1. On 22 October 2025 Susan Sarkis (the Appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Surabhi Verma, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on

25 September 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. On 19 June 2025 the appellant lodged an Application to Resolve a Dispute (ARD) with the Personal Injury Commission (Commission). The appellant, in summary, pleaded that in the course of her employment with Willis Australia Group Services Pty Ltd (the respondent) between about 5 December 2018 and 16 July 2019 she experienced multiple incidents of bullying and harassment and unreasonable/discriminatory treatment sustaining psychological injury on the deemed date of 12 July 2019.
2. The appellant claimed permanent impairment compensation in respect to psychiatric and psychological disorders pursuant to s 66 of the Workers Compensation Act 1987 (1987 Act).
3. The respondent lodged a Reply to Application to Resolve Dispute (Reply) with the Commission on 15 July 2025. The injury was not disputed however the degree of impairment was disputed.
4. The appellant was examined by the Medical Assessor on 22 September 2025. The Medical Assessor assessed due to psychological injury on the deemed date of 12 July 2019 an 8% whole person impairment (WPI).

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 worker to undergo a further medical examination because the information contained in the MAC and the evidence before the Commission was sufficient to determine the appeal and there were no issues which would be assisted by a further examination.

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. In summary, the appellant submits that the Medical Assessor has erred in assessing:

(a) class 2 impairment in respect of Self Care and Personal Hygiene;

(b) class 2 impairment in respect of Social and Recreational Activities;

(c) class 2 impairment in respect of Travel;

(d) class 2 impairment in respect to Social Functioning, and

(e) class 3 impairment in respect of Concentration, Persistence and Pace.

1. In the appellant's submission the Medical Assessor has made demonstrable errors when assessing:

(a) Self Care and Personal Hygiene in their reliance on a photo of the appellant from her 50th birthday;

(b) Social and Recreational Activities in their reliance on photos of the appellant's "visits" to the Royal National Park and associated social media posts;

(c) Travel in failing to provide reasons as to why she "rejected" the appellant's statement evidence;

(d) Concentration, Persistence and Pace in failing to "properly take into account the recent medical evidence and the content of her statement dated 1 August 2025", and

(e) Social Functioning in failing to provide adequate reasoning.

1. In the appellant's submission the Medical Assessor has also erred on the basis of incorrect criteria when assessing:

(a) Self Care and Personal Hygiene in that on the basis of the Medical Assessors examination the appellant should have been assessed as Class 3, and

(b) Social Functioning in that on the basis of the Medical Assessors examination and the appellants statement evidence the appellant should have been assessed as Class 3.

1. In reply, the respondent submits in response to the appellants submissions in respect to demonstrable error:

(a) in respect to Self Care and Personal Hygiene that in line with the presumption of regularity, the Medical Assessor is presumed to have read all the material referred to them. That the Medical Assessor conducted a thorough assessment. That the Medical Assessor did not explicitly stipulate that the photo carried more significance than the other evidence in forming her assessment. That the Medical Assessor explained their path of reasoning and there is no demonstrable error;

(b) in respect to Social and Recreational Activities, that the Medical Assessor clarified with the appellant that her husband drove to the Royal National Park and Bundeena and then drove back home. That in line with the presumption of regularity, the Medical Assessor is presumed to have read all the material referred to them. That the Medical Assessor conducted a thorough assessment. That the Medical Assessor did not explicitly stipulate that the evidence in respect to the Royal National Park carried more significance than the other evidence in forming her assessment. That the Medical Assessor explained their path of reasoning and there is no demonstrable error;

(c) in respect to Travel, the respondent disputes that the Medical Assessor failed to properly engage with the evidence. The respondent submits that in line with the presumption of regularity, the Medical Assessor is presumed to have read all the material referred to them. That the Medical Assessor conducted a thorough assessment and that the Medical Assessors observations were recorded as a direct account provided by the applicant. That the Medical Assessor explained their path of reasoning and there is no demonstrable error;

(d) in respect to Concentration, Persistence and Pace, the respondent disputes that the appellant failed to properly engage with the evidence. The respondent submits that in line with the presumption of regularity, the Medical Assessor is presumed to have read all the material referred to them. That the Medical Assessor conducted a thorough assessment and that the Medical Assessors observations were recorded as a direct account provided by the applicant. That the Medical Assessor explained their path of reasoning and there is no demonstrable error, and

(e) in respect to Social Functioning, that in line with the presumption of regularity, the Medical Assessor is presumed to have read all the material referred to them. That the Medical Assessor conducted a thorough assessment. That the Medical Assessor did not appear to apply any weight to the alleged "inconsistency" in forming her assessment, nor did she raise any issues with the appellant's credibility which supports that she generally accepted the appellant's version of events. That the Medical Assessors findings in respect of her assessment were open to her on the evidence and were not based on the application of incorrect criteria or a demonstrable error. That there was no denial of procedural fairness in the carrying out of the Medical Assessment.

