Crocker v The State of New South Wales (Boorowa District Hospital)
[2021] NSWPICMP 100
•25 June 2021
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Crocker v The State of New South Wales (Boorowa District Hospital) [2021] NSWPICMP 100 |
| APPELLANT: | Narelle Jean Crocker |
| RESPONDENT: | The State of New South Wales (Boorowa District Hospital) |
| APPEAL PANEL: | Member Deborah Moore Dr Douglas Andrews Dr Nicholas Glozier |
| DATE OF DECISION: | 25 June 2021 |
| CATCHWORDS: | WORKERS COMPENSATION- Challenge to the four PIRS categories; the appellant’s submissions as regards most categories were lengthy, confusing and ill-defined, and did not address errors- rather a difference of opinion; Medical Assessor required to separate psychiatric and non-psychiatric factors influencing the appellant’s condition; the non-psychiatric factors included physical limitations, chronic pain and opioid analgesia; Held- MAC confirmed. |
STATEMENT OF REASONS FOR DECISION OF THE APPEAL PANEL IN RELATION TO A MEDICAL DISPUTE
BACKGROUND TO THE APPLICATION TO APPEAL
On 16 March 2021 Narelle Croker lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Samson Roberts, a Medical Assessor (MA) who issued a Medical Assessment Certificate (MAC) on19 February 2021.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act):
· the assessment was made on the basis of incorrect criteria,
· 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.
The WorkCover Medical Assessment Guidelines 2006 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 the WorkCover Medical Assessment Guidelines 2006.
The assessment of permanent impairment is conducted in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 April 2016 (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.
As a result of that preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because none was requested, and we consider that we have sufficient evidence before us to enable us to determine the appeal..
Fresh evidence
Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in additional to or in substitution for the evidence received in relation to a medical assessment appealed against may not be given on an appeal by a party unless the evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before that medical assessment.
The appellant seeks to admit the following evidence:
(a) Certificate of Capacity from Dr Win dated 30 December 2020.
The appellant submits that the evidence is relevant to the assessment by the MA as regards the Psychiatric Impairment Rating Scale (PIRS) category of Employability.
The appellant makes no submissions as to why the evidence was not provided to the MA or as to why it could not reasonably have been obtained prior to the assessment.
The respondent opposes the admission of that evidence because it does not satisfy the requirements of s 323.
The Appeal Panel determines that the evidence should not be received on the appeal because no reasons were provided as to why it was not made available earlier, and the certificate is of little value or relevance, given the various assessments in this category to which we will refer later.
EVIDENCE
Documentary evidence
The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment and has taken them into account in making this determination.
SUBMISSIONS
Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the MA erred in his assessment with respect to four of the PIRS categories.
In reply, the respondent submits that no errors were made.
FINDINGS AND REASONS
The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made
In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
The appellant was referred to the MA for assessment of whole person impairment (WPI) in respect of a psychological injury resulting from a deemed date of injury of 1 May 2018.
The MA saw the appellant on 2 February 2021 and obtained a detailed history of the events leading to the onset of symptoms and subsequent related events, including treatment.
He also noted:
“[The appellant] suffers back pain which worsened in 2015. She explained that she requires procedures to her back. There were times when she wore a TENS machine to work. She has undergone a neurospinal implant with some benefit and also underwent a total knee replacement. She has ongoing pain in her knee which dislocates periodically…”
Present symptoms were described as follows:
“At the time of the assessment, Ms Croker explained that she can now spend time with friends even though she still dreads going out. She has lunch with a friend for an hour when she goes to her psychologist. Even with her husband she will not spend more than an hour out. She stated that her mood is ‘pretty good’ yet she does not enjoy herself and finds herself ‘going through the rhythm’. She no longer becomes teary to the extent that she did previously. She does not derive pleasure in the way that she used to. She misses taking photographs and going for drives, activities which she previously enjoyed. She is not getting pleasure from her grandchildren as she would have expected. When she is out, she starts shaking and the shaking makes her feel anxious. She wants to be aware of the location of exits. This is a concern that has become less prominent over time. She also likes to see who is coming in and out of whichever premises she is in.
