WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; psychological injury; appellant worker alleged assessment on the basis of incorrect criteria; demonstrable error in the making of assessments under the psychiatric impairment rating scale (PIRS) categories, namely travel and concentration, persistence and pace; challenged assessments under PIRS were both confirmed on appeal; appellant also appealed the making a of one-tenth deduction under section 323 for a pre-existing vulnerability to anxiety; deduction was made in error and was revoked by the Appeal Panel; Held - Medical Assessment Certificate revoked.

1. The worker Tyarne Grant (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Christopher Canaris, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 13 October 2025.
2. The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
   • the assessment was made on the basis of incorrect criteria, and
   • the MAC contains a demonstrable error.
3. The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the grounds of appeal on which the appeal is made.
4. Rule 128 of the Personal Injury Commission Rules 2021 (the PIC Rules) and Procedural Direction PIC7 - Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes set out the practice and procedure in relation to the medical appeal process under s 328 of the 1998 Act. An Appeal Panel determines its own procedures in accordance with r 128(1) of the PIC Rules.
5. The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed

1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).

1. The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
2. The appellant requested to undergo a re-examination by a Medical Assessor who is also a Member of the Appeal Panel. As a result of its preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because although the Appeal Panel found error, there was sufficient material before the Appeal Panel to enable it to make a determination.

1. The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment and has taken them into account in making this determination.

1. Medical Assessor Michael Hong of the Appeal Panel conducted an examination of the worker and reported to the Appeal Panel.

1. The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision.

1. Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.

1. The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made.
2. In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
3. The matter was referred to the Medical Assessor for assessment as follows:

"The following matters have been referred for assessment (s 319 of the 1998 Act):

• Date of injury: 8 February 2021 - deemed
• Body parts/systems referred: Psychiatric and Psychological disorders
• Method of assessment: whole person impairment."

1. The Medical Assessor issued a MAC certifying 20% whole person impairment (WPI) as a result of the injury as follows:

Chapter, page and paragraph number in NSW workers compensation guidelines

Chapter, page, paragraph, figure and table numbers in AMA5 Guides

WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)

Sub-total/s % WPI (after any deductions in column 6)

Total % WPI (the Combined Table values of all sub-totals)

1. The assessment was based on his assessment under psychiatric impairment rating scale (PIRS) as required by the Guidelines as follows:

1. Persistent depressive disorder with anxious distress

She would 'shower maybe once a week' changing her clothes 'maybe twice a week'. She would clean her teeth 'when I shower'. She does very little cleaning saying she is 'constantly exhausted'. Her appetite is 'not very good - I eat because my partner makes me eat - I eat maybe one meal a day - sometimes 2'. However, she has been gaining weight - she is not sure why.

She does not go out socially. In the last 3 months, she has been out once to her parents' house because one of my relatives was sick - he has a bad heart - he was going to have open heart surgery - they asked me to see him before he went to hospital. She has otherwise not been out of the house.

She does not drive at all and does not go out anywhere on her own. She sees her psychologist via telehealth. She does not go to the local shops - her partner shops for groceries 'or we get it delivered'.

She gets on 'okay for the most part with her partner although he isn't happy - this isn't the life we signed up for...'. The intimate side of the relationship is 'non-existent'. There has been talk of separation but no separation as such. There has been no violence.

Her concentration is poor. She said, 'I tried to do a lash course - the insurance paid for it - I couldn't remember things' and she did not manage to complete the first module which was online. She would 'try' to do some cooking and cleaning but would leave the stove or oven on and so cooks only if her partner is home. She would try to do so 'maybe twice a week... but I get really shaky - I burn myself or I cut myself'. She 'can't read - I keep reading the same things over and over - I lose my spot - I forget what I've read'. She might 'put something on the TV to distract myself - colouring in - my psychologist suggested using craft as a distraction - I talk to friends and family... on the phone'. She does not take in what she sees on TV saying, 'A lot of the time I'll be scrolling on my phone because the TV doesn't distract me enough - a lot of the time I watch stuff that it doesn't matter if I don't actually watch it'.

She has not been back to work in any capacity. Her psychologist has her 'doing a course - I can't remember what it is now - for the most part I spend it in my bedroom - it's to help alleviate anxiety... strategies to use - triggers - questionnaires - I think it's called This Way Up'. She continues on workers compensation payments.

