Conroy v Secretary, Department of Education

[2025] NSWPICMP 741

DETERMINATION OF APPEAL PANEL
CITATION:	Conroy v Secretary, Department of Education [2025] NSWPICMP 741
APPELLANT:	Maree Conroy
RESPONDENT:	Secretary, Department of Education
APPEAL PANEL
MEMBER:	Jane Peacock
MEDICAL ASSESSOR:	Professor Nicholas Glozier
MEDICAL ASSESSOR:	Douglas Andrews
DATE OF DECISION:	25 September 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of an assessment under one of the psychiatric impairment rating scale (PIRS) categories as well as error in the making of a one-tenth deduction under section 323; Appeal Panel found no error in the assessment of social function at a class 2 mild impairment; Appeal Panel found error in the making of a deduction under section 323 as there was no evidence of a pre-existing condition only situational stress; MAC revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

1. On 23 May 2025 Ms Maree Conroy (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
   29 April 2025.

2. The appellant relies on the following ground of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act):

   (a)    the MAC contains a demonstrable error.

3. 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.

4. 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.

5. The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed
   1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

PRELIMINARY REVIEW

1. 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.

2. The appellant did not seek that she undergo a further medical examination by a Medical Assessor who is also a member of the Panel. As a result of their preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because even though the Medical Assessor erred, for reasons set out more fully below, there was enough material before the Panel for a determination to be made.

EVIDENCE

Documentary evidence

1. 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. 

Medical Assessment Certificate

1. 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.

FINDINGS AND REASONS

1. 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.

2. 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.

3. The matter was referred to the Medical Assessor as follows:

   “The following matters have been referred for assessment (s 319 of the 1998 Act):

   Date of injury: 17 August 2020

   Body parts/systems referred: Psychiatric/Psychological disorder

   Method of assessment: Whole Person Impairment.”

4. 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	17 August 2020	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	7	1/10	6
Total % WPI (the Combined Table values of all sub-totals)					6

1. 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	Maree Conroy	Claim reference number (if known)	W2443/25
DOB	xxxx	Age at time of injury	57 years old
Date of Injury	17 August 2020	Occupation at time of injury	classroom teacher
Date of Assessment	16 April 2025	Marital Status before injury	Married

Psychiatric diagnoses	1. Diagnosis of 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		Ms Conroy showers daily and at times twice a day when she goes out.  She brushes her teeth daily.  She is able to do household chores like cleaning, washing, working in yarn and cooking with her husband.  She reported that she initially gained weight and then gradually lost weight with exercise.  She said that she gained weight up to 127 kg again which is her current weight which she attributed for not caring for herself anymore.  She does not put on any makeup and is not much bothered about her overall looks.
Social and recreational activities			2		She earlier enjoyed socialising, going out, meeting friends, going to the movies, local hotel, socialising with her friends, barbecue and visiting friends in another town. Ms Conroy reported that she now goes for fishing at sometimes on her own at times with her husband and one of her friends accompanies her at least once every six weeks.  She has stopped going to the movies, now she has distanced herself from her friends, however, she is in touch with three to four friends and most of her friends live at a far distance and she has made new friends in town.  She said that she sees one of her friends when she visits her hometown Narrabri which she does every six weeks to get her haircut. She has made two new friends from where she volunteers and sees them when she goes out and goes out for fishing with them.
Travel			1		Ms Conroy has been able to drive to Brisbane.  She said that she at times finds it exhausting but then is able to focus. She denied having any accident or near misses. She goes out on caravan trip with her husband once every “couple of months.”  She went to Port Douglas Everly beach and took her caravan there.
Social functioning			2		She added that her relationship with her husband is strained and they have arguments as she does not understand things, as Ms Conroy does not want to socialise much. It makes him quite angry and sad.  She at times feels that he does not love her and is not attracted to her.  She has close relationship with her daughter.  She said that she used to have a good relationship with her son as well but now gets anxious when she talks to him and as Ms Conroy gets offended quickly. However there has been no separation with her husband.  She visits her family in Brisbane at least once every four weeks.
Concentration, persistence and pace			3		Ms Conroy reported that her concentration is poor. She finds it difficult to focus on things. She is able to watch TV but feels tired easily. She said that she is able to watch TV for about 30 to 60 minutes depending upon what she is watching. She has to rewind things as she forgets and said that if there is too much information she gets confused. She reads to help with memory but finds that tiring as well and is able to read for up to 30 minutes before she gets tired and gives up. She plays Jean Drummey which is a card game and plays for at least an hour altogether with frequent breaks.  She also goes on social media but is not able to focus for a long time.
Employability			4		Ms Conroy currently works as a volunteer at the Gundagai Day Visitor Information Centre and does those three shifts a week and does four hours shifts. She said that there was an incident about three weeks and she came to know that one of the volunteers had made a comment that Ms Conroy had to volunteer because of being on WorkCover and wondered how they came to know about her work. She has to give visitor information when working at the visitor information, however, she has also mentored learner drivers and had to sit beside them where they completed their 100 hours.
Score										Median Class
1	2	2		2		3	4		=2
Aggregate Score Impairment								Total			%
+1	+3	+5		+7		+10	14			7%

