WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; assessment of primary psychiatric injury; appeal by the worker on the basis that the Medical Assessor (MA) applied incorrect criteria and made a demonstrable error with respect to the rating of social and recreational activities; Appeal Panel satisfied that the activities described by the MA in the psychiatric impairment rating scale (PIRS) rating form for the category of social and recreational were properly characterised and the MA did not take into account any irrelevant consideration in the context of assigning a Class 2 assessment for social and recreational activities; Held - Medical Assessment Certificate confirmed.

1. On 13 June 2025 Karen Rowen (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Michael Hong a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 19 May 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 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).

1. The appellant sustained a primary psychological injury in the course of her employment as a teacher with the Secretary, Department of Education (the respondent) on deemed to have occurred on 28 May 2021.
2. The appellant filed an Application to Resolve a Dispute dated 8 April 2025.
3. The matter was referred to Medical Assessor, Dr Michael Hong for assessment of whole person impairment (WPI) of a psychiatric and psychological disorder.
4. The Medical Assessor examined the appellant on 13 May 2025.
5. The Medical Assessor assessed 8% WPI as a result of the injury deemed to have occurred on 28 May 2021.

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 it was not necessary for the appellant to undergo a further medical examination because there was sufficient information on which to make a determination.

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

1. 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.
2. The appellant's submissions include the following:

(a) The Medical Assessor erred in assessing WPI under the Psychiatric Impairment Rating Scale (PIRS) on the basis that he applied incorrect criteria and has made a demonstrable error with respect to social and recreational activities which materially affect the outcome of the assessment of WPI.

(b) The Medical Assessor failed to appropriately and accurately allocate each of his factual findings into the appropriate PIRS category. By failing to allocate as required, the Medical Assessor took into account incorrect criteria in the category of social and recreational activities, which has led to an erroneous class assessment. But for the error, the appropriate class for social and recreational activities would be

Class 3 rather than Class 2 as assessed by the Medical Assessor. Further the Medical Assessor made findings with no factual basis.

(c) International Holiday - the Medical Assessor refers to an overseas trip to Bali in 2024 under this category. Such a holiday has various aspects which ought to properly fall under a number of other categories in the PIRS and the entire trip cannot be claimed to solely be categorised as social and recreational activities, which the Medical Assessor has done.

(d) The act of travelling to Bali ought to be properly assessed under the PIRS category of travel as it is clearly not a social or recreational activity. Similarly, the time spent with her family in Bali should properly fall under the social functioning category. Whilst it is accepted that some family events can be social in nature, there is no evidence offered by the Medical Assessor that the appellant would not have attended but for her son taking her. There is no evidence adduced as to likely prompting by her son to attend nor consideration of the fact that her son is a support person.

(e) Audiobooks - the Medical Assessor does not provide any context, but it can reasonably be assumed that he relies on it as an example of a recreational activity as it is not a social pursuit. The Medical Assessor fails to discern why and in what context the appellant listens to audiobooks. If listening to audiobooks is in fact a recreational activity, it cannot be regarded as an activity engaged in for enjoyment, as the appellant clearly has little capacity to concentrate or follow the content. Accordingly, listening must be for reasons other than pure enjoyment and cannot be categorised as a recreational activity.

(f) Walking dog - it is unclear whether the Medical Assessor relies on dog walking as a social or recreational activity. For the same reasons stated above in relation to audiobooks, this is a solitary activity. There is no evidence suggesting the appellant walks her dog with other people. As he refers to it at paragraph 10c of MAC, the Medical Assessor must consider walking her dog as a solitary recreational activity. This in is itself erroneous and without foundation.

Dr Sinnaduray, in his report dated 16 February 2024, recommended daily exercise to be undertaken by the appellant as a form of treatment and in her statement she states that she walks her dog as a way of getting out of the house. Consequently, walking the dog is incorrectly categorised as a recreational activity.

(g) Contact with a friend (occasional contact with a friend) - the Medical Assessor refers to occasional contact with a friend at 10c, page 9 of the MAC. The fact that the appellant maintains contact with one friend is not correctly categorised as a social and recreational activity, but is appropriately categorised as social functioning. It is possible that having coffee and lunch could be appropriate to social activities. The descriptor used by the Medical Assessor "enjoys" runs contrary to the available evidence.