1. In reply, the respondent submits in response to the appellants submissions in respect to application of incorrect criteria:

(a) that the Medical Assessors assessment in respect to Self Care and Personal Hygiene was open to be made on the evidence and was not based on incorrect criteria, and

(b) that the Medical Assessors assessment in respect to Social Functioning was open to be made on the evidence and was not based on incorrect criteria.

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 appellant challenges the Medical Assessor's assessment in five of the Permanent Impairment Rating Scale (PIRS) scales being:

(a) Self Care and Personal Hygiene;

(b) Social and Recreational Activities;

(c) Concentration, persistence and pace;

(d) Travel, and

(e) Social Functioning.

1. Functional impairment in each PIRS is rated using class descriptors with examples of identifying activities provided for each class. The classes range in severity from 1 to 5, none or minor deficit through to totally impaired.[1] The example activities provided are "examples only."[2] Garling J observed in Jenkins v Ambulance Service of New South Wales [2015] NSWSC 633 at [57]:

"The submission of the plaintiff that, in assigning a class of impairment to each scale, the AMS is restricted only to the examples of activities listed in the tables or, alternatively, to those activities as a minimum, cannot be accepted."

Ground one: demonstrable error with respect to Self Care and Personal Hygiene

1. The Medical Assessor assessed Self Care and Personal Hygiene at Class 2. The appellant submits that she should have been assessed at Class 3.
2. The class descriptors for Self Care and Personal Hygiene appear in Table 11.1 of the Guidelines. Relevantly the descriptors for classes 2 and 3 are as follows:

"Class 2 Mild impairment: Able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food.

Class 3 Moderate impairment: Can't live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit) 2-3 times per week to ensure minimum level of hygiene and nutrition."

1. In recording the history related to the injury and in particular the appellant's social activities/ADL the Medical Assessor recorded:

"Self-care and Personal Hygiene: Ms. Sarkis reported that she showers irregularly but was unable to explain why. She mentioned that she brushes her teeth inconsistently as well. Regarding household chores, she can occasionally wipe down the benches and tries to push the dishes away. She is capable of cooking meals like rice, scrambled eggs, and toast. She has gained about 5kg and now weighs approximately 95kg, compared to 87kg at the time of the incidents at work. She attributed the weight gain to relying heavily on takeaway and being physically inactive. She also reported that she is not overly concerned about her appearance or dress. I then highlighted the photos dated 6 June 2023, which noted that it was her 50th birthday. Ms. Sarkis clarified that it was her 50th birthday, and her family took her to Hyams Beach for lunch with her daughter, which her daughter posted."[3]

1. In assessing Self Care and Personal Hygiene as Class 2 the Medical Assessor recorded the following reasons on the PIRS Rating Form:

"Ms Sarkis reported that she showers irregularly but was not able to give any reasons why she does that. She said that she brushes her teeth irregularly as well. In terms of household chores, she is able to at times wipe the benches, tries to push the dishes away.

She is able to cook simple things like cooking rice, scrambled eggs and toast. She has gained weight about 5kg and currently weighs about 95kg. She used to weigh 87kg at the time of the incidents at work. She attributed the weight gain to relying heavily on a lot of takeaway and physically inactive.

