Luck v Australian Health Management Group Pty Ltd
[2022] NSWPICMP 457
•16 November 2022
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Luck v Australian Health Management Group Pty Ltd [2022] NSWPICMP 457 |
| APPELLANT: | Melanie Luck |
| RESPONDENT: | Australian Health Management Group Pty Ltd |
| Appeal Panel | |
| MEMBER: | Deborah Moore |
| MEDICAL ASSESSOR: | Michael Hong |
| MEDICAL ASSESSOR: | Douglas Andrews |
| DATE OF DECISION: | 16 November 2022 |
| CATCHWORDS: | wORKERS cOMPENSATION - The appellant submitted that the MA erred in two respects, firstly in respect of his assessment regarding the category of social and recreational activities, and secondly in regard to his assessment of concentration, persistence and pace (CPP); fresh evidence, a further statement from the appellant rejected; Held – MA’s assessment consistent with all the evidence; Medical Assessment Certificate confirmed. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 15 August 2022 Melanie Luck (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Professor Nicholas Glozier, a Medical Assessor (MA), who issued a Medical Assessment Certificate (MAC) on 19 July 2022.
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): deterioration of the worker’s condition that results in an increase in the degree of permanent impairment,
· availability of additional relevant information (being additional information that was not available to, and that could not reasonably have been obtained by, the appellant before the medical assessment appealed against),
· 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 although one was requested, no specific reasons were provided as to why this was necessary. In addition, for reasons that will become apparent in the body of our determination, we do not consider it necessary, and we also consider that we have sufficient evidence before us to enable us to determine this 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) further statement by the appellant dated 12 August 2022.
The appellant submits that the evidence is relevant to the claimed deterioration in the appellant’s condition. The appellant submits that the evidence was not available and could not reasonably have been obtained because of the appellant’s changed circumstances since the MA’s assessment and also deals with matters relating to the conduct of the medical assessment and other factual issues.
The respondent objects to the admission of the fresh evidence, and submits:
“In Halliday v G4S Custodial Services Pty Ltd [20 August 2019] M1-1452/19, it was held that admission into evidence of statements which essentially cavil with the opinion of a Medical Assessor ought not be admitted by Medical Appeal Panel, otherwise ‘every aggrieved worker could submit a statement addressing the assessment to automatically meet the requirements for a medical appeal’.
In Petrovic v BC Serv No 14 Pty Ltd t/as Broadlex Cleaning Services [2007] NSWSC 1156, (Petrovic) Hoeben J found that it was critical to consider the content of any statement attached to an application for appeal as containing evidence relevant to the grounds of appeal alleged. His Honour stated that in circumstances where all appellants were to be allowed to provide statement evidence in support of an appeal without consideration for its contents, ‘…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.’
In Petrovic, His Honour further noted that ‘the information must be relevant to the task which was being performed by the AMS…additional relevant information for the purposes of section 327(3)(b) is information of a medical kind or which is directly related to the decision required to be made by the AMS. It does not include matters going to the process whereby the AMS makes his or her assessment’. It was held that statements which related to the way in which a Medical Assessor carried out the examination and the way in which questions and answers were interpreted during examination do not constitute additional relevant information for the purposes of section 327(3)(b).
In State of New South Wales v Ali [2018] NSWSC 1783, Harrison J said that s327(3)(b) limits that right of appeal to circumstances where additional relevant information is available, but only if the additional information was not available to, and could not reasonably have been obtained by, the appellant before the medical assessment. Her Honour relevantly stated: ‘section 327(3)(b) cannot be read in any other way: it deals with the circumstances in which an appeal will lie from an assessment that was allegedly made without the benefit of information that existed at the time. It is not concerned with offering an aggrieved party the chance to run the assessment again because circumstances have since changed. It may be contrasted with s 327(3)(a), which contemplates an appeal when circumstances have actually changed, although limited to cases of an increase in the degree of permanent impairment and not the opposite. That limitation suggests, as a matter of ordinary statutory construction, that an appeal with respect to an alleged reduction in the degree of permanent impairment is neither contemplated by the words of s 327 in general nor provided by s327(3)(b) in particular.’”
The Appeal Panel determines that the evidence should not be received on the appeal because we agree with the thrust of the respondent’s submissions for reasons that follow.
The “fresh evidence” sought to be admitted by the appellant does not meet the requirements of s 327(3)(b).
Further, it is clear to the Appeal Panel that the appellant has failed to provide satisfactory evidence of deterioration.
The appellant claims that her condition has deteriorated in that her marriage has broken up, but there is no evidence that this has occurred as a result of her work injury, nor is there any medical evidence in support of this claim.
