1. On 14 February 2025 Chris Ninopoulos, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ankur Gupta, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 17 January 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 ground(s) 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. Chris Ninopoulos, the appellant, suffered a psychological injury due to events that occurred between July 2018 and 1 February 2023 whilst he was employed as a school teacher at the Ingleburn High School. The Secretary of the Department of Education, the respondent, is the employer of the appellant by virtue of s 26(1) and Part 1 of Schedule 1 of the Government Sector Employment Act 2013.
2. The appellant claimed compensation from the respondent under s 66 of the Workers Compensation Act 1987 (the 1987 Act) for 17% whole person impairment (WPI) that he contended had resulted from his injury. He relied on a report of psychiatrist Dr Abhishek Nagesh dated 23 November 2022 to support his claim.
3. The respondent's insurer refused the appellant's claim. This was on the basis that psychiatrist Dr Matthew Boulton had advised it in a report dated 18 May 2023 that he had assessed the appellant's permanent impairment from his injury is 14% WPI, which is below the threshold imposed by s 65A(3) of the 1987 Act for a worker to be entitled to compensation for permanent impairment resulting from a psychological injury.
4. A medical dispute thereupon arose between the parties and the appellant instituted proceedings in the Personal Injury Commission (Commission) seeking the Commission determine his claim for compensation for permanent impairment. A delegate of the President of the Commission referred the appellant's claim to the Medical Assessor to assess the medical disputes between the parties.
5. The Medical Assessor examined the appellant on 8 January 2025 to conduct that assessment and, as said, issued the MAC on 17 January 2025. He assessed the appellant's permanent impairment by refence to the criteria of Chapter 11 of the Guidelines. That required him, in accordance with paragraphs 11.11 and 11.12 of the Guidelines, to classify the severity of the appellant's impairment in six areas of function, namely self-care and personal hygiene, social and recreational activities, travel, social functioning (relationships), concentration, persistence if pace (CPP), and employability.
6. The Medical Assessor rated the appellant's impairment in self-care and person hygiene social and recreational activities, social functioning, and CPP as mild, that is Class 2. The Medical Assessor assessed the appellant had no deficit or a minor deficit attributable to the normal variation of the general population with respect to travel, that is a Class 1 rating. The Medical Assessor rated the appellant's impairment in employability as moderate, that is Class 3.
7. The Medical Assessor noted that the median of those scores is 2 and that the aggregate is 12, which in accordance with Table 11.7 of the Guidelines converted to 6% WPI, and that is what the Medical Assessor certified in the MAC is the appellant's permanent impairment from his injury.
8. In his appeal against the MAC, the appellant has challenged the Medical Assessor's ratings of his impairment in all the Psychiatric Impairment Rating Scale (PIRS) categories, excepting social functioning (relationships). Within the PIRS rating form in the MAC the Medical Assessor provided the following reasons for his rating for the appellant's impairment in self-care and personal hygiene as Class 2:

"As described in the main body of the report, there is mild impairment. He has grown his beard and can omit showering sometimes. He does not clean his teeth regularly. He does not need any prompting to eat."

1. Relevant to the appellant's function in self-care and personal hygiene, the Medical Assessor also detailed within the body of the MAC that the appellant had reported to him that his hygiene could be better, that he forgets to shower, that he only cleans his teeth when he remembers which is two to three times a week, that he does not cook and eats pre-cooked meals, that his wife does the shopping, and that he is unable to help around the house because of a back injury.
2. The reasons the Medical Assessor provided in the PIRS rating form for his assessment that the appellant's impairment in social and recreational activities is Class 2 are:

"As described in the main body of the report, he has mild impairment. He has been on an international holiday and can go out to restaurants if prompted. His trip would have been enjoyable had he not suffered the bereavement of his dog and uncle."