(h) Time with her mother - the word 'enjoys' has been used as a descriptor. The appellant does spend time with her mother cooking at home and at other times, but this activity should properly be categorised as social functioning, rather than social and recreational activities. The appellant's statement provides that she regularly skips meals and does not enjoy cooking meals for herself. Accordingly, the fact that her mother visits and helps her cook should not be seen as social activity as it is instigated by her mother as a means of ensuring that her daughter eats regularly and well.

(i) Enjoys time with her son's family - the Medical Assessor conflates spending time with her son with spending time with her "son's family." The Medical Assessor states that this is the reason for the appellant moving to be close to them. The appellant moved Nelson Bay to be close to her son rather than moving there to be close to his family.

(j) The Medical Assessor makes the assertion at 10c on page 9 that the appellant "enjoys time with her son's family and that was the main reason she moved there." There is no evidence for this assertion by the Medical Assessor which conflicts with his earlier comments. In any event, spending time with her son is properly categorised under social functioning rather than social and recreational activities.

(k) Support Person or Prompting - It is unclear why the Medical Assessor states that the appellant is actively engaged or does not require prompting or a support person. The activities over the two years prior to this examination clearly show that that the appellant has been involved in activities only involving either family or her one remaining friend both of which, should properly be defined as a 'support person.' The Medical Assessor provides no support for the appellant being actively engaged with these interactions nor is there evidence that the friend does not prompt the appellant to "go out."

(l) What appears clear from the available evidence is that the appellant has one remaining friend and that she does not go out without that person or a member of her family, namely, her mother or son. The Medical Assessor failed to enquire or provide evidence as to whether the appellant would go out without either the friend or family member. Without further explanation or evidence, this cannot be sustained and must be seen as erroneous.

(m) Social activities generally - the appellant provided examples of past events in her statement including a concert, a camping trip, a food and wine festive and a holiday. The evidence shows that the appellant attended these events only with her trusted friend or family and that on attending these events she either leaves early or isolates herself due to adverse effects of her psychological condition. Additionally, the events referred to occurred two or more years ago prior to the MAC assessment, nothing more recent.

(n) Each of the PIRS tables is assessed separately and particular conduct must be applied to the appropriate category - Ballas v Department of Education [2020] NSWCA 86 (Ballas). Bell P and Payne JA said:

"Whilst it is no doubt correct that an AMS must exercise a degree of clinical judgment in assigning a class of seriousness to each area which he or she is required to address in completing a medical assessment, the characterisation of conduct as going to 'social and recreational activities' on the one hand, as opposed to any of the other five scales on the other hand, is not a matter of discretion. Even if there may, as a matter of English language, be some overlap between some of the scales or categories of functional impairment, for the purposes of the WPI assessment exercise, particular conduct will fit within one or other of the scales. This calls for the correct characterisation of the conduct, ie whether it goes to 'self care and personal hygiene', 'social and recreational activities', 'travel', 'social functioning (relationships)', 'concentration, persistence and pace' or 'employability'. This does not involve an exercise of discretion. If conduct is wrongly assigned to one scale, when it should have been assigned to another, this will result in the AMS taking into account an irrelevant consideration in the context of assigning a class to each of the distinct scales."

(o) If the above submissions are accepted, it then follows that the evidence discloses that the only social and social recreational activities attended by the appellant is her trip to Bali in 2024 with her son, who must be seen as a support person. The occasional coffee and lunch with her one remaining friend must also be viewed in light of the lack of consideration that the one remaining friend is actually a support person. It is submitted that, the Medical Assessor failed to provide any or any adequate reasoning for his determination that the appellant is actively engaged and does not require a support person and therefore such a finding is arrived at via an unsupportable reasoning process. The balance of the reasons provided by the Medical Assessor for assessing the appellant as Class 2 are incorrectly applied.

(p) Further, there is no evidence suggesting that the appellant attended any recent social events and it is submitted that such events in the distant past are not a true reflection of the appellant's current condition and ought to be disregarded, particularly as they have not been repeated. The Medical Assessor is required to assess how the appellant's level of functioning, such as attending these events, has varied since the time of her injury. In the appellant's case, the level of functioning has deteriorated with little to no recent social activities attended without a support person.

(q) When the relevant evidence is properly considered, the appellant should have been assessed as Class 3 for social and recreational activities.

(r) The MAC contains a demonstrable error and application of incorrect criteria in the PIRS category of social and recreational activities. It is incumbent upon the Medical Assessor to correctly apply the correct facts and criteria; failure to do so, and for the reasons stated in these submissions, amounts to a demonstrable error.

(s) The Medical Appeal Panel ought to substitute its own assessment under the category of social and recreational activities, without the need to refer to a further medical assessment.

