Secretary, Department of Communities & Justice v Abdilla-Gascoyne

[2024] NSWPICMP 378

DETERMINATION OF APPEAL PANEL
CITATION:	Secretary, Department of Communities & Justice v Abdilla-Gascoyne [2024] NSWPICMP 378
APPELLANT:	Secretary, Department of Communities & Justice
RESPONDENT:	Donna Abdilla-Gascoyne
APPEAL PANEL
MEMBER:	Jane Peacock
MEDICAL ASSESSOR:	Nicholas Glozier
MEDICAL ASSESSOR:	Graham Blom
DATE OF DECISION:	14 June 2024
CATCHWORDS:	WORKERS COMPENSATION - Psychological injury; appellant worker alleged assessment on the basis of incorrect criteria and demonstrable error in the making of assessments under three of the Psychiatric Impairment Rating Scale categories: social and recreational activities, travel and concentration, persistence and pace; Held – Appeal Panel satisfied as to error and required a re-examination; Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

1. On 1 December 2023 the employer Secretary, Department of Communities & Justice (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 6 November 2023.

2. The appellant relies on the following ground of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):

   ·        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; and

   ·        the MAC contains a demonstrable error.

3. 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 grounds of appeal on which the appeal is made.

4. 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.

5. 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

1. 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.

2. The appellant requested that the worker undergo a re-examination. As a result of its preliminary review, the Appeal Panel determined that it was necessary for the worker to undergo a further medical examination because the Appeal Panel found error.

Fresh evidence

1. 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.

2. The appellant seeks to admit the following evidence:

   (a)    Procare report dated 22 November 2023.

3. The appellant submits that the evidence is relevant to the assessments of impairment under psychiatric impairment rating scale (PIRS) categories. The appellant submitted that it was not aware of the extent of the respondent workers travel (around Australia for 12 months) until the appellant read the MAC and therefore the appellant submits that the evidence was not available and could not reasonably have been obtained before the MAC.

4. The respondent worker objected to the admission of the report. The respondent submitted that the submissions of the appellant were disingenuous because the appellant was indeed aware from other evidence before it that the respondent worker had been travelling for months and that indeed for her appointment with Dr Bisht she was far away from home in Western Australia. The respondent worker submitted that to allow the admission of this report would be to betray the principle of finality in litigation.

5. The Appeal Panel determines that the evidence should be received on the appeal because the Appeal Panel is satisfied that the additional evidence could not have reasonably been obtained before the medical assessment because the appellant was not aware of the extent of the respondent worker’s travel until the appellant read the MAC and the history given to the Medical Assessor and the Appeal Panel is satisfied that the evidence is relevant. Being aware that an injured worker is travelling for months, does not equate to an awareness that the worker has travelled for a year. Accordingly, the Appeal Panel determines that the following evidence should be received on the appeal:

   (a)    Procare report dated 22 November 2023.

EVIDENCE

Documentary evidence

1. 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.

Further medical examination

1. Medical Assessor Graham Blom of the Appeal Panel conducted an examination of the worker on 6 May 2024 and reported to the Appeal Panel on 9 May 2024.

Medical Assessment Certificate

1. The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision.

SUBMISSIONS

1. Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.

FINDINGS AND REASONS

1. 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.

2. 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.

3. The matter was referred to the Medical Assessor for assessment as follows:

   “The following matters have been referred for assessment (s 319 of the 1998 Act):

   ·    Date of injury: 23 February 2021

   ·    Body parts/systems referred: Psychiatric and psychological disorders

   ·    Method of assessment: Whole Person Impairment-Teams Meeting-Videoconference”

4. The Medical Assessor issued a MAC certifying as follows:

Body Part or system	Date of Injury	Chapter, page and paragraph number in NSW workers compensation guidelines	Chapter, page, paragraph, figure and table numbers in AMA5 Guides	% WPI	WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)	Sub-total/s % WPI (after any deductions in column 6)
1. Psychological Injury	23 February 2021	Chapter 11 Guidelines 11.1-11.3 11.4-11.6	Guidelines 11.11,11.12 Table :11.1,11.2,11.3,11. 5,11.5,11.6	15%	0%	15%
Total % WPI (the Combined Table values of all sub-totals)					15%