1. Within the body of the MAC the Medical Assessor detailed, relevant to the appellant's function in social and recreational activities, that the appellant reported that he tries to go out for fresh air now and then, that he goes to restaurants with his wife if forced, and that he avoids interactions with people.
2. The reasons the Medical Assessor provided in the PIRS rating form for his assessment that the appellant's impairment in travel is Class 1, that is that the appellant has no impairment or that any deficit he had was within the normal variation of the general population, are:

"As described in the main body of the report, there is no impairment. The psychological injury has not impacted his ability to travel."

1. The Medical Assessor did not within the history he set out in the MAC detail explicitly any incidents that would illustrate the appellant's capacity to travel, except for the appellant travelling to the USA with his wife, going with his wife to see his mother-in law, and not driving long distances because of a back injury. It can also however, be inferred, both from the detail the Medical Assessor set out in the MAC that the appellant will go to a restaurant if forced and from the extracts the Medical Assessor copied in the MAC from the appellant's general practitioner's records, that the appellant does travel in his local area. However, it cannot be known from that whether the appellant requires a support person to be able do that. It can also bot be known from the detail within the MAC whether the appellant is able to travel to areas with which he is not familiar.
2. The Medical Assessor provided these reasons in the PIRS rating form for his assessment of the appellant's impairment in CPP is Class 2:

"As described in the main body of the report, there is mild impairment. He describes reduced concentration and taking longer to become proficient with TAFE's new teaching platform. There was no indication of impaired focus at assessment. It was noted in March 24 that he was doing a Real Estate course. He has been in a teaching role, which he does not find challenging."

1. The Medical Assessor indicated in the MAC that he had conducted an examination of the appellant on 8 January 2025. The Appeal Panel infers that this involved a mental state examination of the appellant. Within the reasons the Medical Assessor provided for his rating relating to the appellant's function in CPP, he noted the appellant did not exhibit any impaired focus during assessment. The Appeal Panel notes that the Medical Assessor also recorded within the body of the MAC that the appellant reported to him that he had been "called up" for making mistakes in his present position with TAFE. The Medical Assessor recorded that the appellant required one on one training to become proficient in the TAFE learning platform.
2. The Medical Assessor's reasons detailed in the PIRS rating form for rating the appellant's impairment in employability as Class 3 are:

"As described in the main body of the report, there is moderate impairment. He is working in a teaching position for 16 hours per week and is looking to increase that to 20 hours per week. He has been able to maintain that employment since September 21. He cannot return to work at Ingleburn High School"

1. The Medical Assessor also detailed in the body of the MAC that the appellant's job involves meetings on Teams, recording lessons, and marking students' assignments, but he does not have any direct student contact.

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. As a result of that preliminary review, the Appeal Panel determined that the appellant should undergo a further medical examination. This is because the Appeal Panel, for reasons explained below, found that the MAC contained a demonstrable error, which the Appeal Panel would consequently need to correct. In order to correct that error, the Appeal Panel considered it required further data that it could only obtain from a further examination of the appellant. The Appeal Panel appointed one of its members, namely Medical Assessor Hong, to conduct that examination, which he did on 22 May 2025. His report to the Appeal Panel on his examination is set out below.
3. During its preliminary review of the medical assessment the Appeal Panel also considered whether it should receive into evidence a statement the appellant signed on 13 February 2025. Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in addition to or in substitution for the evidence received in relation to a medical assessment appealed against may not be given on an appeal by a party unless the evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before that medical assessment. However, even though fresh evidence may meet the threshold of s 328(3), the Appeal Panel is not required to accept the evidence if it is irrelevant or if it does not have "substantial prima facie probative value, in terms of its particularity, plausibility and/or independent support".[1]
4. In his statement of 13 February 2025, the appellant said he had "communication issues in completing the assessment with Dr Gupta". He said that he had "difficulty understanding Dr Gupta's questions". He opined that the Medical Assessor "had difficulty comprehending or understanding my responses". He said that the Medical Assessor asked him to repeat himself numerous times. He said that he found the Medical Assessor's "accent to be difficult to work with" and he opined that there was "some type of language barrier".
5. The Appeal Panel notes that the Medical Assessor did not indicate in the MAC that he experienced any difficulty communicating with the appellant during his examination of the appellant. Further the Medical Assessor did not detail any restriction or limitation he encountered in obtaining a relevant clinical history from the appellant due to any difficulty in communicating with the appellant or the appellant communicating with him.
6. The Appeal Panel also notes that the appellant did not in his statement specify what of Dr Gupta's questions he had difficulty understanding and what within the MAC led him to form the view that the Medical Assessor had difficulty comprehending or understanding his responses.
7. In the Appeal Panel's view, bearing in mind that the Medical Assessor did not indicate in the MAC that he had any difficulty in composing a relevant clinical history to enable him to make an assessment of the appellant's permanent impairment from his injury, the appellant's statement lacks particularity, plausibility and independent support for it to provide any probative value, and consequently, the Appeal Panel exercises its discretion not to receive the statement into evidence.