(t) The MAC dated 9 October 2023 should be revoked.

1. The respondent's submissions include the following:

(a) The Medical Assessor assessed a Class 2 for this category as did

Dr Sidorov.

(b) Attending an international holiday to Bali, spending time outside her room with her family, and having a driver to go and sightsee would be considered 'recreational activities' within the purpose of Table 11.2 and fits within the appropriate category as assessed by the Medical Assessor.

(c) In the matter of Campbell v We Help Ourselves [2024] NSWPICMP 185 (Campbell), the Medical Appeal Panel and Review Panel explains:

"The conduct of a person in engaging in social activities must be assessed by the Medical Assessor within the PIRS category of social and recreational activities, whereas the conduct of the person in maintaining the relationship with their family and friends must be assessed by the Medical Assessor within the PIRS category of social and functioning. So long as the Medical Assessor's focus is on the social and recreational activities in which the person is in (sic) engaged when assessing the worker's impairment in social and recreational activities and the Medical Assessor's focus is on the worker's relationship with family and friends when assessing the impairment in social functioning, then there is no error of the type identified in [84]-[94] of Ballas."

(d) Taking into consideration Campbell and noting the Medical Assessor had taken into consideration the social and recreational activities the appellant was engaged in with her family, rather than the relationship with family itself, the Medical Assessor made no error considering the holiday to Bali when assessing social and recreational activities.

(e) Audio books- the appellant's use of audiobooks were a means of enjoyment, noting the Medical Assessor's history taken that she "enjoys listening to audio books when walking her dog."

(f) In paragraph 82 of the appellant's 's statement dated

19 February 2025, she stated that she tries to listen to audiobooks which she tends to find to be 'a little easier' although she loses concentration. Notwithstanding losing concentration, she has proven that she is using audiobooks as an alternative from books. She stated that she is an avid reader who loved words and writing, which suggests that she enjoys listening to audiobooks.

(g) Walking the dog - the initial rehabilitation assessment report dated

29 June 2021 sets out the appellant's self -reported functional status pre-injury and noted that she reported 'hobbies to include reading and arts activities including painting. She reported she would attempt to walk her dog two to three times per week.' In the same report, the appellant explained her physical routine had always been poor. She reported 'as she was not at work, she was trying to walk her dog more often...' suggesting same is not only a means to get out of the house, but also as a means of physical exercise.

(h) The appellant taking her dog out for physical exercise, engaging in 'small talk' with other dog owners and enjoying listening to audiobooks while walking her dog would amount to recreational activities.

(i) Contact with a friend (occasional contact with a friend) - the Medical Assessor has focused on the conduct of the appellant that involves her engaging in social activities (gone out for coffee or lunch at a café every one to two months in the past two years), and not her maintaining social relations. Consequently, the Medical Assessor did not misassign this conduct into an incorrect category and thereby have regard to an irrelevant consideration when rating impairment in this scale.

(j) Time with her mother - the appellant spends time with her mother cooking at home and at other times. The Medical Assessor has focused on the conduct of the appellant that involves her engaging in social activities (the appellant cooks together with her mother), and not her maintaining social relations with her mother. Consequently, the Medical Assessor did not misassign this conduct of the appellant into an incorrect category and have regard to an irrelevant consideration when rating impairment in this scale.

(k) Enjoys time with son's family - the Medical Assessor has focused on the conduct of the appellant that involves her engaging in social activities (attending a holiday with her son, babysitting), and not her maintaining social relations with her son. Consequently, the Medical Assessor did not misassign this conduct of the appellant into an incorrect category or have regard to an irrelevant consideration.

(l) Support person or prompting - there is no evidence that the friend, or son prompts the appellant to go out particularly when she is eating out at a café with a friend. The Medical Assessor details that the appellant does not need prompting or a support person, noting her solitary recreational activities which include walking the dog and listening to her audiobooks.

(m) The appeal is not made out and the MAC should be confirmed.

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 Appeal Panel reviewed the MAC and the evidence in this matter.

1. The appellant submits that the Medical Assessor failed to appropriately and accurately allocate some of his factual findings into the appropriate PIRS category and therefore took into account incorrect criteria in the category of social and recreational activities. The appellant argued but for this error, any reasonable assessor would determine the appropriate social and recreational activities as Class 3.
2. The examples under Table 11.2 for "social and recreational activities" in the Guidelines are:

"Class 2: 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).

Class 3: 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."

