Barry v State of New South Wales (Northern NSW Local Health District)

DETERMINATION OF APPEAL PANEL
CITATION:	Barry v State of New South Wales (Northern NSW Local Health District) [2023] NSWPICMP 122
APPELLANT:	Julie-Anne Barry
RESPONDENT:	State of New South Wales (Northern NSW Local Health District)
Appeal Panel
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	Nicholas Glozier
MEDICAL ASSESSOR:	Michael Hong
DATE OF DECISION:	31 March 2023
CATCHWORDS:	wORKERS cOMPENSATION - The appellant submitted that the Medical Assessor (MA) erred in his assessment with respect to five of the psychiatric impairment rating scale (PIRS) categories; submissions attempted to introduce new evidence; Panel found they were no more than an attempt to cavil with the MA’s assessments; Panel did accept error with respect to employability; Held – Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 15 December 2022 Julie-Anne Barry (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by
Dr Aman Suman, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 2 December 2022.
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).

PRELIMINARY REVIEW

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 it was not necessary for the worker to undergo a further medical examination because although one was requested, we consider that we have sufficient evidence before us to enable us to determine this appeal for reasons that will become apparent in due course.

EVIDENCE

Documentary evidence

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.

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the Medical Assessor erred with respect to five of the categories in the psychiatric impairment rating scale (PIRS) namely Self-care and personal and hygiene; Social and recreational activities; Social Functioning; Concentration, persistence and pace (CPP) and Employability.
In reply, the respondent submits that no errors were made.

