Blatchford v Newcastle City Council
[2024] NSWPICMP 827
•4 December 2024
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Blatchford v Newcastle City Council [2024] NSWPICMP 827 |
| APPELLANT: | Drew Blatchford |
| RESPONDENT: | Newcastle City Council |
| APPEAL PANEL | |
| MEMBER: | Jane Peacock |
| MEDICAL ASSESSOR: | Douglas Andrews |
| MEDICAL ASSESSOR: | Michael Hong |
| DATE OF DECISION: | 4 December 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under three of the psychiatric impairment rating scale categories because of an inadequate path of reasoning; Appeal Panel found error and a re-examination was considered necessary; Held – Medical Assessment Certificate revoked. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 20 June 2024 the worker, Mr Drew Blatchford (the appellant), lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Surabhi Verma, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 24 May 2024.
The appellant relies on the following ground 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 Appeal Panel notes that the ground that the assessment was made on the basis of incorrect criteria was not relied on in the formal part of the appellant’s “pleadings” but was relied on in the submissions attached to the application to appeal and Newcastle City (the respondent) has had the opportunity to make submissions in response and to meet this ground of appeal and accordingly the Appeal Panel, to the extent that it may be necessary, grants leave to the appellant to rely on the this ground.
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.
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, 4th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th 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 WorkCover Medical Assessment Guidelines 2006.
The appellant requested that he undergo a re-examination by a member of the Appeal Panel who is also a medical assessor. As a result of its preliminary review, the Appeal Panel determined that it was necessary for the worker to undergo a further medical examination because the Appeal Panel found error.
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.
Further medical examination
Medical Assessor Douglas Andrews of the Appeal Panel conducted an examination of the worker on 30 October 2024 and reported to the Appeal Panel.
Medical Assessment Certificate
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.
SUBMISSIONS
Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
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 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: 5 June 2023
· Body parts/systems referred: Psychiatric/psychological disorder
· Method of assessment: Whole person impairment”
The Medical Assessor issued a MAC certifying as follows:
Body Part or system
Date of Injury
Chapter, page and paragraph number in NSW workers compensation guidelines
Chapter, page, paragraph, figure and table numbers in AMA5 Guides
% WPI
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)
1. Psychological Injury
05/06/2023
Chapter 11
Guidelines
11.1-11.3
11.4-11.6
Guidelines
11.11,11.12
Table
:11.1,11.2,11.3,11.
5,11.5,11.6
9%
0%
9%
Total % WPI (the Combined Table values of all sub-totals)
9%
The assessment was based on his assessment under the psychiatric impairment rating scale (PIRS) as required by the Guidelines as follows: (emphasis in original)
“Table 11.8: PIRS Rating Form
Name
Drew Blatchford
Claim reference number (if known)
W2467/24
DOB
xxxx
Age at time of injury
50 years old
Date of Injury
5 June 2023
Occupation at time of injury
Beach Lifeguard
Date of Assessment
22 May 2024
Marital Status before injury
Single
Psychiatric diagnoses
1. Post-Traumatic Disorder with Major Depressive Disorder with anxious distress
Psychiatric treatment
Yes
Is impairment permanent?
Yes
PIRS Category
Class
Reason for Decision
Self-care and personal hygiene
2
Mr Blatchford showers and changes into clean clothes every ‘couple of days’. He at times forgets to brush his teeth. He said he upsets his mother as he does not finish the chores at times. He added that his ‘mum cooks and he orders takeaways at times’. He reported that he previously ‘used to cook a lot’ but now he cannot be ‘bothered to cook’.
He is able to do simple household chores like ‘wiping’. I also noted that he had slightly longer hair and adorned a beard, however, he did that to avoid being recognised in public places. I have also noted that he reported that he just has ‘one meal per day’, however, has gained weight. Therefore, I believe that he is having a good diet.
I have also taken into consideration that his shoulder injury might also be impacting his capacity to do household chores as Mr Blatchford reported that it was quite painful for him to move his shoulders.