1. The Medical Assessor assessed the appellant as Class 2 for social and recreational activities. In the PIRS Rating Form, the Medical Assessor wrote:

She reported having discontinued her usual recreational activities, including park run and crocheting.

Since her work injury, she has engaged in different recreational activities with different people, as previously noted in the body of the certificate, including international holiday in 2024 and occasionally eating out at a café with a friend. She does not need prompting or a support person, as she has solitary recreational activity and I noted that some of the recreational activities are social by nature."

1. Under "Social activities/ADL", the Medical Assessor wrote:

"Ms Rowen reported that after the injury, she moved from Belmont to Soldiers Point to be away from the school and to be closer to her son. Since then, she purchased a property in Nelson Bay, which is only down the street from her son. She only moved in 2 weeks ago, having purchased a duplex house there. She had another 8 sessions of exercise physiologist approved, and resumed having sessions recently. She said she does not stick to routines, some days, she does not go to exercise physiologist and does not like to be in group sessions. She is close to her mother, and said her mother visits her 2-3 times per week. When her mother visits, they cook together. Her mother eats a healthy diet and she is better in her diet too when her mother is there.

Ms Rowen is close to her son and said the move has been good, the relationship was a bit strained as she is not bubbly like in the past, and the relationship with her son is better now. She sees her 2 years old granddaughter regularly as they are close by. She babysits sometimes, as her daughter works, but the in-laws do more babysitting. She said her granddaughter is 'full on' and energetic, and worries if she would be negatively judged by her daughter-in-law and lacks confidence.

I asked her about her friends, and Ms Rowen said she has not seen any friends with them since she ceased work. I noted to her, this seemed inconsistent with what the IMEs wrote. I asked her about the friends she went to concert with as noted by Dr Alexey Sidorov and I read out what he wrote to her, including the concert and that she dated, the year prior to that report in 2023. She said she saw a friend previously, but not for 18 months now. She said she does not see her other friend either. She said the concert was 2 years ago and she had read Dr Sidorov's report and felt devastated by it, and on specific enquiry regarding whether his report was incorrect, she could not confirm one way or the other. She said when she tried to explain things to Dr Sidorov, and he would cut her off. She confirmed I did not cut her off during the assessment today. Ms Rowen said she left Swansea school and has not seen the friends from Swansea school and that was difficult, and she was ostracised. Ms Rowen said she had a friend who invited her out for coffee and she had time, so she had gone out, but could not stay as she saw children around as it was close to Swansea school. She confirmed that meeting involved her and 3 ladies doing park run. She said the last catch-up with those friends was before she ceased work, and I discussed Dr Sidorov wrote it in 2023 and said it happened just before that report. She said she does not agree with some of the things he wrote about her. She said she did go to a wine and food festival with 2 friends, but she hyperventilated in the crowds and she sat away from people. She said she has not been to many concerts and could not give me more details.

Later, she said she has one friend in Nelson Bay, they catch up on average every 1-2 months for lunch or coffee at a café, in the past 2 years. She moved from Belmont to Soldier's Point and rented there, and then bought at Nelson Bay, and said generally maintained contact with that friend from Nelson's Bay during the past 2 years. ...

She no longer crochets now. ...She used to read books, and this has stopped because of concentration difficulties. She listens to audiobooks, at night or when walking the dog, sometimes she does not remember where she was up to. She listens around 30 minutes. Ms Rowen walks the dog, and said she would not be out as much, without her dog. In terms of daily activities, Ms Rowen goes to appointments, dentist, physiologist and psychologist.... She takes walks, watches TV, sees her mother, and they cook together.....

In terms of trips away, Ms Rowen reported going to a holiday with her son,

daughter-in-law and her family for a weekend, up to coast a couple of years ago. On further specific enquiry, she said she had another trip in 2024 with the same people, to Bali for 12 days. She said whilst she enjoyed parts of it, being away was difficult. She said she pushed herself to go. She had her own room and spent time in her room at times. Ms Rowen spent most other times outside her room with her family, and they had a driver to go and sightsee.

Regarding Ms Rowen's 2025 statement, I discussed she wrote about camping

18 months ago but went home early, on specific enquiry, she said the statement was outdated and it was not 18 months prior to 2025, when she did that updated report in February 2025. Ms Rowen thinks the camping was before her granddaughter was born. She said she did not hear from her lawyer after a long time and then they did not want more from her, or another statement from her, and the February 2025 statement was not entirely accurate."

1. At Part 10 c of the MAC, the Medical Assessor wrote:

"Dr Sidorov reported on 26 May 2023...She takes the dog for a walk regularly

but avoids crowded places. She goes out with her mother, and at times with her friends.

