Shahin v Plaspro Enterprises Pty Ltd
[2025] NSWPICMP 656
•29 August 2025
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Shahin v Plaspro Enterprises Pty Ltd [2025] NSWPICMP 656 |
| APPELLANT: | Shariff Shahin |
| RESPONDENT: | Plaspro Enterprises Pty Ltd |
| APPEAL PANEL | |
| SENIOR MEMBER: | Kerry Haddock |
| MEDICAL ASSESSOR: | Douglas Andrews |
| MEDICAL ASSESSOR: | Professor Nicholas Glozier |
| DATE OF DECISION: | 29 August 2025 |
CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; determination by member that appellant had sustained both primary and secondary psychological injury; Medical Assessor assessed whole person impairment (WPI) of 19% of which primary psychological injury accounted for 60%; appellant’s WPI was adjusted to 11%; appellant appealed on basis that assessment made on basis of incorrect criteria and Medical Assessment Certificate (MAC) contained demonstrable error; Held – Appeal Panel found error and appellant examined by Panel member; MAC revoked; Mercy Connect v Kiely, Wingfoot Australia Partners Pty Limited v Kocak, Matheson v Baptistcare NSW & ACT, and El Masri v Woolworths Ltd considered. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 19 March 2025, Shariff Shahin lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ronald Gill, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 26 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):
(a) the assessment was made on the basis of incorrect criteria, and
(b) 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, 4th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).
RELEVANT FACTUAL BACKGROUND
On 23 November 2021, the appellant sustained an injury to his left forearm and wrist when his hand became jammed in a machine.
The appellant also sustained a primary psychological injury.
The respondent did not dispute that the appellant had sustained a primary psychological injury. However, it maintained that the appellant was also suffering from a secondary psychological injury. It therefore disputed the appellant’s claim for permanent impairment compensation on the basis that the extent of his permanent impairment fell below the threshold prescribed by s 65A(3) of the Workers Compensation Act 1987 (the 1987 Act).
The appellant lodged an Application to Resolve a Dispute (Application) on 3 October 2024.
The appellant claimed the sum of $47,490 in respect of 18% whole person impairment (WPI) as a result of psychiatric/psychological disorder sustained on 23 November 2021.
The respondent lodged its Reply on 25 October 2024.
The matter was listed for conciliation/arbitration hearing before Member Strachan on
2 December 2024.On 13 December 2024, Member Strachan issued a Certificate of Determination (COD).
Member Strachan determined that the appellant had sustained a primary psychological injury in the course of his employment with the respondent on 23 November 2021; and the appellant had also sustained a secondary psychological injury consequent on physical injuries sustained on 23 November 2021.
The appellant’s claim for permanent impairment compensation was remitted to the President of the Personal Injury Commission (the Commission) for referral to a Medical Assessor for assessment of permanent impairment.
The medical dispute was referred to Medical Assessor Dr Ronald Gill, for assessment of WPI as a result of psychiatric/psychological disorder resulting from injury on 23 November 2021.
The Medical Assessor examined the appellant on 14 February 2025.
The Medical Assessor determined that the appellant’s primary diagnosis was post-traumatic stress disorder, which developed immediately after the incident, and had remained persistent. The appellant also presented with major depressive disorder (MDD) with anxious distress, which had emerged in response to post-accident stressors, including being dismissed from his employment, financial strain, and progressive social withdrawal.
On 26 February 2025, the Medical Assessor issued a MAC in which he assessed the appellant as having 19% WPI in total. However, the Medical Assessor determined that the appellant’s post-traumatic stress disorder accounted for 60% of his impairment, while MDD contributed 40% as a secondary condition.
The appellant’s final WPI was therefore adjusted to 11%, based solely on the primary psychiatric injury.
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 the appellant should undergo a further medical examination because the Appeal Panel found error, in that the Medical Assessor had failed to provide his reasoning for having apportioned his assessment of WPI in the proportions of 60% and 40%.
Because it found error, the Appeal Panel’s power to require a re-examination was enlivened. Absent a finding of error, the Appeal Panel has no power to require a re-examination. The Appeal Panel cannot examine the appellant to determine whether a ground of appeal has been made out: New South Wales Police Force v Registrar of the Personal Injury Commission of New South Wales [2013] NSWSC 1792.
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.
Further medical examination
Medical Assessor Douglas Andrews of the Appeal Panel conducted an examination of the appellant on 16 July 2025 and reported to the Appeal Panel.