Social and recreational activities
3
He enjoyed spending time at the beach, paddling, swimming, surfing, playing tennis and golf. He grew up playing football and cricket which he enjoyed a lot. He added that he does not engage in water activities anymore and the last time he went to the beach was in March 2024.
He also reported that he had sustained a shoulder injury which impacted his ability to be able to swim, board or paddy as it was quite painful when he did so.
He said that he had a ‘dull ache’ with any movement and hence, it was ‘out of question’.
He added that he was quite social previously, but now he does not meet up with his friends and neither do they visit him at his home. He said that he has also stopped answering to their phone calls. He said that the last time he went out was the ‘middle of last year’ when his friend took him to dinner, but he asked his friend to drop him back to his house in the middle of the dinner. He only goes out with his mum at times.
Travel
2
He said that he leaves home to go for a drive with his mum. He goes to the shops but waits in the car. He takes her to appointments but prefers to stay locally in Belmont. He said that he does not like travelling interstate or driving to far distances as he feels unsafe.
Social functioning
2
Mr Blatchford reported that he has a good relationship with his mum. He added that his mum does a lot for him and he ‘gets on her nerves at times’. He said that his brother has always ‘kept his distance’ and said that they are not that close as before.
Attention, concentration, and pace
2
He reported that his attention and concentration are poor. He added that he is unable to finish chores and is not able to read and is barely able to ‘finish a page as words go in’.
He said that he does not seem to absorb the information and even during conversation, he gets distracted. However, Mr Blatchford was able to sustain attention during the one hour long assessment. I, therefore, believe that he has mild rather than moderate impairment taking in consideration both objective and subjective evidence.
Employability
5
Based on his current mental health symptoms, I believe that Mr Blatchford does not have any capacity to engage in any form of employment currently.
Score
Median Class
2
2
2
2
3
5
=2
Aggregate Score Impairment
Total
%
+2
+4
+6
+8
+11
16
9
Deduction for any pre-existing injuries = 0%.
Adjustment % for effective treatment = 0%.
Final WPI = 9%.”
The worker appealed.
In summary, the appellant submitted that the Medical Assessor made assessments on the basis of incorrect criteria and/or made demonstrable errors in the assessments she made under three of the PIRS categories, namely self-care and personal hygiene, social functioning and concentration, persistence and pace as follows:
(a) in assessing class 2 for self-care and personal hygiene when she should have assessed class 3;
(b) in assessing class 2 for social functioning when she should have assessed class 3, and
(c) in assessing class 2 for concentration, persistence and pace when she should have assessed class 3.
In summary, the respondent employer Newcastle City (the respondent) submitted that the Medical Assessor did not err or make an assessment on the basis of incorrect criteria and the MAC should be confirmed.
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 her 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 scale for mere difference of opinion but must be satisfied as to error.
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 it was not clear that the Medical Assessor had considered all of the evidence before her and further that the path of reasoning was inadequate. The Appeal Panel was satisfied as to error because the history taken by the Medical Assessor was inadequate and did not support an adequate path of reasoning of the assessments made under the contested PIRS categories of self-care and personal hygiene, social functioning and concentration, persistence and pace. In these circumstances the Appeal Panel was satisfied as to error and considered a re-examination was necessary.
In these circumstances of a finding of error the Appeal Panel considered that a re-examination by a Medical Assessor member of the Appeal Panel was necessary. Medical Assessor Douglas Andrews was appointed to conduct the re-examination and he reported to the Appeal Panel as follows (emphasis in original):
“PERSONAL INJURY COMMISSION
APPEAL AGAINST MEDICAL ASSESSMENT
REPORT OF THE EXAMINATION BY MEDICAL ASSESSOR
MEMBER OF THE APPEAL PANEL
Matter Number: | M1-W2467/24 |
Appellant: | Drew Blatchford |
Respondent: | Newcastle City |
Date of Determination: | 30 October 2024 |
Examination Conducted By: | Dr Douglas Andrews |
Date of Examination: | 30 October 2024 |
1. The workers medical history, where it differs from previous records
MA Verma assessed Mr Blatchford on 24 May 2024. One week before this assessment, he had had a right shoulder reconstruction from which he was recovering and which limited his physical activities then. He has since recovered significantly, and his shoulder gives him much less trouble.