Recently, she went to a concert with one of her friends, she had been on dates last year, but they did not result in a long-term relation (Comment: I discussed this with

Ms Rowen during the assessment). ...He wrote: She occasionally goes out to social events and socialises with friends but less frequently than in the past.

I noted Ms Rowen's two statements from August 2021 and February 2025 and also

discussed the recorded history in her statements with her...

Ms Rowen said before the injury she was happy, bubbly, and loved to go out and socialise. She attempted to catch up with friends but did not go. She joined but did not go to the gym.

On one occasion, she bought a ticket to a music concert but did not go. She does not go to the park run anymore or to the football club that was close to her, and does not do gardening, painting, or photography. She attempted camping about 18 months ago with her son and the in-laws but ended up coming home early.

I discussed her statement with her and also took additional history, including her holidays in Bali last year. Since she moved to Nelson Bay, she is still maintaining regular contact with a friend and has done so in the past two years, and since she moved to Soldiers Point and then Nelson Bay. She maintains contact with a friend, while it is not very regular, it does happen every one or two months. They go out to have coffee or eat lunch together at a café. It should be noted that there were some inconsistencies in terms of how she reported her activities, in her statement, to Dr Kuman and Dr Sidorov, and this was discussed with her.

In terms of social recreation, Dr Kumar rated 3 and noted that Ms Rowen does not go out or socialise with anyone and had rare interactions with her friends. She lost interest in gardening and art. Essentially, she has no recreational activity of any kind. I noted Dr Sidorov took a different history and rated 2. In my assessment, I confirmed that Ms Rowen had been overseas for a holiday. She does enjoy listening to audiobooks while walking her dog. She also has occasional contact with a friend and enjoys being out, having coffee, or having lunch together. Aside from that, she enjoys time with her mother, and they cook together at home, and she enjoys time with her son's family and that was the main reason she moved there. Overall, this is consistent with 2 and not 3, as she is actively engaged and does not need prompting or support person, and has different recreational activities with different people, and solitary recreational activities as well."

1. In her statement dated 19 February 2025, the appellant stated that because of the triggers of the work situation and feeling unable to get out of the house and being very close to her previous place of employment she decided to rent her place out and move. She said that she was now closer to her son in a "fresh environment that doesn't have as many triggers."
2. The appellant described herself as a happy, bubbly and friendly person who loved to go out and socialise before she had the subject injury. She stated that outside of work she participated in recreational activities like tennis, kayaking, singing, camping and various art and craft lessons. She stated that her condition has had a huge impact on her social life.
3. The appellant wrote:

"47. I have at times attempted to catch up with friends. On a couple of occasions I have actually made it but only with the aide (sic) of my dog but left a short time later as I became overwhelmed and very teary. I felt like I didn't belong. I felt as if my life was useless and I could not engage in conversation.

1. On other occasions, which is mostly the case, I haven't been able to get myself out of the house to meet with a friend, so I do not attend.
2. One other occasions when I have been out, I saw students from school and I had a panic attack and had to hide in the toilets.
3. I joined a gym but was unable to go due to my anxiety and wasted a 12 month

1. I stopped going out as it was embarrassing and became too hard to explain to

1. On one occasion I bought a ticket to a small music concert but didn't go in the end as my friend could not get me out of my house to go. I have tried on other

1. Prior to my injury I used to go and do the Parkrun, but again had to stop due to

1. I enjoyed going to the 16 Footers club which is close to me. I stopped going as I

could not tolerate the crowds and the potential of running into someone like a

student from school, which did happen so I stopped going. On the occasion I did

attend, I did so with the assistance of a close friend. But in the end it was too much for me and I had to go home early. The anxiety, tremors, difficulty breathing was enormous. My friend eventually saw and helped me out. I was lucky to make it home as I could not breath and I was dizzy and felt sick. When I got home I was

1. I was an avid gardener and it was my happy place. I no longer have the interest

and my garden subsequently became overgrown and messy.

1. I loved art, painting and photography but my interest is just no longer there. I have no energy or interest in pursuing these activities.
2. I have attempted to get back into some activities gradually as recommended by

my treating psychologist but I am not having much success.

1. I loved to go away and go camping. I attempted a camping holiday about 18

months ago with my son and his in-laws. I ended up having to come home early as I was triggered by the children, the isolation and not fitting in.

