Andrews v Aligned Community Care Pty Ltd - [2025] NSWPICMP 748

DETERMINATION OF APPEAL PANEL
CITATION:	Andrews v Aligned Community Care Pty Ltd [2025] NSWPICMP 748
APPELLANT:	Beth Andrews
RESPONDENT:	Aligned Community Care Pty Ltd
APPEAL PANEL
MEMBER:	John Wynyard
MEDICAL ASSESSOR:	Professor Nicholas Glozier
MEDICAL ASSESSOR:	Douglas Andrews
DATE OF DECISION:	29 September 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from 8% assessment for psychological injury; whether error made in psychiatric impairment rating scale (PIRS) categories of social and recreational activity and/or concentration, persistence and pace; whether Table 11.2 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021 (the Guidelines) descriptors limited to activities outside the home and with other participants; whether reasoning adequate with regard to Table 11.5 of the Guidelines; Held – social and recreational activities include solitary activities such as dog walking and home based activities such as gardening; Botha v Secretary, NSW Department of Customs Service, and Diaz v Sydney International Container Terminals Pty Ltd considered and relied on; submissions regarding concentration, persistence and pace assumed a class 2 rating (when a class 3 rating given in the MAC); a higher class 4 rating not available on the facts; MAC confirmed.

BACKGROUND TO THE APPLICATION TO APPEAL

On 6 June 2025, the appellant, Beth Andrews, lodged an Application to Appeal lodged an Application to Appeal Against the Decision of a Medical Assessor . The medical dispute was assessed by Dr Timothy Berry, a Medical Assessor , who issued a Medical Assessment Certificate (MAC) on 9 May 2025.
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.
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.
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.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5). “WPI” is reference to whole person impairment. “Baseline WPI” is a reference to the total WPI assessed before deduction for the effect of pre-existing injury, condition or abnormality pursuant to s 323…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2025] NSWPICMP 748
Decision Date: 29 September 2025

CaseChat Overview and Summary

The plaintiff, Andrews, brought an appeal against Aligned Community Care Pty Ltd concerning the assessment of his permanent impairment due to a psychological injury sustained in the course of his employment. The dispute was adjudicated in the Industrial Court of New South Wales. The crux of the matter was whether the Medical Assessment Certificate (MAC) correctly evaluated the plaintiff's impairment at 8%, particularly focusing on the psychiatric impairment rating scale (PIRS) categories of social and recreational activity and concentration, persistence and pace. The plaintiff contended that there was an error in the assessment of these categories.

The court was tasked with determining whether the descriptors in Table 11.2 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 March 2021, were limited to activities outside the home and with other participants. Additionally, the court had to assess whether the reasoning provided was adequate with regard to Table 11.5 of the Guidelines. The plaintiff argued that social and recreational activities should include solitary activities such as dog walking and home-based activities such as gardening. The court considered the cases of Botha v Secretary, NSW Department of Customs Service, and Diaz v Sydney International Containers Pty Ltd, which were relevant in interpreting the guidelines.

The court held that social and recreational activities do encompass solitary activities and home-based pursuits. The plaintiff's submissions regarding concentration, persistence and pace were based on the assumption of a class 2 rating, despite the MAC assigning a class 3 rating. The plaintiff did not present evidence to support a class 4 rating, which was not available on the given facts. Consequently, the Medical Assessment Certificate was confirmed by the court.

Orders