FINDINGS AND REASONS

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.
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.
The appellant was referred to the Medical Assessor for assessment of whole person impairment (WPI) in respect of a primary psychological injury on a deemed date of injury of
20 January 2020.
The Medical Assessor set out the history he obtained as follows:
“Ms Barry told me that she is working as a ‘senior community and stakeholder advisor for a Nowra Bridge Project.’ She told me that her job involved ‘liaising with all the stakeholders of the project’. Ms Barry told me that she has been working in a full-time role since 6 April 2020. Ms Barry told me that she had previously worked as a ‘department secretary with Northern Sydney Local Health District in early 2017’. She told me that she gave up the job in early 2020 due to mental health stressors.
Ms Barry highlighted that she had been doing well in terms of mental health and general well-being in early 2017, as she started in her role with Northern Sydney Local Health District. She told me, ‘I was bullied from the start.’ Ms Barry highlighted her interaction with her managers as the main reason for her mental health stressors. She told me, ‘I was never supported. My hard work was not recognised. My managers kept not paying me on time or paying me less. It was frustrating. Looking back, I think it was deliberate. I felt targeted.’ Ms Barry told me that she was able to manage her work well, although her interaction with her managers remained the main contributing factor towards her mental health stressors.
Ms Barry was not clear with the timeline. She told me that ‘I started to feel more stressed as they cut down my work hours around mid-2019.’
Work-related documentation highlights concerns in regard to Ms Barry’s work performance. She was formally notified about being placed on a performance management plan around the end of 2019.
Going into details about her mental health issue, Ms Barry told me that she started to struggle with anxiety and depressive symptoms since late 2017/early 2018. She described the gradual worsening of her mental health till late 2019 ‘I felt anxious thinking about work issues all the time…’
On further diagnostic clarification, it was evident that Ms Barry had experienced a mix of anxiety and depressive symptoms due to workplace stressors. Her interaction with her managers in the context of various workplace issues remained the main stressor contributing to her presentation. Ms Barry’s description indicated her suffering from poor sleep, poor concentration and avoiding social interaction secondary to her mental health issues. She described struggling with her confidence as she dealt with performance management issues.
Ms Barry highlighted benefiting from the psychological therapy she received…
Ms Barry highlighted that she had been applying for jobs around the end of 2019/ early 2020 as she wanted to ‘get away from my job’. She told me that she also experienced stress in the context of applying for jobs. Ms Barry's description indicates her struggling with her energy and motivation from late 2019. She avoided any significant social interaction.
Ms Barry applied for jobs after she left her job in January 2020. She was able to secure a new role in March 2020. Ms Barry has been in her current role since early April 2020. Her description indicates improvement in terms of mental health since she left the job in January 2020. Ms Barry denied receiving psychotropic treatment or ongoing psychological inputs from January 2020 onwards.”
The Medical Assessor continued:
“Ms Barry denied receiving input from her general practitioner or mental health services over the last six months. She told me that she has been using medications ‘Restavit and Melatonin to help with my sleep’. She told me that she has struggled with her sleep since around 2019. Ms Barry highlighted experiencing a mix of anxiety and depressive symptoms in the context of social stressors ‘I do get triggered sometimes.’ She told me that she feels low in her mood. She rated her mood as 4/10 (10 best mood). Ms Barry told me that she feels socially isolated at her current accommodation. She told me that she has struggled with her confidence since early 2020.
Ms Barry told me that she has been struggling with energy and motivation on some days. She does go for swimming once every six weeks. Ms Barry has been able to meet her friend approximately a month ago. She remains in touch with a church group online almost every week.”
She denied any paranoia.
She appeared alert and sustained concentration for the duration of the interview.
She complained of attentional difficulties.”
Findings on examination were noted as follows:
“Ms Barry can be described as an average built middle-aged lady. She presented well dressed and kempt. She was alert and oriented to her surroundings. Ms Barry was stressed on two occasions as she discussed previous workplace interactions/experiences. I was not able to form a good rapport with her. Ms Barry appeared irritable and agitated throughout the assessment. She spoke at a faster pace, providing me with excessive details indicating underlying anxiety symptoms.
