Capital One Real Estate Pty Ltd v Campbell
[2025] NSWPICMP 360
•23 May 2025
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Capital One Real Estate Pty Ltd v Campbell [2025] NSWPICMP 360 |
| APPELLANT: | Capital One Real Estate Pty Limited |
| RESPONDENT: | Jennifer Campbell |
| APPEAL PANEL | |
| MEMBER: | Richard Perrignon |
| MEDICAL ASSESSOR: | Michael Hong |
| MEDICAL ASSESSOR: | Douglas Andrews |
| DATE OF DECISION: | 23 May 2025 |
| CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of psychiatric rating scales (PIRS) namely self-care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace; whether Medical Assessor (MA) erred in assessing class 3 impairment; whether MA erred in assessing class 2 impairment in respect of social functioning; whether MA omitted to provide reasons for finding whole person impairment (WPI); Held – findings did not support assessments of impairment in respect of self-care and personal hygiene, social and recreational activities, travel, and social functioning; reasons were not insufficient; Appeal Panel reassessed impairment in respect of self-care and personal hygiene, social and recreational activities, travel, and social functioning; resulting in a total WPI of 22%; MAC revoked; new certificate issued. |
BACKGROUND
The appellant employer appeals from the Medical Assessment Certificate of Medical Assessor Verma dated 13 September 2024.
Medical Assessor Verma examined the worker by video, and assessed a 24% whole person impairment (WPI) (psychological) as a result of injury on 3 July 2023 (deemed date). The figure of 17% WPI appears on the MAC, but she assessed an aggregate of 19 on the psychiatric impairment rating scale (PIRS) with a median of 3, which amounts to 24% WPI. The figure of 17% appears to be a clerical error.
She had earlier examined the worker on 18 March 2024. In a Medical Assessment Certificate dated 27 March 2024, she declined to make an assessment on the basis that the worker had not reached maximum medical improvement. No appeal is brought from that Medical Assessment Certificate.
The appellant submits that, in the Medical Assessment Certificate dated 13 September 2024, the Medical Assessor erred in assessing five out of the six PIRS categories; namely Self-care and personal hygiene, Social and recreational activities, Travel, Social functioning, and Concentration persistence and pace.
In respect of Social functioning, the employer says that a class 1 impairment was more appropriate than class 2 as assessed. In respect of the other four scales, it says that a class 2 impairment was more appropriate than class 3 as assessed.
It also submits (at [8] of its submissions) that the Medical Assessor failed to provide reasons for assessing 24% WPI in September 2024, in circumstances where Dr Khan (an independent psychiatrist retained by the worker’s solicitors) had similarly assessed 24% WPI on 26 June 2023, and the Medical Assessor had reported an improvement in functioning since her first assessment of the worker on 18 March 2024.
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.
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 as follows:
(a) Self care and personal hygiene:
(i)the Medical Assessor assessed a class 3 impairment. A class 2 assessment is more appropriate on the evidence;
(ii)the Medical Assessor failed to take into account the fact that the worker completes household chores to a high standard when reminded of them, wakes up daily at a regular time, has breakfast and watches television, regained weight lost after injury, and the fact that there is no evidence that she is unable to prepare meals or frequently misses meals, and
(iii)the assessment is inconsistent with the matters noted above.
(b) Social and recreational activities:
(i)the Medical Assessor assessed a class 3 impairment. A class 2 assessment is more appropriate on the evidence, and
(ii)the Medical Assessor failed to take into account the worker’s social outings, contact with friends, travel and recreational activities, namely: talks to her friend weekly, goes out for lunch with friends every couple of weeks, flew to Melbourne twice, walks on her own, and attends the shops without evidence of need for a support person.
(c) Travel:
(i)the Medical Assessor assessed a class 3 impairment. A class 2 impairment was more appropriate on the evidence;
(ii)according to the worker’s husband, the fact that they did not travel much was due to people being busy. There was no evidence it was due to her injury;
(iii)the Medical Assessor recorded that the worker could drive to familiar areas on the odd occasion, goes to medical appointments and meets friends occasionally. In 2024, she travelled twice to Melbourne to see her grandson. These factors were not taken into account, and
(iv)the factors considered in the PIRS assessment differed from the history taken that the worker was capable of travelling away from her residence without a support person.
(d) Social functioning:
(i)the Medical Assessor assessed a class 2 impairment, but the evidence supported a class 1 impairment, and
(ii)the worker maintained a positive relationship with her husband. There was no evidence that relationships were strained for a loss of friends due to injury. The worker is able to attend lunches with friends. These factors were not taken into account.