Mr Blatchford believes that his mental health symptoms started around 2018, with reduced tolerance, irritability and increasing anger. He became more aware of the impact of his work on his well-being after the death of his friend and colleague in October 2020. He left work in January 2022 and has not worked in any capacity, paid or voluntary, since.
Despite treatment, Mr Blatchford feels his condition has marginally worsened since onset.
For the last 4-5 years, he has lived with his 77-year-old mother in a freestanding house with a garden.
He continues to see a general practitioner, Dr Damien Whittaker, a psychologist, Ms Sharon Black and a psychiatrist, Dr Pavan Bhandari. He sees his general practitioner as needed and his psychiatrist and psychologist monthly.
His psychiatric medication is sertraline 200 mg daily. There has been a recent discussion of a change in medication.
Mr Blatchford described supportive psychotherapy and a completed course of EMDR, which he found unhelpful. In late 2023, he also attended a 14-week PTSD program at Lakeside Private Hospital. This program has not changed his symptoms or circumstances.
2. Additional history since the original Medical Assessment Certificate was performed
Current symptoms:
Mr Blatchford described moderately severe symptoms. He said, ‘It’s like I’m in a shell… disconnected from life… angry, frustrated.’ His mood is pervasively low without diurnal variation. He has a reduced capacity to experience positive emotions. He said, ‘Everything I enjoyed is gone.’
He is anxious and has a reduced tolerance for people and noise. He lacks confidence, is irritable and prone to anger. He feels vigilant, always watching and listening and on edge away from home. He avoids going out.
He is bothered by intrusive thoughts, often violent, on themes related to his work. He reimagines circumstances that upset him at work. He uses background music to attenuate these thoughts.
He has ongoing thoughts of suicide, imagining ‘ending it all at the beach so that people could see what we had to put up with’ but without intent.
He has middle insomnia and marked restlessness during the night with frequent distressing dreams. These dreams relate to work circumstances such as rescues or altercations.
His appetite is intact, and he has gained some weight recently. His current weight is 90 kg; at 184 cm, his BMI is 26.6, which makes him slightly overweight.
Diagnoses:
The MA had diagnosed Mr Blatchford with post-traumatic stress disorder and a major depressive disorder with anxious distress. My assessment today supports these diagnoses. The MA did not adjust the effects of treatment. Mr Blatchford’s symptoms and impairment have not improved and perhaps have worsened (the appellant was not clear on this). He has not had a substantial or complete remission of symptoms with treatment; therefore, no adjustment is warranted.
Activities of daily living:
Mr Blatchford rises at about 7 AM and spends his day in the house or backyard.
He watches television or short videos on YouTube for 4-6 hours daily. He tends to flick from one video to the other without close engagement. Recently, he has been watching gardening videos.
His mother is ‘old school’ and prefers to do meal preparation, laundry, and lawn mowing. Mr Blatchford said he ‘wasn’t allowed’ to do these chores. He does help with washing dishes, vacuuming, and sweeping the backyard. Last year, he had been doing some home maintenance but gave that up in 2024 because he struggles with motivation.
He showers every 2-3 days, usually without prompting, but his mother sometimes comments on his lack of personal care. He hasn’t had a haircut since leaving work and had allowed his beard to grow long. He shaved his beard off two weeks ago because of persisting complaints from his mother, who started suggesting that perhaps it was time that he moved somewhere else.
He exercises in his backyard using stretch bands. He no longer attends a gym because the environment is stressful for him. He has a bicycle but no longer uses it.