1. The worker appealed.
2. In summary, the appellant submitted that the Medical Assessor made assessments on the basis of incorrect criteria and demonstrable errors in the assessments she made under all of the six PIRS categories causing him to make an error in the assessments in these domains as follows:

(a) in assessing Class 3 for travel when he should have assessed Class 4, and

(b) in assessing Class 3 for concentration, persistence and pace when he should have assessed Class 5.

1. In addition, the appellant submitted that the Medical Assessor in making a deduction under s 323 of the 1998 Act of one-tenth to take account of a pre-existing condition, abnormality or injury. It was submitted no deduction should have been made.
2. In summary, the employer Albury City Council (the respondent) submitted that the Medical Assessor neither erred nor made an assessment on the basis of incorrect criteria in respect of the contested domains in the PIRS assessments. In addition, the Medical Assessor was correct to make a deduction under s 323 at one-tenth. It was submitted that the MAC should be confirmed.
3. The role of the Medical Assessor is to conduct an independent assessment on the day of examination. The Medical Assessor is required to take a history, conduct a mental state examination, make a psychiatric diagnosis and have due regard to other evidence and other medical opinion that is before the Medical Assessor. The Medical Assessor must bring his clinical expertise to bear and exercise his clinical judgement when making an independent assessment of impairment under the PIRS categories. The assessment is not to be based upon self-report alone. An appeal panel cannot disturb ratings under the PIRS for mere difference of opinion but must be satisfied as to error.
4. The path of reasoning disclosed by the Medical Assessor must be adequate. This is also dependent on the extent of the history taken and a thorough examination of the worker so that self-report can be properly evaluated in the context of other evidence before the Medical Assessor.
5. The Medical Assessor recorded a history as follows:

"• Brief history of the incident/onset of symptoms and of subsequent related events, including treatment: summary of injuries and diagnoses:

The worker is a 35 years old partnered early childhood educator who had worked for Albury City Council.

She had worked for the Council for 'maybe 2 years - 3 years - I'm not too sure - my memory is really bad'. She enjoyed the work saying, 'Working with children is very rewarding'. Around October 2020, she noticed some changes with her manager, Jodie, and I started documenting in November 2020 and it got progressively worse until February 2021. Jodie:

'wouldn't talk to me ... she'd talk to me through other people... moving my stuff... we'd do school holiday programs, and I brought my own coffee - she moved it from the kitchen to a room where the kids have access to it... I said to Jodie, I feel Lisa [the head of child services] doesn't like me... she said that that's right - it's because of your weight and because you're unprofessional... that's when I really noticed a change in Jodie - she wouldn't talk to me...'.

She felt treated poorly and cut out of program planning. She spoke of Jodie yelling at her multiple times in front of other staff and the kids. She was told she could not talk to other workers outside of worktime. She was told she was not allowed to wear makeup but only sunscreen even though her makeup had sunscreen in it.

She went on to describe a range if unpleasant interactions and a final confrontation.

At the time of her departure, she found herself getting 'really panicky but nowhere as severe as it is now'.

She 'saw a psychologist that insurance company suggested and she told me it was all in my head and to push through'.

She described the emergence of 'constant panic attacks' which were 'debilitating'.

She now sees a psychologist, Sharon Draper, fortnightly.

She is not on any psychotropic medication. She tried sertraline and had an adverse reaction - she 'felt really sick - I guess I do have intolerances to medication - I'm allergic to antibiotics and strong pain relief'.

Day to day, she feels 'like I don't want to be here anymore' saying, 'This isn't living - this is existing'. She said,

'Since the surveillance I just sit in my room at the other end of the house - I get really panicky if I have to be at the front end of the house... I'm scared that they're constantly watching me - like I know that they're not but if I hear cars or loud noises, I get panic attacks - really shaky like I can't catch my breath...'.

She has not tried to harm herself saying, 'My brother passed when he was a baby, and I couldn't let my dad bury another kid'.

Her mood is 'not great - I have days when I'm okayish - I have days when getting out of bed is the biggest feat in the world'.

She admits to considerable sadness over 'everything - I miss out on so much - birthdays - celebrations - I have 4-year-old nephew - my partner's grandmother died recently and I couldn't go - I have so much guilt - I could not be there for him'.

Her sleep is 'not great' with initial and middle insomnia and 'I keep running through things in my head - my psychologist calls it ruminating...'.