(e) Concentration, persistence and pace:
(i)the Medical Assessor assessed a class 3 impairment, but the evidence supported a class 2 impairment;
(ii)the worker can be distracted during conversation, had difficulty assembling the vacuum cleaner and is unable to read, and
(iii)however, she was again using the washing machine and displayed no significant deficits on examination. She regularly watched a television show in the morning. The Medical Assessor did not take these matters into account.
(f) Insufficient reasons:
(i)Dr Kan assessed a 24% WPI in June 2023. The M Medical Assessor assessed the same in September 2024. However, she noted that mental health and cognitive functioning had improved since her last examination in March 2024, and
(ii)the Medical Assessor failed to explain why her assessment was the same as Dr Khan’s in those circumstances, or why the differences in functioning and histories reported by the two assessors produced the same assessment. (These alleged differences are not specified in the submissions.)
The respondent’s submissions in reply may be summarised as follows:
(a) an Appeal Panel cannot disturb ratings under the PIRS scale for mere difference of opinion but must be satisfied as to error. It cannot interfere with the rating because opinions might differ as to the best fit in each category. There must be error or assessment on the basis of incorrect criteria: Hurley v Westpac Bankinbg Corporation [2024] NSWPICMP 173 at 19-21;
(b) intervention is only justified if the categorisation was glaringly improbable, the Medical Assessor is unaware of significant factual matters, or there was a clear misunderstanding, or an unsupportable reasoning process: Ferguson v State of NSW [2017] NSWSC 887;
(c) examples in the rating scales are examples only. They are not prescriptive: Jenkins v Ambulance Service of NSW [2015] NSWSC 633 at [65], and
(d) the submission that certain evidence was not taken into account by the Medical Assessor is unsupported by specialist medical opinion.
FINDINGS AND REASONS
In Tasevski v Westpac Banking Corporation [2024] NSWSC 401, Schmidt J found as follows:
“35. Even if the Panel identifies that the evidence raised matters about which reasonable minds might differ, it cannot resolve what is in issue about a disputed scale by an observation that what arose to be considered concerned matters about which reasonable minds might differ. Nor can it do so by a finding that the conclusion the assessor reached was ‘open’.
36. It must rather consider and determine whether the assessor applied the incorrect criteria in arriving at his or her conclusion. Or whether there was a demonstrable error in the conclusion reached about that class assignment. For example, by impermissibly taking into account conduct not relevant to the scale, or by arriving at the incorrect conclusion about the class into which that scale fell into, given the conduct which arose to be considered in light of the requirement to take into account cultural background, age, sex and cultural norms.”
Error is demonstrated where the findings relied on by a Medical Assessor to distinguish between two classes of impairment were not sufficient to justify the assessment of the class of impairment which was made: Abdal v Insurance Australia Limited t/as NRMA Insurance [2025] NSWSC per Wright J at [93].
Self-care and personal hygiene
The behavioural consequences of psychiatric disorder are assessed on six scales, each of which evaluates an area of functional impairment: Guidelines at [11.11].
In respect of each scale, the level of impairment is rated using descriptors for each class of impairment. Classes range from 1 to 5, in ascending order of severity. Examples of activities are given in each class. They are examples only: Guidelines at [11.12]. They are not prescriptive: Jenkins at [65]; Ferguson at [25].
In respect of Self-care and personal hygiene, the relevant class descriptors are as follows:
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.
In the PIRS rating form, the Medical Assessor gave the following reasons for assessing a class 3 impairment:
“She showers, three to four times a week and only brushes her teeth when she showers. Greg said that he has to remind her to brush her teeth. Ms Campbell reported that now they have started sharing doing the household chores. Greg added that she is able to do the household chores from beginning to the end and cleans the bathroom hospital grade. She has now started using washing machine and does not have any difficulties in doing so. However, she has to be prompted and reminded by Greg, to do these activities including her self-care or else she forgets.”
The fact that she wakes up daily at a regular time, watches television, or has regained weight lost after injury, are not matters expressly addressed in the descriptors for this rating scale.
However, the reasons given by the Medical Assessor do not include any suggestion that the worker is unable to prepare her own meals or frequently misses meals. On the contrary, she appears to have breakfast regularly – cereal and coffee, MAC at [3]. There is no suggestion that a nurse or family member visits up to three times per week to ensure a minimum level of hygiene or nutrition. The history taken was that she is able to cope with household chores to a high standard, at least on a shared basis with her husband.