He has one remaining friend but has not contacted him in the last three months. At that time, this man visited Mr Blatchford at home, and they sat in the backyard and talked.
In March 2024, he attended a Nippers carnival with his mother because his nephew and niece participated. He sat watching for a few minutes away from the crowd before returning to his car to wait for his mother.
He goes to medical appointments occasionally and goes shopping with his mother. She drives because he is concerned that he will ‘lose my shit while driving.’
His relationship with his mother is strained. He said, ‘She has had enough of me; she is frustrated, angry, sad, can't handle the way I am.’ There is no domestic violence, and she has only recently suggested that he find somewhere else to live, although perhaps this was in frustration.
His relationship with his brother, who visits Mr Blatchford’s mother weekly, is strained. He feels things are okay with his brother’s family, but he doesn’t visit them and rarely sees them. He has no contact with other friends.
He has not been in an intimate relationship for a decade. When asked about dating, he said, ‘No woman needs this [referring to himself].’
He doesn’t read books because he finds it difficult to concentrate. He thinks about maintenance chores around his mother’s house but hasn’t been motivated to start any.
Mr Blatchford appealed the MA’s class ratings for social functioning, concentration, persistence and pace, and self-care and personal hygiene. The MA determined a mild impairment or class 2 rating in each challenged category.
Social functioning:
Mr Blatchford has a strained but supportive relationship with his mother. She continues to care for him but is frustrated, saddened and angry at his lack of progress. His relationship with his brother is distant, and he has reduced contact with his brother’s family. He has infrequent contact with one remaining friend, which he hasn’t initiated (the last being a visit by his friend three months ago). He has lost other friends because of social disengagement. He has not been in an intimate relationship since before the onset of his symptoms and would not now be able to form or sustain such a relationship. Mr Blatchford had minimal social contact, and it is not unusual for a mother to continue to be supportive and caring after other relationships have fallen away. This is consistent with a mild impairment (class 2).
Concentration, persistence and pace:
Mr Blatchford spends several hours a day watching television and looking at video clips on YouTube or scrolling through Instagram. He tends to flick from one video to another without engagement. He has given up reading because he cannot concentrate or retain information. He tried listening to podcasts but has stopped doing so. He has subjective problems with concentration and attention. He has no hobbies and has not pursued maintenance projects in his mother’s home since 2023. He showed some lack of focus during the 75-minute assessment today. He occasionally needed questions restated. This is consistent with a moderate impairment (class 3).
Self-care and personal hygiene:
Mr Blatchford lives with his mother. He depends on her for main meal preparation and some household chores, but to a considerable extent, this is because she refuses to allow him to do things she considers her domain, such as cooking, laundry and lawn mowing. He participates in housework such as washing dishes, vacuuming and sweeping the yard. He prepares simple meals for himself. He neglects his appearance and showers only every 2-3 days. His mother may complain about his lack of hygiene but usually doesn’t directly prompt him. She recently demanded that he shave because he looked unkempt – she threatened to ask him to leave if he disagreed. He eats regular meals but relies on fast food or takeaway unless his mother prepares a meal. He exercises at home using stretch bands. Mr Blatchford could live independently but would be unkempt and rely on simple meals or takeaway food. This is consistent with a mild impairment (class 2).
3. Findings on clinical examination
I assessed Mr Blatchford in his home using an audiovisual link for 75 minutes. The connection quality was adequate for a comprehensive assessment.
He presented as an unkempt, dishevelled man, unshaven with shoulder-length hair. He wore a T-shirt and a grey jumper. He was in his bedroom, and an unmade bed was in the background.
His mood was low, and although he described a pervasive anxiety, this was not evident during the interview. His at factors were restricted, consistent with his stated mood and congruent with the interview content. He maintained his composure.
There was no evidence of any disorder of thought form or perception.
He was cooperative and appeared to be trying to answer my questions openly. He struggled with open-ended questions focus. On a few occasions, I needed to restate questions or redirect him.
He acknowledged thoughts of suicide.