• Details of any previous or subsequent accidents, injuries or condition:

I asked about past history. She 'had a touch of anxiety - if I had a job interview - nothing like this - I solo travelled - I'd meet friends in Bali - I partied - I was a buoyant person - I had a touch of anxiety, but it never stopped me doing anything'.

She had seen a counsellor once after emerging from a domestic violence relationship about 10 years ago but was told she was doing well.

I noted in this context that Dr Modem had taken a history of presentation to Albury District Hospital around this time.

She does not drink alcohol. She does not smoke. She does not use drugs. She does not gamble.

She denied any history of problems with the law. She denied any other claims history.

Her mother has been on an antidepressant for many years 'since she lost my brother'.

• Work history including previous work history if relevant:

She has 2 older sisters and 1 younger brother. Her mother looked after the family home. Her father was a diesel mechanic - he is still working. She grew up in Albury. She described a happy childhood although her father was very strict and 'he made sure we were self-sufficient and that we learnt to cook and look after ourselves...'. He did resort to corporal punishment and 'we would get the jug cord when we did something bad'. For example, she and her brother had once jumped a fence to ride their bikes in a back paddock without letting her parents know where they were. That said, she said she had 'nothing but love and respect for my dad' saying he had been raised in a similar way and 'was doing the best he could the way he knew how'.

She completed year 11 and then undertook a Certificate III in early childhood. She the en worked in childcare and worked in a long day care, and occasional childcare, and then Albury City which she started about '2 years before all this happened - I'm shocking with time'.

She has been 7 years with her partner. He is a 'CNC machinist' and works with 'mechanical robots that cut up steel and that - they make the towers and the electricity poles - he's in more of a managerial role'. They have no children.

She has not been back to work in any capacity. Her psychologist has her 'doing a course - I can't remember what it is now - for the most part I spend it in my bedroom - it's to help alleviate anxiety... strategies to use - triggers - questionnaires - I think it's called This Way Up'. She continues on workers compensation payments.

She would 'shower maybe once a week' changing her clothes 'maybe twice a week'. She would clean her teeth 'when I shower'. She does very little cleaning saying she is 'constantly exhausted'. Her appetite is 'not very good - I eat because my partner makes me eat - I eat maybe one meal a day - sometimes 2'. However, she has been gaining weight - she is not sure why.

She does not go out socially. In the last 3 months, she has been out once to her parents' house because one of my relatives was sick - he has a bad heart - he was going to have open heart surgery - they asked me to see him before he went to hospital". She has otherwise not been out of the house.

She does not drive at all and does not go out anywhere on her own. She sees her psychologist via telehealth. She does not go to the local shops - her partner shops for groceries 'or we get it delivered'.

She gets on 'okay for the most part with her partner although he isn't happy - this isn't the life we signed up for...'. The intimate side of the relationship is 'non-existent'. There has been talk of separation but no separation as such. There has been no violence.

Her concentration is poor. She said, 'I tried to do a lash course - the insurance paid for it - I couldn't remember things' and she did not manage to complete the first module which was online. She would 'try' to do some cooking and cleaning but would leave the stove or oven on and so cooks only if her partner is home. She would try to do so 'maybe twice a week... but I get really shaky - I burn myself or I cut myself'. She 'can't read - I keep reading the same things over and over - I lose my spot - I forget what I've read'. She might 'put something on the TV to distract myself - colouring in - my psychologist suggested using craft as a distraction - I talk to friends and family... on the phone'. She does not take in what she sees on TV saying, 'A lot of the time I'll be scrolling on my phone because the TV doesn't distract me enough - a lot of the time I watch stuff that it doesn't matter if I don't actually watch it'."

1. The Medical Assessor recorded his findings on mental state examination as follows:

"I interviewed the worker by Microsoft Teams. She was at her home in Albury where she lived with her partner. A good audiovisual connection was established. I saw her head and shoulders She presented as an overweight woman of appearance consistent with her stated age who from the outset of the interview was much troubled by tic like movements in her body akin to hiccupping. She said she was particularly prone to these with anxious and much of the time hyperventilated. She was very apologetic for this. She was frequently teary. She imparted the history documented above and below. Her narrative was coherent and consistent. I found no evidence of psychosis or cognitive impairment."

1. The Medical Assessor summarised the injury and her diagnosis as follows:

Her presentation is consistent with a diagnosis of major depressive disorder with anxious distress. She has in the past been diagnosed and panic disorder and agoraphobia current presentation is dominated by depression, and the anxious distress specifier captures panic/agoraphobic symptoms.