Ms Barry described her mood as ‘I am feeling okay now. I was anxious at the start of the interview’. Ms Barry presented with a mix of anxiety and depressive symptoms with restricted affective range and reactivity. She was not preoccupied with past work issues. I was not able to elicit any depressive cognitions. Ms Barry was unhappy with the whole process of being reviewed by multiple independent medical examiners. She denied any thoughts of self-harm. She denied thoughts of hurting others.
I was not able to elicit thought disorder, perceptual disturbances, persecutory ideas or any other forms of psychotic symptoms. I was not able to elicit any decline in her cognitive abilities as per the rudimentary cognitive assessment. Ms Barry displayed good insight in regard to her mental health issues. She told me, ‘I do not want to take any heavy psychiatric medications’. She was agreeable to receiving ongoing psychological therapy.”
In reviewing the documentation he had, the Medical Assessor said:
“Ms Julie-Anne Barry's statement and various workplace documents provide details of her workplace interaction and performance review issues.
Dr Richard Rastogi, in her report dated 12th May 2021, has highlighted various workplace stressors and details of Ms Julie-Anne Barry’s psychology injury. She has provided a diagnosis of ‘adjustment disorder with anxious distress.’ Dr Rastogi provided a whole-person impairment of 15%.
Dr Glenn Smith, in his report dated 29th October 2021, has highlighted
Ms Julie-Anne Barry’s diagnosis as ‘adjustment disorder with mixed anxiety and distress mood, resolving.’ Dr Smith has not provided the whole person impairment highlighting ‘not applicable. As her condition has not reached maximum medical improvement, it is not currently appropriate to perform an assessment of WPI’.”
The Medical Assessor summarised his findings as follows:
“Ms Barry is a middle-aged lady living independently at her South Nowra residence.
As per the review today, it is evident that Ms Barry experienced difficult workplace interactions since around 2018. Her work performance and related formal proceedings remained one of the main stressors for her. Ms Barry explained a mix of anxiety and depressive symptoms due to workplace stressors from around late 2018/ early 2019. Her mental health worsened in mid-2019 with her making a decision to give up her job in early 2020. Ms Barry possibly received psychological input from late 2018 to early 2020. She did not receive any input from a psychiatrist or psychotropic treatment trials.
Ms Barry was able to secure a new job in April 2020. She has experienced fluctuation in mental health, although not required ongoing input from a psychologist or psychiatrist since early 2020.
Ms Barry’s recent presentation indicates her being stressed in the context of taking part in independent medical assessment on multiple occasions. She has otherwise been able to manage her work and personal commitments independently without support from family or friends…”
The Medical Assessor assessed 0% WPI, adding: “Ms Barry has had a good clinical response to the psychological input”.
Dealing firstly with the category of Self-care and personal hygiene, the appellant makes the following submissions:
(a)    The Medical Assessor determined Class 1 and found no deficits as “Ms Barry told me she takes a shower everyday. She is cooking “I cook in batches and store it”. She would occasionally order takeaways.
(b)   The worker instructs that “I find sometimes I am unmotivated with aspects of selfcare now, such as regular exercise and cooking an evening meal”. The worker’s independent medical examiner (IME) Dr Rastogi in the report dated
12 May 2021 assessed the worker in Class 2 as she had a “mild impairment as struggles with routine”.
(c)    It appears the Medical Assessor did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker whom he noted at page 4 “I was not able to form a good rapport with her. Ms Barry appeared irritable and agitated throughout the assessment. She spoke at a faster pace, providing me with excessive details indicating underlying anxiety symptoms.”
(d)   The worker should be assessed as a Class 2.
Based on the history obtained at the time of his assessment in November 2022, his assessment of a Class 1 was entirely consistent with that history.
We note that the Medical Assessor saw Ms Barry some 18 months after Dr Rastogi.
Chapter 1.6 of the Guidelines provides: “Assessing permanent impairment involves clinical assessment of the claimant as they present on the day of assessment …” (our emphasis)
Moreover, it is simply not possible for the appellant to assert that “the assessor did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker …” because only Ms Barry was present.
Even though the Medical Assessor mentioned that he was “not able to form a good rapport with her” it is noted that Ms Barry later said: “I am feeling okay now. I was anxious at the start of the interview.”
Ms Barry made no mention of any difficulties she had in this category in her various statements.
