Giles v State of New South Wales (Northern Sydney Local Health District)

DETERMINATION OF APPEAL PANEL
CITATION:	Giles v State of New South Wales (Northern Sydney Local Health District) [2024] NSWPICMP 821
APPELLANT:	Rosalie Anne Giles
RESPONDENT:	State of New South Wales (Northern Sydney Local Health District)
APPEAL PANEL
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	Ash Takyar
MEDICAL ASSESSOR:	Michael Hong
DATE OF DECISION:	3 December 2024
CATCHWORDS:	WORKERS COMPENSATION - The appellant submits that the Medical Assessor erred in his whole person impairment (WPI) assessment of two of the categories of the psychiatric impairment rating scale (PIRS), namely travel and employability, and failed to provide any or any adequate reasons with respect to her assessment of employability; Panel found no error as regards to travel; error in employability and inadequate reasons; Held – Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 18 September 2024 Rosalie Anne Giles (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 (MA), who issued a Medical Assessment Certificate (MAC) on 21 August 2024.
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, 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

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 the worker should not undergo a further medical examination because although one was requested, the Panel is satisfied that we have sufficient evidence to enable us to determine this appeal for reasons we will set out in due course.

EVIDENCE

Fresh evidence

Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in addition 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) a further statement by the appellant dated 27 August 2024.
The appellant adds: “It is respectfully submitted that this statement ought to be taken into account when considering the grounds of appeal and the submissions.”
The appellant makes no submissions as to whether the evidence is relevant to the grounds of appeal, or was not available and could not reasonably have been obtained because it was only after the issuing of the MAC that it was obtained to correct an alleged error by the MA.
We refer to the comments made by Hoeben J in Petrovic BC Serv No 14 Pty Limited & Ors [2007] NSWSC 1156 where if a statement going to the way in which a medical assessment was conducted was additional relevant information “it would be open to every dissatisfied party to challenge the assessment process of an AMS in the same way thereby gaining automatic access to an appeal.”
The evidence provided in that statement was available to her before the assessment and merely extends what has been previously reported on.
The appellant has failed to satisfy the requirements of s 328(3) of the 1998 Act and Practice Direction No 16.
The Appeal Panel determines that the evidence should not be received on the appeal because it is of little probative value, and the appellant could and should have made the points now raised at the time of the assessment.