Previously, Ms Croker had nightmares of people chasing her and trying to kill her. These would occur three to four times a week. They happen less frequently now. There was a time when she was yelling and screaming in fright at night and this was interfering with her husband’s sleep.
When asked regarding her temper, Ms Croker replied that it improved when she underwent a hysterectomy at age 40 years. This was not a cancer-related procedure. Her appetite is variable. If she is distracted by something, she does not eat. Her concentration is poor as is her level of organisation.
Ms Croker stated that during 2020 she took an excess of tablets during a situation of conflict over a matter related to the workers compensation claim. She explained that her husband became upset and in an effort to calm herself down, she sought to take an excess of diazepam, ultimately only taking four tablets.”
After noting some details relating to the appellant’s general health and psychosocial history, the MA turned to consider the impact of her condition on her social activities and activities of daily living (ADL’s). He said:
“Ms Croker lives with her husband on a sheep farm 28 kilometres from Boorowa. Her husband and her brother-in-law manage the property. She does not participate in the running of the farm. She manages the home with her husband’s help. He sometimes cooks. She acknowledged that she is prone to distraction, for example she may start preparing a meal but not complete it. She may do some shopping when she goes into Boorowa to see her general practitioner or when she goes to Cowra to see her psychologist. Otherwise she prepares a list for her husband. She travels into town to see her general practitioner on a monthly basis and she travels to Cowra each month to see her psychologist.
When asked regarding her sleep routine, Ms Croker replied that over the last couple of months she has felt as if she is on night shift. For example, during the night prior to the assessment, she went to bed at around midnight and woke at 3:00am. She then went next door to her mother’s former home to watch television and to look through old photographs. She estimated that this occurs on a weekly basis. Sometimes she sleeps until midday and sometimes she has a very deep sleep late into the day. She is prone to urinary incontinence and therefore wears pads. During the day, Ms Croker generally has the television on “for company”. She can no longer take photographs as she used to because of her tremor. She attends to housework and explained that she is in the process of sorting through her wardrobe. She is prone to distractibility and disorganisation and in this context she often does not complete tasks. She spends time with her animals. She and her husband have ten dogs, one of which is her pet. She feeds the dogs in the afternoons. She also has three cats, two birds and a stray cat that she feeds. She also has a few pet sheep that she cares for.
Two of Ms Croker’s friends maintain contact. Others have distanced themselves because she does not attend when invited to do so. One of her friends would meet her for coffee in the past when she went to her general practitioner and another friend meets her for lunch in Cowra when she sees her psychologist. Her son and daughter-in-law visit weekly with the grandchildren. Her second son lives 45 minutes away and does not visit often. She has a brother in Adelaide. They had Christmas together at Ms Croker’s home.
Ms Croker is inconsistent with her diet. She typically does not eat breakfast or lunch. She engages in no formal exercise. Most day she attends to her personal care but on occasions she does not shower.
Ms Croker spoke positively of her relationship with her husband. He works in town five and a half hours a day as a shop assistant in addition to managing the farm. He contacts her during the day to check on her. Although her husband cannot understand what is happening to her, he has been very supportive. She stated that most of her friends are also unable to understand.
When asked regarding other activities in which she engages, Ms Croker replied that she checks her emails twice daily to monitor correspondence from the insurance company and from her solicitors. Sometimes she looks on Facebook.
In describing her physical limitations, Ms Croker explained that she sometimes experiences very bad pain. She cannot run and play with her grandchildren. She can no longer ride a horse. She is limited in her ability to walk. Although she uses a lightweight stick vacuum cleaner, she cannot vacuum the entire house in one go. She is able to hang laundry. It takes her approximately one hour to wash up dishes. She does a lot of her household tasks with the assistance of a walker or a pram which she uses to take the rubbish out. She also uses a toilet frame. She has rails in the bathroom and the bedroom. Her need for rails and her difficulty walking was attributed to pain, tremors and unsteadiness. On Christmas day when Ms Croker and her husband were hosting the extended family, she sustained a fall. Although she was shaken by the experience, she did not sustain any injury.”