She reported that she is not overly concerned about how she looks and how she is dressed. I then highlighted the photos dated 6 June 2023 where it mentions that it was her 50th birthday. Ms Sarkis clarified that it was her 50th birthday and her family took her to Hyams Beach for lunch with her daughter and that is what the daughter posted."[4]

1. In the appellants submission "it is clear" that the "photos dated 6 June 2023" have played a significant role in the Medical Assessors assessment of Class 2.
2. An Instagram post dated 6 June 2023 includes an image of the appellant.[5] The post is dated 6 June 2023 however the image is undated. The same image or one taken at the same time appears in the Application to Lodge Additional Documents lodged on behalf of the appellant dated 1 August 2025. That image is date stamped in October 2020 which is consistent both with the appellant advising the Medical Assessor that the photo was taken at her 50th birthday lunch and with the appellant's statement evidence at [8] of her statement made

1 August 2025. 3. Whilst it is presumed, that the Medical Assessor has read all the material referred to them[6] and whilst the Medical Assessor noted that the image was taken at the appellants 50th birthday lunch there is no indication that the Medical Assessor appreciated that the image had been taken in October 2020 and not June 2023. 4. In respect to the time at which the image was taken the Medical Assessor recorded a history that the appellant last worked for the respondent in July 2019, resigned her position in October 2019 and started work with a different employer in November 2019 for about three weeks and was unable to continue and had a work trial in 2020 for two to three weeks but could not proceed.[7] That her treatment included two hospital admission in 2021 and 2022.[8] 5. It is also the appellant's evidence at [143] of her statement made 10 June 2025 that in or around October 2020 she made an attempt to return to the workforce performing a temporary role. 6. The Panel accepts the appellant's submission that the Medical Assessor has placed undue reliance on the image from the appellant's 50th birthday lunch. The assessment of impairment is conducted as at the time of the examination. A significant period of time had elapsed since the image was taken approximately five years prior to the Medical Assessors examination and assessment of the appellant. At the time that the image was taken the appellant was attempting to return to work and following the taking of the image there has been further developments in the appellant's condition including her hospitalisation on two occasions. 7. In the view of the Panel the Medical Assessors reliance on the image is a demonstrable error. In the view of the Panel the reliance on the image lead to the Medical Assessor incorrectly assessing impairment of Self Care and Personal Hygiene as Class 2. In the opinion of the Panel the evidence before the Medical Assessor supported a Class 3 impairment. 8. The appellant reported as noted by the Medical Assessor that she showers and brushes her teeth irregularly. The Medical Assessor noted in respect to the appellant's symptoms that she sometimes forgets to eat and forgets to shower and struggles to organise a pantry.[9] The appellant at [145] of her statement dated 10 June 2025 states that she usually forgets "to eat until the late afternoon, only realising this when I start to feel dizzy." It is the appellant's evidence at [158] of her statement dated 10 June 2025 that she does "not shower regularly, often only once a week. I may wear the same clothes for several days until my husband or daughter notices and encourages me to shower." She performs minimal household chores at times wiping the bench tops and tries to push the dishes away and relies heavily on takeaway food. 9. The classification of the impairment will be considered further in respect to ground five of the appeal which relates to the application of incorrect criteria in respect to Self Care and Personal Hygiene.

Ground two: demonstrable error with respect to Social and Recreational Activities

1. The Medical Assessor assessed Social and Recreational Activities at Class 2. The appellant submits that she should have been assessed at Class 3.
2. The class descriptors for Social and Recreational Activities appear in Table 11.2 of the Guidelines. Relevantly the descriptors for classes 2 and 3 are as follows:

"Class 2 Mild impairment: Occasionally goes to such events eg without needing a support person, but does not become actively involved (eg 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. In recording the history related to the injury and in particular the appellant's social activities/ADL the Medical Assessor recorded:

"Social and Recreational Activities: Ms. Sarkis previously enjoyed photography, going to the beach, visiting Bowral, and exploring antique shops. She mentioned that she now does not take many photographs but still goes to Bowral, enjoys long drives, visits the local dam, and stops at lookout points with her husband. She also goes out with her daughter, walking to the nearby café. She has a few friends who text her good morning and good night messages daily. She sees them face-to-face on their birthdays at the café. She also visited a friend, Betty, at her house. About two months ago, she attended a funeral in Wollongong for her friend's brother-in-law. I highlighted photos of her visits to Royal National Park; she said she and her husband drove there, went to Bundeena, and then drove back home. Her brother also visits her on special occasions, including, Father's Day and his birthday."[10]

1. In assessing Social and Recreational Activities as Class 2 the Medical Assessor recorded the following reasons on the PIRS Rating Form:

"Ms Sarkis previously enjoyed photography, going to the beach, going to Bowral and antique places. She said that now she does not do a lot of photography but continues to go to Bowral, go for long drives, to local dam and to look out points with her husband. She also goes out with her daughter and walks with them to the nearby café.