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. Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
2. In summary, the appellant submitted that the evidence revealed that he had serious lapses in his hygienic practices and needed to rely on his wife. The appellant referred to paragraph 47 of a statement he signed on 28 March 2024 wherein he listed various symptoms and disabilities he experiences which included relying on his wife for cooking, cleaning and shopping. The appellant also referred to the assessments that Dr Nagesh and Dr Bolton had made of his impairment in self-care and personal hygiene, which was Class 3, that is moderate. The appellant submitted the Medical Assessor did not provide a "reasonable explanation" for why his assessment diverged from the assessments of Dr Nagesh and Dr Bolton.
3. The appellant submitted the Medical Assessor's rating of his impairment in travel involved error and the Medical Assessor ought to have assessed his impairment as Class 2. The appellant referred again to his statement in which he described having difficulty travelling outside his local area without a support person. The appellant again referred to the assessments that Dr Nagesh and Dr Bolton had made of his impairment in travel, which was Class 2. The appellant submitted that the only reason the Medical Assessor provided for rating his impairment in travel as Class 1 is that he was able to travel overseas, which the appellant submitted was insufficient reasoning for the rating the Medical Assessor made.
4. The appellant submitted that the Medical Assessor erred by not assessing his impairment in social and recreational activities as Class 3. The appellant noted that Dr Nagesh and Dr Bolton had both assessed his impairment in social and recreation activities as Class 3. The appellant submitted that a Class 2 impairment involves an individual who can attend events without a support person, whereas a Class 3 impairment involves a person attending events when prompted by family or friends. The appellant noted that the Medical Assessor described that he would go to a restaurant with his wife but only if forced. The appellant submitted, given that, that a Class 3 rating is more appropriate than a Class 2 rating.
5. The appellant submitted that the Medical Assessor erred by not rating his impairment in CPP as Class 3. The appellant again referred to his evidence in his statement in which he described the hobbies and pastimes he undertook prior to his injury. He described in his statement experiencing anxiety and frustration when now undertaking these activities.
6. The appellant also noted that Dr Nagesh obtained a history that he struggles with attention and concentration. The appellant noted that in his statement he described having reduced memory and concentration and an inability to read books for more than a few minutes and experiencing difficulty watching television.
7. The appellant submitted that the Medical Assessor's rating of his impairment in employability as Class 3 "is inaccurate" and that a Class 4 rating "is more closely aligned with his functionality" in employability. The appellant noted that he has been working 16 hours a week but is unable to return to his pre-injury employment duties or engage in any face-to-face role.
8. In reply, the respondent submitted that that the Medical Assessor's rating of the appellant's impairment in self-care and personal hygiene accords with the history the Medical Assessor obtained, which the respondent also submitted was a thorough history.
9. The respondent submitted that the appellant is unable to drive long distances due to a back injury, rather than his psychological injury.
10. The respondent noted that the appellant travels with his wife to see his mother-in-law and was able to travel overseas. The respondent submitted that the appellant going overseas indicates that he is able to travel to new environments without supervision. The respondent submitted that the Medical Assessor obtained a detailed history and differentiated between the appellant's impairment in travel resulting from a physical injury, on the one hand, and that resulting from a psychological injury, on the other.
11. The respondent submitted that the appellant has reduced his participation in recreational activities due to back pain as well as his mood and a concern that he will gamble. The respondent submitted that the appellant's impairment in social and recreational activities cannot be entirely attributed to his psychological injury. The respondent submitted that the worker going on an international holiday indicates that he can engage in social and recreational activities.
12. The respondent highlighted that the Medical Assessor obtained a history from the appellant that he attempts to be frugal. The respondent submitted that this indicates the appellant's impairment in social and recreational activities is not solely from his psychological injury.
13. The respondent submitted that the appellant's ability to undertake a real estate course and engage in employment "are not indicative of a moderately impaired concentration persistence and pace". The respondent referred to an entry in the appellant's general practitioner's clinical records on 21 July 2020 in which it was noted that it was okay for the appellant mentally to teach students but the appellant's pain and physical function were limiting factors.
14. The respondent submitted that the appellant taking longer to become proficient in a learning platform is not indicative of a moderate impairment. The respondent submitted that the appellant engaging in Teams meetings and recording lessons and marking students' assignments is inconsistent with a moderate impairment in CPP.
15. The respondent submitted that the history the Medical Assessor obtained that the appellant does not find his teaching role difficult indicates he has a mild impairment in CPP.
16. The respondent submitted that whilst the appellant may be limited to online teaching the appellant has the capacity to work 16 to 20 hours a week. The respondent submitted that the Medical Assessor's rating of the appellant's as Class 3 in employability is correct.