So far as relevant, the evidence establishes that she lives with her husband, who prompts her to shower and brush her teeth a number of times per week, and reminds her about the household chores which they share.
That alone, in all the circumstances above, does not explain why the worker would be unable to live independently, or unable to look after herself. The findings relied on by the Medical Assessor do not justify the selection of a class 3 impairment in preference to a class 2 impairment.
That amounts to demonstrable error, necessitating the setting aside of the assessment, and the making of a further assessment by the Appeal Panel.
Social and recreational activities
In respect of Social and recreational activities, the relevant class descriptors are as follows:
| Class 2 | 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). |
| Class 3 | 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. |
In the PIRS rating form, the Medical Assessor gave the following reasons for assessing a class 3 impairment:
“Ms Campbell used to have a very active social life. She said that they used to go out for holidays three times a year with a group of friends. They used to have [a] barbecue party every week. Greg added that, their friends live in Gordon, which is a 20 minutes drive. Greg added that she talks to her friend once a week and goes out for lunch every couple of weeks. He said that even though Ms Campbell has started socializing, it is nowhere as frequently as they used to. He also added that probably since other people also have been busy and they left Gordon about 24 years back, going back to Gordon every week is just becoming difficult. They flew to Melbourne in January and February 2024 to meet their grandson in Bendigo. Greg, however, reported that Mrs Campbell, never goes out on her own except for going out for walks. She has to be accompanied by, Greg.”
The Medical Assessor took a history at [3] that the worker had “started getting out more and going out for lunch with a couple of girlfriends”. There is no evidence that she did so with a support person. That is consistent with a class 2 impairment. It was relevant to the selection of a class 2 or 3 impairment, and does not appear to have been taken into account in the reasons given in the rating form. Even if it was taken into account, there is no explanation as to how it was taken into account.
In all the circumstances, the findings relied on by the Medical Assessor are consistent with a class 2 impairment, and do not justify the selection of a class 3 impairment. Demonstrable error is made out, necessitating the setting aside of the assessment, and the making of a further assessment by the Appeal Panel.
Travel
In respect of Travel, the relevant class descriptors are as follows:
| Class 2 | Mild impairment: can travel without support person, but only in a familiar area such as local shops, visiting a neighbour. |
| Class 3 | Moderate impairment: cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment. |
In the PIRS rating form, the Medical Assessor gave the following reasons for assessing a class 3 impairment:
“Ms Campbell said that she tried to drive once after the incidents at workplace and remembers that it was raining. She said that I got lost when coming back. She said that she will only drive on odd occasions in daytime and in familiar areas. She leaves her house to go for medical appointments and meeting her friends occasionally, Greg said that we have a boring life now, everyone is busy and has a family life and hence we have not travelled much with friends since COVID.”
The evidence that the worker travelled twice to Melbourne to see her grandson in 2024 was not expressly taken into account in the reasons given in the rating form. If it was taken into account, we cannot be sure how it was taken into account.
The Medical Assessor does not specify where the worker goes for medical appointments or for meeting with her friends. There is no suggestion in the reasons that it is only at the local shops or similar, and no evidence that she needs a support person to do so. That evidence is on its face inconsistent with the descriptors for a class 3 impairment. We are left in doubt as to how the Medical Assessor took it into account in selecting a class 3 impairment.
In those circumstances, the findings relied on by the Medical Assessor are not sufficient to justify selection of a class 3 impairment as distinct from class 2. Demonstrable error is made out, necessitating the setting aside of the assessment, and the making of a further assessment by the Appeal Panel.
Social functioning
In respect of Social functioning, the relevant class descriptors are as follows:
| 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. |
In the PIRS rating form, the Medical Assessor gave the following reasons for assessing a class 2 impairment:
“Mrs Campbell continues to have [a] positive relationship with Greg who has been extremely supportive. Greg said that it is my turn now to support Jennifer. They have been together for 48 years.”
These reasons confirm that the worker has been able to maintain a positive relationship with her husband, despite the effects of injury. They do not demonstrate strain in existing relationships, tension and arguments with family or friends, or loss of friendships. To the extent that other evidence indicates that visiting friends in Gordon has become difficult, the evidence suggests that is due to having moved away.
The reasons do not support a class 3 impairment. That amounts to demonstrable error, necessitating the setting aside of the assessment, and the making of a further assessment by the Appeal Panel.