She has a few friends who text her good morning and good night messages every day. She sees them face to face on their birthday at the café. She also went and visited one of her friends Betty at her house. She attended a funeral in Wollongong about two months back of her friend's brother-in-law.

I then highlighted the photos mentioning her visits to Royal National Park. She said that she and her husband had gone there and drove to Bundeena and then drove back home. Her brother will also visit her on special locations including Father's Day and his birthday."

1. The appellant submits that the Medical Assessor did not properly engage with the evidence and has incorrectly placed weight on a Facebook post.
2. The Medical Assessor does not identify the photos mentioning the appellant's visits to the Royal National Park. It is not entirely clear as to what photos the Medical Assessor was referring.
3. In the appellants submission the Medical Assessor appears to have been referring to page 41 of the Reply. There does not appear to be any other photographs to which the Medical Assessor could be referring. Page 41 of the Reply contains a Facebook post made by the appellant on 2 January 2025. The photographs in the post however appear to come from a website named "Sydney Uncovered" and do not appear to be photographs taken by the appellant. The posts made by the appellant at page 42 of the Reply are in respect to complaints by the appellant and others in respect to it taking years for the road to Garie Beach to be repaired.
4. The appellant at [18] of her statement made 1 August 2025 states in respect to the post that her family used to go to Garie Beach "all the time approximately 5 years ago but had no longer been able to continue going there due to road work issues and that's what I was expressing." The appellants statement evidence is in the view of the Panel consistent with the Facebook posts made on 2 January 2025 which included:

"That's our family beach we used to go every weekend. After lockdown then the road being washed away there it's been so disappointing not to be able to continue our family memories there."

1. The Panel accepts that the Facebook posts and the appellant's evidence indicate that the appellant has not attended Garie Beach for some time. The Panel does not however accept that the appellant has not visited the Royal National Park for some time. The Medical Assessor took a history from the appellant that she had with her husband driven to Bundeena and back to their home.
2. In the opinion of the Panel regardless of any reliance which the Medical Assessor placed on the Facebook post of 2 January 2025 the Medical Assessor has not fallen into error in assessing the appellant as Class 2 for Social and Recreational Activities. The Medical Assessor recorded that whilst the appellant had previously enjoyed photography, she still takes some photographs albeit not many. The appellant still goes to Bowral, enjoys long drives, visits the local dam and stops at lookout points with her husband, goes out with her daughter walking to a nearby café, has a few friends who text her daily and whom she sees at the café on birthdays, and she visited a friend at her home.

Ground three: demonstrable error with respect to Travel

1. The Medical Assessor assessed Travel at Class 2. The appellant submits that she should have been assessed at Class 3.
2. The class descriptors for Travel appear in Table 11.3 of the Guidelines. Relevantly the descriptors for classes 2 and 3 are as follows:

"Class 2 Mild impairment: Can travel without support person, but only in a familiar area such as local shops, visiting a neighbour.

Class 3 Moderate impairment: Cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment."

1. In recording the history related to the injury and in particular the appellant's social activities/ADL the Medical Assessor recorded:

"Travel: Ms. Sarkis reported that she leaves home to see her doctors, pick up things from the shop, and visit the butcher whenever she can. She can drive to the butcher, which is about a 15-minute drive. She mentioned that in 2022, they only had one car, and she often drove her husband and daughters around. She travelled to Melbourne for a week because her daughter has autism and she needed to meet people; since she couldn't do it alone, she accompanied her daughter. In 2023, her father passed away, and she travelled to Tasmania and stayed there for a week."[11]

1. In assessing 'Travel' as Class 2 the Medical Assessor recorded the following reasons on the PIRS Rating Form:

"Ms Sarkis reported that she leaves her home to see her doctors. Pick up things from the shop and butcher whenever she can. She is able to drive to butcher which is about a 15-minute drive. She said that in 2022 they only had one car, and she would often pick and drop her husband and her daughters.