Medical Assessment Certificate
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
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:
(a) there was no legal, jurisdictional or factual basis for the Medical Assessor to have applied the apportionment to the final WPI;
(b) Member Strachan had determined, and the respondent had conceded, that the appellant sustained a primary psychological injury; and the diagnosis was post-traumatic stress disorder;
(c) the Medical Assessor was required to determine the appellant’s WPI as a result of the injury and it was not his function to have apportioned impairment in the manner he did. This was clear from the terms of the referral and the dispute between the parties: Skates v Hills Industries Pty Ltd [2021] NSWCA 142; and Sakr v Merrylands Christian Preschool Association Inc [2022] NSWSC 768;
(d) it was not the Medical Assessor’s function to do more than determine the degree of impairment resulting from the accepted injury, as the liability issues had been resolved in the appellant’s favour: Jaffarie v Quality Castings Pty Ltd [2018] NSWCA 88;
(e) there was no jurisdictional basis for the Medical Assessor to have determined what impairment was causally related to the primary psychological injury, and what impairment was related to the secondary psychological condition;
(f) even if the above were not accepted, the Medical Assessor was in error in excluding the effects of the secondary psychological condition from the impairment that was causally related to the accepted primary injury;
(g) the Medical Assessor made clear there was no novus actus interveniens, or that the primary psychological injury did not contribute to the final impairment of 19% [sic];
(h) the Medical Assessor erroneously apportioned impairment that he considered was solely related to the primary psychological injury. The apportionment and deduction were to the portion of 19% WPI that was contributed to by the secondary psychological injury. (Emphasis in original);
(i) common law principles of causation are applicable when assessing the degree of impairment resulting from an injury: Secretary, New South Wales Department of Education v Johnson [2019] NSWCA 321;
(j) the Medical Assessor misapplied the law pertaining to causation. He did not assess the appellant’s WPI as caused or materially contributed to by the accepted injury: Bindah v Carter Holt Harvey Woodproducts Australia Pty Ltd [2013] NSWSC 1290;
(k) the primary psychological injury only needed to play some part contributing to the assessed WPI and it is sufficient for the injury to be only one cause of the impairment: Hunt & Hunt Lawyers v Mitchell Morgan Nominees Pty Ltd [2013] HCA 10; and Gould v Vaggelas [1984] HCA 68. This was satisfied, noting the Medical Assessor determined the impairment related to post-traumatic stress disorder was the dominant cause of the appellant’s WPI and the secondary condition merely exacerbated his depressive symptoms. (Emphasis in original);
(l) the Medical Assessor did not assess the appellant’s WPI by enquiring whether the final impairment was causally related to the accepted primary injury, that is whether the primary psychological injury made a material contribution to same;
(m) the only basis on which the impairment could be divided or separated in the manner undertaken was if the Medical Assessor determined there was a novus actus interveniens: State Government Insurance Commission v Oakley (1990) 10 MVR 570; [1990] Aust Tort Reports 81-003; Faulkner v Keffalinos (1971) 45 ALJR 80. The Medical Assessor determined there was no novus actus interveniens;
(n) by disregarding the impairment that may have been contributed to by the secondary condition, but remained as a result of the accepted injury, the Medical Assessor did not pay regard to the correct question, that is whether the WPI was caused or materially contributed to by the accepted injury;
(o) there can be multiple causes of impairment: Calman v Commissioner of Police [1999] HCA 60, (1999) 73 ALJR 1609; Cluff v Dorahy Bros (Wholesale) Pty Ltd [1979] 2 NSWLR 435. That the appellant’s impairment may have been contributed to by subsequent events did not warrant any deduction from his final assessed impairment;
(p) the above principles rendered the entirety of the assessed impairment as being causally related to employment;
(q) the Medical Assessor ought not to have performed the apportionment because the impairment as a whole resulted from the injury sustained in the course of employment;
(r) the Medical Assessor’s reasons for apportionment fell short of the mandatory legal standard, because it is not apparent why the ultimate impairment assessed was not causally related to the primary psychological injury: Wingfoot Australia Partners Pty Limited v Kocak (2013) 252 CLR 480, [2013] HCA 43 (Wingfoot); Campbelltown City Council v Vegan (2006) 67 NSWLR 372, [2006] NSWCA 284 (Vegan);
(s) reasons were necessary, given the liability issue had been resolved, it was conceded the appellant sustained primary psychological injury, the Medical Assessor determined there was no novus actus interveniens, and the Medical Assessor made clear the dominant cause of the appellant’s WPI was the primary psychological injury;
(t) without reasons, the appellant does not know why the Medical Assessor reached his conclusions;
(u) the assessment and apportionment were contrary to the Guidelines, clauses 1.6 and 1.27-1.28;
(v) the errors are material. If the errors had not been committed, the appellant’s WPI would be assessed at a higher percentage, and
(w) the MAC ought to be revoked, without the need for re-examination, and the appellant’s WPI ought to be held to be 19%.