Documentary evidence

The Appeal Panel has before it all the documents that were sent to the MA 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 her assessments under two categories of the Psychiatric Impairment Rating Scale (PIRS), namely Travel and Employability, and failed to provide any or any adequate reasons with respect to her assessment of Employability.
In reply, State of New South Wales (Northern Sydney Local Health District) (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 primary psychological injury on a date of injury of 23 February 2022.
The MA obtained the following history:
“She commenced working with New South Wales Health in 2016. Her last day at work was in 2022. She reported that on 23 February 2022, she returned to work after her weekend shifts and was supposed to be working in the morning shift. She said that when she entered the unit, she heard a lot of yelling and shouting from a patient. She put her bag away and then attended the morning handover.
She was allocated to look after the patient who was yelling and screaming. She then walked to the room with her buddy and saw that the patient was physically restrained, and doctors and wardsmen were attending to the patient. She said they were putting a catheter in the patient, and since there were already multiple people in the room, she went to get a handover for another bed.
When she returned, she noticed that the patient had 950 mL of urine in the bladder and a catheter had to be inserted. She then tried changing the bag to a more appropriate size, approached the bed, and raised it to the waist level. As she was reattaching the tube to the patient, the patient then leapt forward and put all his body weight on her. She tried to resist and push him back but unfortunately twisted her back during the process.
She said that the patient was probably intoxicated and was delirious. She added that the patient tried to grab her neck, swore at her and yelled at her but could not help her either. She left the room but recalled that her back was sore but still continued to work through the shift and took some Nurofen.
She said that immediately after the incident, she was quite traumatised and unsettled and took some time off work for a few months. She said that at that time, she had an exemption from COVID-19 vaccination but was not fit enough to work. She was initially put on duties for two days, four hours a day, but was still struggling with her physical and mental health symptoms. She said that she had to lift restrictions of 12 kg at that time.
However, when she returned to work, she started fearing being in the same situation again. She struggled with insomnia, panic attacks, flashbacks. She said that her appetite fluctuated, and she started binge eating. She remembers being quite agitated and snappy. She also experienced panic attacks, which she described as episodes of trembling, throat choking and body shaking which would last for a few minutes.
She said that these episodes were often untriggered and said that they were like massive adrenaline boost and would just come on. She also had nightmares. She said that she would wake up from vivid dreams, which would be very horrific, like being chased.
She said that she was overwhelmed and often not able to regulate her emotions at that time. She used to feel quite unstable and became not a very nice person to be around. She said that physically, she continued to have chronic pain and felt that she had pack of concrete on her back and would have electric shock sensations in her back.
She said that she could not sit or stand for more than 30 minutes because of the pain, and the pain also affected her concentration. She said that if she had to read something, she was not able to focus because of the constant pain. She received some remedial massages, but that, too, only gave her temporary relief from the pain.
She was referred to a Psychologist last year. She started seeing the Psychologist weekly or fortnightly . She has not seen any Psychiatrist as yet.”
The MA then set out details of her personal and family history, before setting out details of her present treatment as follows:
“She is currently on Escitalopram 20 mg (antidepressant), Panadeine Forte, Ibuprofen and Voltaren. She continues to see the Psychologist and is working on strategies to calm herself down when she feels overwhelmed. She said they are probably working on the principles of cognitive behaviour therapy. She also sees her exercise physiologist once a week.”
Present symptoms were noted as follows:
“Ms Giles reported that overall, her mental health is not good. She said that since the accident, she has changed and is a very different person. She has still not returned to work and has no secondary employment or businesses.
She said that she continues to have physical symptoms like headaches and stomach upset. She also gets similar symptoms that she used to get earlier, including panic attacks and flashbacks of patients coming at her. She said that she is in constant pain in her leg and back. Sometimes, the sensation is of an electric shock and that everything is being squashed.
She said that she cannot drive for long as she feels she has a pinch in her legs. She cannot do gardening because she is unable to push the wheelbarrow as it is too heavy. She struggles to play and bathe her baby as the height of the bench and lifting her 9 kg baby is difficult. She said she is unable to vacuum due to twisting movement and picking up washing, which is heavy.
She is unable to stand in the kitchen for too long and hence avoids doing many household chores. She is unable to push the supermarket trolley as it is heavy, which exacerbates her pain. She said that even doing things like taking the pram out of the car also puts a strain on her back and hence, she avoids doing those things.
She added that the pain is quite debilitating and impacts her ability to do simple things like putting on her socks and bending down. Mental health-wise, she said that she feels overwhelmed and continues to get panic attacks. She also experiences insomnia. She said that she sleeps a lot during the day and is awake during the night.
She denied her sleep being impacted by her 8-month-old daughter. She said that her daughter wakes up once or twice during the night, but she said that she continues to have thoughts of harming herself at times, but she knows that she would not act on any such impulses as she finds her kids as a protective factor.
She said that when overwhelmed, she goes for long drives he said that last time she was overwhelmed was about a couple of weeks ago when she drove to Manly which is a 45-minute drive. She sat on the beach and cried. She said that such incidents have happened more than a dozen times in the last year.
