WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; psychological Injury impairment assessment; appellant worker alleged assessment on the basis of incorrect criteria; demonstrable error in the making of assessments under two of the psychiatric impairment rating scale categories for travel, and concentration, persistence and pace; Held - Appeal Panel found no error; Medical Assessment Certificate confirmed.

1. On 15 September 2025, the worker, Gregory Knight (the appellant), lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Gerard Walsh, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 18 August 2025.
2. The appellant relies on the following ground 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 that he 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 Personal Injury 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. 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: 01/06/2022
• Body parts/systems referred: Psychiatric/psychological disorder
• Method of assessment: Whole person impairment

1. The Medical Assessor issued a MAC certifying 13% 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)

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. Venlafaxine 75mg daily which commenced a month.

Class 2 and not Class 1 was selected because he can live independently but has some mild impairment in doing the shopping.

Bathing: He said he showers twice a day. He said on stressful days, he may not shower. Nobody prompts him to shower.

Cooking: The Claimant said he eats once a day because he is on a diet trying to lose weight.

Household chores: He reported that he said he vacuums and does the laundry once a week. He does the dishes once or twice a week.

Shopping: He stated that he has delivery of groceries. He said he does not go shopping because he has anxiety about going into crowds.

He stated that before the subject injury, he was completely independent in bathing, grooming, household chores and shopping.

Class 3 and not Class 2 was selected because he rarely goes to social events, and mostly when prompted by family or close friend. Will not go out without a support person.

Hobbies: He said he sold his boat because he was not motivated to go fishing.

Exercise: He stated that he exercises his dogs once a week. He does not go to a gym or exercise.

Frequency of socialising: He said he said he went out with a friend at the weekend and another friend to a casino for dinner, but he did not enjoy. He goes out socially once every three months for dinner.

The Claimant said a support person was needed to go out.

He stated that before the subject injury, he used to enjoy walking three times a week. He said he used to go fishing once or twice a fortnight. He said he used to socialise at least.

Class 1 and not Class 2 was selected because he can travel to new environments without supervision.

The Claimant said a support person is not required to travel. He drives for work and pricing jobs.

He said he does not like leaving the house as he fears the safety of his animals or the house.

Holidays - he has not been interstate or overseas. He said the last time overseas was around ten years ago.

He stated that before the subject injury, he could travel anywhere without any problem.

Class 3 and not Class 2 was selected because he lost his relationship and has not formed a new romantic relationship since.

Relationship with his partner: He said he said he was in an 8-year relationship, and it ended in February 2025. He was unsure why but thought it was due to his mental health. He said there was court hearing about an alleged harassment toward the end of the relationship against him and no evidence submitted but another one for the outcome will be 27/08/2025.

Relationship with children: He stated that he has two children to his previous relationship. He did not have anyone helping care for her children.

Relationship with siblings: The Claimant said he has two sisters.

He stated that before the subject injury, he went out and interacted with family and friends often.

Class 2 and not Class 1 was selected because he can focus on intellectually demanding tasks for periods of up to thirty minutes. He managed the 1-hour assessment well and had no difficulty sustaining his concentration.

He said his concentration was currently poor. He said he struggled with ADHD pre-injury.

He said he has missed minor information on quotes but has not had work problem raised with him. He said he goes off on tangents.

When asked about previous assessments indicating that he could not follow a television show or follow instructions and that this did not align with his reported current concentration, he thought there had been some improvement.

He said his concentration was good before the subject injury.

Class 3 and not Class 2 was selected because he cannot work at all in same position. Can perform less than 20 hours per week in a different position.

Work: He said he works from 7 to 3pm 3 to four days a week (24 to 32 hours a week). He said he started his own company and is a contractor through another company, PlateAu Tree Services. He said he only got this role because he knew the owner of the company. This is the third year working since May 2023.

He is doing quotes and not working in his pre-injury field.

Volunteering: He stated that he does not do any unpaid work.

He said the barriers to returning to work for more hours were being short tempered, not concentrating, and lack of energy and motivation.

He stated that there were never any issues with employment before the subject injury.

PIRS classes were 2, 3, 1, 3, 2, 3. Thus, the aggregate was 14.

In ascending order: 1, 2, 2, 3, 3, 3. The median was Class 3.

