austlii:nsw/NSWPIC/2025/474
General information, not legal advice.
NSWPIC
2025-09-11
Original judgment source is linked above.
WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; application for reconsideration seeking a revocation of a Certificate of Determination and a referral to another Medical Assessor (MA) pursuant to section 329; challenge to assessment of MA on basis of miscalculation of whole person impairment, deduction pursuant to section 323, lack of detailed reasons, and in the interests of justice; State of New South Wales (NSW Department of Education) v Kaur, Campbelltown City Council v Vegan, Ferguson v State of New South Wales, , , , and discussed and followed; - no merit in applicant's application; application declined.
A brief statement is attached setting out the Commission's reasons for the determination.
Body part/s referred: Psychological/Psychiatric disorder
(a) whether the COD dated 4 June 2025 should be revoked, and
(b) whether the applicant's claim should be remitted to the President for referral back to the Medical Assessor to provide a further assessment of WPI.
(a) the Application with attached documents;
(b) Reply with attached documents;
(c) MAC dated 30 April 2025;
(d) COD dated 4 June 2025, and
(e) report of Dr Pothala dated 10 July 2025.
Personal Injury Act 2020 Workers Compensation Act 1987
(1) The Commission may reconsider any matter that has been dealt with by the Commission in the Workers Compensation Division and rescind, alter or amend any decision previously made or given by the Commission in that Division.
(2) If after the making of a decision by the Commission (and without limiting subsection (1)), the President is satisfied that the decision contains an obvious error, the President may -
(a) alter the decision to correct the error, or
(b) direct a registrar to alter the decision to correct the error.
(3) Without limiting subsection (2), if the decision is contained in a certificate, the President may -
(a) issue a replacement certificate with the error corrected, or
(b) direct a registrar to issue a replacement certificate with the error corrected.
(4) If a decision is altered, the altered decision is taken to be the decision and notice of the alteration is to be given to the parties in the proceedings in the manner directed by the President.
(5) If a replacement certificate is issued, the certificate prevails over any previous certificate.
(6) Examples of obvious errors in a decision are where -
(a) there is an obvious clerical or typographical error in the text of the notice or statement, or
(b) there is an error arising from an accidental slip or omission, or
(c) there is a defect of form, or
(d) there is an inconsistency between the stated decision the stated reasons."
"66 Entitlement to compensation for permanent impairment
(1) A worker who receives an that results in a degree of permanent impairment greater than 10% is entitled to receive from the worker's employer compensation for that permanent impairment as provided by this section. Permanent impairment compensation is in addition to any other compensation under this Act.
Note. No permanent impairment compensation is payable for a degree of permanent impairment of 10% or less.
(1A) Only one claim can be made under this Act for permanent impairment compensation in respect of the permanent impairment that results from an injury..."
"322A One assessment only of degree of permanent impairment
(1) Only one assessment may be made of the degree of permanent impairment of an injured worker.
(2) The medical assessment certificate that is given in connection with that assessment is the only medical assessment certificate that can be used in connection with any further or subsequent medical dispute about the degree of permanent impairment of the worker as a result of the injury concerned (whether the subsequent or further dispute is in connection with a claim for permanent impairment compensation, the commutation of a liability for compensation or a claim for work injury damages).
(3) Accordingly, a medical dispute about the degree of permanent impairment of a worker as a result of an injury cannot be referred for, or be the subject of, assessment if a medical dispute about that matter has already been the subject of assessment and a medical assessment certificate under this Part.
(4) This section does not affect the operation of section 327 (Appeal against medical assessment)."
(1) An assessment certified in a medical assessment certificate pursuant to a medical assessment under this Part is conclusively presumed to be correct as to the following matters in any proceedings before a court or the Commission with which the certificate is concerned:
(a) the degree of permanent impairment of the worker as a result of an injury,
(b) whether any proportion of permanent impairment is due to any previous injury or pre-existing condition or abnormality,
(c) the nature and extent of loss of hearing suffered by a worker,
(d) whether impairment is permanent,
(e) whether the degree of permanent impairment is fully ascertainable.
(2) As to any other matter, the assessment certified is evidence (but not conclusive evidence) in any such proceedings."
