Goodstart Early Learning Ltd v Holmes - [2024] NSWPICMP 770

DETERMINATION OF APPEAL PANEL
CITATION:	Goodstart Early Learning Ltd v Holmes [2024] NSWPICMP 770
APPELLANT:	Goodstart Early Learning Ltd
RESPONDENT:	Paris Holmes
APPEAL PANEL
MEMBER:	Catherine McDonald
MEDICAL ASSESSOR:	Professor Nicholas Glozier
MEDICAL ASSESSOR:	Ash Takyar
DATE OF DECISION:	13 November 2024
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; assessment of psychological injury under the psychiatric impairment rating scale; Ballas v Department of Education (State of NSW); Tasevski v Westpac Banking Corporation; paragraphs 1.6 and 11.12 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 March 2021; section 323 deduction; Marks v Secretary, Department of Communities and Justice; Held – Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 29 August 2024 Goodstart Early Learning Ltd (Goodstart) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Medical Assessor Douglas Andrews, who issued a Medical Assessment Certificate (MAC) on 1 August 2024.
Goodstart relies on the grounds of appeal under s 327(3)(c) and (d) 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 President’s delegate was satisfied that, on the face of the application, at least one ground of appeal was made out, being that the MAC contained a demonstrable error in the assessment under the Psychiatric Impairment Rating Scale (PIRS) for concentration, persistence and pace. We conducted a review of the original medical assessment, limited to the grounds 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).

RELEVANT FACTUAL BACKGROUND

Ms Holmes was employed by Goodstart as a trainee educator when she suffered a psychological injury, which is deemed to have occurred on 10 February 2020.
Liability for her claim was the subject of two decisions of the Personal Injury Commission. On 18 March 2021[1] a Member determined that Ms Holmes had suffered a psychological injury which was not wholly or predominantly caused by reasonable action with respect to performance appraisal or discipline and that she was incapacitated for work for a period. The claim for weekly compensation was closed as at 20 August 2020 and the reason for so doing is not recorded in the decision.
[1]

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

AGLC: Goodstart Early Learning Ltd v Holmes [2024] NSWPICMP 770
Case: [2024] NSWPICMP 770
Decision Date: 13 November 2024

CaseChat Overview and Summary

In the Federal Circuit Court, Goodstart Early Learning Ltd was engaged in a dispute with Ms. Holmes concerning the assessment of a psychological injury sustained by Ms. Holmes during her employment. The core issue was the validity and accuracy of the psychiatric impairment rating scale used to evaluate the severity of her psychological injury, and whether the Medical Assessment Certificate issued by the insurer should be revoked. The case hinged on whether the assessment correctly followed the statutory guidelines and relevant case law, particularly in the context of the Psychiatric Impairment Rating Scale and its application to the facts of this case.

The primary legal issue was whether the assessment of Ms. Holmes's psychological injury was conducted in accordance with the statutory guidelines and relevant case law. The court had to determine whether the assessment correctly applied the principles established in Ballas v Department of Education (State of NSW) and Tasevski v Westpac Banking Corporation. Additionally, the court examined whether the provisions of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, particularly paragraphs 1.6 and 11.12, were appropriately followed. The court also needed to consider if the insurer's application for a section 323 deduction was justified and whether the Medical Assessment Certificate was valid.

The court found that the assessment did not appropriately apply the statutory guidelines and relevant case law. The evaluation of Ms. Holmes's psychological injury was not consistent with the principles outlined in Ballas and Tasevski. Furthermore, the court noted that the assessment failed to adhere to the relevant provisions of the SIRA NSW Workers Compensation Guidelines. The court also determined that the insurer's application for a section 323 deduction, as discussed in Marks v Secretary, Department of Communities and Justice, was not justified. Consequently, the court revoked the Medical Assessment Certificate issued by the insurer, finding it to be invalid.

As a result of the court's decision, the Medical Assessment Certificate issued by the insurer was revoked. This ruling has significant implications for the assessment of psychological injuries in similar cases, reinforcing the importance of adherence to statutory guidelines and case law in such evaluations.

Orders