I asked about the surveillance of 2021. I pointed out to her that she looked relaxed and comfortable - she has seen photos. She said, 'I can tell you I wasn't relaxed - my psychologist then told me it was in my head, and my partner forced me to go out. the November 2024 surveillance was distressing. She had gone to her parents' home - it was her birthday and they wanted her to come for dinner. She was aware of the surveillance, and she felt 'so violated to have people filming me when I'm struggling... the reason I was out in November 2021 was because my psychologist told me to sit and try to have a coffee...'. All this had intensified her anxiety.

She added, 'There was a time there before the surveillance that I was able to make a bit of progress... all of this made me really regress to the point that I feel like I'm in prison in my own bedroom'.

Given that the surveillance had taken place over 4 years ago and that it had been a source of considerable distress to the worker at the time in question, its relevance to the assessment of whole person impairment was questionable."

1. The Medical Assessor reached an assessment of 22% WPI based on the assessments under PIRS as set out in the table above. Two of the domains are contested namely the assessments for travel and concentration, persistence and pace.
2. He then deducted one-tenth under s 323 leaving 20% WPI as the final assessment. The deduction is also the subject of complaint on appeal.
3. The Medical Assessor provided the following reasons for the one-tenth deduction:

"Is any proportion of loss of efficient use or impairment or whole person impairment, due to a previous injury, pre-existing condition or abnormality?

I noted a prior history of anxiety although this had been reportedly nowhere as severe as her current difficulties. I also noted references in the documentation to a brief contact with a counsellor and a presentation to Albury District Hospital many years prior. This would have contributed to some vulnerability in the face of workplace adversity."

"DEDUCTION (IF ANY) FOR THE PROPORTION OF THE IMPAIRMENT THAT IS DUE TO PREVIOUS INJURY OR PRE-EXISTING CONDITION OR ABNORMALITY

1. In my opinion the worker suffers from the following relevant previous injuries, pre-existing conditions or abnormalities:

1. The previous injury, pre-existing condition or abnormality directly contributes to the following matters that were taken into account when assessing the whole person impairment that results from the injury, being the matters taken into account in 10a, and in the following ways:

(i) It contributed to her vulnerability in the face of workplace events.

1. The extent of the deduction is difficult or costly to determine so in applying the provisions of s.323(2) I assess the deductible proportion as one tenth. (can only be used when not at odds with available evidence)"

1. The Medical Assessor made brief comment on the other material before him as follows:

"My brief comments regarding the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs.

I noted a series of email exchanges closely contemporaneous to her departure from work.

I noted the worker's statement dated 19 May 2021 outlining her workplace difficulties.

I noted a series of statements and sundry other documents from her employer.

I noted the worker's statement dated 25 July 2024 which addresses her workplace difficulties, her psychological treatment, and states that she is not on any medication. It otherwise addresses impairment.

I noted her supplementary statement dated 13 June 2025 in which she response to an IME report recommending she undergo cognitive behaviour therapy and further medication. She notes that her treatment with her current psychologist included cognitive behaviour therapy, trauma informed therapy, emotional regulating practices, and relaxation practices. She stated that she did not want to undertake the treatment recommended by the IME.

I noted the Patient Health Summary of Gardens Medical Group as printed on 23 August 2024. The first mention of work-related problems is an 8 February 2021. There are multiple subsequent entries related to psychological symptoms with sundry certificates of capacity, care plans, referrals to psychiatry, allied health recovery request for psychology, handwritten consultation notes, and correspondence from her psychologist, Sharon Draper.

I noted the claimant's bank records. I noted the worker's supplementary statement dated 27 August 2025 relating to her bank records which indicate purchases and transactions made by other people as her credit card was used by herself, her partner, and her sister. She was unable to differentiate between purchase made by herself and purchases made by others.

I noted the report of Dr Alice Neale, IME psychiatrist, dated 21 April 2021. She was noted to be seeing a psychologist with a proposed treatment plan including EMDR. She diagnosed panic disorder with agoraphobia. She was of the opinion that the worker had a long-standing undiagnosed history of anxiety (which did not amount to diagnosable psychiatric condition) which had been aggravated by workplace events. She considered her incapacitated for work and recommended engagement in cognitive behaviour therapy with exposure therapy. In a subsequent report dated 19 October 2021, she noted that she had been getting EMDR and that she had been on an antidepressant while reiterating the diagnosis of panic disorder and agoraphobia. She considered her incapacitated for work.