In reply, the respondent submits that:
(a) Member Strachan’s Statement of Reasons and COD confirmed the presence of both a primary and secondary psychological injury/condition. Whether there was a secondary psychological condition was therefore not “in issue”;
(b) it was a matter for the Medical Assessor to determine the degree of permanent impairment resulting from the appellant’s work-related primary psychological injury: Mercy Connect Limited v Kiely [2018] NSWSC 1421 (Kiely);
(c) the appellant’s submission that the Medical Assessor determined liability issues is incorrect. Following the finding of the secondary psychological condition, the Medical Assessor was required to turn his mind to the issue of whether that condition was in any way contributing to the impairment. If so, in accordance with s 65A(2) of the 1987 Act, the Medical Assessor was obliged to exclude the extent of impairment that he considered was attributable to the secondary psychological condition;
(d) the Medical Assessor provided a “primary diagnosis” of post-traumatic stress disorder; and a “secondary” MDD with anxious distress, which he considered emerged in response to post-accident stress. The finding was consistent with the findings of both Dr Virk and Ms Lee;
(e) the Medical Assessor commented that the secondary psychological condition was “contributing to” but not overshadowing the impairment. This acknowledged that the secondary condition was contributing to the assessment of impairment. The Medical Assessor was thereafter required to engage in apportioning his assessment to ensure no impairment resulting from the secondary condition was included in the final calculation;
(f) the Medical Assessor had made that apportionment, indicating that the post-traumatic stress disorder symptoms equated to 60% and the MDD to 40%, thereby resulting in 11% WPI attributable to the primary psychological injury;
(g) the Medical Assessor had set out that 11% WPI based on the primary post-traumatic stress disorder alone was an accurate reflection of the appellant’s functional limitations;
(h) the degree of permanent impairment that results from an injury is within the definition of medical dispute in accordance with s 319 of the 1998 Act. It was wholly within the Medical Assessor’s jurisdiction to determine the degree of impairment resulting from both the primary psychological injury and the secondary psychological condition;
(i) the circumstances of this case do not involve a “subsequent or intervening accident/injury”. The presence of a secondary psychological condition does not “sever” the causal chain between a primary psychological injury and the resultant impairment, but the effects of the secondary psychological condition can also contribute to the impairment;
(j) it was evident that the Medical Assessor considered that both the primary injury and secondary condition were contributing to the impairment. He was therefore mandated by the legislation and SIRA Guidelines to disregard any impairment he considered resulted from the secondary condition;
(k) the Medical Assessor would have been in error if he had not conducted an apportionment of the impairment, noting there was a finding of a secondary psychological condition, and the Medical Assessor opined it was “contributory” to the impairment;
(l) the Medical Assessor had appropriately applied the requirements of the 1987 Act, the 1998 Act, and the SIRA Guidelines, such that the assessment was not made on the basis of incorrect criteria;
(m) the Medical Assessor was not required to give expansive reasons for the ultimate conclusion but was required to disclose the actual path of reasoning in sufficient detail to enable a court to see whether the opinion involved any error of law: Wingfoot. As confirmed in Vegan, reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgment;
(n) the Medical Assessor did disclose a path of reasoning in relation to apportionment of impairment, at pp 5, 8, 9 and 11 of the MAC;
(o) the Medical Assessor acknowledged that the post-traumatic stress disorder symptoms were the dominant cause of the impairment but also that the secondary MDD “contributed to” the impairment;
(p) the MAC discloses that the assessment has not been made on the basis of incorrect criteria and does not disclose demonstrable errors, and
(q) the MAC 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 Vegan 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 role of the Appeal Panel was considered by the Court of Appeal in Siddik v WorkCover Authority of NSW [2008] NSWCA 116. The Court held that while prima facie the Appeal Panel is confined to the grounds the Registrar has let through the gateway, it can consider other grounds capable of coming within one or other of the s 327(3) heads, if it gives the parties the opportunity to be heard. An appeal by way of review may, depending upon the circumstances, involve either a hearing de novo or a rehearing. Such a flexible model assists the objectives of the legislation.
