1. On 4 June 2025 Brendan Sirol, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Yu Tang Shen, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 7 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. The appellant commenced employment as a police officer with the State of New South Wales, the respondent, in 2006 or 2007. Due to several incidents that occurred during his employment he suffered a psychological injury.
2. He claimed compensation from the respondent for permanent impairment from his injury. He relied on a report of consultant psychiatrist Dr Abdal Khan dated 18 July 2024, who had assessed the degree of his permanent impairment from his injury is 19% whole person impairment (WPI).
3. The respondent denied it was liable to pay compensation to the appellant. It relied on a report of psychiatrist Dr Yajuvendra Bisht dated 18 November 2024. Dr Bisht assessed the degree of the appellant's permanent impairment due to his psychological condition is 17% WPI, but he also considered that a proportion of that was due to both traumatic experiences the appellant experienced whilst previously working for NSW Fire and Rescue and the death of a neighbour. Dr Bisht made a deduction of 10% on account of that, reducing his assessment of the appellant's WPI to 15.3%.
4. Dr Bisht also expressed his view in his report that the appellant's psychological condition comprised both a secondary psychological injury arising from physical injuries the appellant suffered in the course of his employment as a police officer and a primary psychological injury due to the traumatic experiences he experienced. Dr Bisht considered that "the contribution the primary injury to his condition would be about 75% and the secondary injury would be about 25%". Upon apportioning 15.3% between those two causes, he assessed the appellant's permanent impairment from his primary psychological injury is 11% WPI. That did not exceed the threshold stipulated by s 65A(3) of the Workers Compensation Act 1987 of at least 15% for the appellant to be entitled to compensation for permanent impairment under s 66(1) of the 1987 Act.
5. Hence a medical dispute arose between the parties relating to the degree of the appellant's permanent impairment from his injury. That led to the appellant instituting proceedings in the Personal Injury Commission (Commission) seeking the Commission determine his claim for compensation for permanent impairment.
6. A referral was written by delegate by the President of the Commission on 22 April 2025 to the Medical Assessor, in response to which the Medical Assessor examined the appellant on 5 May 2025. He did so using the Microsoft Teams platform. As said, he issued the MAC on

7 May 2025, wherein he certified he assessed the degree of the appellant's permanent impairment from injury is 8% WPI. His assessment was done in accordance with paragraphs 11.11 and 11.12 of the Guidelines. That is to say, he assessed the appellant's permanent impairment by reference to the degree of the severity of the appellant's impairment in the six categories of behaviour comprising the psychiatric impairment rating scale (PIRS). His rating of the appellant's impairment for all categories, excepting employability is Class 2. For employability it is Class 5. 7. The appellant in his appeal against the MAC has challenged the Medical Assessor's rating of his impairment in social and recreational activities (SRA) and in concentration, persistence and pace (CPP). 8. In the PIRS rating form within the MAC the Medical Assessor provided the following reasons for rating the appellant's impairment in SRA as Class 2:

"Since the subject injury, he said he has lost most of his friends, and he has one close friend from the police, and his high school friends. He said he rarely sees his high school friend as they live in Sydney, while he lives out in Grenfell, and he avoided a recent birthday party. He said he will see a friend once a week, but he is not 'as outgoing as before'. He said one friend will visit him, and they will have a beer and sit around a fire on the property. He said he goes to a poker match once a week with another friend, and his wife prompts him to go out.

As he has been socially isolated, though still having regular social interactions with a couple of friends, including engagement in a poker game on a regular basis, even though he is not as outgoing as before, he has mild impairment."