The MA then summarised what he described as “relevant documents” which were essentially those included in the Application to Resolve a Dispute and the Reply.
Relevant to the issues in dispute, he said:
“Psychiatric documentation of Dr Frukacz pertaining to an assessment undertaken on 2 August 2018 refers to a diagnosis of Adjustment Disorder with Anxious and Depressed Mood. It includes an account of symptoms and it is evident that at that time Ms Croker was taking her current regime of Efexor XR. In subsequent documentation from 6 December 2019, Dr Frukacz expressed the opinion that her prognosis would be dependent on the progress and resolution of the workers compensation claim. He undertook an assessment of whole person impairment calculating 17%. It is evident that at that time Ms Croker was significantly more reliant on the support of her husband with respect to household tasks and she was more compromised with respect to her ability to pursue social and recreational activities. It is not clear from Dr Frukacz’s reasons on the Psychiatric Impairment Rating Scale that physical and other non-psychiatric factors were excluded from consideration.
Dr Mark Kneebone, in a psychiatric report of 14 July 2020, obtained the history that Ms Croker’s symptoms were of onset around March 2017. He identified features of anxiety and mood disturbance diagnosing Major Depressive Disorder, Moderate, Recurrent Episode With Anxious Distress and documented a past history of treatment with antidepressant medication in 2008 at the time of the death of Ms Croker’s mother. He calculated whole person impairment of 9% adding 1% for effects of treatment therefore calculating a final whole person impairment of 10%. It is evident that he found that Ms Croker’s impairment in the areas of self-care, personal hygiene and social and recreational activities had diminished since the assessment of Dr Frukacz…”
He added:
“Following the assessment, Ms Croker forwarded an email in which she documented sleep difficulties and difficulties waking. She documented that she has on occasion declined to go to town to see her friend and she does not like being in a room with more than five people. Her tremor has impacted on her handwriting. She can read only short magazine articles. She no longer goes to the hairdresser. She documents that she misses her independence and she documents limitations in her ability to undertake household tasks and to care for her 11-month-old grandson due to shakes and instability on her feet. She documents feeling a burden on her family.”
The MA then reported his findings on examination as follows:
“The Zoom connection was of good quality. Ms Croker was noted to be neatly groomed. It could not be discerned whether she was wearing makeup. Her hair appeared to be tinted however grey roots were evident. No psychomotor agitation or retardation was apparent as may arise in the context of an acute psychiatric illness. She gave an account of a perpetual mild state of depression and anhedonia, namely diminished ability to derive enjoyment. She described anxiety which has limited the extent to which she can engage in social activities. Her lack of confidence was apparent. She presented an articulate account of her circumstances in speech of normal rate, tone and volume. There was mild disorganisation of describing the events in the workplace but not to such a degree as to compromise intelligibility. No features of a psychotic nature were apparent and overall, Ms Croker participated effectively in what was a lengthy interview demonstrating satisfactory concentration and memory.”
In summarising the injuries and diagnoses, the MA said:
“The history presented by Ms Croker reflected the onset of psychiatric symptomatology in the context of the circumstances that arose in the workplace. She described prominent depressive symptomatology in addition to anxiety symptoms. Whilst it is expected that her physical health issues and chronic pain influenced her depressive condition, it is apparent that events in the workplace represent a substantial contributing factor for the causation of Major Depressive Disorder with Anxious Distress.
Ms Croker described improvement of her symptomatology in response to treatment. She remains under the care of a psychiatrist and psychologist despite which it is apparent that her condition has plateaued.”
As regards other medical opinions, the MA said:
“I am in agreement with previous assessing psychiatrists with respect to the presence of a Mood Disorder diagnosed as Major Depressive Disorder with Anxious Distress. There has evidently been an improvement in Ms Croker’s condition over time as described by her and this has been reflected in a reduction in psychiatric impairment. The nature and severity of the tremor is such that exclusion of an organic basis has represented an appropriate consideration. The possibility of there being a pharmacological cause warrants consideration. This does not however influence the primary matters being considered in this certificate.”