1. I will not venture out of the house socially without someone to help me. This will

be a good friend of mine or one of my children who support and stay with me. I

go out socially very seldomly but not without a support person. On these occasions. I do not enjoy myself and I always leave early.

1. Since being unable to return to work and my psychological condition, my social

circle and friends collapsed. I found I was isolated and have difficulty mixing with

people. I cannot cope being in crowded rooms. I have no confidence in putting

myself amongst others. I regularly hyperventilate and freeze. I become emotional.

1. I walk my dog as a way of getting out of the house."
2. Dr Mukesh Kumar, consultant psychiatrist, in a report dated 24 January 2023, assessed Class 3 for social and recreational activities providing the following reasons:

Ms Rowen reported that she does not go out and socialise with anyone. She says that she used to be very social. She still has a few close friends and she does interact with them however this is now quite rare. She says that when she does socialise with her friends she is usually very quiet and withdrawn. She says that she used to like gardening and art, however she has lost interest in these activities and does not engage in any recreational activities."

1. Dr Alexey Sidorov, consultant psychiatrist, in a report dated 26 May 2023 assessed Class 2 for social and recreational activities providing the following reasons:

There is evidence of a mild impairment. Ms Rowen occasionally goes out to social events and socialises with her friends but less frequently than in the past."

"She regularly takes her dog for walks but avoids going to crowded places as this makes her more anxious. She sees her family regularly including her son, daughter-in-law, and granddaughter. She does not like going out much as she feels anxious. She is also embarrassed and ashamed to meet her friends as she is on workers compensation. She enjoys gardening less than she did in the past.

She goes out with her mother and at times with her friends, for example, she recently went to a concert with one of her friends. She had been on romantic dates last year, but they did not result in long-term relationships."

1. The clinical notes and records of the Newpsych Psychologists contain the following entries:

"(a) On 8 November 2023, Ms Lovat noted 'Noosa with Mum was ok, had a nice time but was exhausted at the end of it... Going out with neighbours today for Melbourne Cup. Bit nervous but grateful I was invited.'

(b) On 31 August 2023, Ms Lovat noted 'Creating more friendships / positive interactions with others around local area.'

(c) On 1 August 2023, Ms Lovat noted: 'Connecting with friends a bit more. Got chance to sit down with a couple of them at lunch and say some things. Going to Broken Hill for a music festival with a couple of friends late Aug ... Thinking of taking Mum up to QLD to visit her sister. Foot still in boot. But still trying to get out & walk. Going over to the beach a lot.'"

1. In the report for Rehabilitation Services by Altius dated 4 July 2023, Ms Lovat noted that the appellant was currently in the middle of relocating residences to be closer to her son and granddaughter.
2. The appellant submits that the Medical Assessor failed to appropriately and accurately allocate some of his factual findings into the appropriate PIRS category and therefore took into account incorrect criteria in the category of social and recreational activities. The appellant argued that this led to an erroneous class assessment.
3. The matters raised by the appellant are as follows:

(a) Trip to Bali - the appellant submits that a holiday such as this has various aspects to it which ought to properly fall under a number of other scales in the PIRS. The Appeal Panel accepts the actual activity of travelling to Bali comes under travel, but considers that the time spent on holiday after arriving at the holiday destination, is best described as a recreational activity and is to be taken into account in the scale of social and recreational activities.

Ms Lovat noted on 21 July 2023 that the appellant had been invited to go to Bali with 'Lachlan & Jess and their parents in Feb. Feel good to be included in that.'

In addition, the Appeal Panel noted that Ms Lovat reported on 8 November 2023 that the appellant went to Noosa with her mother. The Medical Assessor noted that the appellant also reported going to a holiday with her son, daughter-in-law and her family for a weekend, up the coast a couple of years ago.

The Medical Assessor noted that the trip in 2024 to Bali was for 12 days and she said whilst she enjoyed parts of it, being away was difficult and pushed herself to go. The Medical Assessor noted that she had her own room and spent time in her room at times. However, the Medical Assessor noted that the appellant spent most other times outside her room with her family, and they had a driver to go and sightsee. The Appeal Panel accepts that the appellant may not have been as engaged and enjoyed the holiday as much as she would have done prior to the work injury and the appellant remained a little bit isolated during it, i.e. less actively involved. The Appeal Panel accepts that the travel to Bali and the quality of her relationships with her family when there reflect conduct rated in other categories but the recreational aspects of her conduct on the holiday match aa a Class 2 descriptor.