1. In the body of the MAC the Medical Assessor also recorded within the history he detailed that the appellant previously engaged in the pastime of hunting but no longer does that because his firearm licence has been revoked. The Medical Assessor also noted that the appellant had informed him that his psychologist said it was safe for him to maintain a firearm. The inference from that is that the appellant's firearm licence was revoked by the relevant authority because of the appellant's psychiatric illness.
2. The Medical Assessor also noted that prior to the appellant suffering his injury, he had many friends whom he saw a few times a week. The Medical Assessor noted that the appellant was involved in football club and coached tag football and that the appellant would have drinks and meals with his friends at the pub after a game.
3. The Medical Assessor observed that his rating of the appellant's impairment in SRA is lower than the ratings both Dr Khan and Dr Bisht respectively made, which was Class 3. The Medical Assessor explained that his rating is lower because the appellant "continues to socialise with his friends regularly, albeit with less frequency and restricted to a narrower range of activities".
4. The Appeal Panel notes that Dr Bisht's reasons for rating the appellant's impairment as Class 3 was that the appellant does not attend social gatherings but is able to leave his residence, and tolerate the company of his GP and psychologist, and occasionally attends poker nights.
5. Dr Khan's reasons were that the appellant previously enjoyed socialising with family and friends and participated in outings, hunting and shooting. Dr Khan noted that the appellant's wife now needs to encourage the appellant to meet up with family and friends and attend poker games, and that otherwise the appellant is socially isolated.
6. In the PIRS rating form the Medical Assessor provided the following reasons for rating the appellant's impairment in CPP as Class 2:

"Since the subject injury, he said his concentration has been 'terrible', and he said he no longer reads, and dislikes filling out forms, and gets assistance to complete forms.

He was alert, and he was able to sustain his concentration for the duration of the assessment. He had no significant difficulties with his recall.

As his concentration difficulties are not so significant as to cause observable impairment, he has mild impairment."

1. In the body of the MAC the Medical Assessor noted that the appellant said that prior to his injury his concentration was "really good", that he could multitask all the time, and could read for up to an hour or so.
2. The Appeal Panel notes that both Dr Khan and Dr Bisht rated the appellant's impairment in CPP as a Class 3. The reasons Dr Khan provided his rating was that the appellant struggled with cognition and experienced difficulties focusing cognitively challenging task such as reading and retaining the information he reads. Dr Khan noted that the appellant becomes easily fatigued after short periods of time when driving, and had an impaired memory.
3. Dr Bisht's reasons for his rating were that the appellant is unable to read more than a few lines before losing concentration. Dr Bisht nevertheless found the appellant was able to sustain concentration throughout the course of his interview with him.

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. This is because the material before the Appeal Panel is sufficient for it to deal with the appeal.

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 Medical Assessor erred by rating his impairment in SRA as Class 2 rather than Class 3 and erred by rating his impairment in CPP as Class 2 rather than Class 3.
3. The appellant referred to the examples of conduct provided in Table 11.2 of the Guidelines for a Class 2 rating and for a Class 3 rating. That table relates to SRA. The appellant submitted that the Medical Assessor's reasons for rating his impairment as Class 2 were not adequate for such a rating. The appellant referred to his evidence in his statement to the effect that he prefers to stay at home, does not go out without a support person, that he attends a poker match with a friend but only when prompted by his wife, and that he recently avoided attending a birthday party. The appellant submitted that evidence is consistent with a Class 3 rating.
4. The appellant referred to both Dr Khan's and Dr Bisht's ratings of his impairment in SRA.
5. The appellant submitted that the Medical Assessor by rating his impairment in SRA as Class 2 based his assessment on incorrect criteria.
6. The appellant noted that the Medical Assessor obtained a history that he has poor concentration whereas prior to his injury he had very good concentration and could multitask all the time and could read up to an hour or so. The appellant referred to the reasons

Dr Khan and Dr Bisht respectively provided for their ratings of his impairment in CPP. The appellant also noted that his evidence in his statement is that he finds it difficult to adapt to new situations and is unable to prepare himself, and that this spikes his anxiety and results in his losing energy. The appellant also noted that his evidence was that he no longer concentrates while watching movies and television shows and that he now completes tasks at a slower pace. The appellant submitted that this evidence is consistent with a Class 3 impairment in CPP. 7. In reply, the respondent submitted that the Medical Assessor's rating of the appellant's impairment in SRA is based on the appellant having a friend visiting him once a week and regularly attending poker games with a couple of friends. The respondent submitted that the Medical Assessor's rating is supported by various pieces of the evidence that were before him, including entries in the records of the appellant's psychologist Ms Jo Merdith dating from September 2022 to June 2023, and the report of Dr Bisht. 8. The respondent submitted that the Medical Assessor's rating of the appellant's impairment as Class 2 in CPP is based on his finding the appellant was alert and able to stay in concentration for the duration for the assessment and had active recall of the issues.