(1) A party to a medical dispute may appeal against a medical assessment under this Part, but only in respect of a matter that is appealable under this section and only on the grounds for appeal under this section.
(2) A matter is appealable under this section if it is a matter as to which the assessment of an approved medical specialist certified in a medical assessment certificate under this Part is conclusively presumed to be correct in proceedings before a court or the Commission.
(3) The grounds for appeal under this section are any of the following grounds:
(a) deterioration of the worker's condition that results in an increase in the degree of permanent impairment,
(b) availability of additional relevant information (but only if the additional information was not available to, and could not reasonably have been obtained by, the appellant before the medical assessment appealed against),
(c) the assessment was made on the basis of incorrect criteria,
(d) the medical assessment certificate contains a demonstrable error.
(4) An appeal is to be made by application to the Registrar. The appeal is not to proceed unless the Registrar is satisfied that, on the face of the application and any submissions made to the Registrar, at least one of the grounds for appeal specified in subsection (3) has been made out.
(5) If the appeal is on a ground referred to in subsection (3) (c) or (d), the appeal must be made within 28 days after the medical assessment appealed against, unless the Registrar is satisfied that special circumstances justify an increase in the period for an appeal
(6) The Registrar may refer a medical assessment for further assessment under section 329 as an alternative to an appeal against the assessment (but only if the matter could otherwise have proceeded on appeal under this section).
Section 329 also allows the Registrar to refer a medical assessment back to the approved medical specialist for reconsideration (whether or not the medical assessment could be appealed under this section).
(7) There is to be no appeal against a medical assessment once the dispute concerned has been the subject of determination by a court or the Commission or agreement registered under section 66A of the 1987 Act...."
"329 Referral of matter for further medical assessment or reconsideration
(1) A matter referred for assessment under this Part may be referred again on one or more further occasions for assessment in accordance with this Part, but only by:
(a) the Registrar as an alternative to an appeal against the assessment as provided by section 327, or
(b) a court or the Commission.
(1A) A matter referred for assessment under this Part may be referred again on one or more further occasions by the Registrar to the approved medical specialist for reconsideration.
(2) A certificate as to a matter referred again for further assessment or reconsideration prevails over any previous certificate as to the matter to the extent of any inconsistency."
Bipolar II disorder, current episode major depressive episode,
GP | Psychologist | Psychiatrist | Psychotropic medications
Psychiatric diagnosis - Whole Person Impairment Rating
[CHC] showers daily but he brushes his teeth less frequently. He tries to complete domestic tasks, including cooking, grocery shopping and cleaning, but he often struggles to motivate himself to do so. [CHC]'s neglect to his self-care is evidenced by his appetite disturbance, weight gain and escalating alcohol use since the subject injury.
[CHC] previously enjoyed socialising with family and friends and attending outings. He does not actively engage in any social and recreational activities. [CHC] prefers to remain socially isolated at his home.
[CHC] is able to travel to familiar places on his own although he struggles with anxiety, panic, hypervigilance and avoidance of crowds when he leaves his home.
[CHC] was not in an intimate relationship at the time of the subject injury. He remains withdrawn from his friends.
[CHC] struggles with his attention and concentration. He has difficulty focusing on tasks such as reading and retaining the information he reads. [CHC] can become easily distracted when in conversation. His short-term memory has been affected.
[CHC] cannot work at all due to his pervasive mental health and cognitive difficulties.
25 October 2023 which is not in evidence. He recorded a detailed history of the circumstances of the applicant's injury, his symptoms and treatment. He noted that the applicant was diagnosed with bipolar affective disorder in 2015 by a general practitioner and a psychiatrist, Dr Al Dury. He had seen a psychologist and since 2015, he had been well managed by his general practitioner with Epilim and he had been stable. He also had a diagnosis of childhood attention-deficit/hyperactivity disorder (ADHD) and was on stimulants. 2. Dr Pothala diagnosed a post-traumatic stress disorder and a pre-existing bipolar disorder which appeared to be stable. He was not satisfied that the applicant had reached maximum medical improvement. 3. In his report dated 10 July 2025, Dr Pothala provided an updated history and noted the applicant's treatment and symptoms. He referred to the diagnosis of bipolar disorder and noted that this had been well managed by medication and was stable. He also recorded the childhood diagnosis of ADHD. 4. Dr Pothala diagnosed post-traumatic stress disorder and noted that both Dr Khan and Dr Singh accepted that diagnosis and they believed that the applicant had reached maximum medical improvement. Significantly, he noted that the applicant's symptoms had remained the same since his previous examination.