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.
3. With respect to the PIRS categories in regards to which the appellant contends the Medical Assessor erred in rating his impairment, the Appeal Panel considers that, when the MAC is read as a whole, the reasons the Medical Assessor provided for his ratings do not support the ratings he had made with the exception of his ratings that the appellant's impairment in CPP is Class and the appellant's impairment in employability is Class 3.
4. What the Medical Assessor described in his reasons for rating the appellant's impairment in self-care and personal hygiene does not, on its face, reveal that the appellant can look after himself adequately. He does not prepare his meals. He neglects to brush his teeth. His wife does the shopping. That is, the Medical Assessor's reasons do not support his assessment that the appellant's impairment in self-care and personal hygiene is mild. That is an error such that the MAC contains a demonstrable error.
5. The Appeal Panel also considers that the Medical Assessor's rating of the appellant's impairment in travel is not supported by the reasons he provided and this also amounts to an error such that the MAC contains a demonstrable error.
6. It is not apparent from the content of the MAC that the appellant can travel to new environments without supervision. It is not apparent from the content of the MAC or from any other evidence that the appellant has no deficit in his function of travel or a minor deficit attributable to the normal variation of the general population. Simply, the Medical Assessor has not obtained a sufficient history to enable a correct rating of the appellant's impairment in travel.
7. The Appeal Panel considers that the Medical Assessor's reasons for rating the appellant's impairment in social and recreational activities as Class 2 do not support a Class 2 rating. The history that the Medical Assessor detailed in the MAC indicates that the appellant currently engaged in very little social or recreational activities. It was limited to going on an overseas holiday in 2024 with his wife and going to a restaurant when prompted by his wife. That does not accord with a severity of impairment described by the descriptors for a Class 2 impairment. Consequently the Medical Assessor was wrong to rate the appellant's impairment, based on what he set out in the MAC, as a Class 2 impairment.
8. As said, the Appeal Panel considers that Medical Assessor's rating of the appellant's impairment in CPP does not involve any error. The Medical Assessor noted the appellant was able to complete a real estate course in 2024. Further, the appellant can manage the TAFE learning platform, although he required one-on-one training to be able to do so. The Medical Assessor noted the appellant does not find his teaching role challenging. The Appeal Panel notes that role requires him to attend at Team meetings and to mark student papers. Whilst the appellant is only undertaking that task for 16 hours a week, in the Appeal Panel's view it would necessarily involve a fair degree of concentration and persistence. The appellant was also able to focus during the assessment.
9. All this indicates that the appellant can focus on intellectually demanding tasks for at least up to 30 minutes and is able to undertake a retraining course or a standard course at a slower pace.
10. Whilst the appellant may experience anxiety and frustration when attempting to undertake his prior pastimes, which indicates some impairment in CPP, it is not such that his impairment in CPP could be rated as moderate. It does not indicate he cannot follow complex instructions, or follow a pattern or is unable to read.
11. In the Appeal Panel's view, the Medical Assessor's rating, for the reasons he provided, accord with the severity of impairment that correlates with the descriptors provided for a Class 2 impairment in CPP. The Medical Assessor also applied the correct criteria, in that he assessed the appellant's impairment by reference to Chapter 11 of the Guidelines.
12. As said too, the Appeal Panel considers that the Medical Assessor did not make an error with respect to his rating of the appellant's impairment in employability. The appellant has been able to work since September 2021 in a teaching position for 16 hours a week, although that position does not require face-to-face contact. That accords with the descriptors provided in Table 11.6 of the Guidelines for a Class 3 impairment. It does not accord with the descriptors provided for a Class 4 impairment which are that a worker cannot work more than one or two days at a time, or less than 20 hours a fortnight in employment in which the pace is reduced and attendance is erratic.
13. As mentioned, the Appeal Panel must correct the errors it has identified in the MAC and the Appeal Panel considered that it required further clinical data to that and consequently appointed Medical Assessor Hong to re-examine the appellant. Medical Assessor Hong's report to the Appeal Panel is as follows:

Mr Ninopoulos confirmed several incidents at the school related to aggressive students, and he ceased working due to trauma symptoms consistent with Post-traumatic stress disorder. He had consulted Hansen Li, psychologist, and treatment with him ended in 2024. Recently he started treatment with another psychologist, Christina King, and only had one session so far. He saw a counsellor from TAFE briefly, before her.

Mr Ninopoulos ceased working with the Department of Education in 2020, and after around 18 months, he commenced work with TAFE, doing online teaching 1 or 2 days per week, and teaches Health and movement HSC course. He said the opportunity was good as it is work from home, he runs sessions for year 11 and 12 students. He leaves notes for students and marks assignments. Mr Ninopoulos prepared new material as it is a new course. He said it should be 8 hours a day, but in reality, it is only a few hours. He takes one class a day,

with 2-5 students, and the class goes for 60 minutes. Altogether there are 100 registered students and he has overseas students too. He responded to questions regarding assignments.

He said he tried to go into the TAFE centre at Strathfield, and sat near other teachers, doing video teaching, but his back hurt and his mental health deteriorated, and he had to get up every 30 minutes. Fortunately, TAFE allowed him to continue working from home.

Mr Ninopoulos said he should have been a principal by now, but he cannot manage in-person teaching. He feels embarrassed by his life circumstance. His wife works in a corporate role for the Department of Education, and works from home.

He completed a Real Estate certificate in 2024, which he said is similar to a sales associate role. It took 6 weeks and was a basic course, only a couple of hours a week. He said if TAFE work finishes, he needs something else, but he has never worked in that industry.

Mr Ninopoulos reported being physically injured at work. He had back surgery August 2020, and he is considering having another surgery, a spinal fusion

with Professor Sheridan. He has back arthritis. He uses ergonomic chair. Mr Ninopoulos said his physical injuries affect his mental health.

In terms of other medical conditions, he had a surgery Appendix cancer, in late 2021 and attended Chris O'Brien Lifehouse. The blood test showed he is in remission.

Physically, he said he cannot run, his walking tolerance is only around 10 minutes. He said he walks regularly for rehabilitation, on his own or with his wife, and does strength training most days on waking in the morning. He usually wakes up at 4am and stretches. He has sciatica too, and is having physiotherapy, cupping and dry needling. He had an exercise physiologist previously and still does the same exercises at home now. With changed weather, he has more back pain.

