1. The employer State of New South Wales (NSW Police Force) (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ankur Gupta, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 29 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 grounds of appeal on which the appeal is made.
4. Rule 128 of the Personal Injury Commission Rules 2021 (the PIC Rules) and Procedural Direction PIC7 - Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes set out the practice and procedure in relation to the medical appeal process under s 328 of the 1998 Act. An Appeal Panel determines its own procedures in accordance with r 128(1) of the PIC Rules.
5. The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed

1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).

1. The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
2. The appellant did not request that the worker undergo a re-examination by a Medical Assessor who is also a Member of the Appeal Panel. As a result of its preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because although the Appeal Panel found error, there was sufficient material before the Appeal Panel to enable a determination to be made.

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

1. The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision.

1. Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.

1. The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made.
2. In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
3. The matter was referred to the Medical Assessor for assessment as follows:

"The following matters have been referred for assessment (s 319 of the 1998 Act):

• Date of injury: 19 September 2022 (deemed)
• Body parts/systems referred: Psychological/Psychiatric disorder
• Method of assessment: whole person impairment."

1. The Medical Assessor issued a MAC certifying 17% whole person impairment (WPI) as a result of the injury as follows:

page and paragraph number in NSW workers compensation guidelines

Chapter, page, paragraph, figure and table numbers in AMA5 Guides

WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)

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

Chapter 11 NSW workers compensation guidelines for the evaluation of permanent impairment 4th edition

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

1. The assessment was based on his assessment under psychiatric impairment rating scale (PIRS) as required by the Guidelines as follows:

As described in the main body of the report, there is mild impairment. Mr Harland tends to shower and clean his teeth most days, but only because his wife reminds him to do so. He does not shave regularly. He is trying to manage his weight and does not need prompting to eat. He does not exercise much, but he does go out for walks.

As described in the main body of the report, there is moderate impairment. His ability to enjoy social and recreational activities is significantly reduced. He does try to go out and socialise for his mental state. He visited some friends and can go out to their local restaurant with his wife. He has lost contact with several friends but does see a couple of his local friends occasionally. He did not enjoy cruising. He went out on a cruise but did not enjoy it. His inability to enjoy the cruise is consistent with his clinical documentation.

As described in the main body of the report, there is mild impairment. He can drive for up to two hours, but the route is familiar. He prefers that his wife drives. He is unable to use public transport.

As described in the main body of the report, there is mild impairment. His relationship with his wife is strained. He gets along well with his children and keeps in touch with his parents.

As described in the main body of the report, there is moderate impairment. He says that he has to reread things. He is unable to absorb information and has stopped reading as a result. He can follow the plot while watching TV, but not significantly so. He needs reminders to take his medication regularly. His wife mainly manages their finances. Although he stated that he did not contribute much in selling and buying their house, his clinical documentation suggests otherwise. On the other hand, Dr Fowler's letter dated 01 May 24, stated that Mr Harland was preoccupied with making a mistake in putting a deposit on a new property near the coast. On balance, a rating of moderate impairment is appropriate.

Mr Harland would like to work, but in my clinical opinion, he is severely impaired in his capacity to work. He is totally impaired from working in any policing or similar roles. He can take up an alternative role, but his work capacity is limited to one to two days per week.

1. The employer appealed.
2. In summary, the appellant submitted that the Medical Assessor made assessments on the basis of incorrect criteria and demonstrable errors in the assessments he made under one of the six PIRS categories, namely social and recreational activities causing him to make an error in the assessment in this domain as follows:

(a) in assessing Class 3 for social and recreational activities when he should have assessed Class 2.

1. In summary, the worker Mr Wayne Michael Harland (the respondent) submitted that the Medical Assessor neither erred nor made an assessment on the basis of incorrect criteria and the MAC should be confirmed. It was submitted the findings were open to the Medical Assessor applying his clinical expertise to the assessment. The respondent's social and recreational activities are significantly reduced from before and he suffers anxiety whilst undertaking them.
2. The role of the Medical Assessor is to conduct an independent assessment on the day of examination. The Medical Assessor is required to take a history, conduct a mental state examination, make a psychiatric diagnosis and have due regard to other evidence and other medical opinion that is before the Medical Assessor. The Medical Assessor must bring his clinical expertise to bear and exercise his clinical judgement when making an independent assessment of impairment under the PIRS categories. The assessment is not to be based upon self-report alone. An appeal panel cannot disturb ratings under the PIRS for mere difference of opinion but must be satisfied as to error.
3. The path of reasoning disclosed by the Medical Assessor must be adequate. This is also dependent on the extent of the history taken and a thorough examination of the worker so that self-report can be properly evaluated in the context of other evidence before the Medical Assessor. The Appeal Panel considered that the path of reasoning was inadequate, and it was not clearly discernible from the reasons given that the assessments under the contested PIRS categories were based upon the correct criteria.
4. The Medical Assessor recorded a history as follows:

