1. On 25 September 2025 the worker Trang Ha (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by

Dr Surabhi Verma, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 28 August 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. It is noted that the appellant also ticked the box on the Application to Appeal that she also relied on additional relevant evidence however no additional material was attached and no submissions were made in regard thereto. The Appeal Panel is satisfied that it is only the above two grounds of appeal upon which the appellant relies. 4. 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. 5. 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. 6. 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 that she 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 the Appeal Panel did not find error. Absent a finding of error, the Appeal Panel has no power to require the worker to undergo a re-examination: see New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales [2013] NSWSC 1792.

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: 9 November 2022
• Body parts/systems referred: Psychiatric/Psychological disorder
• Method of assessment: whole person impairment."

1. The Medical Assessor issued a MAC certifying 8% whole person impairment (WPI) as a result of the injury as follows:

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 her assessment under psychiatric impairment rating scale (PIRS) as required by the Guidelines as follows:

1. Major Depressive Disorder with anxious distress

She showers' once every day to once every two days. She is able to do household chores, but procrastinates and does not do it as often. She does not feel motivated to do household chores on time. She cooks simple food like instant noodles and mostly relies on Uber Eats and take away from her parents. She has gained about 5 kg in the last two to three years.

She previously enjoyed long distance running, boxing and used to go out socialising, checking new bars, going to the restaurants and travelling. She still is able to meet up with her friend at least once a month and they usually meet up at a restaurant. She has been able to attend her friends' birthday parties. She continues to participate in marathons and ran the city to serve 14 km run about two weeks back. She however has not been doing this long distance running as frequently as before. She feels embarrassed to talk about her situation to most of her friends, but there are still few friends who have been really supportive and check up on her regularly.

She leaves her home to meet up with her friends, to see her doctors, Psychologists and to the gym. She is also able to drive to her parents who live in Western Sydney which is about a 30-minute drive and visits them every two to three weeks. She went to Gold Coast in July 2025 and flew there for a marathon and stayed there for three days and denied having any specific difficulties.

She has positive relationship with her parents and they have been quite supportive and she in fact feels closer to them now. She has lost few friendships because of her ongoing mental health issues.

Ms Ha report that her attention and concentration and it took her at least six to seven months to compile her CV and is now applying for job. She said that she watches TV, but is unable to focus and if she plays mobile games then she is only able to do that for up to 15 minutes and then gets distracted. She said that she is unable to read books, newspaper articles and magazines like before.

Ms Ha reported that she has started applying and sent her CV for one position, but her application was unsuccessful. She plans to return to work and get some help from the rehab consultant and is looking back at getting in the office environment.

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 her to make an error in the assessments in these domains as follows:

(a) in assessing Class 2 for self-care and personal hygiene when she should have assessed Class 3;

(b) in assessing Class 2 for social and recreational activities when she should have assessed Class 3;

(c) in assessing Class 1 for travel when she should have assessed Class 2;

(d) in assessing Class 2 for social function when she should have assessed Class 3;

(e) in assessing Class 3 for concentration, persistence and pace when she should have assessed Class 4, and

(f) in assessing Class 4 for employability when she should have assessed Class 5.

1. In summary it was submitted that these errors arose because the Medical Assessor did not provide an adequate path of reasoning for her findings in the contested domains and it could not be discerned on a fair reading of the MAC whether the assessments had been made on the basis of correct criteria. The appellant submitted that the Medical Assessor made errors which included the following:

(a) placed undue reliance on isolated activities (such as participation in the City to Surf) rather than the overall reduction in the appellant's capacity;

(b) failed to reconcile inconsistencies between the appellant's reported incapacity and the assigned PIRS ratings;

(c) failed to consider the opinions of the Dr Nagesh and Dr Sherman, the other IME opinions before her, and

(d) failed to provide an adequate path of reasoning.

