1. On 12 June 2024, Westpac Banking Corporation (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Gerard Walsh, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 15 May 2024.
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 assessment was made on the basis of incorrect criteria, and
   • the MAC contains a demonstrable error.
3. On 17 October 2024, a Medical Appeal Panel revoked the MAC and substituted its own. The Medical Appeal Panel's MAC was in turn the subject of an appeal to the Supreme Court, which by consent overturned the decision of the Medical Appeal Panel as it contained an error of law on the face of the document, namely the Medical Appeal Panel had regard to inadmissible evidence, namely the material attached to the appellants Application to Admit Late Documents dated 26 July 2024.
4. The Supreme Court then remitted the matter to the Personal Injury Commission (Commission) for determination by a new Medical Appeal Panel, with the parties having the opportunity to provide submissions on the admissibility of the reports of Dr Young, independent medical examiner (IME) for the appellant.
5. On 7 October 2025, the Appeal Panel issued a direction requesting the parties make submissions as to the admissibility of Dr Young's reports within 14 days. Those submissions were received by the Commission.
6. On 22 December 2025, the Appeal Panel issued a further Direction that Anna Thorpe (the respondent) be re-examined on 2 February 2026.
7. 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.
8. 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. Much of the factual background in this matter is uncontroversial and is set out in the decisions of the first Medical Appeal Panel and of the Supreme Court. There is no question the respondent suffered a psychological injury in the course of her employment with the respondent, with a deemed date of injury of 19 November 2019. In the MAC dated 15 May 2024, the Medical Assessor assessed the respondent as suffering a 15% whole person impairment.
2. The appellant's complaint regarding the MAC concerns a failure to make a deduction for a pre-existing condition pursuant to s 323 of the 1998 Act. The respondent opposes the appeal.

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.

As a result of that preliminary review, the Appeal Panel determined that the worker should undergo a further medical examination because even if there is no deduction to be made for a pre-existing condition in this matter, the MAC contains an obvious error because it contains insufficient reasons as to why a deduction is inappropriate, and it is necessary therefore the respondent be re-examined to determine the degree of the deduction to be made, if any.

1. Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in addition to or in substitution for the evidence received in relation to a medical assessment appealed against may not be given on an appeal by a party unless the evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before that medical assessment.
2. The appellant seeks to admit the following evidence:

(a) reports of Dr Young, IME including a redacted report of Dr Young.

1. The appellant submits that the evidence is relevant to the question of any deduction to be made pursuant to s 323 of the 1998 Act.
2. The respondent opposes the admission of the reports of Dr Young, noting in compiling his reports, Dr Young relied on medical records which were inadmissible owing to the appellant having inadvertently failed to serve those records on the respondent when issuing its dispute notice. There is no question those records were and remain inadmissible, or that Dr Young in part relied on them in reaching his conclusions.
3. The Appeal Panel determines that the evidence should not be received on the appeal because, even if only the redacted report of Dr Young is admitted, it is impossible to determine merely by excising references to the inadmissible material the extent to which it was relied upon in forming Dr Young's opinion. To use a lay term, it is impossible to unscramble this evidentiary egg if Dr Young's reports are admitted in any form.

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. Medical Assessor John Lam-Po-Tang of the Appeal Panel conducted an examination of the worker on 2 February 2026 and reported to the Appeal Panel. The Medical Assessor's findings on re-examination are set out as follows.

Additional history since the original Medical Assessment Certificate was performed