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 he made under two of the six PIRS categories, namely travel and concentration, persistence and pace, causing him to make an error in the assessments in these domains as follows:

(a) in assessing Class 1 for travel when he should have assessed Class 2, and

(b) in assessing Class 2 for concentration, persistence and pace when she should have assessed a Class 3.

1. In summary it was submitted that these errors arose because the Medical Assessor did not provide an adequate path of reasoning for his findings in the contested domains which were decided on the basis of incorrect criteria.
2. In summary, the employer Shane's Trees 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 his clinical expertise to the assessment.
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. The MAC must be read as whole.
5. The Medical Assessor took a history which broadly accords with the other evidence as follows:

"● Brief history of the incident/onset of symptoms and of subsequent related events, including treatment:

The documentation indicated that on 26/04/2020, the Claimant began working for Shane's Trees initially as a Lead Estimator, then Operations Manager and the General Manager.

On 29/05/2022, he requested an employee to attend shipping containers which were unusually open. Two business vehicles and keys were missing. The next day, he contacted Miranda Police about the vehicle location.

He was contacted by a male claiming knowledge of who took the vehicle.

On the weekend before 01/06/2022, the business was broken into, and equipment and vehicles were taken. He was able to track a vehicle and went to the property to recovery it. He said he had a 30 cm knife pulled on him and he was pushed against a fence.

The Claimant's report of the subject injury of 01/06/2022 (as dated in the PIC documentation):

The Claimant said he was working at Shane's Trees initially as the General Manager.

He said the business owner was overseas when there was a break-in in which two Utes and $160k worth of equipment was stolen.

In a phone call with the owner, the Claimant was given to understand that the company insurance policy was only for $30k and that his employer asked him to track them and made him feel that there would be a major loss to the company if they were not found.

The Claimant said he contacted the police, but at the request of his employer, the Claimant tracked the missing vehicles within 36 hours of the theft and located one of the vehicles abandoned on a street.

The Claimant said he located the other Ute and was contacted by a previous employee who told him to go to an address.

The Claimant said when he arrived, that employee grabbed him by the scruff of the neck and was holding a knife. The Claimant said he felt threatened and thought he was about to be stabbed. He said he pushed the man away and made his escape down the drive.

The Claimant said he made a statement at the police station the following day.

He stated that his mood, concentration, and sleep before the subject injury was good.

He said psychological symptoms began a month after the subject injury.

He said he has anxiety about going into crowds has been since the injury and worsened since.

He said problems with his sleep began a month after the subject injury. Every one or two weeks, he has experienced insomnia due to worries about the days' events. He said that pre-injury he would have dealt with issues the next day rather than them interfering with his sleep.

In 2024, he was self-medicating heavily with alcohol up to 30 plus standard drinks in a day.

In 2025, he was trying to give up alcohol and attended AA which was unhelpful after his partner left but someone at the meeting talked about domestic violence.

He said he had suicidal thoughts four times over two months after his partner left the relationship. He said he had never acted on those thoughts and has never had suicidal thoughts since then.

He said he had thirteen panic attacks over a few weeks after the relationship ended.

He stated that before the subject injury, he was completely independent in bathing, grooming, household chores and shopping.

He stated that before the subject injury, he used to enjoy walking three times a week. He said he used to go fishing once or twice a fortnight. He said he used to socialise at least.

He stated that before the subject injury, he could travel anywhere and went out and interacted with family and friends often.

He said the first psychotropic medication was six weeks after the incident and that his current one, venlafaxine, is the fourth trial of such medication. He said he tried vortioxetine (Brintellix) for eight months, but he was unsure why.

He said he has only seen a counsellor and has not seen a psychologist.

Mood - He described his mood as generally euthymic. Everything is an effort but feels motivated for a few hours a day.

Appetite - He reported being on a planned diet for 7 months and lost 39kg appetite.

Sleep - He described his sleep as generally good for a week. He said he does not have nightmares but wakens suddenly startled with images of that event.

Worthlessness - He felt useless after not being able to work.

Concentration - He said his concentration was currently poor. He said he struggled with ADHD pre-injury. He said he has missed minor information on quotes but has not had work problem raised with him. He said he goes off on tangents.

When asked about previous assessments indicating that he could not follow a television show or follow instructions and that this did not align with his reported current concentration, he thought there had been some improvement.

Suicidal - He said he was not experiencing suicidal thoughts.

He said that he has never experienced hypomanic or manic symptoms before.

