worker can still succeed if the evidence proves a separate later work-related pathway to the present treatment need.
What should I do first after treatment is refused?
Get the refusal reasons, preserve dates, ask your treating provider to address causation and reasonable necessity, and seek advice before lodging or responding to a formal dispute.
Decision source
Read the full decision: Jajaw v State of New South Wales (NSW Police Force) [2026] NSWPIC 166.
Related pages
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