1. In summary, the employer Descartes Underwriting Australia Pty Ltd (the respondent) submitted that the Medical Assessor neither erred nor made an assessment on the basis of incorrect criteria and the MAC should be confirmed. It was submitted that the MAC was adequately reasoned when read as a whole and the findings were open to the Medical Assessor applying her clinical expertise to the assessment.
2. 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 her clinical expertise to bear and exercise her 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.
3. 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.
4. The Medical Assessor recorded a history as follows:
   • Brief history of the incident/onset of symptoms and of subsequent related events, including treatment:

Ms Ha is a 48-year-old single female who lives in Darlinghurst, Sydney on her own. She has no children or dependents.

Ms Ha started working with Descartes Underwriting Australia Pty Ltd in February 2022 as a business development director and worked full-time. Her last day at work was towards the end of November 2023. She has not worked since then. She denied having any secondary employment, owning any businesses, or engaging in voluntary work. Ms Ha reported that when she started working, the environment was quite casual and the manager was "immature and unprofessional." She said that her manager gradually began having arguments with other staff members and would engage in bullying behaviour, especially when they were out for drinks with clients, and he would make inappropriate comments about her, forcing her to drink despite her not wanting to, and verbally abusing her. She reported that he would say things like "I am your manager when I take you to drink, you drink."

She said that when they travelled to Perth for a business meeting, she chose to go to bed after the meeting, but he would call her late at night and message her at 6 am, even on business trips. She mentioned that on that day, they went to the airport separately, and on the flight back home, he was standing at her seat and said, "I will come and find you." Ms Ha felt quite uncomfortable but brushed it off. She said that this was a three- to four-day trip, and he had been drinking excessively, and she actually had to stop him from saying "stupid things in front of the brokers." She reflected that in another meeting in Singapore in October 2022, he was asked to leave the event because of his excessive drinking, and he also "excluded and mistreated her."

She recalls that on one occasion, the manager, under the influence of alcohol, had to be chased down the street, and the police had to be called to intervene. She added that when they returned from the business meeting, he then tried to deflect and refused to discuss his behaviour in Perth, instead starting to talk badly about other people. She said that gradually, her mental health began to be impacted by his bullying behaviour. She then made a complaint to HR, but she was inappropriately terminated by her employer on the pretext of "underperforming." She said that she started experiencing mental health symptoms from February 2023. She remembers feeling emotionally stressed, unable to focus and concentrate, and plagued by intrusive, ruminating thoughts about her manager's condescending comments.

She often felt emotional, teary, and sad, struggling to focus even on her work. She experienced mental anguish, lack of energy, and motivation. She recalls feeling anxious about being in a meeting room with her boss, sometimes breaking into tears, especially if he was present. She would try to put on a brave face, experiencing adrenaline rushes followed by mental exhaustion. There were days when she just withdrew and did not do anything at all. After she stopped working and was terminated, she began drinking more alcohol, at least "a bottle of wine or more every day." She later saw her GP, who recommended medication, but she was initially reluctant to take it. She eventually reached out to her GP again, and in January 2025, she was started on Lexapro. She recalls feeling emotionally numb and irritable when the dosage was increased, and she later switched to a different medication.

Forensic history: Ms Ha denied having any prior criminal convictions.

Family history: Ms Ha denied having any history of mental illnesses in the family.

Personal history: Ms Ha was born in Vietnam and denied any developmental delays. She immigrated to Australia with her family at the age of three. She grew up with her two sisters and her brother, and she is the third in the sibship. Her father worked in a factory, and later, they had their own sewing company and contracted with other businesses. She completed Year 12. She then did a few TAFE courses and worked in hospitality and retail for about 10 to 12 years. Afterwards, she worked in the insurance sector for about 15 years. She obtained a certificate as an insurance broker and a Certificate IV in Insurance. She has been in and out of a few relationships but has never been married and does not have any children.