Frequency - He said anxiety episodes occur every day, more towards the end of the day.

Duration - He said anxiety symptoms can last for a few hours.

Triggers - He stated that anxiety episodes were triggered by thinking about finances and about people at meetings for work.

The Claimant reported that symptoms of anxiety include drifting off, but he does not have physical symptoms of anxiety now.

Intrusive thoughts - He reported having intrusive thoughts about the subject injury twice a week.

Dreams - He described his sleep as generally good for a week. He said he does not have nightmares but wakens suddenly startled with images of that event.

Flashbacks - He said he does not experience flashbacks about the subject injury. He has not had them for around a year or so.

Psychological distress - He reported having psychological distress from stimuli associated with the subject injury.

Physiological distress - Physiological anxiety symptoms experienced when exposed to triggers of the subject injury.

Avoidance of thoughts - He said he avoids television when there are confronting scenes.

Negative thoughts - He said he had experienced negative thoughts. He said it changed his life significantly as he was functioning well before.

Distorted cognitions - He did not experience distorted cognitions.

Negative emotional state - He said he had experienced negative emotional state of shame as to how things have affected him.

Diminished interest - He said he has diminished interest.

Detachment - He said he did feel emotionally detached from others.

No positive emotions - He said he could not experience positive emotions for more than a few hours a day.

Irritable - He reported being irritable with others.

Hypervigilance - He said he was hypervigilant when in public.

Startle - He said he was not easily startled during the day.

Concentration - He said his concentration was currently poor. He said he struggled with ADHD pre-injury.

He said he has missed minor information on quotes but has not had work problem raised with him. He said he goes off on tangents.

When asked about previous assessments indicating that he could not follow a television show or follow instructions and that this did not align with his reported current concentration, he thought there had been some improvement.

He said his concentration was good before the subject injury.

Sleep - He described his sleep as generally good for a week. He said he does not have nightmares but wakens suddenly startled with images of that event.

• Current treatment as per the Claimant on 13/08/2025:

He currently is seeing a counsellor which he funds himself.

There are no current plans for treatment escalation or medication changes.

He is motivated for further escalation of treatment.

The timeline of symptoms is given in the 'History relating to the Injury' section.

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

At 18, he was involved in a car accident on the Harbour Bridge which caused three vertebral injuries. He said it did not affect his mental health and did not have anxiety or depression.

The Clinical records indicated he experienced depression in 2015 after his marriage ended and he saw a psychologist, Vicky Eastam. He was diagnosed with ADHD.

When asked about that, the Claimant said he was not depressed at the time and only saw his psychologist for seven sessions. He said these sessions were supposed to be for couples therapy but his wife did not wish to engage and so he attended alone.

The Claimant had two tonic-clonic seizures in the past, the last occurring in 2016.

When asked about that, the Claimant said he said the seizures were caused from drinking alcohol and not sleeping. He said these did not affect his mental health in any way.

On 15/07/2024, it was documented that his father's lymphoma returned, and he was commencing chemotherapy.

When asked about that, the Claimant said his father is now in remission and his father's health issues did not affect his mental state.

It was documented that the Claimant worked as a Manager at Plateau Trees and was bullied about his spelling for three months by a female in the office.

When asked about that, the Claimant said he did not submit a worker's compensation claim but left because management did not handle the situation well.

The Claimant said he had two car accidents after the subject injury.

He said the first one was three weeks after the subject injury. He backed over a car in a carpark.

He said he did not think his mental health was affected by that incident. There was car damage, but he did not have to attend hospital. He did not have a claim.

The Claimant said the second car accident was six weeks after the subject injury where the side of his car scraped down the garage.

He said he did not have to attend hospital, and his mental health was not affected by that incident.

The Claimant denied any prior engagement with mental health services or admissions to mental health units.

The Claimant also denied ever having any history of previous self-harming behaviours, suicide attempts.

The Claimant said he does drink alcohol. He said before his relationship ended, he was drinking 12 beers daily but then stopped after it. He is now drinking socially fortnightly.

He said friends and family come to visit once a fortnight.

There is no known family history of psychiatric illness.

The Claimant said he was born in Sydney, NSW and has two sisters.

He said he had a happy childhood and that there was no trauma while growing up.

He had learning difficulties and around 7 and 8 he was bullied but managed it.

The Claimant said he left school in Year 9 at Pacific Hills Christian School and left in 1997.

