Coleman v State of New South Wales (NSW Police Force)
[2025] NSWPICMP 608
•14 August 2025
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Coleman v State of New South Wales (NSW Police Force) [2025] NSWPICMP 608 |
| APPELLANT: | Mark Coleman |
| RESPONDENT: | State of New South Wales (NSW Police Force) |
| APPEAL PANEL | |
| MEMBER: | Marshal Douglas |
| MEDICAL ASSESSOR: | Douglas Andrews |
| MEDICAL ASSESSOR: | John Lam-Po-Tang |
| DATE OF DECISION: | 14 August 2025 |
CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) provided adequate reasons; whether MA obtained correct history; whether MA’s ratings of appellant’s impairment in social and recreational activities, travel and social functioning correct; Held – MA provided adequate reasons, obtained correct history and correctly rated appellant’s impairment in all challenged psychiatric impairment rating scale (PIRS) categories; MAC confirmed. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 3 June 2025 Mark Coleman, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Surabhi Verma, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 7 May 2025.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· the assessment was made on the basis of incorrect criteria, and
· the MAC contains a demonstrable error.
The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the ground(s) of appeal on which the appeal is made.
Rule 128 of the Personal Injury Commission Rules 2021 (the PIC Rules) and Procedural Direction PIC7 - Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes set out the practice and procedure in relation to the medical appeal process under s 328 of the 1998 Act. An Appeal Panel determines its own procedures in accordance with r 128(1) of the PIC Rules.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed
1 March 2021 (the Guidelines).
RELEVANT FACTUAL BACKGROUND
The appellant worked for the State of New South of Wales as a Police Officer, commencing on 17 November 1994. His last day of work as a Police Officer was in February 2023. Due to several incidents to which he was exposed in the course of his employment as a Police Officer he suffered a psychological injury.
The appellant claimed compensation for permanent impairment from that injury, relying on a report his solicitors received from psychiatrist Dr Abdal Khan dated 30 April 2024. Dr Khan assessed the degree of the appellant’s permanent impairment from his injury is 22% whole person impairment (WPI). That assessment was done by reference to the psychiatric impairment rating scale (PIRS), as detailed in paragraphs 11.11 and 11.12 of the Guidelines. Dr Khan rated the appellant’s impairment in self-care and personal hygiene as Class 2, in social and recreational activities as Class 3, in travel as Class 2, in social functioning as Class 3, in concentration, persistence and pace as Class 3, and in employability as Class 5.
Relevant to the issues that have been raised in the appellant’s appeal against the medical assessment are the Medical Assessor’s ratings of the appellant’s impairment in social and recreational activities, travel, and social functioning, in regards to which Dr Khan provided in an appendix attached to his report the following reasons for rating the appellant’s impairment as he did in these categories:
Table 11.2
Social and recreational activities
3
Mr Coleman previously enjoyed socialising with family and friends, attending outings, going for meals, going to the movies, playing golf and playing squash. He no longer actively engages in any social and recreational activities. Mr Coleman prefers to remain socially isolated at his home.
Table 11.3
Travel
2
Mr Coleman is able to travel to familiar places on his own although he struggles with anxiety, panic, hypervigilance and avoidance of crowds when he leaves his home.
Table 11.4
Social functioning
3
Mr Coleman was previously married. He separated from his wife after 21 years and they formally divorced after 26 years. Mr Coleman identified his deteriorating mental
state, particularly his agitation and irritability, as the cause of his marriage breakdown. He has been able to enter a new relationship and his current partner of three years is supportive. Mr Coleman’s relationships with his children have become more strained due to his agitation and irritability. He struggles trusting people and he has lost most of his friendships.
The respondent’s insurer disputed the appellant’s claimed entitlement to compensation for permanent impairment. Its reason was the degree of his permanent impairment is not at least 15% WPI. It relied on reports from psychiatrist Dr Brendan Smith dated 16 July 2024 and 7 September 2024.