2. Bipolar affective disorder, currently major depressive
Treatment with mood stabilizer antidepressant and psychological
[CHC] lives with his grandmother who is very supportive. He stated that he struggles to look after himself and may skip showers. He may be lying in his room for most of the day. He mainly showers when he is going out. He may clean his room but not often. His grandmom had hip surgery and he is trying to help around the house and has done mopping and cleaning recently. His appetite is fine and finds it hard to cook. He has no motivation. He is trying to stay away from takeaway food as he has gained 10 kg since being off
[CHC] has seen his friend only twice. He would see his father. He drives to Shellharbour. He does some hobbies with his dad. He will visit his dad in Shellharbour every fortnight. He will go in the morning and then comes back after two to three hours mainly on weekends. He may go to a pub or a Christmas party or a birthday party with his friends but he does not go out often as he is always anxious outside and hypervigilant. He spends his time at home by watching YouTube and tv shows. He may go to the gym every few days sometimes twice a week, but not more than that. He is not going out on his own socially. He does not see his friend regularly and only speaks to them over the phone.
[CHC] does not drive much. He will go to the local gym or drive to the alcohol shops which is 10 to 15
minutes away. He has not driven far from home. He has not been on any holidays. He is not able to catch public transport as he feels anxious. He drives to his dad's place which is again a short drive and tries to avoid traffic, so he will drive in the morning and will
[CHC] stated that he has not been in a relationship for a while. He has good relationship with his parents and grandmother who are very supportive, his mother works very hard. His mother is very supportive through all this and his father also has positive words to say.
[CHC] stated that he struggles with his focus and concentration. He may fall asleep while reading a book as his eyes get tired. He is reading about AI and is doing a bit of coding as well using AI to do and he is reading about digital computing and Analog computers and finds that interesting. He has been slow to read and his attention and focus span is reduced.
[CHC] is not thinking of work. He does not feel that he can work. He definitely cannot work behind the counter in retail. He is always vigilant and worried about his safety and that makes him anxious. He is not
thought of any other jobs as well at the present time.
Misapplication of the Psychiatric Impairment Rating Scale (PIRS)
Unexplained divergence from expert evidence and opinion
Excessive s 323 deduction without a factual basis
Interests of justice and risk of irremediable prejudice
Unexplained divergence from expert evidence and opinion
s 323(1) of the 1998 Act and Marks v Secretary, Department of Communities and Justice (No 2)[13], which confirms that the section requires a deduction to be made when a proportion of the impairment is due to a previous injury, condition or abnormality, regardless of whether the pre-existing condition was symptomatic at the time of injury[14], and to the extent that Guideline 11.10 requires proof of assessable functional impairment prior to the injury, the guideline is inconsistent with s 323(1) of the 1998 Act, and to the extent of the inconsistency, s 323(1) of the 1998 Act prevails, and Guideline 11.10 is invalid.[15] 4. Mr Marhaba submits that the authorities[16] establish that the fact the pre-existing condition had been asymptomatic does not preclude it from contributing to the impairment being assessed. Further, it cannot be assumed that an asymptomatic condition contributes to the impairment. Any contribution must be determined on the evidence which includes the competing specialist's opinion, as well as various other evidence. 5. Mr Marhaba submits that the applicant's submissions do not show demonstrable error on the part of the Medical Assessor when applying a s 323 deduction. The Medical Assessor would have fallen into error if he applied the Guidelines as suggested by the applicant. There was no error in the Medical Assessor's methodology or application of the relevant criteria, and the extent of his deduction ought not to be the subject of challenge, merely because another doctor provided a different assessment. There was no demonstrable error on the face of the certificate.