• Work history, including previous work history if relevant:

The Claimant in his statement documented the following and confirmed today:

He commenced employment at Thornleigh McDonalds for approximately twelve months.

He completed a four-year apprenticeship as a printer machinist through Pottsville Press.

He worked for approximately nine months in printing and then completed a Certificate Ill in Arboriculture through TAFE NSW.

He did an apprenticeship for ANA Arbor for three years and then worked in tree lopping for Four Seasons.

His parents owned the Trimit Tree and Garden Care business and the Claimant ran the business for about 12 years. He became depressed and closed the business after his divorce.

He worked as a Manager at Plateau Trees. He was bullied by a female in the office.

On 26/04/2020, he began working for Shane's Trees initially as a Lead Estimator, then Operations Manager and the General Manager.

On the weekend before 01/06/2022, the business was broken into, and equipment and vehicles were taken. He was able to track a vehicle and went to the property to recovery it. He said he had a 30 cm knife pulled on him and he was pushed against a fence.

He had diverticulitis after the incident at work one-off.

He stated that before the subject injury, he was completely independent in bathing, grooming, household chores and shopping.

Bathing: He said he showers twice a day. He said on stressful days, he may not shower. Nobody prompts him to shower.

Cooking: The Claimant said he eats once a day because he is on a diet trying to lose weight.

Household chores: He reported that he said he vacuums and does the laundry once a week. He does the dishes once or twice a week.

Shopping: He stated that he has delivery of groceries. He said he does not go shopping because he has anxiety about going into crowds.

On 17/06/2024, Dr Tanveer Ahmed wrote: Self-care and personal hygiene Class 2. He could self-care and showered most days. He was less interested in outward appearance and grooming. He gained weight and ate simple meals.

On 27/11/2025, Dr Nabil Malik wrote: Self-care and personal hygiene Class 2. His hygiene was generally adequate but there were days he felt unmotivated and skipped showers. He brushed his teeth and changed clothes regularly with effort. He did not often cook for himself and relied on his partner. He struggled going on errands and to the supermarket.

He stated that before the subject injury, he used to enjoy walking three times a week. He said he used to go fishing once or twice a fortnight. He said he used to socialise at least.

Hobbies: He said he sold his boat because he was not motivated to go fishing.

Exercise: He stated that he exercises his dogs once a week. He does not go to a gym or exercise.

Frequency of socialising: He said he said he went out with a friend at the weekend and another friend to a casino for dinner, but he did not enjoy. He goes out socially once every three months for dinner.

The Claimant said a support person was needed to go out.

On 17/06/2024, Dr Tanveer Ahmed wrote: Social and Recreational Class 3. He had withdrawn from socialising and other hobbies. He went fishing at times, often alone.

On 27/11/2025, Dr Nabil Malik wrote: Social and Recreational Class 3. He was withdrawn from friendship groups and avoided larger social events due to his anxiety, particularly if he did not know people there. He did not go fishing.

He stated that before the subject injury, he could travel anywhere without any problem.

The Claimant said a support person is not required to travel. He drives for work and pricing jobs.

He said he does not like leaving the house as he fears the safety of his animals or the house.

Holidays - he has not been interstate or overseas. He said the last time overseas was around ten years ago.

On 17/06/2024, Dr Tanveer Ahmed wrote: Travel Class 2. He could go outside on his own, but he became easily anxious. He could drive but was more irritable. He avoided public transport.

On 27/11/2025, Dr Nabil Malik wrote: Travel Class 2. He could drive and travel independently to local and familiar places without the need for a support person. Traveling to unfamiliar places was more challenging.

He stated that before the subject injury, he went out and interacted with family and friends often.

Relationship with his partner: He said he said he was in an 8-year relationship, and it ended in February 2025. He was unsure why but thought it was due to his mental health. He said there was court hearing about an alleged harassment toward the end of the relationship against him and no evidence submitted but another one for the outcome will be 27/08/2025.

Relationship with children: He stated that he has two children to his previous relationship. He did not have anyone helping care for her children.

Relationship with siblings: The Claimant said he has two sisters.

On 17/06/2024, Dr Tanveer Ahmed wrote: Social Function Class 2. He was slightly more irritable with his children. His partner was supportive, but they had more arguments. He was more distant from close friends.