Concentration, persistence and pace
In respect of Concentration, persistence and pace, the relevant class descriptors are as follows:
| 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. |
In the PIRS rating form, the Medical Assessor gave the following reasons for assessing a class 3 impairment:
“Ms Campbell reported that sometimes, she gets distracted during the conversation and forgets. She said that she finds assembling the vacuum cleaner difficult, but has restarted using the washing machine. She is unable to read, like previously as she does not have the attention and concentration that she previously had. However, no significant deficits were noted during the one-hour long assessment. Ms Campbell was able to answer to the questions although Greg had to give inputs at times.”
The finding that the worker was unable to read indicates that she satisfies the descriptors for class 3 impairment at the very least, which require that the worker be ‘unable to read more than newspaper articles’. Difficulties with assembling a vacuum cleaner are consistent with an inability to follow complex instructions. That is so, even if she can now cope with a washing machine and watches a television show in the morning, and even if no cognitive deficits (as we interpret the Medical Assessor to mean) were evident on examination.
The evidence does not satisfy us that the worker can focus on intellectually demanding tasks for up to 30 minutes, or that she could undertake a basic or retraining course.
In our view the evidence is consistent with a class 3 impairment, and not consistent with a class 2 impairment.
We can identify neither error nor the application of incorrect criteria. This ground fails.
Insufficient reasons
In his report of 26 June 2023, Dr Khan assessed a 24% WPI. In doing so, he assessed each of the psychiatric rating scales in such a way as to arrive an aggregate of 19, with a median of 3.
On 13 September 2024, Medical Assessor Verma assessed the same level of impairment as Dr Khan in respect of each of the psychiatrist rating scales, yielding an aggregate of 19, with a median of 3. Applying Table 17 of the Guidelines, that yielded 24% WPI, as Dr Khan had assessed.
The Medical Assessor recorded at [3]:
“Ms Campbell reported that since her last appointment, her mental health has improved.”
That was a reference to the initial assessment by Medical Assessor Verma on
18 March 2024. Medical Assessor Verma continued:“ …. She reported that her medications, too, have been changed, and she was started on Quetiapine in July 2024. She added that since starting Quetiapine, she has now started sleeping better and only gets up once every couple of nights.”
The appellant submits, in effect, that the Medical Assessor should have explained why her assessment of impairment was no less than that of Dr Khan, given the lapse of time since his assessment in June 2023, and the fact that the worker had improved since March 2024.
That submission necessarily relies on an assumption that there had been no deterioration in the worker’s impairment between June 2023 and March 2024. No attempt is made by the respondent to justify that assumption. We are not satisfied that it is justified.
It also assumes that Medical Assessor Verma agreed, or would have agreed, that Dr Khan’s assessment in June 2023 was accurate. She made no such finding, confining herself to the condition of the worker on examination in September 2024, as was her duty. It is unclear what Medical Assessor Verma would have assessed in June 2024. The Appeal Panel is likewise in no position to determine whether Dr Khan’s assessment was accurate when it was made.
In the circumstances, it was not necessary for Medical Assessor Verma to explain her assessments in any further detail than she did, save for the deficiencies we have identified above for quite different reasons.
This ground fails.
Referral for examination - report of Medical Assessor Hong
The Panel referred the worker to one of its members, Medical Assessor Hong, for examination and assessment of the rating scales in respect of which it had discerned error. He interviewed the worker by video, with her husband acting as a support person. Medical Assessor Hong’s report follows.
“HISTORY
At the start, I explained to them the reason of the assessment today, and why she was being reassessed today.
Ms Campbell described being mistreated at work and her mental health fluctuated with psychologist and psychiatrist treatment, and with changes in psychotropic medications. She said now, her medications seemed to be all right, she is not as avoidant of going out, she can go out, talk to people, go shopping, however, she went on to describe since Dr Surabhi Verma’s assessment in September 2024, she is much more restricted in her functioning, despite her psychiatrist increasing her Seroquel in December 2024.
She said she consults Nell, her psychologist, recently every 4-5 weeks, and her husband said it should be every 2-3 weeks. She consults Dr Goriparti, psychiatrist, and had 5 sessions since March 2024, the last time was December 2024.
Ms Campbell takes:
• Venlafaxine 150 mg. Her husband said the GP made a mistake and reduced it to 75 mg. She should be on 150 mg. I discussed her psychiatrist wrote she could not tolerate 150 mg. Her husband said her mental health declined on a lower dose.
• Seroquel IR, 25 mg tablet 2 tablets, 50 mg in total. This was increased in December 2024.