4. Results of any additional investigations since the original Medical Assessment Certificate
There have been no additional investigations since the original Medical Assessment Certificate.
Signed: Dr Douglas Andrews
Date: 30 October 2024”
The Appeal Panel considers that the examination undertaken by Medical Assessor Douglas Andrews was conducted in a thorough manner. The Appeal Panel notes the history Medical Assessor Douglas Andrews has provided in his report to the Appeal Panel, including the history as to the appellant’s ability to function in the PIRS categories that have been challenged on appeal, namely self-care and personal hygiene, social functioning and concentration, persistence and pace. The Appeal Panel notes that Medical Assessor Douglas Andrews had clear regard to the other evidence before him, has not relied on self -report alone and has used his clinical expertise on the day of assessment to make recommendations to the Appeal Panel about the assessments of the contested PIRS categories.
Accordingly the Appeal Panel adopts the findings and reasoning of Medical Assessor Andrews in each of the contested PIRS categories.
In respect of Self Care and Personal Hygiene, Table 11.1 of the Guides provides as follows:
Table 11.1: Psychiatric impairment rating scale – self care and personal hygiene
Class 1
No deficit, or minor deficit attributable to the normal variation in the general population
Class 2
Mild impairment: able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food.
Class 3
Moderate impairment: Can’t live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit) 2–3 times per week to ensure minimum level of hygiene and nutrition.
Class 4
Severe impairment: Needs supervised residential care. If unsupervised, may accidentally or purposefully hurt self.
Class 5
Totally impaired: Needs assistance with basic functions, such as feeding and toileting.
Medical Assessor Andrews took a careful and detailed history and reported his findings to the Appeal Panel as follows:
“Self-care and personal hygiene:
‘Mr Blatchford lives with his mother. He depends on her for main meal preparation and some household chores, but to a considerable extent, this is because she refuses to allow him to do things she considers her domain, such as cooking, laundry and lawn mowing. He participates in housework such as washing dishes, vacuuming and sweeping the yard. He prepares simple meals for himself. He neglects his appearance and showers only every 2-3 days. His mother may complain about his lack of hygiene but usually doesn’t directly prompt him. She recently demanded that he shave because he looked unkempt – she threatened to ask him to leave if he disagreed. He eats regular meals but relies on fast food or takeaway unless his mother prepares a meal. He exercises at home using stretch bands. Mr Blatchford could live independently but would be unkempt and rely on simple meals or takeaway food. This is consistent with a mild impairment (class 2).'”
The Appeal Panel adopts the reasoning and findings of Medical Assessor Andrews and agrees that class 2 is the best fit. This is the same as the assessment by the Medical Assessor.
In respect of Concentration, Persistence and Pace, Table 11.5 of the Guides provides as follows:
| Class 1 | No deficit, or minor deficit attributable to the normal variation in the general population. Able to pass a TAFE or university course within normal time frame. |
| Class 2 | 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. |
| Class 3 | Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting. |
| Class 4 | Severe impairment: can only read a few lines before losing concentration. Difficulties following simple instructions. Concentration deficits obvious even during brief conversation. Unable to live alone, or needs regular assistance from relatives or community services. |
| Class 5 | Totally impaired: needs constant supervision and assistance within institutional setting. |
Table 11.5: Psychiatric impairment rating scale – concentration, persistence and pace
Medical Assessor Andrews took a careful and detailed history and did not have regard to self report alone and applied his clinical expertise in the assessment which was based on correct criteria and he reported to his findings and reasoning to the Appeal Panel as follows:
“Mr Blatchford spends several hours a day watching television and looking at video clips on YouTube or scrolling through Instagram. He tends to flick from one video to another without engagement. He has given up reading because he cannot concentrate or retain information. He tried listening to podcasts but has stopped doing so. He has subjective problems with concentration and attention. He has no hobbies and has not pursued maintenance projects in his mother’s home since 2023. He showed some lack of focus during the 75-minute assessment today. He occasionally needed questions restated. This is consistent with a moderate impairment (class 3).”