1. The assessment was based on his assessment under the PIRS as required by the Guidelines as follows:

“Table 11.8: PIRS Rating Form

Name	Donna Abdilla-Gascoyne	Claim reference number (if known)	W5319/23
DOB	Xxxx	Age at time of injury	58 years
Date of Injury	23 February 2021	Occupation at time of injury	Team Manager
Date of Assessment	20 October 2023	Marital Status before injury	Married for 12 years

Psychiatric diagnoses

Major depressive disorder

Psychiatric treatment

Psychology sessions

GP and psychologist follow ups

Is impairment permanent?

Yes

PIRS Category

Class

Reason for Decision

Self Care and personal hygiene

1

She has always been a clean person, and her self-care has never been an issue. She takes care of self, and dresses appropriately. She is not interested in food, just eats for sake of eating, she is a healthy eater, mainly eats salad and fruits. She never used to cook much, and has been into healthy eating for a long time. She goes for walk, puts her head phone on with music, and tries to keep herself healthy.

Social and recreational activities

3

She avoids conversation that is directed towards her, avoids where she may be seen by someone as she is not the same person, doesn’t go out for social events, and her husband is been the best support.

Travel

2

She drives and no issues in driving, there are times when she is upset, can travel without support person, but only in a familiar area such as local shops and known environment. She may get anxious driving in the area where she has worked before and doesn’t want to be seen. She can drive to different place along with her husband.

Social functioning

2

“He loves me and I love him”, there are better days and not so better days, he is my closest mate, and she has a good relationship with her husband. She can be snappy and her husband is constantly reassuring and supporting her. She may be snappy when she is triggered.

Concentration, persistence and pace

3

She struggles with memory, may read a small article, and can’t read her books. She used to do a lot of reading, can’t memorise, if reads something then needs to reread, struggles to recall, and needs to write down name of things.

Employability

4

There is no plan to go back to work, no way she can do what she did, she can’t work for her own mental health, doesn’t want to lose her remaining quality of life, she said “I would  struggle to learn a new job”. Based on the functioning in various domains, from a psychiatric perspective, she would be able to work up to 1-2 days at a time less than 20 hours per fortnight.  She is not able to work with the preinjury employer or in the pre injury role i.e. case management.

Score

Median Class

1

2

2

3

3

4

2.5=3

Aggregate Score Impairment

Total

%

+

+

+

+

+

15

15%

Pre-existing impairment is 0 %

Treatment effects is 0 %

Final WPI is 15 %.”

1. The employer appealed.

2. In summary the appellant submitted that the Medical Assessor made assessments on the basis of incorrect criteria and/or made demonstrable errors in the assessments he made under three of the PIRS categories, namely social and recreational activities, travel and concentration, persistence and pace as follows:

   (a)    in assessing a class 3 for social and recreation activities;

   (b)    in assessing a Class 2 for travel, and

   (c)    in assessing a class 3 for concentration, persistence and pace.

3. The appellant submitted that the Medical Assessor did not adequately interview the respondent which resulted in his over reliance on her subjective self report and led to error.

4. In summary, the respondent worker, Donna Abdilla-Gascoyne (the respondent), submitted that the Medical Assessor did not err or make an assessment on the basis of incorrect criteria and the MAC should be confirmed. The complaints made about the assessments under the three PIRS categories (social and recreational activities, travel and concentration, persistence and pace) cannot be substantiated and are no more than an attempt to cavil with the opinion and assessment of the Medical Assessor.