In terms of her psychological symptoms, Ms Campbell said she has nightmares, related to her children being unsafe and she wakes up from those dreams. She said she does not eat a lot, she tries different ... (I noted word-finding difficulties several times during the assessment), she confirms she meant to say she tries different foods, e.g. pizza, hamburger and Chinese food. She presented as vague and woolly in her thinking and I asked her how these foods are different, her immediate response was bacon and egg. On further enquiry, she said she would not eat pizza or hamburger for breakfast, and they taste different. On further enquiry, she could not identify other differences in the three foods. She then said she tends to buy the same things.
I asked Ms Campbell about her weight and in response, she described ongoing paranoid delusion as noted below. I asked her about her weight again, she thinks she gained weight as her clothes are tighter.
She was taking walks on her own, but a couple of months ago she thought someone followed her, and she has been too scared to go out since. She said she could not see anyone, but was scared and called her husband to take her home. This is after Dr Verma’s last assessment. She mentioned her paranoia to her psychiatrist in December, and she said her Seroquel was increased from 1.5 tablets to 2 tablets at that time.
In terms of ‘voices’ and hallucination, Ms Campbell said at night, she heard noises and she gets up to check. She hears ‘talking’, which keeps her up, but she cannot make out what is said. Her husband told her it is in her head, but she said to her, it is real.
Ms Campbell does not have suicidal ideation.
She reported having major problems with her concentration and memory, ‘the words would not come out in conversation’.
Ms Campbell is anxious and paranoid.
LIFESTYLE
Ms Campbell goes to the shops with her husband and they are close to an Aldi supermarket. Her husband always drives and she goes with him, but usually stays in the car and waits for him.
She does not drive anymore. She tried and had pull over and called her husband to take her home, as she had difficulties with “coordination, steering and the blinkers”.
Ms Campbell said she ‘plays with the same clothes, 3 to 4...’ (outfits), I confirmed she meant she wears the same outfits. She washes and changes clothes 2 times per week. Her husband uses the washing machine and hangs the washing, she said she does not do it as he does it. Ms Campbell cooks sometimes, and her husband cooks more. She said she eats the same breakfast daily, which is cereal.
Ms Campbell generally sleeps from 10pm, and wakes up at different times, if she has an appointment then she sets an alarm, generally gets up at 7am. She showers twice a week, and said ‘it is too much trouble’, and explained once she wakes up, gets dressed and eat breakfast, it is too much trouble to return to the shower. She brushes her teeth only after she showers and if she does not shower, she does not brush. Ms Campbell's husband reminds her to shower sometimes.
Ms Campbell said she follows her husband all day. He is retired. I asked her about things she did yesterday, and she cannot remember. Her husband said she sits inside and does nothing.
Ms Campbell said she watches TV. I asked her about TV she watched yesterday, she could not recall anything, after a while, she said she would have watched something, and after some effort, she thinks she watched a show called ‘Gold something’, about gold digging.
She said she has one friend, and they talk, they catch up every 3-4 weeks.
I asked her about her activities in September 2024, when seen by Dr Verma, that she was going out for lunch with some friends every couple of weeks. She said she lost touch with some people in the past few months, because after half an hour, she wants to go home. Her husband dropped her off and then he picked up after some time. On further enquiry, he said they went out for lunch and dinner, meaning Ms Campbell and her husband, and a couple, every 6 weeks, but sometimes, her husband left her with the couple and picked her up later.
Ms Campbell had more friends before, but she isolated herself from them. She talks to some ‘acquaintances’.
Ms Campbell's husband said her friends think she has dementia, and people avoided her, and no longer wants to talk to her in the past few months. He said they did everything - cerebral MRI scan, PET scan, seeing a neurosurgeon - and no one found anything wrong with her brain in the past 3 years. He said all her friends googled and have an opinion about her condition. Her husband was frustrated that I asked the same questions as Dr Abdal Khan and Dr Surabhi Verma. He left the room at 9.50am, after 50 minutes assessment. Because Ms Campbell presented as quite impaired, I explained I had sufficient information and ended the assessment at that point.
Mental state examination
Ms Campbell was assessed by video with her husband present. She gave most of the history, and her husband sometimes helped when she struggled with recalling information. She was vague and woolly, and struggled with her concentration and memory during the assessment. She turned to her husband for support and help with her recall at times. She had moderately reduced reactivity, and was not thought disordered.