The Appeal Panel agrees with the findings of Medical Assessor Andrews and considers that a class 3 or moderate impairment is the best fit and is an assessment based on correct criteria for the category of concentration, persistence and pace. This is a higher assessment at class 3 than that made by the Medical Assessor at class 2.
In respect of Social Functioning, Table 11.4 of the Guides provides as follows:
Table 11.4: Psychiatric impairment rating scale – social functioning
Class 1
No deficit, or minor deficit attributable to the normal variation in the general population: No difficulty in forming and sustaining relationships (eg a partner, close friendships lasting years).
Class 2
Mild impairment: existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.
Class 3
Moderate impairment: previously established relationships severely strained, evidenced by periods of separation or domestic violence. Spouse, relatives or community services looking after children.
Class 4
Severe impairment: unable to form or sustain long term relationships. Pre-existing relationships ended (eg lost partner, close friends). Unable to care for dependants (eg own children, elderly parent).
Class 5
Totally impaired: unable to function within society. Living away from populated areas, actively avoiding social contact.
Medical Assessor Douglas Andrews findings in respect of social functioning, which category is concerned with the quality of relationships, as follows:
“Mr Blatchford has a strained but supportive relationship with his mother. She continues to care for him but is frustrated, saddened and angry at his lack of progress. His relationship with his brother is distant, and he has reduced contact with his brother’s family. He has infrequent contact with one remaining friend, which he hasn’t initiated (the last being a visit by his friend three months ago). He has lost other friends because of social disengagement. He has not been in an intimate relationship since before the onset of his symptoms and would not now be able to form or sustain such a relationship. Mr Blatchford had minimal social contact, and it is not unusual for a mother to continue to be supportive and caring after other relationships have fallen away. This is consistent with a mild impairment (class 2).”
The Appeal Panel considers that Medical Assessor Douglas Andrews has taken a careful and detailed history in respect of matters relevant to an assessment in the category of social functioning. He has taken the appellant’s self report into account but not relied on self report in isolation to the other evidence before him and has applied his clinical judgment to the assessment of social functioning, taking correct criteria into account. For these reasons, the Appeal Panel adopts the findings of Medical Assessor Andrews on re-examination and considers that a class 2 impairment rating is the best fit. This is the same as the rating by the Medical Assessor.
What this means is that the class assessed by the Appeal Panel is in accordance with the class assessed by the Medical Assessor for the contested PIRS categories of social functioning and self care and personal hygiene. However in respect of the contested category of concentration, persistence and pace class 3 has been assessed by the Appeal Panel in place of the class 2 assessed by the Medical Assessor.
What this means is that all of the contested classes assessed by the Medical Assessor have been confirmed on appeal with the exception of concentration, persistence and pace wherein the Appeal Panel has found an error in the assessment of class 2 when it should have been assessed as class 3.
This means the calculations become as follows:
Score median class
2
2
2
3
3
5
=3
Aggregate Score Impairment
Total
%
+2
+4
+6
+9
+12
17
19
For these reasons, the Appeal Panel has determined that the MAC issued on 24 May 2024 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
WORKERS COMPENSATION DIVISION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter number: | W2467/24 |
Applicant: | Drew Blatchford |
Respondent: | Newcastle City |
This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act1998.
The Appeal Pane revokes the Medical Assessment Certificate of Medical Assessor Surabhi Verma 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 NSW workers compensation guidelines | Chapter, page, paragraph, figure and table numbers in AMA5 Guides | % WPI | 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) |
| 1. Psychological Injury | 05/06/2023 | Chapter 11 Guidelines 11.1-11.3 11.4-11.6 | Guidelines 11.11, 11.12 Table:11.1, 11.2,11.3,11. 5,11.5,11.6 | 19 | 0% | 19 |
| Total % WPI (the Combined Table values of all sub-totals) | 19 | |||||
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.
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