She travelled to Melbourne for a week as her daughter has autism and she had to meet people and since she could not do it on her own, she accompanied her daughter. In 2023, her father passed away and she travelled to Tasmania and stayed there for a week."[12]

1. In the appellant's submission the Medical Assessor has failed to provide reasons as to why she rejected the appellant's evidence relevant to travel contained in the appellant's statement dated 10 June 2025 at ARD pages 1 to 37 and in the appellant's supplementary statement dated 1 August 2025.
2. At [173] of her statement dated 10 June 2025 the appellant states that she is "primarily homebound and only go out for medical appointments or when her family insist." That whilst she lost he driver's licence in "around 2022 due to challenges with maintaining speed limits in tunnels and frequent lapses in focus on the road" she has since regained her licence but "only drive when necessary to attend appointments or drop my children off to the station and to pick up minimal grocery items due to ongoing difficulties with concentration and episodes of dissociation."
3. At [175] the appellant states:

"I typically only leave my home when accompanied by my husband, daughters, or mother. I do not go out except to receive treatment, usually from my psychologist and other therapists but have not been able to and most of my treatment would be via zoom sessions instead for long periods of time. When I drive alone, I often cry in the car and sometimes lose awareness of my location due to dissociation."

1. At [24] of the supplementary statement dated 1 August 2025 the appellant states that she "barely" leaves her home "with the only travel being in relation to the odd medical appointment." It is the appellant's evidence that the majority of her treatment has changed to telehealth due to her "inability to drive." It is the appellant's evidence at [25] that due to her "deteriorating condition, despite only being a 7 minute walk away from Woolworths, I have been required to rely upon Doordash for me and my family's basic shopping item needs."
2. In the appellant's submission it is "clear" from the appellant's statement evidence that the Medical Assessor has failed to address in particular the appellant's reliance on Doordash and that medical appointments have changed from face-to-face to telehealth.
3. In the view of the Panel the Medical Assessor has not erred in assessing the appellant at Class 2 for Travel. The statement evidence on which the appellant relies in respect to the appeal confirms that Medical Assessor has correctly recorded that the appellant leaves her home to attend medical appointments and obtain items from the shops. The appellant may rely on Doordash and the "majority" of her medical appointments may be by way of telehealth, but the evidence supports that she still does leave her home on occasions and drives herself for those purposes as well as to drop her children at the station.
4. It was not necessary in the opinion of the Panel for the Medical Assessor to provide reasons as to why she had rejected the appellant's statement evidence as the observations recorded by the Medical Assessor on which the assessment of Class 2 for Travel is based are consistent with the appellants statement evidence.

Ground four: demonstrable error with respect to Concentration, Persistence and Pace

1. The Medical Assessor assessed Concentration, Persistence and Pace at Class 3. The appellant submits that she should have been assessed at Class 4.
2. The class descriptors for Concentration, Persistence and Pace appear in Table 11.5 of the Guidelines. Relevantly the descriptors for classes 3 and 4 are as follows:

"Class 3 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.

Class 4 Severe impairment: Can only read a few lines before losing concentration. Difficulties following simple instructions. Concentration deficits obvious even during brief concentration. Unable to live alone, or needs regular assistance from relatives or community services."

1. In recording the history related to the injury and in particular the appellant's social activities/ADL the Medical Assessor recorded:

"Concentration, Persistence and Pace: Ms. Sarkis reported that she binge-watches a lot of series. She watches The Block, which is her and her husband's favourite show. She said that her concentration is poor. She forgets that she has already watched things. She often schedules activities at different times and has double booked her appointments. She gets distracted quickly and struggles with multitasking."[13]

1. In assessing Concentration, Persistence and Pace as Class 3 the Medical Assessor recorded the following reasons on the PIRS Rating Form:

"Ms Sarkis reported that she binge watches a lot of series. She watches The Block which is her and her husband's favourite show. She said that her attending concentration is poor. She forgets that she has already watched things. She often schedules things at different times and has double booked her appointments. She gets distracted quickly and struggles to multitask."[14]

1. In the appellant's submission the Medical Assessor failed to properly take into account the recent medical evidence and the content of the appellant's statement dated 1 August 2025 which in the appellant's submission evidences a significant worsening in the appellant's condition since the appellant was assessed by Dr Rastogi and Dr Anwar in May and August 2023 respectively.
2. In the submission of the appellant the recent reports of the treating psychologist, Sharon Rasco, merited significant commentary and consideration when assessing Concentration, Persistence and Pace.
3. The Medical Assessor noted the reports of Ms Rasco on page of the MAC.
4. On 16 April 2025 Ms Rasco reported to EML (icare) that between 19 December 2024 and

10 April 2025 the appellant attended eight treatment sessions. Ms Rasco reported that the appellant continued to be "overwhelmed due to the need to complete her statement for workers compensation and legal matters, and at times experiences symptoms of re-traumatisation including a great deal of dissociative symptoms." 5. At [28] of her statement dated 1 August 2025 the appellant records that she had been provided with a copy of an investigation report dated 18 July 2025 and states:

"I have found it extremely difficult to review and respond to each of the issues in the report given my psychological condition and the brief period allowed. Since suffering my injury, I have struggled cognitively. As detailed in my statement dated 10 June 2025 at paragraph 4, it took me 11 months to complete that statement and this was only done with the patience of my solicitor and others helping. Drafting this statement has been similarly difficult and I have only been able to do so with the help of my solicitor."