The MA assessed 7% WPI to which he added 2% for the effects of treatment. He said:
“For an adjustment for the effects of treatment to be considered in accordance with the Guidelines, effective long-term treatment must have resulted in either a substantial or total elimination of the original degree of permanent impairment and, if the treatment is withdrawn, the claimant is likely to revert to the original degree of impairment. Based on the available information an adjustment for the effects of treatment is necessary because there has been a substantial change in the severity of her symptoms and commensurate impact on permanent impairment. An adjustment of 2% is therefore appropriate.”
The appellant firstly challenges the MA’s assessment with respect to selfcare and personal hygiene.
The MA assessed a Class 2, adding:
“Ms Croker reported missing showers and missing meals. She does however participate in household tasks and she participates in meal preparation. Physical factors were described as compromising her ability to engage freely in household activities. Her impairment was not of a degree as to reflect compromised ability to live independently from a psychiatric perspective.”
The descriptor for a Class 2 is: “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.”
The appellant’s submissions as regards this category are lengthy, confusing and ill-defined. There are detailed comments with respect to the opinions of both the qualified specialists and the MA which do not address the question of error.
For example, the appellant submits that she should be assessed as a Class 3. The descriptor for a Class 3 rating includes “Can't live independently without regular support.” The appellant then adds that because the MA noted that "She has not got the concentration to drive further than Cowra and her husband must drive her on long trips" she therefore “can't live independently without regular support from her husband.”
This submission does not make much sense since not only does it bundle together several PIRS categories it does not address whether the evidence regarding this category supported a finding of a Class 3 rating.
The appellant continues on in this vein as follows:
“Under Class 3 it states: ‘Needs prompting to shower daily and wear clean clothes’. On page 5 of the MAC, the MA stated: ‘Most days she attends to her personal care but on occasions she does not shower’.
The MA did not ask the Appellant did anyone need to prompt her to shower, however it can be assumed that her husband would have to prompt her. The Appellant was not asked about whether she needed prompting to wear clean clothes. Therefore, is [sic] the MA is silent, then you must go to the earlier reports. The Appellant's psychiatrist, Dr Frukacz said: ‘Occasionally prompted to shower and get dressed.’
Therefore, the Appellant needs prompting to shower and the AMS did not ask the Appellant whether she ‘wears clean clothes’ however the Appellant's psychiatrist, Dr Frukacz, did.”
In short, the appellant seems to be taking each aspect of the descriptor then comparing the opinion of Dr Frukacz with that of the MA.
The appellant’s summary in support of a Class 3 rating that “it is clear that [she] cannot live independently without regular support by her husband…needs prompting to shower…does not prepare all of her own meals…frequently misses meals and her husband visits or should visits 2 to 3 times per week, to ensure minimum level of hygiene” is simply without any evidentiary basis.
As the respondent points out, not only did the MA note that the appellant presented as “neatly groomed”, if we were to apply the examples strictly as the appellant attempts to do, the appellant does not meet any of the examples under Class 3. There is no evidence that she requires regular support, nor that she needs daily prompting to shower. On her own evidence, clearly prepares her own meals, and there is simply no evidence that a family member or community nurse is required to visit two to three times a week.
The MA is required to make an assessment on the day of the examination, namely 2 February 2021, which we note is well after the assessment by Dr Frukacz on 22 October 2019, and consistent with the assessment of Dr Kneebone who saw the appellant in July 2020.
In our view, the MA’s assessment on the day of the examination was consistent with the totality of the evidence, and we cannot see that the MA erred in his assessment as regards selfcare and personal hygiene.