She said that she drives long distances, and once she went to Parramatta Park, which is a 45-minute drive, when she was overwhelmed. She denied engaging in any risky behaviours. She said that her life has turned upside down and struggles to function. She continues to experience low mood, agitation, low self-esteem, low motivation and fluctuating appetite.
She continues to have intrusive thoughts about the accident and feels wired. She feels unsafe, is hypervigilant, and always looks out for herself. I then asked her about work, to which she said that she cannot even think about work currently as if she cannot care for herself, she was unsure how she would be able to work.”
The MA then turned to consider the impact of Ms Giles’ injury on her social activities and activities of daily living (ADL’s) and said:
“Ms Giles reported that she is able to shower herself, but struggles at times as she forgets. She said that her husband has to prompt her at times. She said that she has been able to do dusting, making beds, folding, but avoids doing anything heavy that involves pushing. She has been unable to cook regularly as standing for long exacerbates her pain.
Ms Giles used to enjoy sewing, gardening, and baking. She said that all these things involve sitting down for long and hence is unable to do because of the physical pain. Her concentration is also impaired because of the pain and hence does not do these activities. She is unable to do horse riding because of the pain in her back and feeling tired.
She has stopped socialising and is not quite interested in going to the church. However, her husband’s friends come over but she does not actively engage with them. She said that she sometimes goes to the park with her husband but does not go out on her own as she would need help with the pram.
Ms Giles said that she does not go out on her own. She then said that she goes to the nearby shopping malls and drives her son to the daycare. I have however noted that she has driven to long distances for at least 45 minutes to Manly Beach, Parramatta Park, etc. She has been able to go out on her own without any help or support.
Ms Giles reported that her husband who runs a painting business has been very supportive, and has not been intimate since the accident. However, I have noted that Ms Giles has a daughter who is now 8 months old. She said that she spends time with her son and often sits outside and watches her son ride the scooter.
Findings on mental state examination were reported as follows:
“I reviewed Ms Giles via video. She engaged well during the assessment and was cooperative. She presented as a middle-aged Caucasian female who looked the stated age. There was no evidence of any psychomotor agitation or retardation. No abnormal motor movements like tics or mannerisms were noted. She was casually dressed and reasonably well groomed.
Ms Giles’ eyes were closed most of the time during the assessment. She gave a clear account of her symptoms and difficulties. She reported her mood to be sad, and her affect was slightly dysphoric. Her speech was accented, spontaneous and regular in volume and tone. Her thoughts were logical and goal-directed. She currently reports ongoing intrusive ruminations, nightmares, flashbacks, insomnia, fluctuating appetite and fatigue and chronic pain.
There was no evidence of any manic, psychotic or any perceptual abnormalities. She was oriented to time, place and person and was able to focus during the assessment. She was not distracted during the assessment. She had insight into her symptoms and her judgment was intact.
In summarising the injuries and diagnoses, the MA said:
“Ms Giles is a 40-year-old female who currently lives with her husband, 4-year-old son and 8-month-old daughter. Ms Giles was assaulted and attacked by a delirious patient when she was trying to change the catheter bag. She recalled that the patient grabbed her neck, yelled and screamed at her. Ms Giles alleged that she injured her back in the incident and started experiencing chronic pain.
She also reported symptoms of irritability, hypervigilance, agitation, avoidance of trauma- related reminders, insomnia anhedonia, reduced motivation, reduced energy, sleep disturbance, fluctuating appetite, impaired attention/concentration and pervasive suicidal ideation. Her presentation is consistent with the diagnosis of Post-Traumatic Stress Disorder and Major Depressive Disorder based on DSM-5 criterion.
Ms Giles has since received psychological intervention and has been seeing a Psychologist and engaging in cognitive behaviour therapy. She is also on Escitalopram 20 mg and has been on that for more than a year now. I believe that Ms Giles has received evidence-based treatment for her presentation and reached maximal medical improvement.”
The MA added:
“Her presentation was consistent with the history given during clinical interview, documentation received and mental status examination except:
1.Ms Giles has sometimes reported that she does not leave her house without her husband and does not go anywhere unaccompanied. She later stated that she has gone to nearby shopping malls on her own.
2.Ms Giles during the assessment once said that she does not drive at all, and I have noted that she reported the same that she requires her husband to be present when she leaves her home. However, she reported to me that she has driven for long distances for over 45 minutes to Manly Beach, Parramatta Park, when she was overwhelmed and has driven independently without her husband.
3.She reported experiencing difficulty in the attention and concentration and reported that she gets easily distracted even during conversation. However, during my assessment, Ms Giles was able to focus and pay attention without any difficulties. She was focused during the assessment.”
The MA assessed 8% WPI.
She then turned to consider the other medical opinions and material she had before her and said:
“Ms Giles is a 39 year old woman who presents with symptoms of depression and trauma. These symptoms commenced in March 2022 in the context of chronic pain resulting from a violent incident in the workplace. Ms Giles has not been able to return to work secondary to her physical pain and disability, and her mental health symptoms have largely persisted, and she has not reached remission.”
Dr MacDonald opined that Ms Giles has reached maximum medical improvement and calculated the WPI as 22%. Kindly note that my calculation differs in the areas of travel, concentration, persistence and pace, and employability.
I have noted the supplementary report by Dr Kirsty MacDonald dated 10 October 2023 and she mentioned that her condition has not reached maximum medical improvement She mentioned that with assertive treatment, Ms Giles condition might indeed improve over the next 12 months. I however, respectfully disagree and believe that Ms Giles has now reached maximal medical improvement, and her condition might not change more than 3% percent with or without treatment in the next 12 months.”