1. In the appellant's submission the Medical Assessor in the MAC does not take into account the high level of these symptoms as being reflective of a higher impairment rating on the PIRS category. In the appellant's submission it was incumbent upon on the Medical Assessor to provide reasons as to why the applicant's statement evidence and the report of Ms Rasco was rejected.
2. In the opinion of the Panel the Medical Assessor has not fallen into demonstrable error. The appellant in her statement of 1 August 2025 at [28] states that she has "struggled cognitively" since the injury but does not describe those struggles. She then refers to [4] of her statement of 10 June 2025 stating that it "has been similarly difficult" preparing her statement of

1 August 2025 as it had been preparing her statement of 10 June 2025 "and I have only been able to do so with the help of my solicitor." The appellant at [4] of her statement dated 10 June 2025 states:

"This statement has been written with the assistance of therapists and my solicitor due to psychological trauma resulting in severe cognitive impairment. The process has taken close to eleven (11) months to complete in due to retraumatising and severity of symptoms when recalling incidents." [Emphasis Added]

1. The difficulty which the appellant describes at [4] of her statement of 10 June 2025 is retraumatising and severity of symptoms when recalling the incidents. In the opinion of the Panel the appellant's evidence as to her experience in preparing her statement and as recorded by Ms Rasco are not representative of her functioning in respect to Concentration, Persistence and Pace and therefore whether the Medical Assessor accepted or rejected the evidence is irrelevant.

Ground five: application of incorrect criteria in respect to Self Care and Personal Hygiene

1. The appellant submits that given the information elicited from the appellant, the appellant is best assessed as Class 3.
2. In the view of the Panel the Medical Assessor erred in assessing the appellant as Class 2. As discussed above in respect to appeal Ground one it is the view of the Panel that the appellant falls into Class 3. As previously discussed, the appellant reported as noted by the Medical Assessor that she showers and brushes her teeth irregularly. The Medical Assessor noted in respect to the appellant's symptoms that she sometimes forgets to eat and forgets to shower and struggles to organise a pantry.[15] The appellant at [145] of her statement dated 10 June 2025 states that she usually forgets "to eat until the late afternoon, only realising this when I start to feel dizzy." It is the appellant's evidence at [158] of her statement dated

10 June 2025 that she does "not shower regularly, often only once a week. I may wear the same clothes for several days until my husband or daughter notices and encourages me to shower." She performs minimal household chores at times wiping the bench tops and tries to push the dishes away and relies heavily on takeaway food. 3. In the respondent's submission the ability of the appellant to cook simple meals and occasionally wipe down benches and put dishes away indicate an ability to engage in self-care and live independently. The Panel does not accept the respondent's submission. It is the appellant's evidence at [147] of her statement dated 10 June 2025 that although she can at times prepare a basic meal her family lacks confidence in her ability "to cook independently due to many accidents in the kitchen and inability to coordinate the preparation of meals nor follow recipes." At [148] the appellant states that in the past she has left food unattended on the stove resulting in burning, left the gas burner or oven on, left out ingredients 4. In the respondent's submission Dr Anwar assessed Class 2 reporting that the appellant was wearing tidy clothes and appeared well-kempt at her assessment. 5. Dr Nadeem Anwar, psychiatrist, initially examined the appellant on 12 May 2023 providing a forensic report to the respondent dated 13 June 2023. Dr Anwar conducted a further examination of the appellant on 27 July 2023 providing a further forensic report to the respondent dated 25 August 2023. In the report of 25 August 2023 Dr Anwar did assessed impairment of Self Care and Personal Hygiene as Class 2. However whilst Dr Anwar did record, as the respondent submits, that the applicant was wearing tidy clothes and was well kempt at the time of the examination, Dr Anwar also recorded that the appellant's family encouraged her to have a shower and change her cloths regularly and significantly that she showers and changes clothes when attending appointments or visits someone with her family. The Medical Assessor observed that the appellant was not "overly dishevelled" indicating that the appellants presentation to the Medical Assessor was not as kempt as at the time of the appellant's attendance on Dr Anwar approximately two years prior.