The submission that the appellant “instructs” a different scenario to that recorded by the Medical Assessor is essentially an attempt to admit further or fresh evidence which is not admissible pursuant to s 328(3) of the 1998 Act.
In short, the appellant’s submissions do no more than urge an acceptance of the opinion of Dr Rastogi.
It is perhaps timely at this point to set out the task of an appeal panel as stated in Ferguson v Stateof New South Wales [2017] NSWSC 887 where Campbell J said:
“[23] By reference to NSW Police Force v Daniel Wark [2012] NSWWCCMA 36, the Appeal Panel directed itself that in questions of classification under the PIRS: ‘... the pre-eminence of the clinical observations cannot be underrated. The judgment as to the significance or otherwise of the matters raised in the consultation is very much a matter for assessment by the clinician with the responsibility of conducting his/her enquiries with the applicant face to face’ [our emphasis].
[24] The Appeal Panel accepted that intervention was only justified: if the categorisation was glaringly improbable; if it could be demonstrated that the AMS was unaware of significant factual matters; if a clear misunderstanding could be demonstrated; or if an unsupportable reasoning process could be made out. I understood that all of these matters were regarded by the Appeal Panel as interpretations of the statutory grounds of applying incorrect criteria or demonstrable error. One takes from this that the Appeal Panel understood that more than a mere difference of opinion on a subject about which reasonable minds may differ is required to establish error in the statutory sense.
[25] The Appeal Panel also, with respect, correctly recorded that in accordance with Chapter 11.12 of the Guides ‘the assessment is to be made upon the behavioural consequences of psychiatric disorder, and that each category within the PIRS evaluates a particular area of functional impairment’…
[37] The descriptors, or examples, describing each class of impairment in the various We are required to determine if the Medical Assessor made an error, regardless of other ‘reasonable minds’ that may differ.”
For these reasons, we do not consider that the Medical Assessor erred in his assessment in this category. Occasionally being unmotivated to cook an evening meal or exercise are common occurrences within the general population. His assessment was open to him on all of the evidence.
Dealing now with the category of social and recreational activities, the appellant submits as follows:
(a)    The worker instructs that the workplace trauma has
“caused a diminishing of my stress handling capacity. I have difficulty in resolving conflict with family members. As a result of these factors, I feel quite socially isolated. I feel immediate distress by any workplace issues that arise. My boss recently ‘team messaged me to come see him’ and I was immediately triggered, my stomach turned and I panicked as thought I was going to be sacked. because of the workplace trauma I have become more withdrawn, and my social interactions has tapered significantly.”
(b)    Dr Rastogi assessed the worker in Class 3 as she had a
“Moderate Impairment with social isolation and does not get too involved in social activities. She avoids going out and prefers to be home bound, feels socially scrutinised.”
(c)    It appears the Medical Assessor again did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker.
(d)    In Ballas v Department of Education (State of NSW) [2020] NSWCA 86 Bell P and Payne JA (Emmet JA concurring):
“[93] Whilst it is no doubt correct that an AMS must exercise a degree of clinical judgment in assigning a class of seriousness to each area which he or she is required to address in completing a medical assessment, the characterisation of conduct as going to ‘social and recreational activities’ on the one hand, as opposed to any of the other five scales on the other hand, is not a matter of discretion.
…
[96] Whilst it could be said that seeing a friend is a form of social activity, in the context of a process that has a distinct category or scale dealing with relationships and in circumstances where the AMS is directed by s 11.15 of the Guidelines to address each area of functional impairment separately, the degree of regularity of seeing a friend or friends fell squarely within the ‘Social functioning (relationships)’ scale.”
(e)    The appellant submits that the report carries a demonstratable error as the Medical Assessor has fallen into the error identified above in Ballas by not correctly characterising “contact with her own friends” as falling under the “social functioning” scale.
(f)    The appellant submits that based upon the evidence before the Medical Assessor regarding the “social and recreational activities” scale, more weight should be given to the appellant’s recreational activities including her social isolation in the area she was required to move to in order to obtain gainful employment.
We of course accept the principles established in Ballas, but having said that, Ms Barry elected to move away to obtain employment. She had worked in various jobs after ceasing work with the respondent, and elected to move to work full-time in her current position.