On 27/11/2025, Dr Nabil Malik wrote: Social Function Class 2. His partner was incredibly supportive but there was some strain in their relationship. He lost friendships due to his withdrawal and ongoing struggles with anxiety

He said his concentration was good before the subject injury.

He said his concentration was currently poor. He said he struggled with ADHD pre-injury.

He said he has missed minor information on quotes but has not had work problem raised with him. He said he goes off on tangents.

When asked about previous assessments indicating that he could not follow a television show or follow instructions and that this did not align with his reported current concentration, he thought there had been some improvement.

On 17/06/2024, Dr Tanveer Ahmed wrote: Concentration, persistence and pace Class 3. He had deficits in short-term memory and concentration. His organisation was much diminished. He required prompting and was forgetful. He could not follow a TV show or read anything.

On 27/11/2025, Dr Nabil Malik wrote: Concentration, persistence and pace Class 3. He struggled with poor concentration and memory, which affected his daily life and work. He found it hard to follow complex instructions and could not focus on tasks for long. He stopped using social media because he could not concentrate on it.

He stated that there were never any issues with employment before the subject injury.

Work: He said he works from 7 to 3pm 3 to four days a week (24 to 32 hours a week). He said he started his own company and is a contractor through another company, PlateAu Tree Services. He said he only got this role because he knew the owner of the company. This is the third year working since May 2023.

He is doing quotes and not working in his pre-injury field.

Volunteering: He stated that he does not do any unpaid work.

He said the barriers to returning to work for more hours were being short tempered, not concentrating, and lack of energy and motivation.

On 17/06/2024, Dr Tanveer Ahmed wrote: Adaptation and Employability Class 3. He was working four days a week in a similar role but not at the same capacity. He was more disorganised.

On 27/11/2025, Dr Nabil Malik wrote: Adaptation and Employability Class 3. He was working four days a week in a reduced capacity through his own business, GK Works. He focused on estimating and quoting for another company."

1. The Medical Assessor conducted a mental state examination and recorded his findings as follows:

"Mental State on Examination as at Wednesday, 13/08/2025:

Appearance: The Claimant appeared his stated age and was well groomed. He had a short haircut and short beard.

Behaviour: There was no psychomotor disturbance, and he appeared relaxed in his chair. Towards the end of the assessment, he was slightly tearful when talking about the events surrounding the subject injury. There was good eye contact with the videoconference camera.

Speech: Speech was spontaneous and normal in volume, rate, rhythm, and prosody.

Mood: He described his mood as generally euthymic. Everything is an effort but feels motivated for a few hours a day.

Affect: His affect was warm, reactive, and appropriate, with a restricted range.

Thought form: The thought form was logical, with no formal thought disorder noted.

Thought content: The main themes were about the effects of the subject injury on his life and shame of how things have affected him.

There were no delusions noted. He said he was not experiencing suicidal thoughts.

Perceptions: There was no perceptual abnormality described, and he did not appear to be responding to any abnormality on observation.

Cognition: Formal testing of cognition was not performed. The Claimant attended the assessment alone and at the correct time. A reasonable history was obtained. He could manage the 1 hour assessment well and had no difficulty sustaining his concentration."

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

• ➢ Post-Traumatic Stress Disorder - as the circumstances of the subject accident are sufficient to meet Criterion A, and there are sufficient symptoms to meet Criterion B to E, with sufficient duration longer than a month, causing significant distress and impairment.
• ➢ Alcohol Misuse Disorder, in partial remission. He had significant alcohol use in response to the subject injury.

The Claimant appeared consistent in his presentation."

1. The Medical Assessor outlined that the facts on which his assessment was based was from The information provided in the interview, my observations of the claimant during the course of the interview, and the medical records provided to me.|
2. The Medical Assessor assessed a total of 13% WPI based on the scores in the PIRS Table as set out above.
3. The Medical Assessor noted that in making the assessment of 13% WPI he had considered the following matters:

"The information from the assessment and my observations of the Claimant, which can be found above, as well as information from the relevant documents, have been summarised below:

01/06/2022 - Statement of a Witness, the Claimant, NSW Police Force

Significant portions of the statement were redacted.

The Claimant documented that he had been working for Shane's Trees as a General Manager for two years.

On 29/05/2022, he requested an employee to attend shipping containers which were unusually open. Two business vehicles and keys were missing. The next day, he contacted Miranda Police about the vehicle location.