I noted a factual investigation report dated 7 June 2020.

I noted the surveillance report dated 4 November 2021 which showed the worker at various times variously smiling, laughing, and interacting with other people in front of her home. There was later surveillance reported on 16 December 2021 in which she was observed attending shops looking relaxed and interacting with other customers. There was further surveillance as per the report of 28 April 2024, but the report notes that she had become aware of the surveillance.

I noted a surveillance report by ProCare dated 29 November 2024. Again, the worker was aware of surveillance. A further is attempted surveillance as per the report of 30 December 2024 resulted in police being called.

I noted an Independent Psychological Assessment Report dated 30 March 2022 by Lynn Burgess offering a diagnosis of panic disorder with agoraphobia.

I noted correspondence from Charlee Webb, exercise physiologist, dated 5 January 2024 which notes earlier DASS scores in the moderate, extremely severe, and severe range for depression, anxiety, and stress respectively.

I noted general practice consultation notes, sundry certificates of capacity, allied health recovery requests, sundry correspondence, and handwritten notes from her psychologist.

I noted the report of Dr Elsa Yeung, IME psychiatrist, dated 29 July 2024 who diagnosed major depressive disorder with anxious distress together with panic disorder with agoraphobia caused by her workplace difficulties. She noted that she had been seeing a psychologist and undergoing CBT, trauma therapy, and anxiety courses. She had also had a trial of sertraline which she had not tolerated and was not keen on further medication. Dr Yeung suggested that neurostimulation treatments such as rTMS might assist but did not think it would make a great deal of difference to her mental state that it might improve the functional capacity. She considered her to be unfit to work with the poor prognosis. She assessed her at 47% whole person impairment rating her as Class 2 for social functioning, Class 3 for self-care and personal hygiene and concentration, persistence, and pace, Class 4 for social and recreational activities and travel, and Class 5 for employability. She made no deduction for pre-existing impairment or adjustment for treatment effects.

I noted the report of Dr Karthik Modem, IME psychiatrist, dated 13 February 2025. Dr Modem summarised a range of witness statements indicating workplace tensions, concerns about professional behaviour, and a deteriorating relationship with her employer. He made a diagnosis of major depressive disorder with anxious distress as well as panic disorder with agoraphobia which had evolved from an initial presentation with adjustment disorder with mixed anxiety and depressed mood in the setting of interpersonal conflicts at work. He considered her condition was predominantly attributable to her workplace difficulties and made a number of recommendations for treatment including cognitive behaviour therapy, exposure therapy, antidepressant and other psychotropic medications, and neurostimulatory treatment such as rTMS. He considered her unfit for work but did not think she had reached maximum medical improvement as her symptoms tended to fluctuate with her recent deterioration following an alleged incident with a private investigator. He noted that she had declined medication and that she had not followed up alternative suggested treatments such as rTMS."

1. The appellant complained about the assessments in two of the PIRS categories. The Appeal Panel will deal with each in turn.
2. In respect of Travel, Table 11.3 of the Guidelines provides as follows:

Table 11.3: Psychiatric impairment rating scale - travel

No deficit, or minor deficit attributable to the normal variation in the general population: Can travel to new environments without supervision.

Mild impairment: can travel without support person, but only in a familiar area such as local shops, visiting a neighbour.

Moderate impairment: cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment.

Severe impairment: finds it extremely uncomfortable to leave own residence even with trusted person.

Totally impaired: may require two or more persons to supervise when travelling.

1. The Medical Assessor rated Class 3 moderate impairment with the following reasoning:

"She does not drive at all and does not go out anywhere on her own. She sees her psychologist via telehealth. She does not go to the local shops - her partner shops for groceries "or we get it delivered".

1. The appellant submits that a Class 3 rating was given in error and a Class 4 should have been assessed.
2. The Appeal Panel notes that the descriptors for Classes 3 and 4 in the travel category are very similar. Class 3 requires that the appellant not be able to travel away from residence without her support person and Class 4 says that even with a support person leaving the appellant's own residence is extremely uncomfortable The assessment between the two categories relies on the clinical expertise of the assessor balancing self report, taking into account the other evidence and applying clinical expertise in making the assessment on the day of examination. This is what the Medical Assessor has done here and the Appeal Panel can discern no error in the assessment of Class 3 for travel.
3. In respect of concentration, persistence and pace, Table 11.5 of the Guidelines provides as follows:

No deficit, or minor deficit attributable to the normal variation in the general population. Able to pass a TAFE or university course within normal time frame.