1. For about 18 months prior to the present evaluation, Ms Thorpe reported that members of the Jehovah's Witness congregation from Gilgandra would visit her on a Thursday. She said that between two and six people would visit her, spending around five hours reading the Bible.
2. Around April 2025, Ms Thorpe advised that she ceased regular consultations with her general practitioner, Dr Mason. She said that she has not had a regular general practitioner since then.
3. From around June or July 2025, Ms Thorpe advised she no longer had a cleaner come to her house.
4. At some point in 2025, Ms Thorpe made an unsuccessful application for funding under the National Disability Insurance Scheme: "I tried to get NDIS but I was knocked back... straight away". She explained that her application requested funds to pay for transport from her farm to Dubbo, as well as cleaning services.
5. In October 2025, Ms Thorpe advised that she was the subject of an apprehended violence order applied for by local police. She stated, "The police have charged him; he is under serious conditions. I wasn't the only victim... I was told this by someone at hospital".
6. In December 2025, Ms Thorpe was conveyed to the Dubbo Base Hospital on an involuntary basis under the NSW Mental Health Act. She recounted that police and ambulance services attended her residence after she was referred to them by a man whom she referred to as a community figure. She described him as a stalker, and said that the reason she was referred was "because I had a stalker and I didn't conform to his wishes". She recounted, "The first time they had handcuffed me... they injected me on my front footpath. I don't remember anything". She said that she has video cameras on her property, and was able to piece together what had happened by watching stored footage after the event: "I watched that they did to me". Ms Thorpe was assessed in the Emergency Department of the hospital, and admitted overnight. After this, she alleged she was "discharged to the street in PJs", and no transport back to her farm. She recounted, "Some man offered to drive me home", which she described as sheer luck, however, it is noted that she paid him $300 for the trip.
7. Following the admission to hospital, Ms Thorpe advised that she did not receive any phone calls or follow-up from the community mental health service.
8. Ms Thorpe advised that her last visit from Jehovah's Witness congregants occurred in December 2025. Having said that, she said that the last time she had any visitors to her farm was three months prior to the current evaluation (i.e. early November 2025).
9. In January 2026, Ms Thorpe was referred to emergency services. She alleged that she had referred by a "seventy-four year old man... he's a chronic stalker". She has been lead to believe that the reason for referral is, "I'm that depressed". Police and ambulance attended her property, and she was conveyed on an involuntary basis under the NSW Mental Health Act to the Emergency Department of Dubbo Base Hospital. She stated that she was assessed there, but said she was not administered or prescribed any medication: "They let me out straight away, but I had to get home again". She said that she paid someone $400 to drive her to her farm. She advised that she had not received any phone calls or other follow-up from the Dubbo community mental health service since this incident.
10. On the day prior to the evaluation, Ms Thorpe stated she had to do some work on her farm. She explained that some livestock had to be culled. Referring to her sheep, she initially stated, "I killed them all yesterday", but then change this to: "We had to kill three [sheep]... someone came in to assist". She added, "I gave five [sheep] away yesterday". She added, "We're in drought; we have no water". She advised in addition to sheep, she has an estimated 20 goats, one horse, four guinea fowl, around 20 chickens, two peacocks and seven peahens.
11. Ms Thorpe gave conflicting descriptions of how much time she spent tending to her animals and garden. She stated that she spends "all my time" tending to her farm, adding, "I spend all day". She explained that she had an orchard, grew vegetables and herbs, and had a lucerne paddock, stating, "I'm watering every day". At another point in the interview, Ms Thorpe advised she spends "not even an hour" per day on farm-related activities.

1. Ms Thorpe presented as a Caucasian woman of stated age, neatly presented, wearing a checked shirt, and glasses. She had long blonde hair. She smoked a cigarette intermittently in the assessment.
2. Ms Thorpe was distressed from prior to the start of the examination, and remained so for the 100-minute evaluation. She was highly emotional when heard on the phone to her support person, prior to logging on to the Teams call. She was not able to join the Teams call until about 15 minutes after the scheduled start time.
3. Ms Thorpe's speech was spontaneous, normal in rate, and normal to loud in volume. There were occasional pauses prior to, or during response to questions. Her affect was restricted in range, in that she rarely smiled, and then only briefly. Her affect was labile, and increased in intensity. She was tearful on a number of occasions. Her mood was dysphoric and anxious. Some of her answers were indirectly related to the questions asked, but no consistent formal thought disorder was observed. No delusional thought content was expressed or observed during the interview. Some of her responses were highly implausible, for example, she claimed she had not eaten at all for one to two weeks, and when asked to clarify this, confirmed this assertion. Some of her responses represented exaggeration, for example, she stated she had not slept for three weeks, and then later advised she had slept some hours each night during the same period.
4. Ms Thorpe presented as alert and oriented throughout the evaluation. She did not appear drowsy at any time, nor did she display any fluctuation in level of consciousness. She was able to correctly state her age, but was unable to state her age in years, on two separate occasions. Formal cognitive testing was not undertaken.