He was contacted by a male claiming knowledge of who took the vehicle.

Symptoms of trauma were noted over that time including anxiety, hypervigilance, irritability, poor sleep, racing thoughts, and at times suicidal thoughts.

15/07/2024 - His father's lymphoma returned and was commencing chemotherapy.

In 2025, he was trying to give up alcohol and attended AA which was unhelpful.

He was in a relationship of seven years with his partner.

05/07/2022 - Final Report, Huxley Hill & Associates

16/06/2022 to 23/02/2025 - GP Clinical Records, Mymedical Health Centre

16/06/2022 - It was noted that the work vehicle had been stolen and that a knife had been brandished to the Claimant. A history of ADHD and anxiety were noted. He began psychology sessions soon after.

07/02/2024 - the plan was to switch escitalopram to vortioxetine (Brintellix).

Depression mild, Anxiety extremely severe, Stress extremely severe.

Various Dates - Certificate of Capacity / Certificate of Fitness

He described flashbacks, avoidance behaviours, emotional numbing, irritability and a marked decline in social and occupational functioning. He continued to feel threatened when he went out. He was self-medicating heavily with alcohol up to 30 plus standard drinks in a day. He still binged but not drinking daily.

At the time of this assessment, the prescribed medications were Brintellix. He continued having psychology sessions.

Self-care and personal hygiene Class 2. He could self-care and showered most days. He was less interested in outward appearance and grooming. He gained weight and ate simple meals.

Social and Recreational Class 3. He had withdrawn from socialising and other hobbies. He went fishing at times, often alone.

Travel Class 2. He could go outside on his own, but he became easily anxious. He could drive but was more irritable. He avoided public transport.

Social Function Class 2. He was slightly more irritable with his children. His partner was supportive, but they had more arguments. He was more distant from close friends.

Concentration, persistence and pace Class 3. He had deficits in short-term memory and concentration. His organisation was much diminished. He required prompting and was forgetful. He could not follow a TV show or read anything.

Adaptation and Employability Class 3. He was working four days a week in a similar role but not at the same capacity. He was more disorganised.

PIRS classes were 2, 3, 2, 2, 3, 3. Thus, the aggregate was 15.

In ascending order: 2, 2, 2, 3, 3, 3. The median was Class 3.

Maximum medical improvement was considered to have been reached.

He had two tonic-clonic seizures in the past, the last occurring in 2016.

He was working four days a week in a reduced capacity through his own business, GK Works.

Self-care and personal hygiene Class 2. His hygiene was generally adequate but there were days he felt unmotivated and skipped showers. He brushed his teeth and changed clothes regularly with effort. He did not often cook for himself and relied on his partner. He struggled going on errands and to the supermarket.

Social and Recreational Class 3. He was withdrawn from friendship groups and avoided larger social events due to his anxiety, particularly if he did not know people there. He did not go fishing.

Travel Class 2. He could drive and travel independently to local and familiar places without the need for a support person. Traveling to unfamiliar places was more challenging.

Social Function Class 2. His partner was incredibly supportive but there was some strain in their relationship. He lost friendships due to his withdrawal and ongoing struggles with anxiety

Concentration, persistence and pace Class 3. He struggled with poor concentration and memory, which affected his daily life and work. He found it hard to follow complex instructions and could not focus on tasks for long. He stopped using social media because he could not concentrate on it.

Adaptation and Employability Class 3. He was working four days a week in a reduced capacity through his own business, GK Works. He focused on estimating and quoting for another company.

PIRS classes were 2, 3, 2, 2, 3, 3. Thus, the aggregate was 15.

In ascending order: 2, 2, 2, 3, 3, 3. The median was Class 3.

2% deduction for a pre-existing condition. Calculated as 1/10th of 15% equalling 1.5 and rounded to 2%.

Maximum medical improvement was considered to have been reached.

Going by Dr Malik's calculations, the deduction should have been 2% and not 1% as Dr Malik recorded and so the final WPI should have been 13%.

In saying that, I do not consider such a deduction to have been warranted given the lack of functional impairment before the subject injury."

1. In addition to the comments on the other evidence before him as set out above, the Medical Assessor made further brief comment on the other medical opinion that was before him as follows:

"My assessment of 13% WPI% is less that the outcome other IME Assessors. My reasoning for each specific domain is to be found within the PIRS**.**

PIRS classes were 2, 3, 1, 3, 2, 3. Thus, the aggregate was 14.