She said that she discovered her husband’s affair on 3 August 2022, and that he decided to leave the relationship on 7 August. This is just a few weeks after Professor Glozier’s MAC of 19 July 2022. The appellant was understandably upset by these events. Affairs leading to marriage breakups are commonplace and do not mean that the appellant’s condition has deteriorated or that she is more impaired in any sustained way.
In addition, her statement largely addresses the way in which Professor Glozier carried out the assessment and contains her criticisms of how he carried out his examination. This is contrary to the principles established in Petrovic.
We also agree with the respondent’s submission that:
“Annexure B to her statement does not verify that the text message information that the appellant seeks to rely on was not available to, and could not reasonably have been obtained by, her prior to the assessment of Dr Glozier. The text messages do not verify the dates that the appellant alleges her marriage ended, nor when she allegedly discovered her husband’s affair which led to the termination of the relationship. Annexure B therefore does not satisfy section 327(3)(b).”
EVIDENCE
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 two respects, firstly in respect of his assessment regarding the category of social and recreational activities, and secondly as regards his assessment of concentration, persistence and pace (CPP).
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 primary psychiatric/psychological injury resulting from a date of injury of 5 March 2019.
The MA obtained the following history:
“I used Ms Luck’s statement which contained a detailed history of her negative experiences within the workplace to inform this history. I also used her treating clinicians notes and reports to corroborate this and address any inconsistencies. I explained that we did not need to go into the workplace events in significant detail as they were all very well recorded and she seemed comfortable with this although we did touch on key issues.
She had been working with AHM since 2011, initially in sales and later as an IT professional which included projects in Melbourne. She returned from maternity leave in October 2016, working 3 x 6½-hour days per week. She became a Knowledge Management Analyst in April 2017 with a new manager, DR.
She reported that her problems started in November 2017 with DR placing her on a PIP for what she thought was unfair. She said she was distressed by this and consulted her GP. Her GP notes of November 2017 identify that she presented with work stress, was told to have a day off, and that she was to see a counsellor through work. The GP records indicate that the she was due for a mental health care plan review for a mental health care plan (MHCP) written six months previously where she had presented to the GP feeling overwhelmed, anxious and depressed for many months, attributed to her social situation including ‘fighting often’ with her mother-in-law, dealing with her stepchildren, her own young child and having poor sleep, irritability, not coping, having no time for herself. She was deemed to have anxiety and depression and referred for CBT. Notably this pre-dated the report of workplace problems which she said both today and in her statement started in November that year.
She reported that problems at work with her alleged performance and management continued over the subsequent 18 months although she says she continued at work and believed there were no problems with her performance. However, over time she said she became irritable, anxious, angry after work, tense with the family and had sleep problems (very similar symptoms to those noted some months prior). She was able to distract herself at the weekend with her work for a wedding company. In late 2018 she had her first panic attack and over time the level of anxiety and panics increased in severity and frequency.
By March 2019 there were further issues with the way she was treated regarding her performance and what she reported as aggressive, harassing and bullying behaviours by colleagues and her manager including one colleague yelling at her and being aggressive. She consulted her GP again on 5 March 2019, having not consulted her for some 14 months previously about work-related problems. Things escalated over the next month with her becoming increasingly upset, distressed and anxious. The gp notes indicate that there was anxiety and distress in the past and ‘now things are worsening again’ and that she had ‘organised CBT through work.’ On 1 April 2019 there was an issue over an apparent spelling mistake she had made which she noted would take only a tiny amount of time to correct. At this stage she became increasingly distressed, realising her team were not supportive, and arranged to see her EAP and left work. She has not worked since then and was terminated later that year.
Her statement and her GP notes indicate difficulties with return to work, insurance and other aspects of the system over the subsequent years. She was treated by her GP who also referred her to a psychologist, Loan Pham, in mid-2019. Ms Luck reported CBT strategies and exercises with Loan. Ms Pham, identifies in a report later that year of her obsessive tidying the house, increased cardio activities and ongoing stress with workplace as well as her son’s disorder perpetuating her condition at the time. Ms Pham noted ‘irrational, rigid thoughts, distrust and safety behaviours’. Ms Luck reported that Ms Pham stopped seeing her because the treatment was not working and she was not improving.
