Senior Rebels motorcycle gang member Darren Wallace was killed at a service station at Picton, southwest of Sydney, in December 2015.
Police found the body of his killer, also suspected to be part of the outlaw bikie gang, inside a nearby creek.
Geraldine Cox, who has not worked since March 2016, has filed a Supreme Court proceeding claiming her mental health was not taken care of by NSW Ambulance after the incident.
She and a colleague, Leigh Easterbrook, had been waiting at the service station to fill up their ambulance with petrol moments before the shooting.
Mr Wallace was shot point-blank in the head by another man he was earlier seen arguing with, according to court documents seen by AAP.
The 32-year-old was heard pleading for his life, saying "don't do it" before he was shot, witnesses told police.
The shooter then turned towards the ambulance, raising his arm with the gun and causing the two paramedics to duck for cover.
After he fled, Ms Cox and Ms Easterbrook administered medical care to Mr Wallace before he died.
In her lawsuit, filed in September 2025, Ms Cox accused NSW Ambulance of failing its duty of care to her afterwards.
She is seeking compensation for lost income, totalling more than $1600 per week, from March 2016 until the date she was due to retire at age 66.
She has also asked for more than $87,000 in alleged underpayments, plus lost superannuation payments.
Ms Cox claimed she was not offered proper counselling or psychological assistance, but was instead told "not to change her routine".
After returning to work nine days after the incident, she alleged her duties exposed her to further trauma, including as she was required to go back to the petrol station where the shooting took place.
In its defence, NSW Ambulance admitted to owing a duty of care to Ms Cox but denied it had been negligent in its actions.
If Ms Cox had suffered any injury, it was because of her failure to disclose any psychological symptoms, the government-run entity claimed.
The former paramedic had also not sought support from the Employee Assistance Program, peer support officers, nor the chaplain, the defence said.
Ms Cox had been paid workers' compensation after the incident, NSW Ambulance said.
It has argued the lawsuit was filed out of time due to legislation, which requires personal injury claims to be commenced within three years of any incident.
The matter will next come before the court on May 7.
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