Results of any additional investigations since the original Medical Assessment Certificate

1. Ms Thorpe described her mood as depressed at the time of the interview, and rated it as 0/10 on a 10-point scale, where 0/10 represents a profoundly depressed mood, and 10/10 represents a very cheerful mood. She did not report diurnal mood variation. She did not report anhedonia, commenting, "I just try and find things to be grateful for... [such as] my peacocks".
2. Impaired appetite was reported by Ms Thorpe, who stated, "I have probably not eaten for a week or two", and re-stated this assertion when it was questioned. She said she could not answer a question about whether her weight was stable, increasing or decreasing. When asked if she thought that her clothes seemed looser, tighter or unchanged, she replied that people in the country wore different types of clothing to people in the city. She described her energy levels as "shit".
3. When asked about sleep patterns, Ms Thorpe replied, "I haven't slept for probably three weeks". She then stated she typically went to sleep at around 2.00 to 3.00am, and woke up at around 5.00 to 6.00am.
4. Ms Thorpe was able to confirm her date of birth. When asked to state her age in years, she incorrectly said that she "turned 50 the other day". When advised this was inconsistent with her correctly stated date of birth, she could not state how old she was in years. Later in the interview, this question was revisited, and she responded, "Fifty! Fifty-one! I'd say, fifty-two, fifty-three".

1. Ms Thorpe lives alone on her own property, and does not receive any domiciliary or family support in order to maintain her independence. She estimated bathing twice a week, and commented that she attended to dental hygiene every couple of days. She stated she does not wash her hair on a regular basis, and cuts her own hair. She stated she changed her clothing five times a day due to the heat. She gave differing estimates of her food intake. She said she typically would eat one to two meals per week and denied eating any snacks. She added, "I haven't had a meal for a couple of years now. Nup, nothing". It was understood that Ms Thorpe was referring to full meals.
2. Ms Thorpe commented, "I can't drive anymore", and could not give an estimate as to when she last drove her car.
3. Ms Thorpe said her daughter set up a FaceBook account for her, but was unable to provide an estimate of how often she accessed the account. She said that she can receive emails, with difficulty.
4. When asked about personal administration, such as payment of bills, Ms Thorpe said she was connected to very few services. She said that her electricity bill is paid by direct debit. She said she was responsible for paying her land rates.
5. Ms Thorpe advised she did not have a TV, and did not watch TV programs through the internet.
6. Inconsistent estimates of contact with parents was provided by Ms Thorpe. She initially advised she was not in contact with her parents, and had last spoken to them a year ago. She then later stated, "My mum I talk to occasionally... maybe once a month".
7. When asked to estimate how recently Ms Thorpe had spoken to her siblings, she replied, "Six months ago, no... longer. A long time ago, maybe a couple of years now".
8. Ms Thorpe said that she was in occasional contact with two friends, one of whom was her support person during the assessment. She estimated being in contact with this friend every three months. She said she last saw this friend in person a year ago.

1. Ms Thorpe advised she no longer had a regular general practitioner, and was not consulting a psychologist or psychiatrist.
2. Ms Thorpe advised she was taking the following medications:

1. Ms Thorpe advised she had been prescribed pregabalin but had ceased taking it.

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 respondent suffered from a pre-existing psychological condition in the nature of alcohol dependency syndrome, and that the Medical Assessor failed to take this condition into account or make any relevant deduction for it.
3. In reply, the respondent submits that there is no relevant evidence of any pre-existing condition or, if any such condition exists, sufficient evidence to support a finding a deduction should be made.

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. As noted, the Appeal Panel was of the view the respondent should be re-examined, as such re-examination is necessary in order to determine whether there was any relevant pre-existing condition, and if so the deduction, if any, which should be made in order to take it into account.
4. The re-examination of the respondent revealed two recent involuntary admissions into emergency psychiatric care. It is apparent the respondent has also withdrawn from treatment, whether voluntarily or involuntarily and is presently unable and/or unwilling to provide a coherent and usable history. When the respondent was seen by Medical Assessor Walsh in May 2024, she was able to engage meaningfully with the assessment. She is no longer able to do so. Given the obviously unstable condition of the respondent, it is apparent to the Appeal Panel that her condition has not reached maximum medical improvement.
5. A further re-examination of the respondent will need to take place not less than six months from the date of this MAC, and only after a report or reports from a treating clinician or clinicians that she is engaged in some treatment and that her condition is then stable. Any such re-examination should take place face-to-face rather than electronically.
6. For these reasons, the Appeal Panel has determined that the MAC issued on 15 May 2024 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 Gerard Walsh 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)