Over 2021 she used SSRIs including Sertraline and Fluoxetine without benefit and by late 2021 was taking Escitalopram 20mg. In late 2021 she was referred to a psychiatrist, Dr Allison, who noted the presence of a mixed episode of depression and anxiety, and symptoms of feeling flat, poor concentration, fatigue, amotivation, middle insomnia and intrusive recollections and ruminations about work with associated work avoidance. In his later reports he noted the ‘underlying personality vulnerabilities perpetuating Melanie’s symptoms’ including a rigid and perfectionist style which he noted probably contributed in part to the difficulties at work. She said today he has ceased seeing her. She then saw a new psychologist two weeks ago who had a conflict of interest and has referred her to a counsellor, indicating her being ‘downgraded’ and reinforcing the sense of her being ‘passed on’ and not treated properly. She said that Dr Allison ceased her antidepressants but Dr Allison’s report suggests that it was her who wanted to stop them. Regardless, she re-started them three weeks ago.”
Present treatment was described as follows:
“Escitalopram 10mg daily She is waiting to commence with a new counsellor although reported she has had little positive benefit from previous psychological and psychotherapeutic interventions. She also took sleeping tablets for some time, but has not used any for over a year and although is prescribed Valium, uses this only very infrequently.”
Present symptoms were noted as follows:
“She reports feeling flat and with reduced sense of self. She says she must have control over her life and her surroundings in order to function. She goes to sleep very early, between 7-10pm, and falls asleep quickly. She then wakes 5-6 hours later, between 2-3am, with dreams and may be awake for 2-3 hours, falling asleep again for a few more hours. As such she has a poor efficiency but normal sleep duration with a middle insomnia pattern. She describes avoidance of areas where she might run into people at work, e.g. downtown Wollongong during the week and the local supermarket, having recently bumped into Cindy at the deli. These can trigger panics and she described a full range of panic symptoms where she has to leave and recover in the car. She has numerous s negative cognitions about how she sees herself, how this has been caused by the workplace, people’s treatment of her, and that this has been perpetuated by other parts of the system including the health system. She feels her identity has been taken away from her as she was heavily invested in her work role, not just in doing her job, but being part of a social committee and organising a range of activities around the workplace which also provided her with significant social input. She described seeing a recent P&C meeting as representing a workplace scenario which led to an increase in her anxiety, again increasing her entrenched avoidant behaviour of such workplace-style demands. She frequently ruminates about how she has been treated at work. She continues to be irritable, overly-sensitive and easily-annoyed and frustrated.”
As regards any previous conditions, the MA said:
“She reported two episodes of counselling, one after her mother and father separated, and again after an ex committed suicide. She did not mention the family-related difficulties in early 2017 leading to a mental health care planned treatment for what appears to be an adjustment disorder by her GP.”
After noting Ms Luck’s general health and work history, the MA then set out details of the impact of her injury on her social activities and activities of daily living (ADL’s) as follows:
“Prior to the onset of the problems at work in November 2017, she was living with her partner Steve, an ICU nurse. She had returned from maternity leave and had a young son. Steve’s two children from his previous relationship lived with them half the time, in part relating to his shift pattern. She described a close relationship with her mother and brother, seeing them frequently as they live nearby in Albion Park. She reported, contrary to the GP notes, that she had a very good relationship with her in-laws, although it may be that this has improved over time. She was working part-time and was very invested in work, involved in the social committee and had a social life with friends from work. She said she would be flexible about the hours she worked. She shared all of the household duties with Steve. She would go out with her friends, went away for the weekends down to their family holiday home, and enjoyed swimming and the beach. She described no problems driving in any modalities. She obviously used IT equipment at work extensively.
Currently the days are dominated by her various household and childcare activities and Steve’s work demands as he may well be working night shifts and they have different numbers of children staying with them. She generally gets up around 7-7:30am, makes breakfast for the kids, gets them ready for school and takes Hendrix (?spelling), her six-year-old son, to school in Dapto. She then spends the day doing chores and describes a full range of household chores which she does over the week, including washing, cleaning, errands, shopping, and cooking, but some days may return to bed. She sees her mum two-three times a week and will also see some of her closest circle of old friends although with a reduced frequency. Some days she will go out for lunch or coffee with them, Sometimes they will go down to the holiday home, the last being a couple of months ago during the school holidays. This summer they spent the time at their holiday home at Lake Tabourie with her husband and friends. She helps take the kids to their activities including Hendirx’s gym and Gabby’s cheerleading, both during the week and at the weekends. She said she went to a recent P&C meeting to try and get involved but found that she was unable to contemplate the demands of the volunteer tasks which made her very anxious and she wanted to leave as it upset her. She describes being able to drive without difficulty where she needs to and will share the driving down to Lake Tabourie. She does not go to some places because of anxiety of bumping into people at certain times. She watches various shows on the television, currently The Big Fat Gypsy Wedding which she enjoys because of its cultural references, can watch a whole series but does not binge-watch episodes. She says she has less focus on reading but also little time in which to do so now. Although she attempted an online course in event management, she noted that she was unable to complete this even though they offered for her to take it for another year. Her GP notes that she actually did well in the first assignment and the course was going well in Spring 2020, although she says this changed and she was unable to complete it. She flew to New Zealand earlier this year with Steve for her grandmother’s funeral, meeting her father. She remains in close and regular video contact with him. She has a close relationship with both her family and with Steve, although reported that there is ongoing tension and anxiety in the relationship and he says that she is ‘a changed person’ which makes her worried for the security of their relationship. She describes no difficulties in the interaction with her children and being supported by some old close friends. She uses her phone for internet banking, phone banking, Facebook, emails and is responsible for the family budget although much of this is automated with direct debits now.”