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. An assessment of a workers' impairment by reference to PIRS requires a Medical Assessor to make an evaluative judgement. In doing that the Medical Assessor is required to apply his or her clinical skill to the material before him or her, which will include the history the Medical Assessor composed based on the interview with the worker. The Medical Assessor is entitled to give pre-eminence to his or her clinical observations when evaluating the impairment a worker has from an injury.[1]
4. Regarding the explanation a Medical Assessor must provide for the assessment he or she makes, s 325(2)(c) and (d) of the 1998 Act requires a Medical Assessor to set out the reasons for his or her assessment and set out the facts on which the assessment is based. That obligation clearly requires a Medical Assessor to explain his or her opinion but it does not require a Medical Assessor to explain why their findings or their reasons upon which they make an assessment differ from the findings or opinions of others. A Medical Assessor is required to consider the material that is before him or her insofar as that is relevant to the assessment the Medical Assessor makes. That material of course includes the opinions of any specialist practitioner on which a party has relied to support or oppose a claim. If the Medical Assessor has considered that material, the Medical Assessor will not have erred by forming an opinion different from that the other specialist expressed, and specifically, the Medical Assessor will not have erred by not explaining why his opinion differs from another examiner.[2] Essentially, and in any event, by abiding the obligation under s 325(2) it will be apparent why the Medical Assessor's opinion differs.
5. With respect to the Medical Assessor's rating of the appellant's impairment in SRA, the Appeal Panel considers the Medical Assessor made no error, and based his assessment on the correct criteria, and sufficiently explained why he rated the appellant's impairment as Class 2.
6. The Medical Assessor was required, in accordance with paragraph 1.6. of the Guidelines, to assess the appellant based on his circumstances and presentation on the day of the assessment, and, as said, this involved an evaluative judgement being made by the Medical Assessor. The Medical Assessor was consequently required to apply his clinical expertise to determine the severity of the appellant's impairment in the several categories of behaviour comprising the PIRS. In doing that the Medical Assessor was to be guided by the descriptors of behaviour provided in Tables 11.1 - 11.6 of the Guidelines. But, as paragraph 11.12 emphasises, those descriptors are not prescriptive.
7. The fact that a worker may exhibit conduct according one or some of the descriptors in a particular class does not compel a Medical Assessor to rate a workers' impairment within that class. The Medical Assessor must evaluate all of the material and data before him or her, which includes the clinical history the Medical Assessor has elicited for the purpose of determining the level of impairment the worker has in a particular PIRS category. That history, and the detail otherwise within material before the Medical Assessor, may result in a Medical Assessor rating a worker's impairment in a particular category differently from a class containing a particular descriptor of behaviour the worker displays. Ultimately the task of the Medical Assessor is to consider and weigh all conduct of a worker relevant to a PIRS category in order to evaluate the degree of impairment of the worker in the particular category.[4] That may involve the Medical Assessor give greater weight to the history she or he has obtained over some of the other evidence.
8. It is apparent from the MAC that the Medical Assessor had regard to the appellant's evidence in his statement dated 20 March 2025 and hence was aware of what the appellant said therein regarding his SRA. The Medical Assessor was also aware of how Dr Khan and