Interests of justice and risk of irredeemable prejudice
4 June 2025 and a referral to a Medical Assessor pursuant to s 329 of the 1998 Act to correct obvious and material errors that would otherwise cause injustice. He submits that the difference in assessments is severe and warrants an investigation. 2. The applicant seeks to rely on fresh evidence, namely a report of Dr Pothala dated 10 July 2025 which could not reasonably have been provided earlier. 3. The applicant submits that Dr Pothala recorded new clinical findings and functional descriptions relevant to the PIRS categories as follows:
(a) Employability: certified no work capacity;
(b) Social/Recreational & Social Functioning: sustained avoidance/withdrawal and reduced social engagement;
(c) Concentration/Persistence/Pace: ongoing impaired focus, low motivation/drive impacting task completion;
(d) Travel: restricted driving and significant anxiety in public settings, and
(e) Self-care: reduced hygiene/routine (irregular showering/shaving), loss of day-to-day structure.
30 April 2025. 2. The applicant submits that he does not seek an appeal against the MAC pursuant to s 327 of the 1998 Act. Section 327(3) of the 1998 Act provides that specific grounds need to be satisfied, such as a deterioration in the injury, or additional relevant information since the MAC that was not available and could not reasonably have been obtained before the MAC, or the assessment was made on the basis of incorrect criteria, or the MAC contains a demonstrable error. 3. Section 327(7) of the 1998 Act provides that there can be no appeal against a MAC once the dispute has been determined by a court or the Commission or by a Complying Agreement. Therefore, given that the COD issued on 4June 2025 determined the dispute, an appeal at this stage is not an option. Accordingly, the MAC issued on 30 April 2025 is conclusively presumed to be correct as to the degree of the applicant's permanent impairment by reason of s 326(1) of the 1998 Act. 4. Sections 329(1)(a) of the 1998 Act provides that the Registrar may refer a matter for further assessment as an alternative to an appeal as provided by s 327 of the 1998 Act, but only if the matter could have otherwise proceeded on appeal. In this matter, no appeal was filed because the applicant's legal representatives had advised him that it was "not worth it". 5. The submissions of the respondent focus on the applicant's failure to lodge an appeal within 28 days of the MAC. Given that the applicant does not seek to set aside the MAC to lodge an appeal, these submissions carry minimal weight. 6. However, s 329(1)(b) of the 1998 Act provides that a matter can be referred again or on more further occasions by a court or the Commission. 7. Procedural Direction PIC 7 sets out the procedural requirements for reconsideration applications and directs that the reasons for reconsideration should specify the demonstrable error or the application of incorrect criteria. It also explains what matters will be considered to determine if a claim should be referred to a medical assessor for reconsideration. I will refer to these matters below. 8. Section 57 of the PIC Act gives the Commission the power to reconsider any matter and rescind, alter or amend any decision that the Commission has previously dealt with. So, the Commission has the power to reconsider the COD, which is a decision of the Commission, but not a MAC, which is the decision of a Medical Assessor, who is not a member of the Commission. In the absence of a successful appeal to a MAP, the MAC is conclusively presumed to be correct and is binding on the parties. 9. Section 57(2) of the PIC Act provides that if the President is satisfied that the decision contains an obvious error, the President, or alternatively the Registrar, can alter the decision to correct the error. 10. Section 57(6) of the PIC Act gives examples of obvious errors that include an obvious clerical or typographical error, an error arising from an accidental slip or omission, a defect of form, or an inconsistency between the stated decision and the stated reasons.