Section 327(2) was amended with the effect that, while the appeal was to be by way of review, all appeals as at 1 February 2011 were limited to the ground(s) upon which the appeal was made. In New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales [2013] NSWSC 1792, Davies J considered that the form of words used in s 328(2) of the 1998 Act being, “the grounds of appeal on which the appeal is made” was intended to mean that the appeal is confined to those particular demonstrable errors identified by a party in its submissions.
Medical assessment certificate
The parts of the MAC issued by the Medical Assessor that are relevant to the appeal are set out below.
Under “History relating to the injury”, at pp 2 and 3 of the MAC, the Medical Assessor recorded:
“On 23 November 2021…Mr Shahin sustained a workplace injury when a malfunctioning bottle moulding machine restarted unexpectedly, causing a metal rod to pierce his left forearm while crushing his wrist against the mould. He remained trapped for approximately 30 seconds before managing to free himself. Despite the pain and distress, he was administered first aid, wrapped his wound, and drove himself to Campbelltown Hospital…He was discharged after several hours but later required further medical intervention due to an infection…
His psychological symptoms emerged almost immediately…Initially, he dismissed the intrusive thoughts, nightmares, and heightened anxiety as a temporary reaction to the shock. However, these symptoms persisted and intensified over time, manifesting as flashbacks, panic attacks while commuting, hypervigilance, emotional detachment, and avoidance behaviours. His attempts to return to normalcy were undermined by a growing fear of machinery, and his daily routine became increasingly dictated by avoidance patterns.
Returning to work one week later…[T]he faulty machine had been fitted with a safety curtain, but no one acknowledged the incident. He struggled with intense fear and anxiety, experiencing panic attacks during commutes and at work. His focus deteriorated, and he became withdrawn, feeling increasingly isolated and unsupported. Workplace tensions escalated as surveillance cameras were installed in communal areas, reinforcing his sense of being scrutinised rather than supported.
By December 2021, his mental health had significantly deteriorated, and his ability to function in the workplace had declined markedly. In February 2022, he was dismissed over the phone. This loss exacerbated his depressive symptoms, reinforcing feelings of failure, low self-worth, and uncertainty about his future.
…his anxiety remained pervasive. He became socially withdrawn, avoiding previous hobbies…His wife observed a marked shift in his personality, describing him as emotionally distant, irritable, and lacking motivation. Sleep disturbance became a persistent issue, with frequent nightmares and night terrors…
Attempts at resuming employment in November 2023 saw him take a part-time role at Darrell Lea factory, but his capacity remained significantly impaired. He avoided machinery-heavy tasks, struggled with consistent attendance, and frequently required extended breaks due to psychological distress.
· Present Treatment
Mr Shahin is engaged in fortnightly psychological therapy with Ms Viviana Lee…His treatment focuses on Cognitive Behavioural Therapy (CBT), psychoeducation, relaxation techniques, and exposure therapy, [which] is limited by avoidance behaviours. He previously trialled Sertraline…but found it ineffective, and he has not engaged with a psychiatrist or trialled alternative psychiatric medications.
· Present Symptoms
His symptoms remain persistent and functionally limiting. He experiences intrusive memories and flashbacks, particularly when encountering workplace-related stimuli. His avoidance behaviours are pronounced, with an active reluctance to engage in machinery-related environments. He continues to exhibit hypervigilance, a heightened startle response, and difficulties with concentration and memory. Sleep remains poor, characterised by nightmares and frequent waking.
Anxiety continues to affect his ability to engage in daily tasks, particularly when driving or in public spaces. His low mood and emotional detachment have contributed to social withdrawal, with minimal engagement in previously enjoyed activities. He describes himself as feeling mentally fatigued, with a limited capacity to engage in complex tasks. At home, he remains irritable and has reduced frustration tolerance, impacting family interactions.
· Details of Any Previous or Subsequent Accidents, Injuries, or Conditions
There is no history of pre-existing psychiatric conditions. Prior to the accident, he had no record of psychological distress, workplace injuries, or significant trauma. There had been no subsequent accidents or injuries impacting his psychiatric condition.
…
· Work History, Including Previous Work History
…he worked as a night shift supervisor at [the respondent]. He had a prior ten-year history in logistics coordination and had also completed training in cement rendering and gyprock.
Following his injury, he attempted to [work] in November 2023…part-time…at Darrell Lea…He struggled with attendance and consistency. He actively avoided machinery-related tasks…and frequently took extended breaks to manage his symptoms. He is not engaged in any employment activities currently.