Dr Bisht had rated the appellant's impairment in SRA and was aware of their respective reasons for their ratings. 9. The Medical Assessor was aware that the appellant no longer participates in his past-time of hunting. The Medical Assessor was aware that the appellant had become somewhat socially isolated and had lost contact with some of his friends That was in part due to the appellant living in Grenfell and his friends living in Sydney. The Appeal Panel notes that the quality and loss of friendships is conduct rated under social function although has implications for social and recreational activity. 10. In assessing the conduct of SRA the Medical Assessor noted the appellant had avoided a recent birthday party. The Medical Assessor was aware that the appellant's wife prompted him to go to a poker match once a week with a friend. The frequency of this activity is more than rare (and weekly in fact, more than occasional) and by definition playing poker in a "match" indicates active involvement. The Medical Assessor also noted that one of the appellant's friends visits him weekly and that they sit and have a beer around a fire. The Medical Assessor concluded that the appellant's social interactions with a couple of friends were regular weekly social events and that he regularly engaged in a poker game, and the Medical Assessor reasoned that represented a mild impairment in SRA. 11. The examples provided in Table 11.2 of the Guidelines for a Class 2 and Class 3 impairment in SRA are:

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

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

1. The Appeal Panel is of the view that the Medical Assessor took into relevant facts relating to the appellant's frequency and engagement in function in SRA. The Appeal Panel considers that the Medical Assessor did not consider any irrelevant matter when rating the appellant's impairment in SRA. The Medical Assessor's rating is not inconsistent with the level of severity described by the examples in Table 11.2 for a Class 2 rating.
2. In those circumstances, the Appeal Panel discerns no demonstrable error in the Medical Assessor's rating of a mild impairment and that the evidence before him led to a rating of a moderate impairment. The Medical Assessor has based his assessment on correct criteria given he assessed the appellant's impairment in accordance with the criteria with Chapter 11 of the Guidelines.
3. The Appeal Panel however considers that the Medical Assessor erred with rating of the appellant's impairment in CPP. Whilst the Medical Assessor observed the appellant exhibited no difficulties in concentration during his interview, the evidence is that the appellant reports his concentration as terrible relative to what it was before his injury. Further, prior to his injury the appellant read for at least an hour or so, but now no longer reads. The appellant cannot manage to complete forms without assistance.
4. The descriptors provided in Table 11.5 for a Class 2 impairment for CPP are:

"Mild impairment: can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache."

"Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (e.g. operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting."

1. The Medical Assessor has, essentially, rated the appellant as having a Class 2 impairment in CPP solely because the Medical Assessor found the appellant was able to maintain concentration and was alert during his interview of the appellant. It seems to the Appeal Panel that the Medical Assessor has placed weight on that single fact to rate the appellant's impairment in CPP compared to the appellant no longer reading when he could for an hour pre-injury and inability to fill out forms, a task akin to following manuals and frequently more complex than newspaper articles. The appellant's inability to fill out forms reveals he would have difficulty following complex instructions.
2. The matters the Medical Assessor considered, which were all relevant matters, fall within a class of severity of impairment described by the examples of conduct for Class 3, far more so than a severity of impairment described by those for Class 2. The Medical Assessor has not sufficiently explained why, based on the matters he considered and the information he elicited and recorded, which accords with other evidence, he rated the appellant's impairment as Class 2. The MAC consequently contains a demonstrable error.
3. The Appeal Panel must correct that error. It does so by rating the appellant's impairment CPP as Class 3. When that is done the aggregate of his PIRS scores 16. The median remains 2. That accords with 9%, and a treatment effect uplift of 2%, arrives at 11% WPI.
4. For these reasons, the Appeal Panel has determined that the MAC issued on 7 May 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 Yu Tang Shen 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] Cheers v Midcoast Council [2024] NSWSC 1553 at [29] - [31]: [52]; Ferguson v State of New South Wales [2017] NSWSC 887

[2]3 Wingfoot Aust Partners Pty Ltd v Kocak [2013] HCA 43 at [47]; Campbell J in the State of New South Wales (NSW Department of Education) v Kaur [2016] NSWSC 346

[4] Rogers v Help Service Union NSW [2025] NSWSC291 at [43] - [45]