Pillington v State of New South Wales (NSW Police Force)

DETERMINATION OF APPEAL PANEL
CITATION:	Pillington v State of New South Wales (NSW Police Force) [2025] NSWPICMP 282
APPELLANT:	Anne Marie Pillington
RESPONDENT:	State of New South Wales (NSW Police Force)
APPEAL PANEL
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	Douglas Andrews
MEDICAL ASSESSOR:	Graham Blom
DATE OF DECISION:	24 April 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appellant submits that the Medical Assessor erred in his assessments under four categories of the psychiatric impairment rating scale (PIRS); submissions attempted to introduce fresh evidence which was rejected; Held – Appeal Panel found error in one category only; MAC revoked; new certificate issued.

BACKGROUND TO THE APPLICATION TO APPEAL

On 21 February 2025 Anne Marie Pillington (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by
Dr Himanshu Singh, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 5 February 2025.
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;
·        availability of additional relevant information (but only if the additional information was not available to, and could not reasonably have been obtained by, the appellant before the medical assessment appealed against); 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 it was not necessary for the worker to undergo a further medical examination because although one was requested, the Panel is satisfied that we have sufficient evidence before us to enable us to determine this appeal without any re-examination of Ms Pillington.

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 Medical Assessor erred in his assessments in four categories in the psychiatric impairment rating scale (PIRS) namely Self-care and Personal Hygiene, Social and recreational activities, Social Functioning and Concentration, Persistence and Pace.
The Respondent submits that the MAC contains an assessment which was open to the Medical Assessor, and that it should be confirmed.