5. The role of the Medical Assessor is to conduct an independent assessment on the day of examination. The Medical Assessor is required to take a history, conduct a mental state examination, make a psychiatric diagnosis and have due regard to other evidence and other medical opinion that is before the Medical Assessor. The Medical Assessor must bring his clinical expertise to bear and exercise his clinical judgement when making an independent assessment of impairment under the PIRS categories. The assessment is not to be based upon self-report alone. An appeal panel cannot disturb ratings under the PIRS scale for mere difference of opinion but must be satisfied as to error.

6. The path of reasoning disclosed by the Medical Assessor must be adequate. This is also dependent on the extent of the history taken and a thorough examination of the worker so that self- report can be properly evaluated in the context of other evidence before the Medical Assessor. The Appeal panel has allowed the additional evidence of the ProCare desktop report over the objection of the respondent. The Appeal Panel considers that the respondent undertaking a trip of some 12 months around Australia was not something that was readily apparent to the appellant until after the issue of the MAC. The Appeal Panel was satisfied as to error because the history taken by the Medical Assessor was inadequate and did not support an adequate path of reasoning of the assessments made under the PIRS categories of social and recreational activities, travel and concentration, persistence and pace. In these circumstances the Appeal Panel was satisfied as to error and considered a re-examination was necessary. The re-examination would afford the worker the opportunity to offer an explanation for matters raised in the Procare report noting that the respondent worker did not submit that the Appeal Panel should allow her the opportunity to tender an additional statement or other evidence but relied only on her submission that the Appeal Panel should not admit the Procare report.

7. In these circumstances of a finding of error the Appeal Panel considered that a re-examination by a Medical Assessor member of the Appeal Panel was necessary. Medical Assessor Graham Blom was appointed to conduct the re-examination and he reported to the Appeal Panel as follows (emphasis in original):

PERSONAL INJURY COMMISSION

APPEAL AGAINST MEDICAL ASSESSMENT

REPORT OF THE EXAMINATION BY MEDICAL ASSESSOR

MEMBER OF THE APPEAL PANEL

Matter Number:	M1-W5319/23
Appellant:	Secretary, Dept. of Communities and Justice
Respondent:	Donna Abdilla-Gascoyne
Examination Conducted By:	Dr. Graham Blom
Date of Examination:	6 May, 2024

1. The workers medical history, where it differs from previous records.

The major area of contention in Ms Gascoyne’s history related to her trip around Australia which occurred from approximately October 2022 through to October 2023. During this time Ms Gascoyne travelled with her husband, Neil, to Queensland then on to the Northern Territory, Western Australia, South Australia,  and then she briefly returned to Queensland before returning to New South Wales. The trip was undertaken, she said at the encouragement of her husband, friends and her psychologist. They travelled in a modified small truck and carried a boat. She said that mostly they parked in free camping areas although occasionally in caravan parks. When I asked her about socialising during the trip, she said that essentially, she spent the time reasonably solitary except for time spent with her husband. She said that on the trip, they mostly spent their time driving and when they stopped they would either go bike riding together, fishing in their boat, or she would go for long walks alone, which she said helped her to calm herself. She is religious and often prayed whilst walking. Ms Gascoyne was quite adamant that she avoided socialising on the trip. She said that in many of the places they stopped there were no other people but if there were she tended to limit the interactions. She described the trip as a form of therapy for herself saying that “I don’t have any joy or laughter anymore.”

The appellant had specifically raised Google reviews that Ms Gascoyne had written about a couple of caravan parks in Queensland. I asked her about these. She said that they had stayed for an extended time at the Kurrimine caravan park because Neil’s parents regularly visited this caravan park and the owners had been particularly helpful during their stay, assisting with the washing machines et cetera. She said that Neil’s parents were not at the caravan park at the time that they visited in October 2022’s, so they had returned in October 2023 so that Neil could spend time with them. Again, she was very specific that whilst she had had some brief interactions with the owners of the caravan park, this did not extend to socialising together and she remained reasonably withdrawn and that time undertaking in recreational activity was undertaken with Neil only.

I asked also about the driving during the trip. Ms Gascoyne said that she only drove very occasionally as Neil had a truck driver licence and was happy to drive. She also intimated that she was not very comfortable driving this rather large vehicle.