"The subsection and its predecessors have been considered in a number of cases. Having reviewed those cases the following summary of principles may be made as to its application:
"The factors relevant to the exercise of the discretion in section 36 of the 1926 Act were considered by the Court of Appeal in Schipp v Herfords Pty Ltd [1975] 1 NSWLR 413 ('Schipp'). The court noted the following factors were relevant in deciding whether the discretion should be exercised in favour of the moving party:
2. whether the worker had a right of appeal from the first decision but failed to
4. rescinding an earlier award will allow a worker to bring fresh proceedings."[22]
"Having regard to the above authorities and the provisions and objectives of the 1998 Act I believe that the following principles are applicable to reconsideration applications under section 350(3) of the 1998 Act:
1. the section gives the Commission a wide discretion to reconsider its previous
2. whilst the word 'decision' is not defined in section 350, it is defined for the
purposes of section 352 to include 'an award, order, determination, ruling and
direction'. In my view 'decision' in section 350(3) includes, but is not
necessarily limited to, any award, order or determination of the Commission;
3. whilst the discretion is a wide one it must be exercised fairly with due regard
to relevant considerations including the reason for and extent of any delay in
bringing the application for reconsideration ('Schipp');
4. one of the factors to be weighed in deciding whether to exercise the discretion
in favour of the moving party is the public interest that litigation should not
5. reconsideration may be allowed if new evidence that could not with reasonable
diligence have been obtained at the first Arbitration is later obtained and that new evidence, if it had been put before an Arbitrator in the first hearing, would have been likely to lead to a different result ('Maksoudian');
6. given the broad power of 'review' in section 352 (which was not universally
available in the Compensation Court of NSW) the reconsideration provision in section 350(3) will not usually be the preferred provision to be used to correct errors of fact, law or discretion made by Arbitrators;
7. depending on the facts of the particular case the principles enunciated by the
High Court in Port of Melbourne Authority v Anshun Pty Ltd [1981] HCA 45; (1981) 147 CLR 589 ('Anshun') may prevent a party from pursuing a claim or defence in later reconsideration proceedings if it unreasonably refrained from pursuing that claim or defence in the original proceedings ('Anshun');
8. a mistake or oversight by a legal adviser will not give rise to a ground for
9. the Commission has a duty to do justice between the parties according to the
substantial merits of the case ('Hilliger' and section 354(3) of the 1998 Act)."[23]
Unexplained divergence from expert evidence and opinion
Interests of justice and risk of irremediable prejudice
[1] Aguiar v Registrar of the Workers Compensation Commission of New South Wales [2005] NSWSC 1017, [17] (Aguiar) (per Malpass AsJ) .
[2] Hurst v Goodyear Tyre & Rubber Co Australia [1953] WCR 29, (Hurst).
[3] Kolundzic v Quickflex Constructions Pty Ltd (2014) NSW SC 1523, [51] (Kolundzic) (per Campbell J), and Campbelltown City Council v Vegan [2006] NSWCA 284; 67 NSWLR 327, [8] and [82] (Vegan).
[4] Merza v Registrar of the Workers Compensation Commission [2006] NSWSC 939 (Merza), [39] (per Hoeben J0.
[5] Jenkins v Ambulance Service of New South Wales [2015] NSWSC 633, [73], (Jenkins) (per Garling J).
[6] Ferguson v State of New South Wales [2017] NSWSC 887, [23] (Ferguson), and NSW Police Force v Daniel Wark [2012] NSWWCCMA 36, [33] (Wark) (per Campbell J)
[7] State of New South Wales (NSW Department of Education) v Kaur [2016] NSWSC 346, [55] (Kaur) (per Campbell J).
[8] Parker v Select Civil Pty Limited [2018] NSWSC 140 (Parker).
[9] Vegan [122], (per Basten JA (Hadley and McColl JJA agreeing).
[10] Bojko v ICM Property Service Pty Ltd & Ors [2009] NSWCA 175
[11] (2010) NSWSC 78, (Cole).
[12] Ryder v Sundance Bakehouse [2015] NSWSC 526 [45], (Ryder).
[13] [2021] NSWSC 616, (Marks).
[15] Marks [18] and [22] - [29].
[16] Elcheikh v Diamond Formwork (NSW) Pty Limited (in liquidation) (2013) NSW 365.
[17] Marina Pitsonis v The Registrar of the Workers Compensation Commission & Anor [2008] NSWCA 88 (Pitsonis).
[20] [2006] NSWWCCPD 141 (Samuel).
[21] [1975] 1 NSWLR 413 (Schipp).
[24] Project Blue Sky, [69] - [71] (per McHugh, Gummow, Kirby and Hayne JJ); Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (NT) [2009] HCA 41; 239 CLR 27, [47] (per Hayne, Heydon, Crennan and Kiefel JJ).
CHC
Park Pty Ltd [2025] NSWPIC 474;
(1999) 19 NSWCCR 235
(1995) 12 NSWCCR 225
(1989) 5 NSWCCR 192
(1981) 147 CLR 589
(1993) 9 NSWCCR 642
(1990) 6 NSWCCR 154