That was not a result of any impairment: it was a choice she made to change her life and move away. It was perhaps inevitable that she would experience a degree of isolation in her present accommodation as noted by the Medical Assessor.
Once again, the submission that the appellant “instructs” a different scenario to that recorded by the Medical Assessor is essentially an attempt to admit further or fresh evidence which is not admissible pursuant to s 328(3) of the 1998 Act.
In assessing a Class 2, the Medical Assessor said:
“Ms Barry told me that she does not feel like socialising. She went to meet a friend in Kellyville a month ago. She enjoyed the meetings. She also remains in touch with her church group via weekly online meeting.”
The Medical Assessor earlier noted: “She does go for swimming once every six weeks” but there is no real evidence as to whether this is indeed a social or recreational activity or a solitary pursuit in line with Ballas – we simply note it.
The descriptor for a Class 2 reads:
“Mild impairment: occasionally goes out to such events eg, without needing a support person, but does not become actively involved eg (dancing, cheering favourite team).”
For a Class 3 it reads:
“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.”
On the history obtained by the Medical Assessor, Ms Barry does not meet the descriptor for a Class 3.
There is no evidence that she is unable to go out without a support person, or needs prompting to go out, or that she does not become actively involved, for example, she participates in weekly meetings with her church group.
For these reasons, we cannot see any error in the assessment in this category.
Turning now to the category of Social Functioning, the appellant submits as follows:
(a)   The worker instructs that the workplace trauma has
“caused a diminishing of my stress handling capacity. I have difficulty in resolving conflict with family members. As a result of these factors, I feel quite socially isolated. I feel immediate distress by any workplace issues that arise. My boss recently ‘team messaged me to come see him’ and I was immediately triggered, my stomach turned and I panicked as thought I was going to be sacked. because of the workplace trauma I have become more withdrawn, and my social interactions has [sic] tapered significantly.”
(b)   Dr Rastogi assessed the worker in Class 2 as she had a “Mild Impairment as existing relationships strained with children causing relationship strain”.
(c)    It appears the Medical Assessor again did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker.
(d)   Class 2 of the Guides appear to be more accurate.
Again, there is simply no evidence that the Medical Assessor “did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker.”
Equally, the appellant is again attempting to cavil with the Medical Assessor’s findings by introducing new evidence which she has apparently “instructed” her lawyer to include.
Again, such evidence is not admissible for reasons stated earlier.
The Medical Assessor rated Ms Barry a Class 1, adding:
“Ms Barry highlighted that she does not have many friends around her place. She does remain in touch with her previous friends in Kellyville.”
The descriptor for a Class 2 reads: “Mild impairment: Existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.”
There is simply no evidence that Ms Barry has lost friends, or that any existing relationships are strained. It is perhaps inevitable that having moved, she may take some time to establish new relationships.
On the history obtained by the Medical Assessor, to categorise Ms Barry as anything other than a Class 1 would be inconsistent with the evidence.
We repeat our comments earlier regarding the task of an Appeal Panel.
For these reasons, we cannot see that the Medical Assessor erred in his assessment in this category.
Turning now to the category of CPP, the appellant submits as follows:
(a)    The worker instructs that the workplace trauma has
“My concentration is now not at the high level that I had previously. I struggle with focus retention and feel more distractable than usual. I feel the need to write things down now, rather than relying on my short-term memory.”
(b)    Dr Rastogi assessed the worker in Class 2 as she had a
“Moderate impairment as feels tired and exhausted and struggles with complex tasks, poor decision-making capacity and loss of confidence.”
(c)    It appears the Medical Assessor again did not sufficiently question the worker at the assessment and reached the conclusion based on a quick summary assessment of the worker.
The Medical Assessor noted earlier that on testing:
“I was not able to elicit any decline in her cognitive abilities as per the rudimentary cognitive assessment. Ms Barry displayed good insight in regard to her mental health issues …”
The assessment itself is a cognitively demanding task that enables an objective evaluation of an appellant’s impairment in concentrating and persisting with such a task, and the pace at which an appellant can do this.
We repeat all our comments earlier as regards all three submissions.
The Medical Assessor determined Class 1 for this category and found no deficits as
“Ms Barry told me that she is able to work long hours and is able to manage her work commitments independently”.
Ms Barry is working full-time. To suggest that she should be assessed as a Class 2 is again inconsistent with all the evidence, particularly in circumstances where Ms Barry confirmed in her statements that she had worked in several jobs since ceasing work with the respondent. She said:
“I resigned from my employment on 7 July 2020 and started work full-time in a private cardiologist clinic … I worked in other roles after my dismissal and have been working full time in my current role for the past 5 months.”
In these circumstances, we do not agree that the evidence supports a Class 2 rating.
Finally, as to the issue of employability, the appellant submits as follows:
(a)      The worker instructs that the workplace trauma has [sic]