1. Additional history since the original Medical Assessment Certificate was performed

   Prior to undertaking their trip, Mr and Mrs Gascoyne had sold their house because Ms Gascoyne found it triggering for her anxiety. She said that she had worked from home at times, and now became anxious in the house and so they decided to sell it. When they returned from their travels they stayed with Ms Gascoyne’s mother in Mount Hutton ( a Newcastle suburb) for several months, till March 2024. During this time, she said that she had the opportunity to spend time with her children and grandchildren who lived reasonably close by – she said that she took the grandchildren to the park and did craft with them. The only social interactions, beyond spending time with her grandchildren involved family barbecues which were relatively infrequent. She also went out to coffee with her mother or sister. She said that prior to her injury she spent considerable time socialising with friends from work as well as with long-term friends that she had. She said that they would go to coffee or after-work drinks or engage in sporting activities such as cycling. She said that now she only sees friends infrequently, once every six months or so, she said, and on those occasions, they never go out - rather they would come to her place or she and Neil would visit their place.

   In March 2024 they moved to Bonny Hills (a town south of Port Macquarie) to stay in Neil’s parents’ house while they were in Queensland. She said that she and Neil had purchased a property in Old Bar near Taree. It was on 2 ½ acres and afforded her the opportunity isolation. She said that she and Neil had been involved in the process of purchasing the house after checking properties and prices on RealEstate.com. After the purchase, they had organised renovations of the house – redoing the kitchen, bathrooms and having rooms painted. They were planning to be moving by June of this year although difficulty getting tradespeople, she said might delay that.

   Ms Gascoyne said that she was medically retired in April of this year. When talking about this she became quite distressed and briefly tearful.

2. Current treatment.

There has been no significant change in Ms Gascoyne’s treatment regime since the Medical Assessment. She continues to consult her psychologist approximately once every month. She said that whilst she was travelling around Australia she maintained this contact, having purchased a Start Link connection in order to ensure that this was possible. She said that the treatment primarily consists of EMDR, support and various cognitive behavioural techniques. She continues to take St Johns wort, but has reduced this to 1 tablet/day. She is unwilling to undertake treatment with other psychotropic medications.

1. Current Symptoms.

Ms Gascoyne described her mood as persistently down – she said that she feels angry, discarded and hopeless. She is only occasionally tearful now. She has great difficulty experiencing pleasure or joy and feels somewhat bitter about this. She said that she prefers to be isolated and alone, as a man of managing her anxiety. She has difficulty with sleep tending to have broken sleep with repetitive waking. She is often restless during the night and continues to have nightmares, although less frequently, currently approximately once every three or four weeks. She said her appetite is somewhat reduced but tends to fluctuate. There has been no significant change in her weight. She complained of difficulties with concentration and memory saying that she regularly had to reread items that she previously could read. For example, she said that she was unable to read the material related to the workers compensation process. However, she said that she was able to watch videos on YouTube for up to 30 minutes. These were primarily videos about fishing she said. She said she was not particularly interested in television and did not watch it very frequently. When I ask her specifically, she said that she was able to read the Bible for limited periods of time, for example a parable or one or two Psalms.

She continues to experience regular anxiety, marked by bodily tension, panicky feelings and gastrointestinal symptoms such as upset stomach and diarrhoea. She says that generally she feels more stressed and is less able to deal with the day-to-day upsets of life. She feels that she is easily triggered into anxiety by events that remind her of work, and hence tends to be avoidant of these.

She said that she only drinks alcohol very occasionally and does not smoke cigarettes. She does not use illicit drugs, nor does she abuse prescribed medication.