In his earliest report, Dr Smith advised the insurer that he assessed the degree of the appellant’s impairment from his injury is 22% WPI. That was based on his rating the appellant’s impairment in self-care and personal hygiene as Class 2, in social and recreational activities as Class 3, in travel as Class 2, in social relationship functioning as Class 3, in concentration, persistence and pace as Class 3, and in adaption/employability as Class 5. The reasons he detailed in a PIRS rating form within his report for social and recreational activities, travel and social relationships functioning were:
Social and recreational activities
3
Mr Coleman reported avoiding social interaction substantially. He denied engagement in any form of hobby or activity. Apart from attendance at his medical appointments, he is largely remaining in the
home environment.
Travel
2
Mr Coleman has struggles with road rage, anxiety and irritability when driving. However, he is able to drive effectively to local and familiar areas.
Social functioning
3
Mr Coleman has experienced a separation and divorce from his ex-wife, contributed significantly to by his poor mental health symptoms. There has been an impact on the relationship with his two adult children, as well as the loss of a significant number
of friendships.
In his subsequent report, which was addressed both to the respondent’s insurer and the respondent’s solicitors, Dr Smith indicated that he had reviewed a letter of instruction from the respondent’s solicitors and the clinical notes of the general practice at which the appellant attended.
The solicitors’ letter of instruction is not before the Appeal Panel. It would seem however, from Dr Smith’s report, that within that letter Dr Smith’s attention was drawn to the appellant having travelled to Europe in 2023, having regularly attended band practice, playing the "trumpet" (actually, the tenor horn), and catching up with his former work colleagues. It would seem that the respondent’s solicitors requested Dr Smith to reconsider his assessment of the appellant’s permanent impairment having regard to those matters.
Dr Smith, in his latest report, advised that “based on provided evidence, there would appear to have been mild to moderate minimisation of certain aspects of Mr Coleman’s function state”. Dr Smith revised his ratings of the appellant’s impairment in social and recreational activities to Class 2 and in travel to Class 1. Having done that, he revised his assessment of the appellant’s degree of permanent impairment to 8% WPI, and hence the respondent’s rejection of the appellant’s claim for compensation for permanent impairment.
The appellant thereafter initiated proceeded in the Personal Injury Commission (Commission), seeking the Commission determine his claim for compensation for permanent impairment from his injury. The matter was referred by a delegate of the President of the Commission to the Medical Assessor by means of referral dated 14 April 2025. The Medical Assessor’s examination of the appellant, in order to conduct that assessment, occurred on 28 April 2025, and, as already noted, the Medical Assessor issued her certification of her assessment of the medical disputes referred to her on 7 May 2025. In that she certified she assessed the degree of the appellant’s permanent impairment from his injury is 8% WPI. That was based on her rating the appellant’s impairment in self-care and personal hygiene as Class 2, in social and recreational activities as Class 2, in travel as Class 1, in social functioning as Class 2, in concentration, persistence and pace as Class 3, and in employability as Class 5. Importantly, with respect to the matters the appellant has raised in his appeal, the Medical Assessor provided the following reasons in the PIRS rating form attached to the MAC for rating the appellant’s impairment in social and recreational activities as Class 2:
“Mr Coleman previously enjoyed playing squash, golf, going to the movies and restaurants. He said that he has been part of the band since 1982. His psychologist
and mother encouraged him to continue attending the band, which he attends every Monday night and spends about two hours there. He, however, has to take
propranolol to attend the band.
He said that he does not spend time with the other band players like before. His other band players go to pub after their performance, but he returns home. He has ‘three mates from work’ who live close to where he lives. He meets up with them every ‘couple of Fridays’ and then they talk about funny things at work.”