• Endone as needed for pain
• Panadol
• Sertraline 100 mg
• Melatonin 20-30 mg

He recently commenced treatment with a new psychologist.

Mr Ninopoulos continues to have Post-traumatic stress disorder symptoms, and nightmares. He has anxiety and low moods. He worries about losing his job at TAFE.

He was drinking heavily, but he developed fatty liver, and he cut back his alcohol intake some time ago, and does not drink daily anymore. Early in 2025, he started Mounjaro and lost 10kg. He does not have a dietician, and said he follows dietary advice from his GP, he limits his calories, and eats more protein, and fasts daily for 18 hours, with no food from 6pm to midday. On the weekend, he may have cheat days. He exercises and uses the home pool when it is not cold.

Mr Ninopoulos has sleep problems and always has bad dreams. He has flashbacks and avoids the local area, where the students or ex-students go, and said some ex-students live in the area.

He has concentration difficulties and described it as 'average, below average'.

His wife thinks he has Bipolar disorder, with highs and lows. He explained with a caffeine hit (double shot, twice a day), he does more things, but by the afternoon, he has no energy.

Mr Ninopoulos drives in the local area. He does not drive long distances as he does not want an accident if his leg cramps up.

On the days off work, he watches TV, reads books about motivation and about real estate, or something he thinks will assist his future career. He worries about making phone calls and talking to strangers, and feels anxious if he has to do real estate work.

He said he had a panic attack 2 weeks ago and had an ECG.

Mr Ninopoulos said her wife is his best friend and they are close. She works from home most of the time. His son goes to Wollongong university 3 days per week and works too, and so he is not home much.

He said he uses a deodorizer roller, and cannot be bothered with showering, and sometimes he needs help due to back pain from his wife. He uses a non-slip mat in the showers. He feels he only needs to shower 2 or 3 times a week. He changes to clean clothes and showers 2-3 times a week without prompting. Sometimes his wife would remind him but nevertheless without prompting, he would shower 2-3 times per week now.

He goes to the gym for physiotherapy and goes on his own too. Sometimes his wife comes with him. He avoids the periods when ex-students would go to the gym.

Mr Ninopoulos puts dishes away and occasionally cooks, with a slow cooker. His wife and son cook more. He said he buys everything online, and they buy the groceries online. He said he buys underwear from Woolworths supermarket.

In terms of usual recreational activities, Mr Ninopoulos likes training, golf, cricket and use to run a social group for golf. He has not done it since his surgery. His friends invite him, but he told them he cannot due to his back.

He follows a lot of sports on TV, as he cannot do anything physically. He goes to the golfing range occasionally, but cannot play a real game.

3 weeks ago, Mr Ninopoulos flew to Brisbane with his family for a couple of days for a nephew's wedding. Apart from the August 2024 trip to the US, with his wife and sons, he has not had other trips away. He said the US trip was a disaster, his dog was sick immediately before the trip and died suddenly from cancer during the trip, and an uncle died shortly after in a nursing home.

He said they rarely eat out, only specific occasions like Mother's day, only

He does not gamble much now as he has limited funding. His wife stopped his sports bet on the app, and does not play pokies as was recorded (he said he had communication problems with Dr Gupta).

Mr Ninopoulos was assessed by video. He was at home during the assessment and his wife was also home. He had short greying hair and a moustache and a goatee beard, and wore glasses. He was kempt with no evidence of neglect. He engaged well with the assessment process. There was no psychomotor slowing or abnormal movements.

He was moderately restricted in his affect range and reactivity. He spoke spontaneously and gave long answers, and was not distracted during the assessment for over 1 hour. He stood up due to pain at times, and gestured regularly.

At the end of the assessment, he discussed everything is subjective with at assessment, different doctors made different things, and the Panel will put a percentage, but it is also subjective. The insurer and the Department of Education do not care about him. He feels embarrassed. He said he does not care about the threshold, appeals anymore.