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 Medical Assessor for assessment of whole person impairment (WPI) in respect of a primary psychological/psychiatric injury occurring on a deemed date of injury of 9 August 2023.
The Medical Assessor obtained the following history:
“Ms Pillington told me that she started working with New South Wales Police Force on 18/02/1996, and she stopped working on 09/08/2023. Ms Pillington has not worked since August 2023 since she stopped working with the New South Wales Police Force. She has also not engaged in any form of educational activity.
Ms Pillington stated that she has been anxious about today's appointment as she does not like to talk about what happened during her employment, and it increases her stress. Ms Pillington stated that she had made notes and documents about what she underwent and the way she was treated during her employment. I advised Ms Pillington that I had access to her statements that she had given earlier and to previous assessments, and the documents have been provided to me for review.
Ms Pillington stated that she was allegedly bullied and harassed for more than a decade during her employment with the New South Wales Police Force. She stated that she had made multiple complaints about her commander. She was sent away from her main workplace for longer periods of time. Ms Pillington stated that after her second child, she developed ulcerative colitis, though she provided the medical certificate to her commander and went on restrictive duties. When she came back, one of the inspectors stopped her in the station. Ms Pillington showed me the layout of the station and that it was a very common area where everyone else could hear their conversation. Despite her already providing the medical certificate, the inspector demanded to tell what was the reason she went on leave and what was the surgery about? Ms Pillington had to go into all the details, which was private and confidential. This was the beginning of the complaint against her superior.
Ms Pillington stated that on various other occasions, she was bullied and harassed by her commander, and her commander baited and sagged her. Ms Pillington stated that at one of the stations while she was working, she had to undergo through the files of serious offenders. There were cases of sexual assaults, aggravated sexual assaults of children. She stated that she had to read all those materials, and it added to her mental trauma. She was looking at the material by herself, though it was not in her job description and was not part of her duty. There was no support given to her, and she was left on her own. She also stated that there was no action for the inspector's behaviour for which she lodged complaints.
I have noted the statement by Ms Pillington dated 07/12/2023. I've highlighted the salient points related to the history of injury. Ms Pil/ington, during her career with New South Wales police force, attended numerous incidents of death, destruction, violence, fear, and injury. Ms Pillington had attended the multiple sites of deceased. The trauma of policing process after we found him and the sadness associated with his death. This job affected me from day one. I attended and still haunts me. I still remember the feel of her skin. I still remember the feel of her skin when I was checking for vital signs through the driver's window. I've numerous nightmares and broken sleep from this job. She had children, and I remember thinking of her poor family. The crime scene triple homicide job still haunts me today. It also gives me chills as there were innocent children involved, and a grandfather and a mother left without her children. I have nightmares and flashbacks due to the horror of what occurred, and the victims involved. - Visiting a terminally ill child - Attending multiple vehicle accidents - I slept early that night, and I have had flashbacks of this accident and get anxious when I drive towards Menai on that road - Attending Menai bushfires evacuations of residents, approximately 2001. Some minor distress at that time from the fear within the community of the evacuation from their homes, which I recovered from. I'm quite anxious during fire season when I smell smoke as I've experienced a fire during a holiday where I was woken from a fire alarm and had to evacuate my own children and husband out of a holiday accommodation approximately 8 years ago after a neighbouring fence was deliberately lit.
Ms Pillington stated that though she continued to work, however, in the last 5 years, her mental health declined and deteriorated gradually. She noticed symptoms such as anxiety, increased irritability, being jumpy or startled, sleep disturbance, impaired concentration, and being hypervigilant about her safety and that of her children. She also experienced symptoms of panic, often triggered by nightmares and flashbacks. Ms Pillington continued to experience symptoms and was diagnosed with post-traumatic stress disorder. She continued to have nightmares, flashbacks, avoidance behaviour and being socially withdrawn and isolated. She would feel sick and upset. She would wake up in the night with all the stuff in her head and would ruminate with that. She would think repeatedly about it. She would not sleep very well and would fall out of bed and injure and bruise herself. She stated that her work was not supportive as they were anti part time, and she was the most skilled at her employment and what she did.
I have noted the letter by A/Professor Neil Jeyasingam. consultant psychiatrist. dated 09/09/2023. The report stated: "I did not consider her to have a post-traumatic stress disorder, but rather an acute stress disorder given the relatively short duration of symptoms. The issue that these are presenting now, following years of good functioning and the trigger episode was relatively benign, makes me suspicious that she has complicated grief, perhaps related to the lack of a funeral for her mother as well as other unresolved issues. Ms Blomfie/d a 55-year-o/d police officer who had her normal functioning tour until approximately 1 month ago, although there had been minor deteriorations prior to this. She advises that the deterioration occurred after she was required to transport a police dog to a child with stage 4 cancer. She initially started by saying that she felt her workplace were insensitive in sending her. 'Didn't realise I had all these losses'. And the event culminated in a presenting to yourself the day after, severely distressed and unable to cope. She has not worked since (09/08/2023). Since then, she has had frequent nightmares and is preoccupied with multiple events. In terms of losses, she describes the Joss of her dog, her stepfather, (in September 2022) and that of her mother to multiple mye/oma in February 2023. She stated that her mother was discovered to have had depression following a car accident in her twenties and that they have not yet had a funeral. I could not find any evidence of recurrent nightmares, hypersensitisation, substantial work impairment prior to a month ago, and she denies any impairment it moved prior to a month ago. Apart from a daughter with anxiety, there is no other family mental health history, and no known drug and alcohol history nor medical history. And then suicidal ideation."
The Medical Assessor continued as follows:
“Present treatment:
Ms Pillington started to see her GP and was referred to a psychologist, Stephen Scicluna, and psychiatrist, Dr Pawan Bhandari. Treatment started mainly in around August 2023.
She has seen her GP regularly to provide work capacity certificates. The psychologist appointments have been every 2 weeks. Earlier, they used to be weekly, and the psychiatrist appointments are once a month. She also sees an occupational therapist, Trudy Henry, through axis injury management. She has exercise physiology sessions once a week, and she has physiotherapy sessions for her neck injury, which is because of the damaged disc and bulge. Also has left shoulder, left knee injury, which are all work related. She had those injuries during her employment because of handling dogs and chasing people over the fences.
Ms Pillington stated that she currently takes escitalopram 20 mg every day. She also did a PTSD course last year. She has got some strategies such as breathing exercise and mindfulness. However, she goes backward when she is triggered to something which reminds her of work. Her body does not like visiting this stuff again and again, and she tends to avoid assessments like today.