Findings on mental state examination were reported as follows:
“Ms Luck was clean, well-kempt and showed no problems with her self-care. She was a focused and clear historian, showing no concentration difficulties or problems with the pace of the assessment for well over an hour. Her affect was reactive although somewhat restricted for much of the assessment and she became tearful on relating the incident at the recent P&C meeting. She describes a flat mood, reduced enjoyment & motivation, negative and resentful cognitions, ruminations, poor sleep efficiency with entrenched avoidant behaviours and, as noted by others, some quite rigid and fixed beliefs about work and its impact on her. There were no psychotic phenomena.”
The MA summarised the injuries and diagnoses as follows:
“Ms Luck appeared to have pre-existing anxiety and depression in the months prior to difficulties emerging at work that had already occasioned a referral under a mental health care plan. The difficulties at work in November 2017 and the ongoing problems culminated in the development of a Major Depressive Disorder with marked anxiety, characterised by at least one of the two cardinal symptoms and several other symptoms, both biological and cognitive. She has had recurrent panics and developed entrenched avoidant behaviours to prevent further panics, indicative of a Panic Disorder. This has not responded to prolonged psychotherapy and recurrent antidepressants, some of which have been taken for a sufficient duration. She feels the treatment has in part perpetuated her views of organisations and her inability to cope with them. Although she is due to see a new counsellor, it is unlikely this is going to lead to any significant improvement given the failure of improvement with previous interventions.”
As regards consistency of presentation, the MA said:
“Ms Luck was internally consistent, with the exception of her presentation with anxiety and depression in the months prior to the onset of the work-related injury difficulties, indicative of a pre-existing condition, likely to be an Adjustment Disorder caused by interpersonal and family stressors.”
The MA assessed 8% WPI from which he deducted one-tenth in respect of Ms Luck’s pre-existing condition.
He assessed a Class 2 in respect of social and recreational activities and the same in respect of CPP.
He then turned to consider the other medical opinions and evidence and said:
“I included Ms Luck’s statements of 1 May 2019 and 13 April 2022 into the history above.This also notes infrequent gym attendance and her not doing her nails as previously with reduced showering.
The clinical notes from Dr Singh, referrals and the reports from Ms Pham and her treating psychiatrist Dr Allison from late 2021 have been included into the history above.
Report for the worker’s lawyers from Dr Allan dated 14 December 2020.
Eighteen months ago Dr Allan identified similar symptoms pre-dating her taking any medication. He was unaware of the anxiety and depression in the months prior to the injury as he had not had access to the GP notes. He makes the same diagnosis. I would disagree with him in terms of one of the classes, that of Social and Recreational Activities. He noted some outdoor activities. Today she reported that she continues to have regular, although reduced frequency, social interactions with her close circle of friends, going for coffees or lunches and going down to their holiday home. Social activities are, by definition, with friends and reflect her friendship group, rather than ‘support persons,’ and this is indicative of a mild impairment. Although on the cusp of a Class 1 / Class 2 Self-Care and Personal Hygiene, given the amount of input she gives to the family, as she reports reduced showering, not doing her nails and looking after herself as previously, she probably just qualifies for a class 2 mild impairment in this domain. There were no objective cognitive, pacing or persistence difficulties in the assessment today.
There is desktop surveillance showing family photos with her and her child in a few recreational places but little else.
Reports by Dr Chow, consultant psychiatrist, for the insurer In the first of these Dr Chow diagnoses an Adjustment Disorder and suggests she needs further treatment and provides a good prognosis. In a subsequent report dated 4 March 2021, he noted her injury continuing to resolve and thought at that stage she had a chronic Adjustment Disorder and that because she had just started treatment she had not reached MMI.