Deduction for pre-existing impairment = 1/10 = 0.7, and

Final WPI = 6.3 = 6%.”

1. The worker appealed.

2. In summary, the appellant submitted on appeal:

   (a)    the Medical Assessor erred when she assessed Class 2 for social functioning when she should have assessed Class 3, and

   (b)    the Medical Assessor erred when she deducted 1/10^th under s 323 for
   pre-existing injury, abnormality or condition when she should have made no deduction.

3. In summary, the respondent submitted that the assessment of Class 2 for social functioning and the deduction of 1/10^th under s 323 was open to the Medical Assessor. The Medical Assessor did not err and the MAC should be confirmed.

4. 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 her clinical judgement when making an 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.

5. 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 relationship she ended (e.g. lost partner, close friends). Unable to care for dependants (e.g. own children, elderly parent).
Class 5	Totally impaired: unable to function within society. Living away from populated areas, actively avoiding social contact.

1. The Medical Assessor assessed a mild impairment at Class 2 with the following reasoning:

   “She added that her relationship with her husband is strained and they have arguments as she does not understand things, as Ms Conroy does not want to socialise much. It makes him quite angry and sad. She at times feels that he does not love her and is not attracted to her. She has close relationship with her daughter.  She said that she used to have a good relationship with her son as well but now gets anxious when she talks to him and as Ms Conroy gets offended quickly. However there has been no separation with her husband. She visits her family in Brisbane at least once every four weeks.”

2. The appellant submitted that a moderate impairment at Class 3 should have been assessed. Dr Dougherty, the IME qualified to provide an opinion on behalf of the appellant, assessed a Class 3 in this domain. Dr Verma, the IME qualified to provide an opinion on behalf of the respondent, assessed a Class 2. The Medical Assessor must make an independent assessment.

3. The appellant submitted:

   “The history taken by Dr Erin Dougherty and their whole person impairment assessment indicates that there was a period of domestic violence and separation. Whilst the appellant acknowledges that the examples outlined in the PIRS are meant to be ‘examples only’ there is explicit mention of domestic violence and separation under Class 3 examples. It is the appellant’s submission that based on the evidence, the appellant should have been assessed at a Class 3 under the ‘social functioning’ category of the PIRS.

   The appellant submits that the Medical Assessor has failed to take into account the history of domestic violence and separation the appellant experienced when making an assessment under the ‘social functioning’ category of the PIRS. The appellant submits that this constitutes a demonstrable error.”

4. Assessment cannot be based on self-report alone but regard must be had to the other evidence and the MAC must be read as a whole. Clinical judgment is being exercised by the Medical Assessor when assessment is made under the PIRS categories. Social functioning is concerned with the quality of relationships. There has been no separation from her husband although there has been a strain on the marital relationship sometimes characterised by tension, arguments and verbal aggression. The appellant provided three statements in evidence which detail strain on the relationship but no separation. She gives evidence about verbal aggression with tension and arguments but she gives no evidence of physical violence in the relationship. These statements also detail that her husband remains supportive of her, for example by encouraging her to eat well and look after herself. Her husband reports in his statement of late 2024 that “Our love for each other and our faith have kept us together. There have been and continues to be many times we want to end our marriage. At times, we despise each other and say derogatory comments using abusive language towards each other during our unpredictable arguments.” This indicates strain and tension but none of the descriptors matching a Class 3 impairment. The Medical Assessor took a history that the appellant has two adult children aged 34 and 37 at the time of the medical assessment who live in Brisbane. The appellant regularly visits both her son and daughter approximately every four to six weeks. The relationship with the appellant’s son has experienced strain but there is no estrangement from him. The appellant maintains a close relationship with her daughter which has not experienced strain. The appellant remains involved with her grandchildren and their lives eg being there for them on their “colour run”. She describes at times feeling irritable with them. The findings are really only consistent with a mild rather than a moderate impairment. The Appeal Panel agrees with the finding of
   Class 2, which accords with the correct criteria and no error can be discerned.