Present symptoms:
Ms Pillington stated that things are messed up. Her kids reassure her, but she is worried and anxious about their safety and their well-being all the time. She often freaks out and panics all the time. She stated that COVID-19 affected her and her children, but no one cared about them. In her dreams, she continues to see the various incidents at work. She may at times wake up and then starts to smell smoke and wakes up at times to screams of her daughter. And when she checks with her husband, this has not happened, and it's just in her dreams.
Ms Pillington stated that she wakes up through the night. She wakes up once to go to the toilet, which is fine, but then she would wake up few times in the night. She was getting dreams and flashbacks about the incidents at work, which have been settling a bit. She would still wake up and freak out and sometimes wakes up in a panic mode. She is tired and fatigued straight away in the morning as she does not feel rested in the night. She also feels irritable and agitated all the time during the day. She is trying to have a routine in her day, but it's difficult. She has a pet dog. She stated that she is worried about the dog as she had lost so many dogs at work. She showed a photo of her work dog, which she lost in 2013. She stated that she will take the dog out for walk at around 05:30 in the morning. She goes early as she tends to avoid seeing people while she's out. She would not go to the park. This just helps her to get some fresh air, and then she will come home. She'll sit in the front veranda. She does not want to see or talk to people and avoids people. She'll give the dog a toast and look after him, and then she continues to stay in the front area. She avoids going inside to the children as she may upset them by her worries about them.
Ms Pillington currently lives with her husband and her two children. She has a daughter who is 19 and a son who is 16. She's married to her husband since 2002.Ms Pillington stated that at home, she spends most of the time in her room. She may forget and miss to shower on certain days and showers on second or third days and showers when she stinks. She'll brush in the morning. She had some help to clean the house, which has stopped. She would try to sweep the floor in small portions, and she can't mop the floor due to her physical issues as well. Her husband may do some vacuuming, and she struggles to vacuum as well as it starts to hurt. She's not looking after her lawn and garden and is overgrown. She's not cooking regularly. She did some meals for Christmas, and she said that it was mostly ready meals. She has no motivation and desire to do any positive activity. She also does not have any appetite, and she misses her meals. However, she eats healthy when she will and relies mostly on takeaway food. And this has been the pattern since COVID-19.
Ms Pillington stated that she used to play competitive baseball. However, she has lost interest in it. 2 years ago, she went away and played a baseball game in Surfers Paradise. She flew up there and got a rental car to drive around. She's not playing games now, and she's not into any of her hobbies. She has not played baseball since December 2024. Her husband may take her out for meals, and they may go to Aldi or for coffee. She stated she does not go out on her own. She has gone out with her son during the school holidays to get takeaway. She does not have any friends, and they all have died. She tends to isolate herself and does not want to see people.
Ms Pillington goes to her appointments and drives by herself. She can drive and move around in the local area, but she is anxious to drive to unfamiliar or new places. Ms Pillington stated that her relationship is not good. Her husband is 68, and they often have arguments. There is no domestic violence and no period of separation. At times when there are arguments, she will walk and sit outside. Her husband has been supportive through all this, but he does not understand much. She can't communicate very well with her daughter and believes that that relationship has been affected as well. She does not have any friends to go out [with].
Ms Pillington used to read gardening and cooking books, but now she struggles with it reading the same page repeatedly and cannot retain information. She can watch TV as long as it doesn't trigger her. However, she avoids any movie with warnings of sexual content, sexual violence, or drug use.”
The claimant was treated by her local medical practitioner and psychologist. She was prescribed evidence-based pharmacotherapy, escitalopram 20 mg in the morning for this primary psychological injury.
The Medical Assessor continued:
“General health: Ms. Pillington's statement indicates a history of physical injuries, including fractures, a shoulder injury, a knee injury, an ankle injury, a brachia! plexus injury, lumbar back pain, and ulcerative colitis.
Social activities/ADL:
Ms Pillington wakes up a few times during the night and feels fatigued and tired in the morning. She may occasionally forget to take a shower regularly, usually showering every second or third day when she notices an odour. She brushes her teeth each morning. She assists her husband with house cleaning by sweeping the floor in small portions but is unable to mop due to physical injuries, which also make vacuuming difficult, so her husband handles that task. She does not tend to her garden regularly and has reduced her cooking activities. Her appetite has decreased, leading to missed meals, although she generally eats healthy.
Ms. Pillington previously played baseball but stopped participating since December 2024 due to a loss of interest in training and sports. Her husband takes her out to eat, shop at Aldi, or have coffee together. She does not go out alone and only takes her son along for takeaways during his school holidays. She currently does not have a social life, as all her friends have passed away, and she does not engage in social interactions.”
Findings on mental state examination were reported as follows:
“Ms. Pillington participated in today's video conference via a Teams meeting on her own. She appeared dressed appropriately and was clean, wearing glasses and a black top. Good eye contact was maintained throughout the assessment, and rapport was established. Ms. Pillington discussed her multiple traumas and provided detailed descriptions. At times, she needed redirection to focus on the current assessment rather than delving into specific incidents.
Ms Pillington participated in today's video conference via a Teams meeting on her own. She appeared dressed appropriately and was clean, wearing glasses and a black top. Good eye contact was maintained throughout the assessment, and rapport was established. Ms. Pillington discussed her multiple traumas and provided detailed descriptions. At times, she needed redirection to focus on the current assessment rather than delving into specific incidents. She reported that the work injury affected her and had impacts on her family and relationships. Her speech was spontaneous with a normal rate, tone, and volume. She described her mood as low and flat, and her affect was found to be restricted. She indicated disturbances in sleep and appetite, along with low energy and motivation. She mentioned experiencing low self-worth and levels of self-esteem and confidence, and an inability to enjoy various activities.
Ms. Pillington described incidents during her policing career, including alleged bullying and harassment at work. She reported ongoing effects from these incidents, such as nightmares, flashbacks, hypervigilance, and avoidance behaviour related to work-related triggers. She denied having any active or passive suicidal thoughts, intents, or plans, and there were no thoughts of harming others. There were no indications of grandiosity, racing thoughts, or increased energy levels. There was no evidence of formal thought disorder, delusional thinking patterns, or perceptual abnormalities. Ms Pillington described her attention and concentration as being affected but had intact judgment and reasonable insight into her issues, seeking help accordingly.”