The Appellant’s Submissions

These are as follows:
Regarding the category of Travel, the appellant submits:
(a)    Class 2 indicates a mild impairment. The descriptor for class 2 states: "can travel without a support person, but only in a familiar area such as local shops, visiting a neighbour".
(b)    Class 3 indicates a moderate impairment. The class 3 descriptor states "cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment."
(c)    The evidence before the MA was that:
“When overwhelmed the Worker goes for ‘long drives’.
She drives long distances when overwhelmed and once went to Parramatta Park which is a 45 minute drive.
The last time she was overwhelmed was a couple of weeks prior to the assessment and she ‘drove to Manly’ which is a 45 minute drive. She sat on the beach and cried.
Such incidents have happened ‘more than a dozen times in the last year’.
She sometimes goes to the park with her husband but does not go out on her own.
She goes to nearby shopping malls and drives her son to daycare.”
(d)    The MA reported some inconsistencies in this category.
(e)    The appellant stated in her statement dated 27 August 2024 that she does not drive her son to daycare. She walks him to and from daycare when her husband is not available, which is a very rare occurrence. This statement accords with the evidence recorded by Dr Verma at page 5 of the MAC that on:
"a typical day, she gets up in the morning and helps her son get dressed for daycare and feeds her daughter. Her husband then takes her son to daycare and she has her breakfast. She later has a nap with her daughter. She then wakes up mid to late afternoon and gets ready for her son to return."
(f)    Occasionally, she does walk her son to and from the daycare, as it is only about 150 metres from her home. She does not drive to the daycare centre.
(g)    The appellant also explained in her statement that she told the MA that she went on long drives when she felt suicidal or had thoughts of selfharm.
(h)    The appellant also took issue with the recorded evidence that she had gone on long drives on a dozen occasions in the last year. The appellant denied this, stating that she had an infant to look after and that it was not possible to do that and that this indicates that Dr Verma recorded the wrong history in relation to the appellant’s ability to travel.
(i)    The appellant’s statement of clarification ought to be accepted as it accords with the evidence provided to the MA.
(j)    The MA has confused the act of driving to different places albeit with overwhelming feelings of self-harm with the ability to travel to new environments without those feelings.
(k)    The appellant’s evidence is that "when overwhelmed" by her feelings of distress she gets in her car to drive long distances as a way of relieving her feelings of distress and overwhelming feelings of self-harm.
(l)    The appellant denies that she told Dr Verma that she was able to travel to local shopping malls on her own. Her evidence is that she is only able to do so in the company of her husband as otherwise she feels unsafe and uneasy.
(m)     No consideration was given by the MA to the evidence recorded by Dr Macdonald for the employer in her report dated 23 October 2023 that the appellant described "increased anxiety when being in public areas and around crowds" and that "she avoids going out of the house unless necessary".

As regards the category of Employability, the appellant submits:
(a)    the employability scale looks to the injured worker's ability to work in the real world. In order to be able to function in a work environment, a person is required to comply with directions, interact with all manner of people, maintain a routine, be accountable, be subject to the prospect of discipline, and be subordinate to and take direction from others. There is no evidence that the MA considered any of these factors.
(b)    The evidence recorded by the MA was that the appellant feels overwhelmed, continues to have panic attacks, sleeps a lot during the day and is awake at night, continues to experience low mood, agitation, low self-esteem and low motivation.
(c)    She cannot even think about work as she cannot care for herself, and she was unsure how she would be able to work.
(d)    Her husband has to prompt her to shower.
(e)    The MA failed to consider the requirements of attending employment and retaining employment.
(f)    These matters properly considered would result in a finding that the appellant cannot work at all.
(g)    Dr Khan considered that a Class 5 was appropriate because the appellant could not realistically work at all due to her “pervasive mental health and cognitive difficulties.”
(h)    The MA failed to provide any adequate reasons for her assessment.