The Medical Assessor provided the following reasons in that form for rating the appellant’s impairment in travel as Class 1:
“Mr Coleman leaves his house to go to band practise, which is in Chatswood, and which is around 70 km and takes an hour. He also drives to the local shops and to
his mom's place, which is about 15 minutes. He reported that he went to Europe for six weeks and as he had paid for it the year before the incidents at workplace happened. However, he found Normandy was a happy place and he felt happy there.”
The Medical Assessor also said within the body of the MAC that her rating of the appellant’s impairment differed from Dr Khan’s rating. The Medical Assessor also said, with respect to Dr Khan’s rating, that Dr Khan made no mention “of Mr Coleman of being able to drive for his band practice”.
The Medical Assessor said within the body of the MAC that her rating of the appellant’s impairment in travel differed from Dr Smith’s rating. The Appeal Panel observes that was the case with respect to Dr Smith’s original rating as advised in his report of 16 July 2024, but not with respect to his rating advised in his latest report.
The Medical Assessor provided the following reasons in the PIRS rating form for rating the appellant’s impairment in social functioning as Class 2:
“Mr Coleman reported that he was with his wife for 21 years and separated in 2019 as he was angry all the time and they formally divorced in March 2024. He has been in his current relationship for about three years now and his current partner is very understanding and supportive. He has positive relationship with his children and talks to them on the phone. He sees them when they come and visit him as they are in uni. Mr Coleman has mild impairment in social relationship and social functioning, as he had the capacity to be in another relationship and has been in that relationship for about three years now.”
The Medical Assessor noted that her rating of the appellant’s impairment in social functioning differed from the rating Dr Khan had made. With respect to that, she expressed that whilst
Dr Khan had noted the appellant had divorced from his ex-wife, Dr Khan possibly had not considered the appellant’s current relationship when making his evaluation of the appellant’s ability in his current social functioning.
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 appellant to undergo a further medical examination. This is because the Appeal Panel came to the view that the appellant had not established the grounds for appeal on which he relied, and consequently the Appeal Panel neither has power nor reason to examine the appellant.[1]
[1] New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales [2013] NSWSC 1792 at [33]; Saveski v Brunjev Pty Ltd [2025] NSWSC 157 at [66]; Masters v Healthshare NSW [2025] NSWSC 821 at [45]-[48].
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 submitted that the Medical Assessor did not provide a clear path of reasoning such that the reasons for her assessment could be understood.
The appellant noted that the Medical Assessor commented that her certificate is similar to
Dr Khan’s assessment in most aspects except for the degree of permanent impairment, but the appellant submitted there are stark differences between the Medical Assessor’s assessment and Dr Khan’s report.The appellant submitted that his evidence in a statement he signed on 17 March 2025 accords with the history that Dr Khan detailed in his report for rating his impairment in social and recreational activities as Class 3.
The appellant noted that the Medical Assessor found that he takes anti-anxiety medication before attending band practice and that he is prompted by his psychologist and mother to attend band practice each week. The appellant further noted that he no longer plays squash or golf or goes to movies or restaurants. The appellant submitted that this is consistent with a Class 3 rating in social and recreational activities.
The appellant submitted it is unclear from the MAC why his meeting up with friends every couple of weeks warrants a Class 2 rating rather than a Class 3 rating in the domain of social and recreational activities.
The appellant noted that he had been travelling to Chatswood for band practice for 43 years and submitted, as consequence, Chatswood is to be considered as a familiar area to him. The appellant submitted it is unclear why, due to his going to band practice each week, the Medical Assessor rated his impairment as Class 1, rather than Class 2, in the domain of travel.
The appellant noted that Dr Smith had found he struggled with road rage anxiety and irritability when driving. The appellant noted that in his statement he said he did not want to travel overseas in October 2023 but did so because he had already paid for the trip, that he forced himself to go on the trip, and that whilst overseas he experienced moments where he was overwhelmed and anxious and on numerous occasions had to retreat to his hotel room to calm down.