The Medical Assessor summarised the injury as:
“In my opinion Ms Pillington has sustained a psychological/psychiatric injury while working as a police officer in State of New South Wales (NSW Police Force). She continues to present with symptoms which are ongoing and with symptoms meeting the criteria of a DSM-5-TR diagnosis of post-traumatic stress disorder and major depressive disorder.”
The Medical Assessor assessed 9% WPI.
He then turned to consider the evidence before him and said:
“I have noted the independent medical examination report by Dr Robert Gertler, consultant psychiatrist, dated 24/10/2023. The report stated:
"In my opinion, Ms Blomfield was exposed to numerous incidents involving trauma during her more than 25 years in the New South Wales Police Force. While she had been able to cope with emotions equally of being exposed to those incidents for many years, her ability to do so deteriorated significantly in the last several weeks before she went off work. They related initially to a multiple vehicle motor vehicle accident in which she provided assistance and finally having to attend a function for a terminally ill child. In my opinion, the post traumatic stress disorder has developed as a result of Miss Bloomfield's employment with New South Wales Police Force. Ms Blomfield meets the criteria for a diagnosis of post traumatic stress disorder. Ms Blomfield is, in my opinion, motivated to ultimately return to her previous duties. The return to work goal is to return to full duties possibly via graduated return to work program. Ms Blomfield currently totally incapacitated for work because of ongoing symptomatology and the fact that to return to work would lead to a deterioration in our emotional state."
I have noted the independent medical examination report by Dr Robert Gertler, consultant psychiatrist, dated 18/10/2024. The report stated:
"In my opinion, Ms Blomfield is suffering from post-traumatic stress disorder with associated major depressive disorder. The post-traumatic stress disorder with associated major depressive disorder has developed as a result of Ms Blomfield's employment with the New South Wales Police Force, specifically her exposure to traumatic incidents and also the effect of her having allegedly being bullied and harassed by senior officers over a period of years. In my opinion, maximum medical improvement has been reached considering that there appears to have been little change in her level of impairment during the last three months and is unlikely to change substantially by greater than three percent in the next twelve months. A effective treatment which has provided some benefit is one percent. So the total whole person impairment is 9 %."
I have noted the report by Dr Pavan Bhandari, consultant psychiatrist, dated 27/01/2024. The report stated: "Ms Blomfield is currently unfit to undertake operational policing duty as a consequence of post-traumatic stress disorder. Miss Bloomfield's incapacity for employment with New South Wales Police Force, his operational role is permanent. Ms Blomfield is permanently unfit to return to employment with New South Wales Police in either an operational or non-operational role."
I have noted independent medical examination report by A/Professor Michael Robertson, consultant psychiatrist, dated 18/10/2024. The report stated: "She presents with chronic post-traumatic stress disorder and likely ceased duties amidst a comorbid major depressive disorder. Her injuries are stable and unlikely to change over the next twelve months. As such, she has reached a point of maximum medical improvement. There is no deductible portion. There is no addition for treatment benefit. There is 19 % whole person impairment. "