5. Turning now to the question of the deductible proportion under s 323.

6. It is well settled that a deductible proportion can only be applied under s 323 if, on the available evidence, the pre-existing injury, condition or abnormality has contributed to the overall level of permanent impairment assessed. If the extent of the contribution of the
   pre-existing condition would be too difficult or too expensive to assess, a 1/10 deduction should be applied.

7. The Medical Assessor took a history of pre-existing and subsequent conditions and recorded as follows:

   “Details of any previous or subsequent accidents, injuries or condition: Ms. Conroy reported that she was having issues with her son, Ben, who used Ice from 2014 to 2019. She saw Suzie, a psychologist, a couple of ties to get strategies to support both her son and herself. She remembers having trouble sleeping because she worried about him and was sad. She took about a week off work during that time. She was not prescribed any antidepressants or anti-anxiety medications. She said that once he stopped using Ice in 2019, she was no longer impacted by his health. She mentioned that he is now employed full-time and well-settled. 

   She was also in a domestic violence relationship because her ex-husband was an alcoholic. She had an episode of possible depression when her children were young while experiencing physical and mental abuse at home.

   However, she did not receive any specific treatment for this, and her symptoms resolved. Soon after, she separated from her ex-husband and met her current husband. She denied having any history of seeing a psychiatrist, being on any antidepressant or anti-anxiety medication, any history of self-harm, suicide attempts, or hospitalisation in a mental health unit.”

8. The Medical Assessor explained his reasoning for making a 1/10^th deduction under s 323 as follows:

   “DEDUCTION (IF ANY) FOR THE PROPORTION OF THE IMPAIRMENT THAT IS DUE TO PREVIOUS INJURY OR PRE-EXISTING CONDITION OR ABNORMALITY

   a.     In my opinion the worker suffers from the following relevant previous injuries,
   pre-existing conditions or abnormalities:

   (i)Ms Conroy has a previous history of being a victim of sexual abuse, but did not see a Psychologist or Psychiatrist straight away. However, she has talked to her Psychologist about it. Ms Conroy also reported being in a domestic violent relationship and was subjected to both physical and verbal abuse. Ms Conroy had another episode of possible depression in the context of her son's Methamphetamine use, which lasted from 2015 to 2019, which is when her son stopped using Ice. I believe that these previous pre-existing episodes impacted her mental health and predisposed her to develop the symptoms at this stage.

   b.     The previous injury, pre-existing condition or abnormality directly contributes to the following matters that were taken into account when assessing the whole person impairment that results from the injury, being the matters taken into account in 10a, and in the following ways:

   The mental health symptoms which Ms Conroy was experiencing since 2015 in context of her son's Ice use which continued until 2019 were directly contributing to her mental health at that time which is around the same time when she started experiencing symptoms in context of her workplace incidents as well, I believe that this episode along with her past experiences predisposed her to develop Major Depressive Disorder and should be taken into account.

   c.     The extent of the deduction is difficult or costly to determine so in applying the provisions of s 323(2) I assess the deductible proportion as one tenth.”

9. The reasoning of the Medical Assessor is flawed because in order to make a deduction under s 323 it is the contribution of any pre-existing condition to the overall level of permanent impairment that needs to be assessed. It is not concerned with past experiences pre-disposing a person to psychological injury which is a question of causation. In this case, there is no strong history of the appellant experiencing mental health issues rather the history taken, consistent with the other evidence, is that is the appellant was experiencing situational stress with no evidence that she was under any impairment prior to the work injury. Therefore no deduction should have been made. When the deduction is removed, the impairment as a result of injury is 7% WPI. Accordingly, the MAC will need to be revoked.

1. For these reasons, the Appeal Panel has determined that the MAC issued on 29 April 2025 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:	W2443/25
Applicant:	Maree Conroy
Respondent:	Secretary, Department of Education

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 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	17 August 2020	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	7	NIL	7
Total % WPI (the Combined Table values of all sub-totals)					7

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.