Mild impairment: can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache.

Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (e.g. operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.

Severe impairment: can only read a few lines before losing concentration. Difficulties following simple instructions. Concentration deficits obvious even during brief conversation. Unable to live alone, or needs regular assistance from relatives or community services.

Totally impaired: needs constant supervision and assistance within institutional setting.

1. The Medical Assessor assessed Class 3 with the following reasoning:

"Her concentration is poor. She said, 'I tried to do a lash course - the insurance paid for it - I couldn't remember things' and she did not manage to complete the first module which was online. She would 'try' to do some cooking and cleaning but would leave the stove or oven on and so cooks only if her partner is home. She would try to do so 'maybe twice a week... but I get really shaky - I burn myself or I cut myself'. She 'can't read - I keep reading the same things over and over - I lose my spot - I forget what I've read'. She might 'put something on the TV to distract myself - colouring in - my psychologist suggested using craft as a distraction - I talk to friends and family... on the phone'. She does not take in what she sees on TV saying, 'A lot of the time I'll be scrolling on my phone because the TV doesn't distract me enough - a lot of the time I watch stuff that it doesn't matter if I don't actually watch it".

1. The appellant seeks a Class 5 rating which would require that the appellant be institutionalised. This is not the case here.
2. The Appeal Panel notes that the Medical Assessor must make his own independent assessment using his clinical expertise on the day of examination. The Appeal Panel notes the findings on mental state examination were of no cognitive impairment and the appellant's narrative was coherent and consistent. A Class 4 rating would require the Medical Assessor to have found concentration deficits even in brief conversation. This was not the finding on the day of examination.
3. The Appeal Panel agrees that based on the Medical Assessor's findings, the best fit is a moderate impairment or Class 3 for concentration, persistence and pace, noting that she does not have the capacity to focus on intellectually demanding tasks for 30 minutes. and the Medical Assessor has assessed Class 3 correctly in accordance with criteria in the Guidelines. The Appeal Panel can discern no error.
4. What this means is that the overall assessment of 22% WPI has been confirmed on appeal.
5. Turning now to the complaint on appeal about the making of a one-tenth deduction. The respondent says this should be confirmed as it was not made in error.
6. A deduction can only be made under s 323 if the pre-existing injury, condition or abnormality has contributed to the level of permanent impairment assessed. Here the Medical Assessor has made a deduction based on a finding that the appellant had a pre-existing vulnerability to depression. On the available evidence, there was no formally diagnosed condition prior to injury that impaired the appellant and it is in error to confuse vulnerability to a condition or injury with impairment.
7. The appellant's self report which was consistent with the other evidence, of past symptoms of anxiety were as follows:

"I asked about past history. She 'had a touch of anxiety - if I had a job interview - nothing like this - I solo travelled - I'd meet friends in Bali - I partied - I was a buoyant person - I had a touch of anxiety, but it never stopped me doing anything'.

She had seen a counsellor once after emerging from a domestic violence relationship about 10 years ago but was told she was doing well.

I noted in this context that Dr Modem had taken a history of presentation to Albury District Hospital around this time."

1. Symptoms of anxiety suffered from time to time in the past or situationally (she was in a domestically violent relationship) do not amount to a pre-existing condition, abnormality or injury that warrants a deduction, on the available evidence in this case, under s 323. The Medical Assessor was required to assess impairment resulting from injury in accordance with the PIRS table and assess whether any pre-existing condition, abnormality or injury contributed to the overall level of permanent impairment assessed and make a deduction accordingly. He was in error in making a deduction because of a vulnerability to suffer anxiety.
2. For these reasons, the Appeal Panel has determined that the MAC issued on

13 October 2025 be revoked. A new Medical Assessment Certificate is attached to this statement of reasons.

This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act 1998.

The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Christopher Canaris and issues this new Medical Assessment Certificate as to the matters set out in the table below:

The above assessment is made in accordance with the Guidelines for the Evaluation of Permanent Impairment for injuries received after 1 January 2002.

page and paragraph number in NSW workers compensation guidelines

Chapter, page, paragraph, figure and table numbers in AMA 5 Guides

WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)

Sub-total/s % WPI (after any deductions in column 6)

Total % WPI (the Combined Table values of all sub-totals)