Discussion

To begin with, as the respondent correctly pointed out:
“The “Grounds of Appeal” selected by the Appellant in the formal parts of the Application to Appeal include “The assessment was made on the basis of incorrect criteria” and “The medical assessment certificate contains a demonstrable error”. The Appellant selected “no” when asked “Do you seek leave to rely on the availability of additional relevant information that was not available before the medical assessment or that could not reasonably have been obtained before the medical assessment?”. However, in the Appellant’s submissions, she identified three Grounds of Appeal, including “availability of additional relevant information”. The Appellant did not describe or attach any additional information. The Appellant does raise one apparently new issue, being that she allegedly had difficulties accessing the videolink for the assessment. The Appellant has not served a statement or other evidence regarding this, or identified whether this is said to be additional relevant information for the purposes of this appeal. As the Appellant’s appeal submissions relate to “demonstrable error” and “incorrect criteria”, the Respondent has assumed that the Grounds of Appeal are limited to “incorrect criteria” and “demonstrable error”. If the Appellant presses “additional relevant information” as a Ground of Appeal, the Respondent says the Respondent has not made that ground out, noting that no such information or evidence has been identified or attached.”
In these circumstances, we propose to address the categories appealed by reference to “demonstrable error” and “incorrect criteria.”
Dealing firstly with self-care and personal hygiene, the Medical Assessor assessed a Class 2 rating and said:
“Ms Pillington wakes up several times at night and feels tired in the morning. She sometimes forgets to shower, doing so every second or third day when needed or when she realises that she stinks. She brushes her teeth daily and helps her husband clean the house by sweeping but cannot mop due to physical injuries. She struggles with vacuuming, which her husband handles, and she may help occasionally. She does not attend to her garden regularly and rarely cooks; missing meals at times due to low appetite but typically eating healthily.”
The appellant submits that:
“Given the appellant’s clarification (our emphasis) that she often misses meals, requires her husband to maintain a hygienic living environment and does not shower until she ‘stinks’, it would be more accurate to place her in Class 3 rather than Class 2.”
We do not understand what “clarification” the appellant is referring to. It seems to us that the appellant is simply trying to introduce some kind of “fresh evidence” where there is none. As the respondent noted: “The Appellant did not describe or attach any additional information.”
The descriptor for a Class 2 rating reads: “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.”
For a Class 3 it reads:
“Moderate impairment: Can’t live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit)
2–3 times per week to ensure minimum level of hygiene and nutrition.”
There is nothing in the history obtained by the Medical Assessor that fits with a Class 3 rating.
Although the appellant may not shower as regularly as she did prior to her injury (and when she was working) “doing so every second or third day when needed or when she realises that she stinks”, she brushes her teeth daily and her diet is healthy.
In addition, it must be noted that some of her restrictions noted by the Medical Assessor were due to physical impairments resulting from earlier injuries.
There is no suggestion that Ms Pillington can’t live independently, or needs prompting to shower, or regularly misses meals, or requires assistance “to ensure minimum level of hygiene.”
The Medical Assessor addressed all the relevant issues in this category, and his assessment was consistent with the evidence.
Turning next to the category of Social and recreational activities, the Medical Assessor assessed a Class 3 and said:
“Ms Pillington used to play baseball but stopped since December 2024, losing interest in sports. Her husband takes her out for meals, coffee, or grocery shopping but she does not go out alone and has no social life as her friends have passed away.”
The appellant submits as follows:

“The appellant rarely engages in social or recreational activities without her husband’s prompt [sic] and attendance as support person. When the appellant does venture out, such as going to her medical appointments or rarely would she go to get a coffee with her husband, it often triggers anxiety. The appellant rarely does grocery shopping and relies on her husband to complete this task as being in public is confronting and the shopping is too heavy. She lacks trust in people and is guarded which makes it difficult to leave the house and be in social settings. The appellant is not motivated to participate in hobbies such as baseball. Her friends have all moved away and she does not have the motivation or desire to engage in social interaction. One friend passed away in December 2024 who the appellant had previously played baseball with. Her parents have passed away. The appellant has lost the ability to communicate with her children and therefore their relationship is broken down which causes the appellant distress. Most mornings, the appellant sits staring at her garden out the front of home and does not engage or assist in readying the children for their day. She relies on her husband to assist the children with their daily needs as she is anxious and has low self-worth. Conversation with her husband often becomes difficult and she will sit outside. The bullying which that appellant was subject to is something which she ruminates on and interferes with her social and recreational functioning as it contributes to her low self-worth. The examples of social activities provided by the appellant of leaving the home on rare occasion to get groceries or attend medical appointments. Most commonly it is her husband who would leave the home to get groceries. Given the appellant lives with her family and isolates herself from being in close proximity to them, does not see friends, has deceased family members and feels she has no life purpose, as seen above, it would be more accurate to place her in Class 4 rather than Class 3.”