1. Findings on clinical examination

Ms Gascoyne was seen by teleconference. She was alone throughout the interview. The audiovisual connection was problematical at times. Initially when we connected on the application, the sound quality was poor, and I had to contact the commission to re-establish a working connection. We both had to disconnect and then reconnect with the application. Whilst the application generally progressed satisfactorily after this, there were times when the audio quality became poor at my end and occasionally Ms Gascoyne also had problems. It was noticeable that she navigated all of these difficulties without any great problems. If there was a problem during the meeting, she was able to make herself clear that such a problem existed and we were able to address it. This clearly required a reasonable degree of persistence and focus. This was also displayed by Ms Gascoyne in her capacity to deal with an interview that lasted just under 1 ½ hours (including 10 – 15 minutes confirming the set up at the beginning).

Ms Gascoyne appeared stressed during the interview. She was somewhat ill kempt, with no makeup and untidy hair. She was cooperative. It was clear that she was angry and frustrated with her injury and treatment by her employer as well as the overall workers compensation process. I felt that this meant that sometimes her description of symptoms and impairment were shaped by this. Certainly, her description of cognitive impairment (memory, concentration and focus) was not consistent with her capacity to manage this reasonably challenging interview.

She appeared mildly depressed, although she had a reasonable range of affect. She was occasionally tearful and generally somewhat tense. She looked drawn and tired.

There was no evidence of psychotic phenomena, particularly she did not display formal thought disorder, hallucination or delusions.

As described above, whilst she occasionally had memory lapses in distress during the interview, she was able to focus, persist and remain alert over 1½ hours.

While there were difficulties with the audiovisual connection, I was confident that I was able to obtain an adequate and accurate history and undertake an appropriate mental state examination. I asked Ms Gascoyne if she had any further questions or statements at the end of the appointment and was able to t’s ake in the matters that she raised.

1. Results of any additional investigations since the original Medical Assessment Certificate N/A

2. Diagnosis.

Using the DSM 5 classificatory system of diagnosis, at the time of my assessment Ms Gascoyne met the criteria for:

I.Persistent Depressive Disorder (PDD) – with intermittent Major Depressive disorder without current episode.

II.Anxiety disorder – Not otherwise Specified.

The diagnosis of PDD is made because of the presence of depressed mood, with insomnia, low self-esteem, mild concentration difficulties and feelings of hopelessness. These symptoms are not sufficient however currently to meet the criteria for Major Depressive disorder.

The diagnosis of Anxiety Disorder, Not Otherwise Specified, is made because of the presence of a variety of anxiety symptoms including rumination, panicky feelings in the presence of traumatic like anxiety without sufficient criteria to meet the diagnosis of PTSD.”

1. The Appeal Panel considers that the examination undertaken by Medical Assessor Graham Blom was conducted in a through manner. The Appeal Panel notes the history Medical Assessor Graham Blom has provided in his report to the Appeal Panel, including the history as to the respondent’s ability to function in the PIRS categories that have been challenged on appeal, namely social and recreational activities, travel and concentration, concentration and pace. The Appeal Panel also notes Medical Assessor Graham Blom’s findings on clinical examination of the respondent and Dr Blom’s diagnosis made after clinical examination of the respondent of persistent depressive disorder (PDD) – with intermittent major depressive disorder without current episode and anxiety disorder – not otherwise specified.

2. In respect of social and recreational activities, while the respondent spent 12 months travelling around Australia with her husband, from the description given on re-examination, it is reasonably apparent to the Panel that her social and recreational activities were extremely limited and almost exclusively focused upon activities with her husband. Much of this conduct rightly falls under the category of social functioning. She does engage in recreational activities but from her description almost exclusively with her husband or alone. She spent some time, on her return to Newcastle, with her grandchildren although the Panel does not view this as primarily a social and recreational activity. She also had barbecues with her children, but the Panel considers these are primarily a feature of her relationship with her family indicating the mild impairment in the category of social functioning. She very occasionally has some form of social activity with friends but only at either their home or her home. As such the Appeal Panel considers that she has moderate impairment in this scale and assessment at class 3 is the correct fit