(b) Audiobooks - the Appeal Panel noted that there was no reference to listening to audio books in reasons for decision provided in respect of the social and recreational category in the PIRS Rating Form. The reference to listening to audio books in the PIRS Rating Form was contained in reasons for decision provided in respect of the scale of concentration, persistence and pace. The Appeal Panel accepts that the Medical Assessor referred to the listening to audiobooks in the MAC under the heading 'Social activities/ ADL' and also at Part 10 c. However, the Appeal Panel considers that it is clear that the Medical Assessor did not rely on the listening to audiobooks as an example of a Class 2 recreational activity in the PIRS Rating Form. However, even had the Medical Assessor taken this into account, the Appeal Panel is not persuaded that removal of this activity would result in a material change to the rating in this category, given the number of examples of a mild impairment.

(c) Walking her dog - the Appeal Panel noted that there was no reference to walking the dog in reasons for decision provided in respect of the social and recreational category in the PIRS Rating Form and no reference to walking the dog in the PIRS Rating Form. The Medical Assessor did state in the Reason for Decision in the scale of social and recreational activities in the PIRS rating form that since her work injury, 'she has engaged in different recreational activities with different people, as previously noted in the body of the certificate' and that she 'also has solitary recreational activity.'

Stern JA in Botha v Secretary, NSW Department of Customer Service [2024] NSWSC 781 at [68] considered the aim of Table 11.2 and said: "Rather, the intention in table 11.2 is to provide a tool for assessing the worker's ability to engage in activities that are properly characterised as 'social or recreational."

The Appeal Panel accepts that walking a dog can be a social as well as a recreational activity if there is interaction with other dog owners.

The appellant submits that while the Medical Assessor might consider walking her dog as a recreational activity, this is erroneous and without foundation. The Appeal Panel accepts that Dr Dinesh Sinnaduray in his report dated 16 February 2024 recommended daily exercise to be undertaken by the appellant as a form of treatment and her statement at paragraph 61 she states that she walks her dog as a way of getting out of the house. The appellant argues that consequently, walking the dog was incorrectly categorised as a recreational activity. Many recreational activities are recommended by clinicians as part of recovery and sustaining wellbeing. The ascertainment of impairment is determined on the capacity to undertake such activities, not the reason why.

The Initial Assessment report of Rehabilitation Services by Altius dated

17 August 2021, which set out the appellant's self-reported functional status pre-injury, noted that she reported 'hobbies to include reading and arts activities including painting. She reported she would attempt to walk her dog two to three times per week.' In the same report, the appellant explained her physical routine had always been poor. She reported 'as she was not at work, she was trying to walk her dog more often...' The Appeal Panel infers that walking her dog is not only a means to get out of the house, but also as a means of physical exercise. In this report, it was also noted that when the appellant was at the dog park, she would engage in 'small talk' with other dog owners.

The Medical Assessor noted that the appellant stated that she walks the dog, and said she would not be out as much, without her dog. He also noted that she enjoyed listening to audiobooks while walking her dog. On balance, the Appeal Panel is satisfied that walking the dog is an activity that is properly characterised as social or recreational. Further, even if the Appeal Panel was wrong in characterising walking the dog as social or recreational, this would not result in a material change to the rating in this category.

(d) Contact with friend - in the Reasons for Decision provided in respect of the social and recreational category in the PIRS Rating Form, the Medical Assessor referred to engaging in different recreational activities with different people and occasionally eating out at a café with a friend.

The appellant submits that the fact that she maintains contact with one friend is not correctly categorised as a social and recreational activity but is appropriately categorised as social functioning. The appellant accepts that it is possible that having coffee and lunch could be appropriate to social activities, but the descriptor used by the Medical Assessor 'enjoys' runs contrary to the available evidence.

The Medical Assessor noted in the MAC under 'Social Activities/ADL' that the appellant saw a friend previously but not for 18 months, does not see her other friends and has not seen friends from the Swansea school. He then noted that she said she was not going to 'many concerts', had one friend in Nelson's Bay and for the last two years they would catch up on average every one to two months for lunch or coffee at a café.

The Medical Assessor used the word 'occasionally' not 'rare' in his reasons when stating that the appellant occasionally eats out at a café with a friend. The use of the word 'occasionally' rather than 'rare', in the context of going with a friend, is significant and consistent with a Class 2 Descriptor in this category. The Medical Assessor specifically stated that the appellant did not need prompting or a support person as she had some solitary recreational activities and some of the recreational activities were social by mature.