The respondent’s submissions

The respondent’s submissions are as follows:
(a)    The appellant’s submissions simply cavil with the difference in clinical opinion of the MA.
(b)    As stated in Ferguson v Stateof New South Wales [2017] NSWSC 887 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’ (our emphasis).
[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’…”
(c)    In summary, there is nothing “glaringly improbable” about the MA’s assessments, nor can we see that she demonstrated that she was unaware of significant factual matters, or misunderstood such matters or demonstrated an unsupportable reasoning process.
(d)    The appellant has not successfully established how the MA’s application of clinical judgement to PIRS does not conform or is inconsistent with the PIRS, allowing for the general indicators in the tables.
(e)    The appellant has shown the ability to travel without a support person to familiar areas.
(f)    Given the consistency in the MA’s actual observations to the examples in Table 11.3 of the Guidelines, no error is made out.

Discussion
Travel

We agree with the thrust of the respondent’s submissions for reasons that follow.
The MA assessed a Class 2 rating and said:
“Ms Giles said that she does not go out on her own. She then said that she goes to the nearby shopping malls and drives her son to the daycare. I have however noted that she has driven to long distances for at least 45 minutes to Manly Beach, Parramatta Park, etc. She has been able to go out on her own without any help or support.”
As noted by the MA, the appellant demonstrated inconsistencies in her account to the MA.
The appellant’s submissions reflect the contents of her additional statement which we have rejected for reasons set out above.
Irrespective of the reasons for her travels, for example, "when overwhelmed" by her feelings of distress, as the appellant noted: “she gets in her car to drive long distances as a way of relieving her feelings of distress and overwhelming feelings of self harm.”
In short, her ability to travel in our view is consistent with a Class 2 rating as assessed by the MA.
A Class 3 rating indicates a moderate impairment. The descriptor states "cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment."
There is no evidence to suggest that Ms Giles is anxious or cognitively impaired to the point she needs a support person when out. The evidence is that she does not go out on her own regularly, but she can do so when needed.
The MA was required to make an assessment of Ms Giles at the time of the examination.
The appellant’s submissions were no more in the final analysis than the expression of a difference of opinion about which reasonable minds might differ. (See Diaz v SydneyInternational Container Terminals Pty Ltd [2024] NSWPICMP 437.)
In addition, the basis for the reservation in Chapter 11.12 that the descriptors are intended to be non-binding examples, giving a general guide to the level of the behavioural consequences of the particular psychiatric disorder, and thus allowing a wider discretion to be applied than if the descriptors were intended to be strict criteria, must be considered.
The MA gave detailed reasons for her assessment, and we see no error by her in this category.

Employability

The MA assessed a Class 4 rating and said:
“I believe that Ms Giles has severe impairment and cannot work more than one or two days at a time and less than 20 hours per fortnight.”
The descriptor for a Class 4 rating reads: “Severe impairment: cannot work more than one or two days at a time; less than 20 hours per fortnight. Pace is reduced, attendance erratic.”
In this instance, we agree with the appellant.
The MA’s reasons were clearly inadequate and without explanation.
The appellant has not worked since February 2022, over 2.5 years prior to the MA’s assessment.
She has had extensive treatment for her various symptoms and has been unable to move forward despite continuing to see her psychologist and working on strategies to calm herself down when she feels overwhelmed.”
In our view, a Class 5 rating is appropriate based on the “best fit” given the symptoms and level of impairment to which we have referred.
For these reasons, the Appeal Panel has determined that the MAC issued on 21 August 2024 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.

WORKERS COMPENSATION DIVISION

APPEAL PANEL

MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter number:	W23549/24
Applicant:	Rosalie Anne Giles
Respondent:	State of New South Wales (Northern Sydney Local Health District)

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 WorkCover Guides

Chapter, page, paragraph, figure and table numbers in AMA 5 Guides

% WPI

Proportion of permanent impairment due to pre-existing injury, abnormality or condition

Sub-total/s % WPI (after any deductions in column 6)

1. Psychological

23 February 2022

Chapter 11 Guidelines:

11.1-11.3

11.4-11.6

Guidelines 11 and Table 11

Nil

Total % WPI (the Combined Table values of all sub-totals)

[2024] NSWPICMP 821

3 December 2024