Current Treatment: She is presently seeing Deborah Haines, a psychologist, who consults with her fortnightly. She is working on EMDR and processing traumatic events and bullying behaviour she experienced. She has consulted her psychiatrist, David Sturrock. She is currently taking Lexapro, which she has been on for the past six months, and has recently been prescribed Agomelatine 25 mg for insomnia.

Ms Ha reported that the medications have "helped her a little bit." She is now slightly more motivated to go to the gym and can at least attend once a week instead of not going at all. She can now get out of bed easily and engages more in doing her household chores. However, she continues to feel low and paranoid that people will talk about her and that she is not good enough. Her sleep is "broken and she struggles to sleep." She takes naps throughout the day, feels fatigued by the evening, and has to calm herself down.

She said her life has changed from earlier when she could attend five to six back-to-back meetings, but now she finds it difficult to focus for more than 15 to 20 minutes. Her appetite fluctuates, and she sometimes skips meals. She mentioned she sometimes skips meals but has been working on changing her lifestyle and doesn't binge eat as much as she used to. She has also seen a dietitian for her pre-diabetic condition. She feels anxious around people and crowds and feels the need to leave crowded places quickly. She stopped drinking completely in Jan 2025. She said she wanted to do something about her health and decided not to drink anymore. She denied using any illicit drugs. She continues to experience feelings of anxiety, restlessness, and "feeling" insecure."

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

Ms Ha reports that she was a victim of sexual abuse when she was younger. However, she has no memories or recollections of the event. When she was around 17 or 18 years old, her uncle inappropriately approached her and claimed that she had been okay with him when she was a child. She mentioned that she might have blocked out the memories but did not remember the incident itself. She did feel angry about what her uncle might have done but denied that it impacted her mental health.

• General health: She has been diagnosed with hypercholesterolemia, but is not on any

• Work history including previous work history if relevant: Ms Ha denied having any previous

Self-care and personal hygiene: She showers once every day or two days. She can do household chores but tends to procrastinate and does them less often. She lacks motivation to do chores promptly. She usually cooks simple meals like instant noodles and mostly relies on Uber Eats and takeaway from her parents. She has gained about 5 kg over the past two to three years.

Social and recreational activities: She previously enjoyed long-distance running, boxing, and socialising, such as checking out new bars, going to restaurants, and travelling. She still manages to meet her friend at least once a month, usually at a restaurant. She has attended her friends' birthday parties. She continues to participate in marathons and ran a 14 km city-to-surf run about two weeks ago. However, she has not been doing long-distance running as often as before. She feels embarrassed to discuss her situation with most friends, but a few supportive friends regularly check up on her.

Travel: She leaves her home to meet friends, see her doctors and psychologists, and go to the gym. She can drive about 30 minutes to her parents' place in Western Sydney and visits them every two to three weeks. In July 2025, she went to the Gold Coast for a marathon, stayed there for three days, and reports no specific difficulties.

Social functioning: She has a positive relationship with her parents, who have been very supportive, and she feels closer to them now. She has lost a few friendships due to her ongoing mental health issues.

Concentration, persistence, and pace: Ms. Ha reports that it took her at least six to seven months to compile her CV, and she is now applying for jobs. She says she watches TV but cannot focus easily, and can only play mobile games for up to 15 minutes before getting distracted. She finds it difficult to read books, newspaper articles, and magazines like before.

Employability: Ms. Ha has started applying for jobs and sent her CV for one position, but her application was unsuccessful. She plans to return to work with help from a rehab consultant and is considering working in an office environment."

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

"I reviewed Ms Ha via video, who appeared as a middle-aged female of Vietnamese background. She was dressed casually, was wearing a beanie and was be spectacle. She was teary-eyed at the beginning of the interview, but was able to be comforted. There was no evidence of any psychomotor agitation or retardation, and no abnormal motor movement like tics or mannerisms was noted. She gave a clear account of her symptoms and difficulties. She reported her mood to be low, and her affect ranged from being teary to reactive.