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

Mr Harland joined the NSW police service in 2009 and left in January 2023. He retired on medical grounds in 2024. He was working as a full-time senior constable, based at Gloucester, when he left. He always worked as a frontline police officer. He believes that his injury has been caused by exposure to traumatic events over the years. He says that his symptoms started a couple of years before he eventually stopped. He had started getting tearful and anxious at work. He used to be irritable and grind his teeth. He says that 'it had all built up' until an incident in January 23. He says that there was a house fire where the resident died in a burning garage. The fire service personnel were emotional, and he had to provide support to them. He says that "triggered him" and he stopped working. He has not tried to return since.

Mr Harland is on a statin, perindopril and vortioxetine 20mg. He is also on medication for weight loss. He sees psychiatrist Dr Fowler and psychologist Dr Tanya Hollier. He sees his psychiatrist every six weeks and his psychologist weekly. He has just 'wrapped up' EMDR.

Mr Harland says that his mood has improved slightly since he stopped working. He is not tearful as frequently, but it 'goes in waves'. He says that he still grinds his teeth. He says that he is 'quite happy' not to do anything and sit in front of the TV. He says that he feels anxious most of the time, but that is 'least' when he is at home. He says that he tries to go out and do things, but that aggravates his anxiety. He says that his sleep is 'okay'. He does not experience nightmares. He says that he is 'very sensitive' to sudden loud noise and 'startles easy'. He says that he is always looking out for danger and likes to sit where he can observe the exit. He says that he moved to Old Bar, near Taree, from Gloucester twelve months ago, to avoid flashbacks. He says that he used to run into people he knew and had flashbacks while going past the site of incidents. He has an exaggerated startle response to police sirens but does not suffer flashbacks. He says that he gets irritable 'quite quickly' which has been noticed by his children. He says that he has not been in any altercations and denies road rage incidents as well. He says that his energy levels are lacking, but that has improved somewhat. He says that he enjoys being at home. He enjoys going on walks with his wife, but says that he has lost interest in most things. He says that he feels less confident as a person. His libido is 'normal'. He says that he used to feel guilty about having 'failed' and feels 'lost'. He says that he used to be a confident person but has changed in that regard. He says that his 'future is uncertain'. He denies any suicidal ideation.

Mr Harland says that he drinks a couple of bourbon cans five days per week. He says that he has been trying to cut down on his drinking. He does not use any drugs.

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

Mr Harland says that he had a happy childhood and denies suffering from any abuse or trauma. His biological parents raised him, but they separated when he was 16 or 17 years old. He is not aware of any history of mental illness in his family.

He is married and has been with his wife for fifteen years. His wife works part-time as a nurse. He does not have any children of his own, but has three grown-up stepchildren. He lives with his wife. One of his stepsons is living with them temporarily.

He denies any history of mental illness before joining the police service.

Mr Harland suffers from hypertension, raised cholesterol and sleep apnoea syndrome. These conditions were diagnosed in the last couple of years.

• Work history including previous work history if relevant:

Mr Harland used to work as an air conditioning technician before joining the police academy in 2009. He continued with the service until his injury.

Mr Harland says that he tries to maintain his hygiene. His wife reminds him to have showers, but he can forget. He says that he forgets to clean his teeth and shave as well. However, he says that overall, he usually showers and cleans his teeth 'nearly everyday'.

He says that his appetite had increased with medication, but he is trying to reduce it. He says that he generally eats two meals per day. He says that he tries to cook and clean when his wife is working. He says that he has not exercised for a while, but tries to go on walks.

He says that he has tried to go out and socialise to help his mental state. He says that he travelled to Gloucester a couple of weeks ago for a day trip to visit friends. He says that he goes out with his wife to the local restaurant, but only during the daytime. He says that he has lost contact with a lot of friends since leaving Gloucester. He says that he knows a couple of people locally and sees them once in a while. He says that he can go to the shops on his own if his wife is not there. He travelled on a cruise last year, but he did not enjoy it as it was 'too much'.