The appellant also noted that in one of his consultations with his general practitioner, his general practitioner had recorded a history that the “business [sic] of Paris” was stressful to him, though is also reported to have "enjoyied [sic], lots of walkgin [sic]".
The appellant noted that the Medical Assessor did not mention his road rage and irritability when driving.
The appellant submitted that the Medical Assessor’s history with respect to his function in travel was “cursory” and did not address his well documented difficulties with his trip overseas.
The appellant submitted that the reasons the Medical Assessor provided for rating his impairment in social functioning as Class 2 is inconsistent with his difficulties in social functioning. The appellant referred to the reasons Dr Smith and Dr Khan provided for their respective ratings in social functioning. The appellant submitted that the Medical Assessor failed to consider the available evidence when rating his impairment in social functioning, including his strained relationship with his two adult children.
In reply, the respondent submitted that the ratings the Medical Assessor made for the appellant’s impairment in the PIRS categories under challenge were open to her to make based on the information provided during examination and for the reasons the Medical Assessor provided.
The respondent submitted that the Medical Assessor exposed a clear path of reasoning to explain the assessment she made.
The respondent submitted that the Medical Assessor’s consideration of the evidence to make her assessment of appellant’s permanent impairment was not limited to Dr Khan’s report or the appellant’s statement, but included all the evidence including the clinical notes in evidence and the desktop surveillance report that contained detail of the appellant’s trip to Europe, his band practice, his playing the tenor horn, and his catching up regularly with work colleagues.
The respondent submitted that the Medical Assessor did not misapply or misconstrue the Guidelines in making her assessment and that her assessment is not inconsistent with the Guidelines.
The respondent submitted that the Appeal Panel cannot substitute its assessment for a class rating of a particular PIRS category on the basis that the Appeal Panel considers another class rating may be more appropriate than the class rating the Medical Assessor made, and the Appeal Panel can only alter a class rating if the assessment the Medical Assessor made is unable to be justified.
The respondent submitted that the fact that the appellant has to take medication to attend his band practice “is neither here nor there” and a worker’s subjective experience of what they experience when they attend events is not relevant when rating the worker’s impairment in social and recreational activities and that what is relevant is the objective assessment of whether or not the worker is able to engage activities.
The respondent noted that appellant failed to provide a history of his band practice and meet ups with his friends to Dr Khan, and also initially to Dr Smith.
The respondent also submitted that the appellant “concealed” a history to both Dr Khan and Dr Smith regarding his trip to Europe. The respondent submitted that the fact that the appellant travels to a familiar area for band practice is not inconsistent with a Class 1 rating.
The respondent further submitted that a consideration of a worker’s subjective experience of travelling is not relevant when rating a workers’ impairment in travel and what is relevant is whether the worker can travel.
The respondent submitted that the appellant’s submission with respect to the Medical Assessor’s rating of his impairment in social functioning does not establish that the Medical Assessor’s rating is incompatible with Class 2.
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.
Section 352(2)(c) of the 1998 Act requires a Medical Assessor to provide reasons for his or her medical assessment. That obligation requires the Medical Assessor to explain sufficiently the actual path of his or her reasoning for the assessment such that a Medical Appeal Panel is able to determine whether there is any error in it.[2]
[2] Wingfoot Australia Partners Pty Ltd v Kocak [2013] HCA 43; Tradieh v LM Hayter & Sons Pty Ltd [2025] NSWSC 840 at [33] – [42].
The Appeal Panel considers that the Medical Assessor has complied with that standard. Her reasons are clearly and cogently set out in the MAC. The crucial part of her reasoning for her specific ratings of the appellant’s impairment in the several PIRS categories are detailed in the PIRS rating form. It is apparent from that what she says therein why she rated the appellant’s impairment as she did. There is no lack of clarity. Her reasons are readily understood by the Appeal Panel, and in the Appeal Panel’s view that would be the case for any objective and fair minded reader.