3. In respect of travel, while the respondent did not drive very frequently on her trip around Australia, the Appeal Panel noted that on questioning by Medical Assessor Graham Blom on re-examination, it is evident that she has her own motor vehicle and that she is able to drive it with only minimal difficulties. She said that normally she drives in the local area, including to Mount Catti to see her son (this was about 15 minutes drive from Bonny Hill where she was staying, but presumably was somewhat unfamiliar area, as she previously lived much further south in Stockton). She also said that she was planning to drive from Bonny Hills to Newcastle for Mother’s Day, alone, as Neil was unable to accompany her. This is a distance of approximately 230km, on roads that clearly do not fall into the local area. While she has some anxiety driving and her husband usually drives (something that occurred even prior to the injury and is somewhat socially determined), the respondent’s capacity clearly falls within the normal range for travel and so class 1 is the best fit.

4. In respect of concentration persistence and pace, the Appeal Panel notes that the respondent complained of difficulties in reading novels and other material although said that she was able to watch YouTube videos for up to 30 minutes. During the interview with the Medical Assessor Graham Blom on re-examination, she was able to deal with disruptions in the audiovisual link and still maintain persistence, pace and focus throughout a prolonged interview, in total of about 90 minutes (including disruptions). She also was able to explain, in some detail the reasons for extending her stay at Kurrimine Caravan Park as well as give a good account of her trip. Recently she and her husband have purchased a property some distance from where they normally live. This inevitably involved the respondent in activity that required reasonable levels of concentration persistence and pace. Taking all this in account, the Appeal Panel considers her impairment is consistent with mild impairment, and class 2 is the best fit.

5. Accordingly the Appeal Panel’s assessment of the PIRS categories under Table 11.8 is as follows:

Name	Donna Abdilla-Gascoyne	Claim reference number (if known)
DOB	Xxxx	Age at time of injury	58 years of age
Date of Injury	23 February 2021	Occupation at time of injury	Team Manager
Date of Assessment	6 May 2024	Marital Status before injury	Married

Psychiatric diagnoses	1. Persistent Depressive Disorder – with intermittent Major Depressive disorder without a current episode		2. Anxiety Disorder – not otherwise specified.
3		4.
Psychiatric treatment	St Johns wort; psychological treatment
Is impairment permanent?	Yes
PIRS Category			Class		Reason for Decision
Self Care and personal hygiene			1		As determined by the MA. This category was not under appeal.
Social and recreational activities			3		Her social and recreational activities are extremely limited and almost exclusively focused upon activities with her husband. Many of these rightly fall under the category of Social Functioning. She does engage in recreational activities but from her description almost exclusively with her husband or alone.
					She very occasionally has social contact with friends but only at either their home or her home. As such I believe that she has moderate impairment in this scale – class 3 is appropriate
					Travel			1		While Ms Gascoyne did not drive very frequently on her trip around Australia, on questioning it is evident that she has her own motor vehicle and that she is able to drive it with only minimal difficulties. She said that normally she drives in the local area, including to Mount Catti to see her son (this was about 15 minutes drive from Bonny Hill where she was staying, but presumably was somewhat unfamiliar area, as she previously lived much further south in Stockton). She also said that she was planning to drive from Bonny Hills to Newcastle for Mother’s Day, alone, as Neil was unable to accompany her. This is a distance of approximately 230 km, on roads that clearly do not fall into the local area.
Social functioning			2							As determined by the MA. This category was not under appeal
Concentration, persistence and pace			2		Ms Gascoyne complained of difficulties in reading novels and other material although said that she was able to watch YouTube videos for up to 30 minutes. During this interview, she was able to deal with disruptions in the audiovisual link and still maintain persistence, pace and focus throughout a prolonged interview, in total of about  90 minutes (including disruptions). She also was able to explain, in some detail the reasons for extending her stay at Kurrimine Caravan Park as well as give a good account of her trip. Recently she and husband have purchased a property some distance from where they normally live. This inevitably involved Ms Gascoyne in activity that required reasonable levels of concentration persistence and pace. I believe for all of these reasons, her impairment is consistent with mild impairment, class 2 is
Employability			4		As determined by the MA. This category was not under appeal
Score										Median Class
1	1	2		2		3	4		2
Aggregate Score Impairment
1+1	+2	+2		+3		+4	=13			WPI 7%

Total       7    %

1. The Appeal Panel concluded that the respondent worker has a median score of 2 under the PIRS, and an aggregate of 13, with a total whole person impairment of 7%. The Medical Assessor made no deduction under s 323 nor adjustment for treatment and neither of these have been appealed. Accordingly, the Appeal Panel will revoke the MAC.