The appellant submits that the word 'enjoys' attaches significant meaning in the context of psychiatric symptoms and use of it assumes that the appellant is actively engaged and does not require prompting to attend such events. The Appeal Panel reject this submission as both Class 2 and Class 3 descriptors for social and recreational activities refer to the worker not being actively involved and make no reference to enjoyment.

(e) Time with mother - the Appeal Panel noted that there was no reference to time with mother in the reasons for decision provided in respect of the social and recreational category in the PIRS Rating Form and no reference to her mother in the PIRS Rating Form under 'social functioning.' The Medical Assessor did state in the Decision under 'Social activities/ADL' that she was close to her mother and 'they cook together.' He noted that she said her mother visits her two to three times per week. While the Appeal Panel accept that time with her mother is in the main characterised as social functioning, once they go out, or go on holiday to Noosa or get together and start cooking, the activity then becomes one that can be characterised as social and recreational. The quality of the relationship with the mother is characterised as social functioning, but activities that they do together are social and recreational activities.

(f) Enjoys time with son's family - the Appeal Panel noted that there was no reference to time with son's family in the reasons for decision provided in respect of the social and recreational category in the PIRS Rating Form and only a reference to the relationship with her son and in-laws in the social functioning category in the PIRS Rating Form. The appellant submits that the Medical Assessor conflates spending time with her son with spending time with her 'son's family' and she moved to Nelson Bay to be close to her son rather than moving there to be close to his family. The Medical Assessor noted in the MAC that the appellant enjoys time with her son's family and that was the main reason she moved there. Ms Lovet, in a report for Rehabilitation Services dated 4 July 2023, noted that the appellant was in the middle of relocating residences to be closer to her son and granddaughter. In addition, as noted above, the appellant has been on holidays with her son and his family to Bali and up the coast. The appellant submits that spending time with her son is properly categorised under social functioning rather than social and recreational activities. The Appeal Panel is satisfied that the Medical Assessor did in fact categorise time with her son under social functioning, but any social and recreational activities in which she engaged with her son and his family, such as going on holidays, can be taken into account in the assessment in this category.

(g) Support person and prompting - the Medical Assessor, in the reasons for decision provided in respect of the social and recreational category in the PIRS Rating Form, expressly found that the appellant did not need prompting or a support person. The Appeal Panel is satisfied that the Medical Assessor would have explored this with the appellant during the examination. The appellant submits that the Medical Assessor contends that the appellant is actively engaged but provides no support for this contention. The Appeal Panel notes that this should be read in the proper context. The Medical Assessor wrote:

'In my assessment, I confirmed that Ms Rowen had been overseas for a holiday. She does enjoy listening to audiobooks while walking her dog. She also has occasional contact with a friend and enjoys being out, having coffee, or having lunch together. Aside from that, she enjoys time with her mother, and they cook together at home, and she enjoys time with her son's family and that was the main reason she moved there. Overall, this is consistent with 2 and not 3, as she is actively engaged and does not need prompting or support person, and has different recreational activities with different people, and solitary recreational activities as well.'"

1. The Appeal Panel also noted the reference by Ms Lovat on 7 November 2023 to the appellant going out with "neighbours today for Melbourne Cup. Bit nervous but grateful I was invited." There was no suggestion that the appellant required a support person to attend that event or need prompting to go. A support person is someone who provides a person with the emotional, psychological or practical support needed to manage that circumstance and distinguishable from a companion who happens to be available and accompanies the person.
2. In respect of social activities generally, the appellant provided examples of past events in her statement including a concert, a camping trip, a food and wine festive and a holiday. The appellant argues that the evidence shows that she attended these events only with her trusted friend or family and that on attending these events she either leaves early or isolates herself due to adverse effects of her psychological condition. Additionally, the appellant submits that the events referred to occurred two or more years ago prior to the assessment by the Medical Assessor, nothing more recent. The Appeal Panel notes that evidence in fact shows that during the last two years the appellant went on holidays to Noosa and Bali and attended a Melbourne Cup function with her neighbours in November 2023.
3. The Appeal Panel does not accept that the Medical Assessor failed to provide any or any adequate reasoning for his determination that the appellant is actively engaged and does not require a support person. The Appeal Panel is satisfied that the activities described by the Medical Assessor in the PIRS Rating Form for the category of social and recreational were properly characterised as of social and recreational activities and the Medical Assessor did not take into account any irrelevant consideration in the context of assigning a Class 2 assessment for social and recreational activities.
4. These grounds of appeal are not made out.
5. For these reasons, the Appeal Panel has determined that the MAC issued on 19 May 2025 should be confirmed.