Ground six: application of incorrect criteria in respect of Social Functioning

1. The Medical Assessor assessed Social Functioning at Class 2. The appellant submits that she should have been assessed at Class 3.
2. The class descriptors for Social Functioning appear in Table 11.4 of the Guidelines. Relevantly the descriptors for classes 2 and 3 are as follows:

"Class 2 Mild impairment: Existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.

Class 3 Moderate impairment: Previously established relationships severely strained, evidenced by periods of separation or domestic violence. Spouse, relatives or community services looking after children."

1. In recording the history related to the injury and in particular the appellant's social activities/ADL the Medical Assessor recorded:

"Social Functioning: Ms. Sarkis gave one contrasting reply, stating she has a good relationship, but also mentioning it has been strained. However, she said her daughters and her husband have been very helpful. She is attending couples counselling with her husband to help him learn how to cope with the illness. She denied any periods of separation or divorce from her husband."[16]

1. In assessing Social Functioning as Class 2 the Medical Assessor recorded the following reasons on the PIRS Rating Form:

"Ms Sarkis gave one contrasting reply and she said that she has a good relationship and on the other she said it has been strained. She said that however her daughters and her husband have been very helpful. She is attending couples counselling with her husband to help him learn how to cope with the illness. She denied any periods of separation or divorce from her husband."[17]

1. In the appellant's submission the Medical Assessor recorded on page 3 of the MAC in respect to the appellant's present symptoms that "[s]he often has panic attacks, especially in public places, which cause her to hyperventilate and feel unsafe", that "[s]he mentioned feeling 'verbally attacked' by others quite often", that "[s]he tends to stay at home and has become socially withdrawn" and "[s]he is sensitive interpersonal, frequently feeling that others are attacking her."
2. It is the appellant's evidence at [161]-[162] of her statement dated 10 June 2025 that her relationship with her husband and friends has become strained. That her relationship with her husband feels "disconnected", that her husband is struggling to cope with the injury.
3. In the opinion of the Panel the Medical Assessor has not erred in assessing Class 2 for Social Functioning. The appellant's relationships are strained however there is no evidence of any periods of separation from the husband or domestic violence. The children are not being cared for separately however it is noted that the appellant's children are older.

Ground seven: denial of procedural fairness in respect to Social Functioning

1. In the appellant's submission the Medical Assessor failed to provide reasons as to why she determined that the appellant was best suited to Class 3. In the appellants submission if it was due to an alleged inconsistency in the evidence "stating she has a good relationship, but also mentioning it has been strained" then the Medical Assessor failed to raise this inconsistency with the appellant or engage with the statement evidence.
2. The Panel rejects the appellant's submission. Whilst the Medical Assessor recorded that "Ms Sarkis gave one contrasting reply and she said that she has a good relationship and on the other she said it has been strained" that contrasting reply does not impact the appellant being assessed as Class 2 and not Class 3. The examples provided in Class 2 refer to existing relationships being strained however the examples for Class 3 refer to relationships being severely strained as evidenced by periods of separation or domestic violence which is not the case. The path of the Medical Assessors reasoning is clear. In the Panels view there has been no denial of procedural fairness or failure to provide adequate reasons.

1. With the assessment of impairment in respect to Self Care and Personal Hygiene increased to Class 3 the median class score in accordance with [11.14] of the Guidelines is Class 3 with an aggregate score of 17 which in accordance with Table 11.7 of the Guidelines provides an impairment of 19% WPI from which a deduction of 1/10 is applied as assessed by the Medical Assessor for pre-existing impairment giving an impairment of 17% WPI.
2. For these reasons, the Appeal Panel has determined that the MAC issued on

25 September 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 Surabhi Verma 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)

Guidelines 11.11, 11.12 Table: 11.1, 11.2, 11.3, 11.4, 11.5, 11.6

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

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

[1] See: Ferguson v State of New South Wales [2017] NSWSC 887.

[6] State of NSW (NSW Police Force) v Pirie [2022] NSWPICMP 444 at [41].