With respect to the appellant’s submission relating to the Medical Assessor saying the MAC is similar to Dr Khan’s assessment in most aspects except for her ratings of the appellant’s impairment in the PIRS category, and his submission that there are stark differences between the MAC and Dr Khan’s report, the consequence of which is to create a lack of clarity in the Medical Assessor’s path of reasoning, the Appeal Panel does not accept this is the case. In the Appeal Panel’s view there is similarity between most aspects of the the MAC and the content of Dr Khan’s report, in terms of the history each has detailed relating to the occurrence of the appellant’s injury, and the appellant’s symptoms and treatment, and the diagnosis of the appellant’s illness. There are obvious differences between how the Medical Assessor rated the appellant’s impairment in some of the PIRS categories and how Dr Khan rated these. Hence there is no uncertainty regarding the Medical Assessor’s reasoning for her assessment that arises from her remark that the MAC is similar to Dr Khan’s assessment in most aspects.
It is apparent to the Appeal Panel that the Medical Assessor has composed the history she detailed in the MAC, including with respect to the appellant’s current function in social activities and activities of daily of daily living, by reference to the information she elicited from the appellant during her examination of him, and the documentary evidence that the Commission provided her, which included the appellant’s statement, the reports of Dr Smith and Dr Khan, and the clinical records and report of the various clinician who have treated him. The Medical Assessor was entitled to assess the appellant’s impairment by reference to the history she obtained, rather than the history either Dr Khan or Dr Smith obtained. Further, it is apparent to the Appeal Panel that the histories that Dr Khan obtained and Dr Smith obtained may not have been complete. For example, Dr Khan did not obtain a history of the appellant regularly engaging in band practice and meeting up with his former work colleagues. Dr Khan did not obtain a history of the appellant having travelled to Europe in late 2023. Dr Smith initially did not obtain a history of the appellant being engaged in any hobby or activity, until apprised of that by the respondent’s solicitors.
The examples provided in Table 11.2 of the Guidelines for a Class 2 and Class 3 impairment in social and recreational activities are:
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.
The Appeal Panel does not consider that the Medical Assessor made an error with respect to her rating the appellant’s impairment in social and recreational activities as Class based on the history she obtained.
The Medical Assessor took account of the fact that the appellant attends band practice regularly. It is implicit from the nature of this activity, that the appellant must be actively involved, and this is because it involves him playing a musical instrument. It does not matter that his taking medication assists in him being able to do this. His injury comprises a psychological illness, and his taking medication is for treatment of that. The purpose of his taking medication is to allay or ameliorate the harmful effects of his illness and to improve his function. What is relevant in terms of his rating the severity of his impairment in social and recreational activities is what function he currently has to engage in such activity. It is further noted that the appellant has entered and placed in instrumental competitions, as well as performing in band concerts, again indicating active participation.
The Medical Assessor also had regard to the appellant meeting regularly with three of his friends in a social context. The Medical Assessor noted that they have coffee and talk about funny things. Implicit in that, is that the appellant is also actively involved in this activity.
In the Appeal Panel’s view, the appellant’s engagement in these activities correlates with a severity of impairment described by the examples set out in Table 11.2 for a Class 2 impairment. That is to say, the appellant can go to social and recreational events at least occasionally without the need of a support person. His level of severity in this PIRS category does reach a level of severity such that it can be rated moderate. He goes to events more than rarely and without a support person - his impairment does not reach the severity of a Class 3 impairment.
For completeness the Appeal Panel rejects the respondent’s submission to the effect that a worker’s subjective experience in social and recreational activities is irrelevant when evaluating the worker’s impairment in social and recreational activities. It is relevant in terms of establishing whether a worker can actively engage in social and recreational activities and also the extent to which a worker engages in such activities. In this case however, and as already noted, the appellant does actively engage in social and recreational activity.