Her speech was spontaneous and normal in volume and tone. Her thoughts were logical and goal-directed. She currently reported ongoing low mood, lack of interest in activities, sleep disturbances, fluctuating appetite, low energy levels and lack of motivation. There was no evidence of any manic, psychotic or any perceptual abnormalities. She had insight into her condition and continues to engage with her treatment providers, and her judgment was intact. She denied having any thoughts of harming others, suicidal ideas, plans or intent."

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

Ms Ha is a 48-year-old single woman who previously worked as a business development director at Descartes Underwriting Australia. She reported being bullied, harassed, verbally abused, belittled, and undermined by her supervisor, and these incidents affected her mental health. At the time of assessment, she displayed symptoms including persistent anhedonia, loss of interest in activities, fluctuating appetite, low energy and motivation, difficulty concentrating, and feelings of worthlessness and hopelessness. Her presentation aligns with a diagnosis of Major Depressive Disorder with anxious distress. She has received treatment, including sessions with a psychologist and input from a psychiatrist. She has trialled antidepressants, which were stopped earlier due to side effects.

She is currently on Lexapro 30 mg and Valdoxan 25 mg. I believe that she has received evidence-based treatment for her mental health symptoms and has reached maximal medical improvement.

Ms Ha presentation was consistent with the history given during the clinical interview, documentation received and mental status examination. There was no feigning, malingering or exaggeration noted."

1. The Medical Assessor reached an assessment of 7% WPI based on the assessments under PIRS as set out in the table above. She then added 1% WPI for the effects of treatment about which there is no complaint on appeal.
2. The Medical Assessor set out that she had taken the following into account in making her assessment:

"In making that assessment I have taken account of the following matters:-

1. The Medical Assessor made brief comment on the other material before her 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

• IME by Dr Abhishek Nagesh, dated 1 October 2024. I have noted that Dr Nagesh concluded with the diagnosis of Major Depressive Disorder. I agree with the diagnosis, I have also noted that he calculated the WPI as 19%. I have however respectfully disagreed with the calculation in the areas of social and recreational activities, travel, and employability.
• Clinical notes from East Sydney doctors.
• East Sydney doctors, I have noted record visit dated 1 June 2023 by Dr Mark O'Reilly mentioning reason for visit as PTSD and mentioning that "found out earlier that a male colleague earning higher income and discussed same with the manager who was intoxicated at that time and then she received a pay rise.
• Visit dated 21 May 2024, mentioned lost job after conflict with boss, feels unfair dismissal, though did not qualify for fair work Australia involvement with the diagnosis of Adjustment Disorder with anxiety.
• Letter by Dr Richard Parkinson, dated 20 February 2023 mentioning that Ms Tran has motor and sensory left 6-7 radiculopathy due to disc herniation and surgery should be considered at 8 weeks post onset of symptoms.
• Referral by Dr Mark O'Reilly to Deborah Haines, dated 5 June 2023.
• IME by Dr Ian Sherman dated 17 February 2025. Dr Sherman concluded that that her presentation is consistent with Social Anxiety Disorder and Adjustment Disorder with depressed mood chronic. He further opined that the prognosis is reasonably optimistic as she is attending her Psychologist fortnightly and feels that she has turned the corner, although at times she felt that nothing has changed. Dr Sherman did not calculate the WPI as he did not believe that she has reached maximum medical improvement.
• Report by Actevate Pty Ltd, dated 31 October 2024, mentions that she could work 4 days per week and 4 hours per day and 4 days per week."

1. The appellant complained about the assessments in each of the PIRS categories. The Appeal Panel will deal with each in turn.
2. In respect of self-care and personal hygiene Table 11.1 of the Guidelines provides as follows:

Table 11.1: Psychiatric impairment rating scale - self care and personal hygiene

No deficit, or minor deficit attributable to the normal variation in the general population

Mild impairment: able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food.

Moderate impairment: Can't live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit) two to three times per week to ensure minimum level of hygiene and nutrition.

Severe impairment: Needs supervised residential care. If unsupervised, may accidentally or purposefully hurt self.

