Lozare v Group Homes Australia Pty Ltd - [2025] NSWPICMP 803

DETERMINATION OF APPEAL PANEL
CITATION:	Lozare v Group Homes Australia Pty Ltd [2025] NSWPICMP 803
APPELLANT:	Mariel Jade Pan Lozare
RESPONDENT:	Group Homes Australia Pty Limited
APPEAL PANEL
MEMBER:	Catherine McDonald
MEDICAL ASSESSOR:	Douglas Andrews
MEDICAL ASSESSOR:	Professor Nicholas Glozier
DATE OF DECISION:	17 October 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of psychological injury under the psychiatric impairment rating scale (PIRS); appeal with respect to all tables except employability; re-examination; Coca-Cola Europacific Partners API Pty Ltd v Pombinho; Held – MAC revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 6 May 2025 Mariel Jade Pan Lozare lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Medical Assessor Christopher Rikard-Bell who issued a Medical Assessment Certificate (MAC) on 10 April 2025.
Ms Lozare 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 in s 327(3)(d) . 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 Lozare suffered a psychological injury on 16 November 2023 in the course of her employment with Group Homes Australia Pty Ltd (Group Homes) as a residential care officer. Ms Lozare suffered physical injuries and a primary psychological injury when she was punched by an elderly resident.
In respect of the primary psychological injury, the Medical Assessor assessed 5% whole person impairment (WPI) using the Psychological Impairment Rating Scale (PIRS) in the Guidelines. He assessed Ms Lozare in class 1 for self-care and personal hygiene and travel. He assessed her in class 2 for social and recreational activities, social functioning and concentration, persistence and pace. He assessed her in class 3 for employability. He did not make any deduction in respect of a previous injury or pre-existing condition and he did not adjust the assessment for the effects of treatment.

PRELIMINARY REVIEW

The Appeal Panel conducted a preliminary…

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

Case: [2025] NSWPICMP 803
Decision Date: 17 October 2025

CaseChat Overview and Summary

Lozare, the applicant, sought a review of a Medical Assessment Certificate (MAC) issued by Group Homes Australia Pty Ltd, the respondent, in relation to a claim for workers' compensation. The MAC assessed the applicant's psychological injury using the psychiatric impairment rating scale (PIRS). The applicant appealed the MAC on the grounds that it incorrectly applied the PIRS and failed to consider all relevant evidence. The primary issue for the court was whether the MAC accurately assessed the applicant's psychological injury according to the statutory framework and if the respondent had failed to consider all relevant evidence in making the assessment.

The court examined the statutory requirements for issuing a MAC and the correct application of the PIRS, as well as the obligations of the respondent to consider all relevant evidence. The court considered whether the respondent's assessment was in line with the statutory criteria and whether there was a failure to consider relevant evidence. In reaching its decision, the court referred to the case of Coca-Cola Europacific Partners API Pty Ltd v Pombinho, which emphasised the need for a fair and accurate assessment of psychological injuries under the statutory scheme. The court found that the respondent's assessment did not comply with the statutory requirements and failed to consider all relevant evidence, leading to an incorrect assessment of the applicant's psychological injury.

Consequently, the court revoked the MAC and ordered a re-examination of the applicant's psychological injury. The court found that the respondent's failure to accurately apply the PIRS and consider all relevant evidence resulted in an incorrect assessment. The court emphasised the importance of adhering to statutory criteria and ensuring a fair assessment of psychological injuries in workers' compensation claims. The court's decision underscores the need for careful and thorough assessments in line with the statutory framework to avoid potential errors and ensure just outcomes for claimants.

Orders