He says that he gets anxious while driving and prefers that his wife drives. He does drive to Newcastle to see his psychiatrist, which is a two-hour trip, but the route is familiar to him. He says that he prefers his wife to drive if they are going to a new place.

He says that he finds it hard to focus on things. He has to re-read things to 'absorb'. He avoids reading because of that. He says that he has the TV on, but as a distraction. He says that he changes channels a lot but can 'get a rough idea what's going on'. He has reminders on his phone for medication concordance. He says that his wife mostly manages their finances. They sold their house in Gloucester and bought a new place. He says that his wife organised it all.

He says that his relationship with his wife is 'pretty strained'. They argue and have 'conflict'. He denies any periods of separation. He gets along well with his three stepchildren. He also keeps in touch with his parents.

He says that working is a 'big unknown' for him. He says that anxiety of going to new places and his ability to learn new skills would be a barrier for him to work. He will also struggle to be out of the safety of his house for long.

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

In my opinion, Mr Harland is suffering from chronic post-traumatic stress disorder and persistent depression.

No inconsistencies were observed during the assessment."

1. The Medical Assessor rated impairment at 17% WPI based on his assessments under PIRS as set out in the table above.
2. The Medical Assessor explained that in making that assessment he took into account the following matters:

"In making that assessment, I have taken account of the following matters:-

• Psychiatrist Dr Asad Saboor provided an independent medical examination report dated 28 February 25. It was advised that the diagnosis was post-traumatic stress disorder, which had caused 19% impairment of the whole person.
• Treating psychiatrist Dr Ian Fowler has provided several reports and letters. In the letter dated 01 May 24, it was noted that Mr Harland was preoccupied with the mistake of putting a deposit on a new property near the coast.
• Dr Fowler provided a letter dated 22 January 25. He advised that Mr Harland's depression had virtually recovered, but there was still ongoing diurnal variation in motivation and energy. He was considering engagement with a rehabilitation provider and was on edge when he went out.
• In his letter dated 19 March 25, Dr Fowler stated that Mr Harland had lost some weight and his clothes were fitting better, which was helping his mental state. He had visited the local rural fire service at his partner's suggestion and was looking for a voluntary position with them. Catastrophisation was noted as well.

• Dr Saboor provided a supplementary report dated 28 March 25. It was noted that in Dr Fowler's documentation, there was a mention of travelling to Sydney with a group of close friends to watch test cricket and going on a 10-day cruise, along with fishing at a boat ramp, working towards obtaining a boat license, and completing tasks on the farm. He advised that the rating for social and recreational activities was changed from class three to class two, but all other ratings remained the same. It was further noted that according to Dr Fowler's documentation, Mr Harland's mental state was affected by the housing situation from March to August 24, when he had to sell his property to complete the purchase of a new property. Dr Saboor stated in the report that there was 9% impairment of the whole person.
• In his letter dated 07 May 25, Dr Fowler noted that Mr Harland's weight loss had continued. However, intolerance of loud noises and other trauma-related symptoms were noted. He was also complaining of being withdrawn and irritable. It was further noted that Mr Harland had attended the rural volunteer fire service on six occasions and was attending for about three hours on a Monday evening. However, he was struggling with anxiety the entire time. Dr Fowler pointed out that his work as a volunteer with the fire service was not an indication that he was ready to consider a return to work.
• Clinical records from treating psychiatrist Dr Fowler were provided. The following pertinent information is documented:
  • On 20 September 23, it was noted that he was forcing himself to go out.
  • It was further noted that he was going on a cruise, but was being pushed in this regard by his partner. He had last been in Sydney for a family funeral and was anxious about going there to take the cruise.
  • On 25 October 23, it was noted that he had been on a 10-day cruise to Cairns and Port Douglas. It was further noted that he was withdrawn and went back to his room several times, needing quiet time on the balcony.
  • On 17 February 24, it was noted that he decided to move to Old Bar because the farm was too much and his wife always wanted to be near the beach. They found a place but needed to sell their 37 acres.
  • On 27 March 24, it was noted that he was trying to sell his property before 12 August and described anxiety in that context.
  • On 26 June 24, it was noted that the selling process of the house was stressful. He was fearful of losing the £135,000 deposit.
  • He reported ongoing anxiety on 07 August 24 and noted that he had been treading water for the last six months with the house sale process.
  • On 18 September 24, it was noted that he was fixing stuff, including cleaning the pool and spa. His wife was undertaking training, and he was alone at home most of the time.
• Patient health summary from Warner's Bay Consulting Suites, printed on 07 August 25, was provided. The following pertinent information is documented:
  • Documentation starts on 08 January 25.
  • On 22 January 25, it was noted that he became anxious whenever he went out. He was not anxious at home, but he had a slight edginess with his stepson.
  • On 19 March 25, it was noted that he was suffering from anxiety and catastrophic thinking. He was getting along better with his wife.
  • Depression and anxiety were noted on 07 May 25.
  • Hesitancy with driving was noted on 25 June 25. It was noted that he was still going to the Rural Volunteer Fire Service most Mondays. He was looking after his father, who was suffering from bowel cancer.
• Dr Fowler's most recent letter is dated 25 June 25. His mood was noted to be stable. However, he was suffering from worry and anxiety. There had been an increase in anxiety while driving as well."