It is perhaps timely at this point to set out the task of an Appeal panel as stated in Ferguson v Stateof New South Wales [2017] NSWSC 887 where Campbell J said:
“[23] By reference to NSW Police Force v Daniel Wark [2012] NSWWCCMA 36, the Appeal Panel directed itself that in questions of classification under the PIRS: ‘... the pre-eminence of the clinical observations cannot be underrated. The judgment as to the significance or otherwise of the matters raised in the consultation is very much a matter for assessment by the clinician with the responsibility of conducting his/her enquiries with the applicant face to face’.
[24] The Appeal Panel accepted that intervention was only justified: if the categorisation was glaringly improbable; if it could be demonstrated that the AMS was unaware of significant factual matters; if a clear misunderstanding could be demonstrated; or if an unsupportable reasoning process could be made out. I understood that all of these matters were regarded by the Appeal Panel as interpretations of the statutory grounds of applying incorrect criteria or demonstrable error. One takes from this that the Appeal Panel understood that more than a mere difference of opinion on a subject about which reasonable minds may differ is required to establish error in the statutory sense.
[25] The Appeal Panel also, with respect, correctly recorded that in accordance with Chapter 11.12 of the Guides ‘the assessment is to be made upon the behavioural consequences of psychiatric disorder, and that each category within the PIRS evaluates a particular area of functional impairment’…
[37] The descriptors, or examples, describing each class of impairment in the various categories are ‘examples only’…”
The appellant next challenges the assessment with regard to social and recreational activities.
The MA assessed a Class 2, adding:
“Ms Croker goes out for lunch when in Cowra after seeing her psychologist. This represents the only social engagement which she undertakes independently. She is noted to be physically compromised and it is expected this also influences her independence. She stated that she is limited to one hour outings but this is evidently not the case as she spends an hour having lunch with her friend on the same day as seeing her psychologist. Irrespective, her participation in social and recreational activities is impaired though not to the extent as to render her unable to go out without a support person.”
Dr Kneebone also assessed a Class 2.
The descriptor for a Class 2 is: “Mild impairment: Occasionally goes to such events eg without needing a support person, but does not become actively involved (eg dancing, cheering favourite team).”
The appellant submits that she should be assessed as a Class 3, as Dr Frukacz assessed her.
The descriptor for a Class 3 is: “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 appellant’s submissions are again lengthy and seem to focus on alleged ‘omissions’ by the MA. For example, the appellant submits that:
“The only information obtained by the AMS was that she maintained contact with two friends and only one of these friends would meet her for coffee "in the past" when she attended her general practitioner.”
This is incorrect. The MA obtained much more detailed information regarding the appellant’s social and recreational activities which he mentioned throughout the MAC and in particular, in the PIRS Table accompanying the MAC.
As the respondent points out, the MA has “carefully considered the appellant’s ability to interact with and visit her friends…her son and daughter also visit weekly with the grandchildren.”
The respondent added:
“The AMS also takes a history that the applicant is a user of Facebook, which is conveniently absent from the appellant’s submissions. Stating the obvious, the respondent notes that Facebook is an online social media and social networking service. The respondent submits that the appellant’s ability to operate and willingness to operate a social networking platform is simply inconsistent with someone alleging to have the significant social impairments.”
Submissions such as “The AMS took down no factual basis to make his assessment of Class 2” are simply without foundation for reasons set out more fully below.
We repeat the comments made earlier as regards the task of an Appeal Panel. In our view, there is no evidence that the assessment by the MA was in any way “glaringly improbable” nor did it demonstrate “an unsupportable reasoning process.”
The Panel notes that the MA was also required to assess “the behavioural consequences of psychiatric disorder” which required him, in this particular case, to discount any limitations which may have been imposed by the appellant’s pain and disability resulting from her physical injuries.
In other words, he was essentially required to separate any secondary depression resulting from her back and knee pain in respect of all PIRS categories.
In our view, he did this thoughtfully and thoroughly, for example, when he said: “She is noted to be physically compromised and it is expected this also influences her independence.”
In short, again we cannot see any errors in the assessment with regard to social and recreational activities.