This is not a submission but rather an ‘expanded’ statement by the appellant, and is of little assistance to the Panel, because it does not refer to any specific evidence in support of the assertions made.
Having said that, 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.”
For a Class 4 it reads:
“Severe impairment: never leaves place of residence. Tolerates the company of family member or close friend, but will go to a different room or garden when others come to visit family or flat mate.”
Again, there is nothing in the evidence that supports a Class 4 rating.
The appellant is clearly able to leave her “place of residence” albeit often with her husband as a support person, consistent with the descriptor for a Class 3 rating.
The appellant simply urges us to allocate a higher rating without any proper evidentiary basis for her assertion.
In addition, as the respondent correctly points out:
“In her submissions the Appellant identifies that one friend passed away and that others have moved away. This does not demonstrate that her social and recreational activities have diminished as a result of her injury, but rather suggests there are other factors which have contributed to her reduced involvement in social and recreational activities.”
The Medical Assessor’s assessment in this category was consistent with the evidence.
Turning next to the category of social functioning, the Medical Assessor assessed a
Class 2 and said:
“Ms Pillington describes her relationships as strained, often arguing with her husband and children. She avoids conflicts by walking away. Despite her husband's support, she feels misunderstood, and intimacy is low due to her physical and mental health issues. There is no history of domestic violence or separation.”
The descriptor for a Class 2 reads:
“Mild impairment: existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.”
For a Class 3 it reads:
“Moderate impairment: previously established relationships severely strained, evidenced by periods of separation or domestic violence. Spouse, relatives or community services looking after children.”
The Medical Assessor’s assessment is entirely consistent with the evidence.
He specifically ruled out a Class 3 by noting that: “There is no history of domestic violence or separation.”
The appellant submits:
“Due to the appellant’s severe PTSD, her relationship with her husband and children is very broken. The appellant feels she has lost communication and relationship with her children. The appellant isolates herself if there is a lot happening in the home. As mentioned at ‘social and recreational activities’, the appellant will sit out the front in the morning and not participate in the morning routine of the children getting out the door. The appellant often retreats to sit outside at night also. The appellant’s daughter is 18 years of age and she struggles with anxiety. The appellant is extremely sad about the effects on her family bonds; however, she lacks motivation and ability to communicate effectively and removes herself from avenues of conversation which may lead to argument.
There is no intimacy with her husband, which has been the case for a long period of time which upsets her. Their communication is minimal and often will result in arguments. This results in the appellant removing herself from close proximity to her husband as she has no motivation to participate in conversation or daily living activities.
The appellant has no friends. All friends have moved away and she no longer participates in hobbies as she did previous to her injury.
Given the appellant’s clarification, it would be more accurate to place her in Class 3 rather than Class 2. This being where the appellant’s family relationships are severely strained and her husband tends to the care of their children. The appellant has no intimacy with her partner and isolates herself in the home.”
Once again, these are not submissions addressing the evidence, but merely a “further statement” by the appellant adopted by her solicitor.
We also note that the appellant’s IME, A/Prof Robertson, also assessed Class 2 for this category. Again, while the Medical Assessor was not bound to accept that assessment, as the respondent noted: “the appellant apparently did not take issue with it when she chose to rely upon it.”
The Medical Assessor addressed all the relevant issues in this category
For these reasons, we are of the view that the Medical Assessor’s assessment in this category was consistent with the evidence.
Turning finally to the category of Concentration, Persistence and Pace, the Medical Assessor assessed a Class 2 and said:
“Ms Pillington finds it hard to concentrate on books, reading the same page repeatedly and has been slow to read. She can stay on task for short period and gets tired. She can watch TV if it doesn't trigger her, and the content is not related to her traumas. She was able to well sustain her attention and concentration during the one-hour assessment.”
The descriptor for a Class 2 rating reads:
“Mild impairment: Can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache.”
For a Class 3 it 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.”
The appellant submits as follows:
“Prior to the appellant joining the meeting for assessment, she became overwhelmed and was unable to understand how to access the video link. She required the support of Trudy Henri, AXIS Injury Management, and another lady whose name she cannot recall, to assist her to access the video. The appellant had attempted to prepare notes of examples for the assessor, however, prior to the video commencing she became overwhelmed and distressed. The appellant broke down crying. The appellant attempted to implement strategies to relieve the anxiety prior to the assessment commencing and had expelled much of her distress prior to the call.
The appellant is fatigued from time of waking and most of the day. She experiences burnout where she attempts to concentrate for any period of time and this both exacerbates the fatigue but also the inability to concentrate. As evidenced above, the appellant becomes overwhelmed if too many things are happening, example in the mornings she will remove herself from the family unit and isolate out the front while morning routines are carried out.
The appellant is triggered by visual and auditory stimuli which causes her anxiety, distress and to lose motivation to participate in daily activities such as leaving the home as she may hear sirens or see places where a traumatic incident had occurred. The appellant previously enjoyed reading from time to time. She is no longer able to do so as she is unable to retain information and will repetitively re-read the same page. If she returned to carry on reading, she would not recall what had happened and be required to re-read that which she had already read. Similarly, if the appellant watches films or television, which doesn’t involve any triggering material, she will have to rewind to recall what is happening as she cannot train the story. The appellant becomes overwhelmed by simple instruction and routine activities. She require assistance care and the care of their children. [sic] Accordingly, a - from her husband to maintain their home, her self would be more appropriate.” [sic]
The respondent submits:

“In making submissions in relation to this category, the Appellant asserts that she was unable to understand how to access the videolink for the assessment, and that she required the assistance of two people to access the video. The MA observed that she participated alone.
The Appellant described being overwhelmed and distressed prior to the commencement of the assessment. The Respondent observes that there is no evidence (such as a statement) of this, as this issue has only been raised in submissions, and not in any evidence. Further, the MA recorded that there was good eye contact and that rapport was established. He recorded that she was able to sustain her attention and concentration during the hour-long assessment. He did not record observing that she was particularly distressed by difficulties in connecting, and in fact, did not record that she had any such difficulties. Given his experience and expertise, the Respondent submits that the MA was capable of making an assessment as to whether the Appellant was distressed or overwhelmed during the assessment. 39. The Appellant also said she had tried to make notes to assist with the assessment and that she was unable to do so due to her distress. The Respondent observes that the MA recorded that the Appellant had made notes, and that the MA advised her that he had access to her statements and previous assessments, implying that he assured her that it was not necessary for her to provide any additional notes for the assessment.
The MA recorded difficulties with concentrating on books, fatigue after focusing on a task and an ability to watch TV if it does not relate to her traumas. The Respondent notes that he gave appropriate consider[sic] to activities that are relevant to this category. The description given by the Appellant in her submissions is more aligned with Class 2 than Class 3 impairment.”

The appellant’s submissions are once again little more than “further evidence” without reference to the specific evidence before the Medical Assessor.
The respondent makes some valid submissions, but having said that, the Panel agrees that a Class 3 rating in this category is the “best fit” for reasons that follow.
To begin with, the Medical Assessor seems to have placed considerable weight on the appellant’s ability to maintain focus during the one- hour assessment process.
The Medical Assessor’s assessment contradicts his own history since he noted:
“At times, she needed redirection to focus on the current assessment rather than delving into specific incidents…
Ms Pillington used to read gardening and cooking books, but now she struggles with it reading the same page repeatedly and cannot retain information. She can watch TV as long as it doesn't trigger her.”
The appellant made frequent references to her fatigue.
Consistent with a Class 3 rating, it is clear that Ms Pillington has a very limited reading ability, and finds it difficult to maintain focus on many aspects of her everyday life.
She certainly is unable to: “focus on intellectually demanding tasks for periods of up to 30 minutes.”
As the Medical Assessor noted: “she struggles with [reading], reading the same page repeatedly and cannot retain information.”
For these reasons, we agree with the thrust of the appellant’s submissions (defective as they are for reasons stated above) that a Class 3 rating in this category is appropriate.
This then means that the ratings are:
(a)    Self-care and personal hygiene – Class 2;
(b)    Social and recreational activities – Class 3;
(c)    Travel – Class 2;
(d)    Social functioning – Class 2;
(e)    Concentration, persistence and pace – Class 3, and
(f)    Employability -- Class 5.
The aggregate of class ratings is 17, median 3 for a 19% WPI.
For these reasons, the Appeal Panel has determined that the MAC issued on 5 February 2025 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
.
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WORKERS COMPENSATION DIVISION

APPEAL PANEL

MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter number:	W29818/24
Applicant:	Anne Marie Pillington
Respondent:	State of New South Wales (NSW Police Force)

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 Dr Himanshu Singh, 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)
Psychological	9/8/2023	Chapter 11	Chapter 14	19%	19%
Total % WPI (the Combined Table values of all sub-totals)					19%

[2025] NSWPICMP 282

24 April 2025