1. In respect of social and recreational activities, Table 11.2 of the Guides provides as follows:

Table 11.2: Psychiatric impairment rating scale - social and recreational activities

No deficit, or minor deficit attributable to the normal variation in the general population: regularly participates in social activities that are age, sex and culturally appropriate. May belong to clubs or associations and is actively involved with these.

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.

Severe impairment: never leaves place of residence. Tolerates the company of family member or close friend, but will go to a different room or garden when others come to visit family or flat mate.

Totally impaired: Cannot tolerate living with anybody, extremely uncomfortable when visited by close family member.

1. The Medical Assessor assessed a Class 3 or moderate impairment with the following reasoning:

"As described in the main body of the report, there is moderate impairment. His ability to enjoy social and recreational activities is significantly reduced. He does try to go out and socialise for his mental state. He visited some friends and can go out to their local restaurant with his wife. He has lost contact with several friends but does see a couple of his local friends occasionally. He did not enjoy cruising. He went out on a cruise but did not enjoy it. His inability to enjoy the cruise is consistent with his clinical documentation."

1. The Appeal Panel considers that there has been an error in the assessment of a moderate impairment for social and recreational activities. The respondent submitted that the Medical Assessor has exercised his clinical judgment which the appellant is merely seeking to cavil with and the Appeal Panel should not interfere. However, the assessment of a moderate impairment does not accord with the criteria for this class. An assessment cannot be based on self-report alone. Here the worker has been able to go on a cruise which the Medical Assessor notes he did not enjoy "too much", he is able catch up with friends locally as he tries to socialise. The panel notes this is reported by the worker as "for his mental state" but the reason is both similar to that reason most people socialise and not relevant to assessing his impairment. He has been camping at Gloucester, he has been able to visit Sydney to watch the cricket with friends, he goes out to cafes with his wife during the day, and he fishes at the local boat ramp. Volunteering almost weekly at a rural fire station also has a social activity component. The social and recreational activities engaged in by the respondent are regularly and not rarely undertaken. The fact that the respondent's social and recreational activities are reduced from those undertaken prior to injury does not mean that that they are not regularly undertaken which is part of what forms the basis for the assessment of a mild impairment in accordance with the correct application of the criteria in the Guidelines. Even though some level of anxiety might be felt by the respondent whilst undertaking social and recreational activities, this does not mean the impairment is moderate because that would be to conflate symptoms with impairment. The test is whether the claimant can participate in social and recreational activities, not whether he does so with anxiety or enjoyment. An assessment of moderate impairment requires rare participation in social and recreational activities and only with a support person in attendance. This is not the case here. The regular social and recreational activities undertaken by the respondent is not consistent with a rating of a moderate impairment which has been assessed in error. It is consistent with a rating of a mild impairment at Class 2.
2. This means the calculations become as follows:

1. For these reasons, the Appeal Panel has determined that the MAC issued on

29 September 2025 be revoked and a new MAC 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 Pane revokes the Medical Assessment Certificate of Medical Assessor Ankur Gupta and issues this new Medical Assessment Certificate as to the matters set out in the table below:

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

page and paragraph number in NSW workers compensation guidelines

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

WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)

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

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