In May 2021 there is an injury management report by Dr Cameron, consultant occupational physician, which identifies the medical condition of her son via a discussion with Dr Pham and problems with the vocational process.
I would disagree with Dr Chow in that approximately 15 months later she reports a very similar condition and impairment with having had months of further treatment.”
Dealing firstly with the category of social and recreational activities, the appellant submits that she should be assessed as a Class 3 because of her “marriage breakdown and separation from her husband…” This is in reliance on the additional statement which the Panel rejected.
In assessing a Category 2, the MA said:
“Today she reported that she continues to have regular, although reduced frequency, social interactions with her close circle of friends, going for coffees or lunches and going down to their holiday home.”
In our view this is entirely consistent with the detailed and thorough history the MA took in relation to Ms Luck’s social activities and ADL’s.
The descriptor for a Class 2 reads: “Mild impairment: occasionally goes out to such events eg without needing a support person, but does not become actively involved (eg dancing, cheering favourite team).”
The descriptor for a Class 3 reads: “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.”
There is nothing in the history obtained by the MA that suggests that Ms Luck would rate a Class 3. She has a relatively active social life, and there is no evidence that she requires a support person to assist her in any of her activities. As the MA pointed out, “Social activities are, by definition, with friends and reflect her friendship group, rather than ‘support persons,’ and this is indicative of a mild impairment.”
The appellant also points to some of the other medical reports which, it is submitted, warrant a Class 3 assessment, such as Dr Allan. The MA addressed some of the other medical reports in his MAC, and explained his reasons why he disagreed with those opinions.
He also relevantly noted that Dr Allan assessed Ms Luck some 18 months prior to his own assessment which we regard as a significant period of time where symptoms may well abate to some degree.
It must also be noted that Chapter 1.6 of the Guidelines states: Assessing permanent impairment involves clinical assessment of the claimant as they present on the day of assessment…” (our emphasis).
As we said, the MAC was both thorough and detailed.
For these reasons, we do not accept the appellant’s submissions in this category such that this ground of appeal fails.
Turning next to the category of CPP, the MA assessed a Class 2, stating:
“Although she stated that she hasn’t read books, despite having bought some recently, and doesn’t watch more than one episode of a television programme at a time, she suggested this was in part due to time constraints, she does the family finances and demonstrated no cognitive difficulties within a stressful assessment or problems with following its pace.”
The appellant submits that she should be assessed as a Class 3.
The descriptor for a Class 2 reads: “Mild impairment: can undertake a basic re-training course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feel fatigued or develops headache.”
Class 3 reads: “Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg, operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.”
Again, many of the appellant’s submissions focus on her supplementary statement which we rejected.
We point out however that the appellant was clearly capable of “typing a long document”, that statement, and did not demonstrate any cognitive difficulties in so doing.
The appellant once again refers to other medical opinions in support of this ground of appeal, and maintains that the MA erred in his history taking, for example, that she was in fact incapable of completing a course of study about which she told Dr Cameron.
Dr Cameron in May 2021 noted: “Ms Luck has only completed 1 module out of 9 in the events management course, which was funded by the insurer. It seems unlikely that she will complete this course.”
He added: “She also said she ‘doesn't like meeting new people’, which seems inconsistent with a career in events management.”
However in March 2021 Dr Chow opined: “She is currently fit to continue studying eight hours a week.” He also added: “Despite slow, there is further scope for improvement especially with more therapeutic antidepressant.”
There were clearly some conflicting opinions in the past however, we again point out that the MA assessed Ms Luck on 13 July 2022, well over two years after both Dr Cameron and Dr Chow.
We repeat the comments we made earlier as regards the findings on the day of assessment.
The MA conducted a thorough mental state examination. The assessment itself is a cognitively demanding task that enables an objective evaluation of an appellant’s impairment in concentrating and persisting with such a task, and the pace at which an appellant can do this. The MA recorded that Ms Luck “was a focused and clear historian, showing no concentration difficulties or problems with the pace of the assessment for well over an hour.” She provided a coherent history. She recalled a reasonable amount of detail regarding her work, and limited history regarding her past psychiatric history. She remained attentive during the assessment.
The MA concluded that the appellant’s abilities in this category were mildly impaired and consistent with the general descriptor of a Class 2 rating.
The descriptors are just that: a broad outline of the sorts of activities or cognitive impairments in a particular category.
In our view, the MA’s assessment was open to him on all the evidence and his own findings on examination.
For these reasons, the Appeal Panel has determined that the MAC issued on 19 July 2022 should be confirmed.
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