In summary, Mr Ninopoulos was been threatened and assaulted on different occasions when working as a teacher, leading to a psychiatric injury, PTSD with depression and anxiety symptoms. He also sustained a physical injury. He had turned to alcohol to cope with pain and anxiety, and since being diagnosed with a fatty liver, he has been making an effort to lose weight, eat healthily, and not drink alcohol to excess. He had been gambling, which led to his wife intervening, and he rarely gambles now.

Mr Ninopoulos was not having psychologist treatment for a while and recently started treatment with a new psychologist. He has been taking Sertraline for a long time. There were times when he felt better and stopped taking it, and he is on the same dose as when seen by the MA.

Since Mr Ninopoulos stopped working for the department, he has been maintaining part-time employment doing online teaching work for TAFE, which in theory is up to 18 hours a week.

There has been some fluctuation in Mr Ninopoulos' overall mental health, but the trajectory has been stable for a long time now and his psychological injury is permanent."

1. The Appeal Panel considers that Medical Assessor Hong conducted a thorough examination of the appellant and consequently the Appeal Panel accepts the history Medical Assessor Hong obtained and the Medical Assessor's finding from his examination of the appellant. The Appeal Panel also agrees with the summary Medical Assessor Hong provided of the appellant's injury and his diagnoses.
2. Based on Medical Assessor Hong's report, the Appeal Panel assesses the appellant's impairment in self-care and personal hygiene as Class 2. The Appeal Panel observes that the appellant described to Medical Assessor Hong that he is attentive to his weight management, that he exercises, that he pays attention to his diet, and that he has lost weight, which the Appeal Panel notes is partly due to the appellant taking Mounjaro injections and partly due to his fasting and calorie restrictions. The Appeal Panel notes that the appellant does some cooking, that he helps with light household chores, and that he showers two to three times a week. Although the appellant's wife may prompt him at times with respect to his showering, the Appeal Panel considers, based on the history Medical Assessor Hong obtained, that the appellant can maintain basic nutrition and hygiene independently, which is consistent with a Class 2 rating.
3. The Appeal Panel rates the appellant's impairment in social and recreational activities as Class 3. The Appeal Panel notes, based on the report of Medical Assessor Hong, that the appellant reported having two trips since his injury. In both cases he was supported by his wife during the trip and while away generally remained withdrawn. The Appeal Panel notes that the appellant rarely eats out and that whilst he does engage in solitary activities such as following sports at home his psychiatric symptoms remain a problem that inhibit his recreational activities relative to that in which he engaged prior to his injury. The appellant no longer engages socially with his friends and overall has become socially withdrawn.
4. The Appeal Panel rates the appellant's impairment in travel as Class 2. The Appeal Panel notes based on Medical Assessor Hong's report that the appellant was able to travel overseas with his family and drives locally but he avoids certain places, including where ex-students might go and also avoids driving near schools. That is consistent with an impairment described by the descriptors for a mild impairment.
5. Noting that the Appeal Panel did not find any error in the Medical Assessor's rating of the appellant's impairment in CPP, which was Class 2, and in employability, which was Class 3, and that there was no appeal raised regarding the Medical Assessor's rating of the appellant's impairment in social functioning, which was Class 2, that means that the median of the appellant's class ratings is 2 and that the aggregate increases to 14, which in accordance with Table 11.7 of the Guidelines equates to 7% WPI. That is how the Appeal Pane rates the appellant's permanent impairment resulting from his injury.
6. For these reasons, the Appeal Panel has determined that the MAC issued on 17 January 2025 should be revoked, and a new MAC should be issued. The new 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 Ankur Gupta and issues this new Medical Assessment Certificate as to the matters set out in the table below:

Chapter, page and paragraph number in NSW workers compensation guidelines

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

Proportion of permanent impairment due to pre-existing injury, abnormality or condition

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

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

[1]Lukacevic v Coates Hire Operations Pty Ltd [2011] NSWCA 112 at [78] and [102].