2. For these reasons, the Appeal Panel has determined that the MAC issued on
   6 November 2023 should be revoked, and a new MAC should be issued.  The new certificate is attached to this statement of reasons.

PERSONAL INJURY COMMISSION

APPEAL PANEL

MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter number:	W5319/23
Applicant:	Donna Abdilla-Gascoyne
Respondent:	Secretary, Department of Communities & Justice

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 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 NSW workers compensation guidelines	Chapter, page, paragraph, figure and table numbers in AMA5 Guides	% WPI	WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)	Sub-total/s % WPI (after any deductions in column 6)
1. Psycho-logical	23/2/21	11, page 55-60	14	7%	NIL	7%
Total % WPI (the Combined Table values of all sub-totals)					7%

PERSONAL INJURY COMMISSION

Table 11.8: PIRS Rating Form

Name	Donna Abdilla-Gascoyne	Claim reference number (if known)
DOB	Xxxx	Age at time of injury	58 years of age
Date of Injury	23 February 2021	Occupation at time of injury	Team Manager
Date of Assessment	6 May 2024	Marital Status before injury	Married

Psychiatric diagnoses	1. Persistent Depressive Disorder – with intermittent Major Depressive disorder without a current episode		2. Anxiety Disorder – not otherwise specified.
3		4.
Psychiatric treatment	St Johns wort; psychological treatment
Is impairment permanent?	Yes
PIRS Category			Class		Reason for Decision
Self Care and personal hygiene			1		As determined by the MA. This category was not under appeal.
Social and recreational activities			3		Her social and recreational activities are extremely limited and almost exclusively focused upon activities with her husband. Many of these rightly fall under the category of Social Functioning. She does engage in recreational activities but from her description almost exclusively with her husband or alone.
					She very occasionally has social contact with friends but only at either their home or her home. As such I believe that she has moderate impairment in this scale – class 3 is appropriate
					Travel			1		While Ms Gascoyne did not drive very frequently on her trip around Australia, on questioning it is evident that she has her own motor vehicle and that she is able to drive it with only minimal difficulties. She said that normally she drives in the local area, including to Mount Catti to see her son (this was about 15 minutes drive from Bonny Hill where she was staying, but presumably was somewhat unfamiliar area, as she previously lived much further south in Stockton). She also said that she was planning to drive from Bonny Hills to Newcastle for Mother’s Day, alone, as Neil was unable to accompany her. This is a distance of approximately 230 km, on roads that clearly do not fall into the local area.
Social functioning			2							As determined by the MA. This category was not under appeal
Concentration, persistence and pace			2		Ms Gascoyne complained of difficulties in reading novels and other material although said that she was able to watch YouTube videos for up to 30 minutes. During this interview, she was able to deal with disruptions in the audiovisual link and still maintain persistence, pace and focus throughout a prolonged interview, in total of about  90 minutes (including disruptions). She also was able to explain, in some detail the reasons for extending her stay at Kurrimine Caravan Park as well as give a good account of her trip. Recently she and husband have purchased a property some distance from where they normally live. This inevitably involved Ms Gascoyne in activity that required reasonable levels of concentration persistence and pace. I believe for all of these reasons, her impairment is consistent with mild impairment, class 2 is
Employability			4		As determined by the MA. This category was not under appeal
Score										Median Class
1	1	2		2		3	4		2
Aggregate Score Impairment								Total       7			%
1+1	+2	+2		+3		+4	13