The Appeal Panel finds the Medical Assessor has assessed the appellant’s impairment in social and recreational activities by reference to the correct criteria in that she assessed by applying the criteria of Chapter 11 of the Guidelines.
The Appeal Panel also decerns no error in the Medical Assessor’s rating of the appellant’s impairment in travel as Class 1. The Medical Assessor took account of the appellant regularly travelling to Chatswood, which is a distance of 70 km from his residence and which takes him an hour to drive. He does this on his own. The Medical Assessor also took into account that the appellant drives to his local shops and to his mother’s place. The Medical Assessor noted that the appellant experiences anxiety and rage. The Appeal Panel observes this does not prevent him from travelling. The Medical Assessor also had regard to the appellant travelling to Europe for a six-week holiday. The Appeal Panel also observes that the appellant experienced stress during this trip, but again this did not prevent him from travelling overseas.
As the respondent observed in its submissions Dr Khan did not describe in the history he obtained the appellant being able to drive 70 km for approximately an hour each week to attend band practice. The Appeal Panel further notes that the claimant travelled to various venues other than Chatswood to perform and compete with his band. The appellant being able to do this is not indicative, in the Appeal Panel’s view, of a mild impairment in travel. In any event, a difference of opinion does not amount to a demonstrable error. That is to say, assuming Dr Khan did obtain that history but merely did not detail it in his report, and hence the assessment of Dr Khan and the Medical Assessor were based on the same or similar circumstances, the fact that the Medical Assessor had a different opinion based on those facts than Dr Khan does not demonstrate error in her assessment.
The Appeal Panel sees no error in the Medical Assessor’s reasoning that the appellant’s impairment accords with Class 1, that is, it is no worse than a minor deficit attributable to the normal variation in the general public. In the Appeal Panel’s view, based on the history the Medical Assessor obtained, it does not reach a level of severity described by the examples for a Class 2 impairment. Based on the history the Medical Assessor obtained there is no impediment on the appellant’s function in travel other than he experiences a level of road rage, but as indicated, that is not preventing him from travelling.
Again, the Medical Assessor applied the correct criteria to assess the appellant’s impairment in travel given that she applied the criteria detailed Chapter 11 of the Guidelines.
The Appeal Panel also does not accept the appellant’s submission that the Medical Assessor made an error with respect to her assessment of his impairment in social functioning. It is apparent that the Medical Assessor did consider all the evidence when composing the history she detailed in the MAC. As said earlier, she is entitled to make her assessment based on that history. The descriptors provided for a Class 2 rating are in Table 11.4 of the Guidelines for a Class 2 impairment are:
“Mild Impairment: Existing relationships strained. Tension and arguments with partner or close family member, loss of friendship.”
The descriptors provided for a Class 3 impairment are:
“Moderate Impairment: Previously established relationships severely strained, evidence by periods of separation or domestic violence. Spouse, relatives or community services looking after children.”
Prominent in the Medical Assessor’s reasons for rating the appellant in social functioning as Class 2 is the fact the appellant has been able to maintain a supportive relationship with his partner for three years and maintains relationships with his two adult children. His current capacity in social functioning squarely accords with a level of severity described by the examples for a Class 2 impairment. There is no evidence of any strain in his current relationship with his partner. He has lost some friendships. Even if there is some tension in his relationship with his adult children, that would not elevate his impairment in social functioning to Class 3. Again, the Appeal Panel discerns no error with the Medical Assessor’s rating of the appellant’s impairment in social functioning. She has considered all relevant factors, and she has not taken into account any irrelevant factor. There is no apparent error in the exercise of her judgement, based on the history she detailed, by rating the appellant’s impairment in social functioning as Class 2.
The Medical Assessor has also applied the correct criteria to rate the appellant’s impairment in social functioning given that she has utilised the criteria in Chapter 11 of the Guidelines.
For these reasons, the Appeal Panel has determined that the MAC issued on 7 May 2025 should be confirmed.
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