Summary
Ms Campbell does not have a past psychiatric history and developed anxiety and depressive symptoms as a result of her employment. Her symptoms are consistent with Major depressive disorder with psychotic features, as she developed paranoid and psychotic symptoms over time. She has been treated with antipsychotic medication and antidepressant. She continues to have symptoms since Dr Verma’s assessment and her psychological injury has not resolved.
Self-care and personal hygiene – class 3
Ms Campbell described general impairment in self-care, and similar to Dr Verma, I took a history she was heavily reliant on her husband. She cooks with support from her husband. She needs to be reminded to shower by her husband. As she could not maintain basic nutrition and hygiene without her husband, she is not independent in living.
Social and recreational activities – class 2
Ms Campbell has regular activities with her friends and husband, and sometimes her husband leaves her on her own without support person, until her friends do not want to talk to her. In terms of psychiatric impairment from her diagnosis, she continues to enjoy regular recreational activities and does not need a support person. Her diminished recreational activities since the subject injury are consistent with class 2.
Travel – class 3
Ms Campbell reported she could not go out on her own, and always needs a support person. She does not go to the shops on her own any more.
Social functioning – class 2
Her relationship with her friends has definitely deteriorated, and she is more distant from her own family. She has a supportive husband.”
Having regard to his specialist expertise, to the history taken, to his observations on examination, and to the reasons he has given, we agree with his assessments of each rating scale. They are reflected in our assessment.
We have calculated an aggregate score of 18, with a median of 3. Applying Table 17 at page 58 of the Guidelines, that yields 22% WPI. Medical Assessor Verma assessed an aggregate of 19, with the same median. On our calculation that yielded 24% WPI, rather than 17% which appears in the MAC before us.
The MAC issued on 13 September 2024 is revoked, and replaced by the attached MAC.
WORKERS COMPENSATION DIVISION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter Number: | W619/24 |
Applicant: | Jennifer Campbell |
Date of Assessment: | 11 September 2024 |
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 Verma and issues this new Medical Assessment Certificate as to the matters set out in the table below:
| 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 | 3.7.2023 | 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 | 22% | 0 | 22% |
| Total % WPI (the Combined Table values of all sub-totals) | 22% | |||||
Table 11.8: PIRS Rating Form
| Name | Jennifer Campbell | Claim reference number (if known) | W619/24 |
| DOB | Age at time of injury | 66 | |
| Date of Injury | 3.7.2023 | Occupation at time of injury | Property manager |
| Date of Assessment | 27.8.2024 | Marital Status before injury | Married |
| Psychiatric diagnoses | 1.Major Depressive Disorder with psychotic features | |||||||||||
| Psychiatric treatment | Yes | |||||||||||
| Is impairment permanent? | Yes | |||||||||||
| PIRS Category | Class | Reason for Decision | ||||||||||
| Self Care and personal hygiene | 3 | Ms Campbell described general impairment in self-care, and similar to Dr Verma, I took a history she was heavily reliant on her husband. She cooks with support from her husband. She needs to be reminded to shower by her husband. As she could not maintain basic nutrition and hygiene without her husband, she is not independent in living. | ||||||||||
| Social and recreational activities | 2 | Ms Campbell has regular activities with friends and husband, and sometimes leaves her on her own without support person, until her friends do not want to talk to her. In terms of psychiatric impairment from her diagnosis, she continues to enjoy regular recreational activities and does not need a support person. She has diminished recreational activities since the subject injury, and this is consistent with class 2. | ||||||||||
| Travel | 3 | Ms Campbell reported she could not go out on her own, and always needs a support person. | ||||||||||
| Social functioning | 2 | Her relationship with her friends has definitely deteriorated, and she is more distant from own family. She has a supportive husband. | ||||||||||
| Concentration, persistence and pace | 3 | Ms Campbell reported that sometimes, she gets distracted during the conversation and forgets. She said that she finds assembling the vacuum cleaner difficult, but has restarted using the washing machine. She is unable to read, like previously as she does not have the attention and concentration that she previously had. However, no significant deficits were noted during the one-hour long assessment. Ms Campbell was able to answer the questions although Greg had to give inputs at times. | ||||||||||
| Employability | 5 | Ms Campbell does not have any capacity to engage in any form of employment. | ||||||||||
| Score | Median Class | |||||||||||
| 2 | 2 | 3 | 3 | 3 | 5 | =3 | ||||||
| Aggregate Score Impairment | Total | % | ||||||||||
| +2 | +4 | +7 | +10 | +13 | 18 | 22 | ||||||
Deduction for pre-existing impairment = 0%
Final WPI = 22 - 0 = 22%
0
4
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