In ascending order: 1, 2, 2, 3, 3, 3. The median was Class 3.

PIRS classes were 2, 3, 2, 2, 3, 3. Thus, the aggregate was 15.

In ascending order: 2, 2, 2, 3, 3, 3. The median was Class 3.

PIRS classes were 2, 3, 2, 2, 3, 3. Thus, the aggregate was 15.

In ascending order: 2, 2, 2, 3, 3, 3. The median was Class 3.

2% deduction for a pre-existing condition. Calculated as 1/10th of 15% equalling 1.5 and rounded to 2%.

1. The appellant complained about two of the assessments in the categories of travel and concentration, persistence and pace. In the contested domain of travel the Medical Assessor rated a Class 1 at no deficit and the appellant submit that this rating was erroneous and seeks a mild impairment rating (Class 2). In the contested domain of concentration, persistence and pace, the Medical Assessor rated a mild impairment at Class 2 and the appellant seeks a moderate impairment rating of Class 3.
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 1 (no or minor deficit) with the following reasoning:

"Class 1 and not Class 2 was selected because he can travel to new environments without supervision.

The Claimant said a support person is not required to travel. He drives for work and pricing jobs.

He said he does not like leaving the house as he fears the safety of his animals or the house.

Holidays - he has not been interstate or overseas. He said the last time overseas was around ten years ago.

He stated that before the subject injury, he could travel anywhere without any problem."

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 his clinical findings on the day of assessment. He 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 him and noted that both Dr Ahmed the IME qualified to provide an opinion on behalf of the appellant and

Dr Malik, the IME qualified to provide an opinion on behalf of the appellant had assessed a mild impairment for travel and the Medical Assessor has relied on his own clinical findings on the day of assessment. The Medical Assessor is required to exercise his clinical judgment on the day of assessment and form his own independent view. 3. The Medical Assessor has taken a detailed history and has taken into account the appellant's self report as well as the other evidence before him. He has carefully explained why he rated a Class 1 not a Class 2. He is clearly cognisant of the other IME opinion before him, but has relied on his own findings on the day of assessment and exercised his clinical judgment that has correctly aligned with the criteria for Class 1 in travel. The appellant's self report is that he feels anxious leaving home and he doesn't like to do so, however, symptoms of anxiety can't be conflated with impairment and the appellant is leaving home without supervision on a regular basis and travelling to new locations regularly. This accords with the criteria for Class 1 and the Appeal Panel can discern no error in the rating of Class 1. 4. In respect of concentration, persistence and pace, Table 11.5 of the Guides 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 (eg 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 rated Class 2 (mild impairment) with the following reasoning:

"Class 2 and not Class 1 was selected because he can focus on intellectually demanding tasks for periods of up to thirty minutes. He managed the 1-hour assessment well and had no difficulty sustaining his concentration.

He said his concentration was currently poor. He said he struggled with ADHD pre-injury.

He said he has missed minor information on quotes but has not had work problem raised with him. He said he goes off on tangents.

When asked about previous assessments indicating that he could not follow a television show or follow instructions and that this did not align with his reported current concentration, he thought there had been some improvement.

He said his concentration was good before the subject injury."

1. The appellant submitted that a Class 3 or moderate impairment should have been assessed in this domain.
2. The MAC must be read as a whole. The Medical Assessor was clearly cognisant of the other medical opinions, noting that both the IME qualified to provide an opinion for the appellant, Dr Ahmed, and the IME qualified to provide an opinion on behalf of the respondent, Dr Malik, had rated a Class 3 (moderate impairment). The Medical Assessor had to make an independent assessment. The appellant is able to undertake quotations and meet deadlines which requires a level of concentration and persistence that is not consistent with a moderate impairment. He was specifically asked by the Medical Assessor about previous assessments which reported much greater deficit in concentration and the appellant thought there had been some improvement. The Medical Assessor was entitled to form his own clinical judgment of the day of assessment.
3. The Medical Assessor must make his own independent assessment using his clinical expertise not based on self-report alone. This is what the Medical Assessor has done here. The Appeal Panel can discern no error in the rating of a mild impairment or Class 2 for concentration, persistence and pace for which rating the Medical Assessor has given adequate reasons that accord with the correct criteria in the Guidelines.
4. For these reasons, the Appeal Panel has determined that the MAC issued on