Totally impaired: Needs assistance with basic functions, such as feeding and toileting.

1. The Medical Assessor assessed Class 2 or mild impairment with the following reasoning:

She showers' once every day to once every two days. She is able to do household chores, but procrastinates and does not do it as often. She does not feel motivated to do household chores on time. She cooks simple food like instant noodles and mostly relies on Uber Eats and take away from her parents. She has gained about 5 kg in the last two to three years.

1. The appellant is able to live independently and is able to do household chores albeit with procrastination. She does cook simple meals such as noodles but also has takeaway meals. All of this is entirely consistent with criteria for the rating of a Class 2 or mild impairment as rated by the Medical Assessor who assessed Class 2. There is no error.
2. In respect of social and recreational activities, Table 11.2 of the Guides provides as follows:

Table 11.2: Psychiatric impairment rating scale - social and recreational activities

No deficit, or minor deficit attributable to the normal variation in the general population: regularly participates in social activities that are age, sex and culturally appropriate. May belong to clubs or associations and is actively involved with these.

Mild impairment: occasionally goes out to such events e.g. without needing a support person, but does not become actively involved (e.g. dancing, cheering favourite team).

Moderate impairment: rarely goes out to such events, and mostly when prompted by family or close friend. Will not go out without a support person. Not actively involved, remains quiet and withdrawn.

Severe impairment: never leaves place of residence. Tolerates the company of family member or close friend, but will go to a different room or garden when others come to visit family or flat mate.

Totally impaired: Cannot tolerate living with anybody, extremely uncomfortable when visited by close family member.

1. The Medical Assessor rated a mild impairment or Class 2 with the following reasoning:

"She previously enjoyed long distance running, boxing and used to go out socialising, checking new bars, going to the restaurants and travelling. She still is able to meet up with her friend at least once a month and they usually meet up at a restaurant. She has been able to attend her friends' birthday parties. She continues to participate in marathons and ran the city to surf 14 km run about two weeks back. She however has not been doing this long distance running as frequently as before. She feels embarrassed to talk about her situation to most of her friends, but there are still few friends who have been really supportive and check up on her regularly."

1. The appellant submitted that the rating of Class 2 was in error and submitted a Class 3 rating should have been given. The appellant submitted that there was an undue reliance placed by the Medical Assessor on an isolated activity such as the City to Surf rather than an overall reduction in the appellant's capacity.
2. The Appeal Panel considers there has been no error in the assessment. The appellant undertakes regular social and recreational activities, albeit less than pre-injury. She engages in long distance running (although not as frequently as before) and was able to participate in the City to Surf (2 weeks prior to the medical assessment) as well as other marathons. She regularly goes to a restaurant with a friend (once a month), and goes to friend's birthday parties. There is no identification of the need for a support person to participate in these activities. All of this is entirely consistent with the rating of Class 2 and there is no error.
3. 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 1 (no or minor deficit) with the following reasoning:

"She leaves her home to meet up with her friends, to see her doctors, Psychologists and to the gym. She is also able to drive to her parents who live in Western Sydney which is about a 30-minute drive and visits them every two to three weeks. She went to Gold Coast in July 2025 and flew there for a marathon and stayed there for three days and denied having any specific difficulties."

1. The appellant submits that a Class 1 rating was given in error and a Class 2 should have been assessed.
2. The MAC must be read as a whole. The Medical Assessor must make an independent assessment based on her clinical findings on the day of assessment. She must have due regard to the other evidence before him and not rely on the appellant's self-report alone. The Medical Assessor was clearly cognisant of the other medical opinion before her and noted that Dr Nagesh, the IME qualified to provide an opinion on behalf of the appellant, had assessed a different rating for travel with which the Medical Assessor disagreed. The Medical Assessor is required to exercise her clinical judgment on the day of assessment and form her own independent view. To assess a mild impairment the Medical Assessor would have had to find that the appellant could only travel to familiar environments by herself or would need a support person for moderate impairment. This is not consistent with the self report of the appellant to the Medical Assessor and the Medical Assessor notes that the appellant was able to travel to the Gold Coast for a marathon. The Appeal Panel can discern no error in the rating of a no deficit or minor impairment or Class 1 for travel for which rating the Medical Assessor has given adequate reasons that accord with the correct criteria in the Guidelines.
3. In respect of Social Functioning, Table 11.4 of the Guidelines provides as follows:

Table 11.4: Psychiatric impairment rating scale - social functioning

No deficit, or minor deficit attributable to the normal variation in the general population: No difficulty in forming and sustaining relationships (eg a partner, close friendships lasting years).

Mild impairment: existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.

Moderate impairment: previously established relationships severely strained, evidenced by periods of separation or domestic violence. Spouse, relatives or community services looking after children.

Severe impairment: unable to form or sustain long term relationships. Pre-existing relationships ended (eg lost partner, close friends). Unable to care for dependants (eg own children, elderly parent).

Totally impaired: unable to function within society. Living away from populated areas, actively avoiding social contact.

1. The Medical Assessor assessed Class 2 with the following reasoning:

"She has positive relationship with her parents and they have been quite supportive and she in fact feels closer to them now. She has lost few friendships because of her ongoing mental health issues."

1. The appellant submitted that the Medical Assessor should have assessed a moderate impairment at Class 3.
2. Social functioning is concerned with the quality of relationships. The appellant continues to enjoy a strong relationship with her parents and in fact feels closer to them now. Whilst she has lost some friendships, others continue to endure. The loss of some friendships is consistent with the criteria for Class 2. The Appeal Panel can discern no error in the Class 2 rating.
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:

"Ms Ha report that her attention and concentration and it took her at least six to seven months to compile her CV and is now applying for job. She said that she watches TV, but is unable to focus and if she plays mobile games then she is only able to do that for up to 15 minutes and then gets distracted. She said that she is unable to read books, newspaper articles and magazines like before."

1. The Appeal Panel agrees that based on these 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. The appellant seeks a rating of Class 4 or severe impairment. The criteria for Class 3 and Class 4 in this domain are very similar but they are distinguished because Class 4 requires an inability to live alone or regular assistance from relatives or community services. This is not the case here and the Medical Assessor has assessed Class 3 correctly in accordance with criteria in the Guidelines. The Appeal Panel can discern no error.
2. In respect of Employability, Table 11.6 of the Guides provides as follows:

No deficit, or minor deficit attributable to the normal variation in the general population. Able to work full time. Duties and performance are consistent with the injured worker's education and training.

The person is able to cope with the normal demands of the job.

Mild impairment. Able to work full time but in a different environment from that of the pre-injury job. The duties require comparable skill and intellect as those of the pre-injury job. Can work in the same position, but no more than 20 hours per week (eg no longer happy to work with specific persons, or work in a specific location due to travel required).

Moderate impairment: cannot work at all in same position. Can perform less than 20 hours per week in a different position, which requires less skill or is qualitatively different (eg less stressful).

Severe impairment: cannot work more than one or two days at a time, less than 20 hours per fortnight. Pace is reduced, attendance is erratic.

1. The Medical Assessor assessed a severe impairment at Class 4 with the following reasoning:

"Ms Ha reported that she has started applying and sent her CV for one position, but her application was unsuccessful. She plans to return to work and get some help from the rehab consultant and is looking back at getting in the office environment."

1. The appellant submitted that a total impairment should have been assessed at Class 5. The Medical Assessor was clearly cognisant of the differing opinion of Dr Nagesh in respect of employability. However the Medical Assessor was required to make her own independent assessment. A Class 5 rating would require a finding that the appellant cannot work at all which is inconsistent with her own attempts to return to employment. The Appeal Panel can discern no error in the rating of Class 4.
2. For these reasons, the Appeal Panel has determined that the MAC issued on