“I am now working in a completely different job. I am working more than 20 hours a week; however, I can manage a full-time job in a different context but feel that my focussed attention and retention is significantly impaired from my baseline. To gain suitable employment, after the traumatic workplace experience, this necessitated me to live and work outside Sydney Metropolitan area. As a result of working in a regional area, I am isolated from my friends, local church, and support systems.
I also needed to find a job to payback my home loan, which I put on hold for 12 months (I was going to lose my home). I incurred a significant financial loss, due to the reduction of a fulltime hours to only 3 days a week and my salary was reduced significantly to $29k per annum in 2020. Having moved to a regional area, I have not been yet able to source a local counsellor for regular support, which I would like to continue, as there are limited resources available. During 2020, I was involved in 3 car accidents, where I had to pay the excess fee of $500 for each collision, which I believe was caused due to the stressors in the workplace. I can provide evidence of such, if required.
As a result of the workplace bullying, I have gained significant weight and I feel quite emotionally overwhelmed when asked about providing information about this workplace trauma, over and over.”
(b)      Dr Rastogi assessed the worker in Class 3 as she had a “Moderate impairment as she is working in step down role and cannot work in her previous employment”. He stated:
“(She) is disadvantaged financially as well as in her future career goals due to psychological injury sustained at work impeding her functioning and causing hindrance with multitasking and management dealing with complex issues and working in high paced environment. She does have a guarded vocational prognosis as she will never return to preinjury role as her stress coping is limited due to anxiety, issue of trust, loss of confidence and poor self esteem.”
(c)    The appellant submits that based upon the evidence before the Medical Assessor, the only possible class finding for the Category of Employability and Adaption was that of Class 2 or 3; alternatively, the appellant submits that the Medical Assessor has failed to provide any, let alone sufficient, reasons for the Class 1.
In assessing a Class 1, the Medical Assessor said:
“Ms Barry is able to manage her current full- time role which comes with significant responsibilities and requires her to interact with various stakeholders.”
The descriptor for a Class 1 reads:
“No deficit, or minor deficit attributable to the normal variation in the general population. Able to work full time. Duties and performance are consistent with the injured worker's education and training. The person is able to cope with the normal demands of the job.”
For a Class 2 it reads:
“Mild impairment: Able to work full time but in a different environment from that of the pre-injury job. The duties require comparable skill and intellect as those of the pre-injury job. Can work in the same position, but no more than 20 hours per week (eg no longer happy to work with specific persons, or work in a specific location due to travel required).”
For a Class 3 it reads:
“Moderate impairment: Cannot work at all in same position. Can perform less than 20 hours per week in a different position, which requires less skill or is qualitatively different (eg less stressful).”
To begin with, given Ms Barry’s evidence we referred to in the category of CPP, the evidence simply does not support a Class 3 assessment in this category.
For reasons stated earlier, we reject the “fresh evidence” sought to be admitted by the appellant. Dr Rastogi’s assessment is inconsistent with the information obtained by the Medical Assessor.
Having said that, we agree with the appellant that a Class 2 is appropriate for reasons that follow.
In her statements Ms Barry said:
“The hospital has contacted me and advised they have found a suitable job for Monday 10 February 2020 answering phones for 4 hours on the front Reception Desk. I declined that on 3 things, one being I would see Vicki, secondly my work colleagues would see me and ask what was going on, and thirdly I was due to see my doctor the next day and the psychologist did not want me attending.
I am anxious about being able to get back to work, I love my job and want to return as soon as possible. I get upset thinking about this.
I continue to see my counsellor once a month. I continue to feel anxious about the events at Royal North Shore Hospital, with difficulty sleeping and thinking about how unfair the treatment was.”
In short, she is able “to work full time but in a different environment from that of the pre-injury job”. Her duties appear to “require comparable skill and intellect as those of the pre-injury job”.
However, she is unlikely to be able to work in the same position. Although clearly able to work more than 20 hours per week, it is clear from her statements that she could no longer work “with specific persons”.
We point out that the descriptors are simply that: a general guide to the sorts of limitations a claimant may experience in the various PIRS categories.
The evidence in this category is broadly consistent with a Class 2 rating.
This then means that the aggregate score is as follows: 1,2,1,1,1,2.
The WPI is then 1%.
For these reasons, the Appeal Panel has determined that the MAC issued on
2 December 2022 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.

PERSONAL INJURY COMMISSION

APPEAL PANEL

MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter number:	W6533/21
Applicant:	Julie-Anne Barry
Respondent:	State of New South Wales (Northern NSW Local Health District)

This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act1998.

The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Dr r Aman Suman, and issues this new Medical Assessment Certificate as to the matters set out in the Table below:

Table - whole person impairment (WPI)

Body Part or system

Date of Injury

Chapter,

page and paragraph number in WorkCover Guides

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

% WPI

Proportion of permanent impairment due to pre-existing injury, abnormality or condition

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

1.Psychiatric disorder

20 January 2020

Chapter 11, page 54-60

Chapter 14, pg 361-365

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.

[2023] NSWPICMP 122

31 March 2023