As regards concentration, persistence and pace (cpp), the MA assessed a Class 2, stating:
“Ms Croker’s account reflected psychiatric and non-psychiatric factors influencing concentration, persistence and pace. The non-psychiatric factors include physical limitations, chronic pain and opioid analgesia. She gave an account of forgetfulness and disorganisation but she nevertheless engages in some household roles and cares for animals. She participated effectively in a lengthy interview. Whilst her account indicated moderate impairment overall, the psychiatric contribution to her impairment is considered mild. Namely, the influence of such medications as Palexia and Panadeine Forte on memory and concentration is likely to represent a prominent factor, as is the presence of pain and physical limitations.”
The appellant submits:
“Dr Frukacz [also assessed a Class 2] and stated ‘Took an hour to type out two sentences - couldn't find things on keypad’.
Dr Kneebone [assessed a Class 3] stating ‘Ms Croker complained of forgetfulness and impaired concentration, such that she no longer reads books quickly, losing her focus [after] only 15 or 20 minutes when watching a movie’.”
The appellant added:
“It is submitted that the Appellant would fall within Class 4, as she only reads a few lines in a magazine article. The Appellant is unable to live alone and needs regular support by her husband. Even, the Appellant's husband temporarily left the matrimony home and lived in a flat.”
Again, this submission is confused and ill-defined.
The descriptor for a Class 4 is:
“Severe impairment: Can only read a few lines before losing concentration. Difficulties following simple instructions. Concentration deficits obvious even during brief concentration. Unable to live alone, or needs regular assistance from relatives or community services.”
There is simply no evidence that the appellant falls within this class.
We accept that the appellant has indeed some limitations in this category, as all doctors agreed. The appellant seems to have simply taken one aspect of the descriptor, namely “can only read a few lines before losing concentration” as justifying a Class 4 rating.
At the time of his assessment, the MA observed:
“She presented an articulate account of her circumstances in speech of normal rate, tone and volume. There was mild disorganisation of describing the events in the workplace but not to such a degree as to compromise intelligibility. No features of a psychotic nature were apparent and overall, Ms Croker participated effectively in what was a lengthy interview demonstrating satisfactory concentration and memory.”
These observations in our view are consistent with the rating ascribed by the MA, and we cannot see any error in his assessment.
It is clear to us that the appellant has improved somewhat since being seen by both Dr Frukacz and Dr Kneebone. It is worth noting the comments by the MA as follows:
“Ms Croker explained that she can now (our emphasis) spend time with friends even though she still dreads going out. She has lunch with a friend for an hour when she goes to her psychologist… She stated that her mood is ‘pretty good’… She no longer becomes teary to the extent that she did previously (our emphasis). She does not derive pleasure in the way that she used to. She misses taking photographs and going for drives, activities which she previously enjoyed.”
That is not to say that the appellant still has some fairly significant symptoms, but her obvious improvement is reflected in the assessment by the MA in February 2021.
Finally, the appellant challenges the assessment with respect to employability.
The MA assessed a Class 4, adding:
“Ms Croker’s account reflected the contribution of psychiatric and non-psychiatric factors influencing employability. Having regard for the nature and severity of her psychiatric symptomatology, it is evident that even in the absence of non-psychiatric factors, she would remain severely impaired in this area. This is based on the nature and severity of her psychiatric condition.”
We note that Dr Frukacz assessed a Class 4 and Dr Kneebone a Class 5, which, as the respondent points out, reflects “a difference of opinion… whereby reasonable minds can differ…”
The appellant submits that she should be rated as a Class 5. Notwithstanding our rejection of the late evidence the appellant sought to admit, it is clear, as the MA noted, that the appellant is “severely impaired” in this area.
No errors have been identified by the appellant. The submissions simply state that she should be assessed as a Class 5.
We agree with the respondent’s submission that “there is no criticism made of the way in which the MA conducted the examination or any information provided but not taken into account, or otherwise recorded erroneously.”
In our view, the MA conducted a thorough and considered assessment and we are unable to find that he erred in any of his assessments the subject of appeal.
For these reasons, the Appeal Panel has determined that the MAC issued on 19 February 2021 should be confirmed.
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