· Social Activities and Activities of Daily Living (ADLs)
His social engagement has significantly declined. He no longer participates in previously enjoyed hobbies and has withdrawn from interactions with extended family and friends. Anxiety has made public spaces overwhelming, leading him to avoid crowded places. His personal hygiene has suffered…He sleeps on the couch…and frequently wakes…
His driving is limited, as he finds it anxiety-provoking, particularly over long distances. He has difficulty engaging in family activities, often feeling detached or emotionally distant…his functional limitations are clear across social, occupational, and personal domains.”
Under “findings on mental state examination”, at p 4 of the MAC, the Medical Assessor recorded:
“…Mr Shahin was cooperative and engaged appropriately…his grooming was somewhat neglected…slightly slumped and was anxious with noticeable fidgeting and tension in his body language.
His speech was coherent and goal-directed, with a regular rate and volume, but…underlying tone of apprehension, particularly when discussing work-related topics. He was overinclusive in his responses…suggesting a preoccupation with the trauma and its ongoing impact.
Affect was restricted, with a noticeable anxiety and irritability. He described his mood as low and drained, consistent with his presentation of emotional detachment and limited reactivity to discussion topics. There was no evidence of psychotic symptoms, no delusions or perceptual disturbances, and no indication of formal thought disorder.
His thought content revolved around his workplace injury and its consequences, with recurrent themes of helplessness, frustration, and distrust towards his former employer.
He displayed marked hypervigilance, describing persistent fears around machinery and environments resembling his previous workplace. He was easily startled during the conversation, particularly when discussing his flashbacks and work-related distress.His cognitive function was intact, though his attention was intermittently disrupted by intrusive thoughts about his trauma. He described brain fog and difficulty concentrating, which aligns with his…reduced efficiency…His working memory appeared affected, and he required repetition of some questions…
Insight was partial. He recognised that his mental health had deteriorated, but there was some difficulty in acknowledging the extent of his impairment and how avoidance behaviours were reinforcing his symptoms. His judgment appeared reasonable, though there were indications of avoidance-based decision-making, particularly…employment choices and social interactions.
There was no suicidal ideation, intent, or plan…denied any history of self-harm or reckless behaviour…protective factors included his family and children…”
Under the heading “summary”, on p 5 of the MAC, the Medical Assessor recorded:
· summary of injuries and diagnoses:
“Mr Shahin sustained a psychiatric injury as a result of his workplace accident on 23 November 2021. The primary diagnosis is post-traumatic stress disorder (PTSD), which developed immediately following the incident and has remained persistent despite ongoing psychological treatment. Alongside PTSD, he presents with major depressive disorder with anxious distress, which emerged in response to post-accident stressors, including his dismissal from employment, financial strain, and progressive social withdrawal.
His symptoms include intrusive memories, flashbacks, nightmares, severe anxiety, hypervigilance, social withdrawal, emotional detachment, cognitive impairments, and persistent low mood. His condition has remained stable but chronic, with no evidence [of] significant improvement despite engagement in fortnightly psychological therapy. He has not trialled alternative psychiatric medication since discontinuing Sertraline…which was ineffective. His overall functional capacity remains significantly impaired, particularly in occupational and social settings.”
· consistency of presentation:
“…presentation has been consistent across multiple independent psychiatric assessments, clinical records, and mental state examinations. His reported symptoms align with established diagnostic criteria for PTSD, and there is no indication of symptom exaggeration, malingering, or feigned distress. His descriptions of intrusive thoughts, avoidance behaviours, heightened startle response, and cognitive disruptions remain unchanged…reinforcing the chronic and entrenched nature of his impairment.
His ability to sustain employment has been significantly restricted…His current work role…remains limited to part-time, non-machine-based tasks, and he struggles with attendance and consistency…avoidance of environments resembling his previous workplace further highlights the persistence of his trauma-related symptoms.
His engagement with treatment is appropriate, though his reluctance to engage in exposure-based therapy reflects the severity of his avoidance behaviours. Despite his adherence to therapy, there has been no meaningful reduction in his symptom[s]…reinforcing the permanent nature of his condition.
His psychiatric impairment is fully ascertainable, with no expectation of significant improvement beyond minor symptom management. His…functioning is unlikely to improve in a meaningful way…”
Under the heading, “the facts on which the assessment is based”, at p 7 of the MAC, the Medical Assessor recorded:
“Mr Shahin’s psychiatric impairment is directly linked to the workplace accident…The sudden and distressing nature of the incident, combined with the physical pain and shock, triggered an immediate and lasting psychological impact.
His post-incident trajectory shows a consistent pattern of trauma-related symptoms. He developed intrusive recollections, hypervigilance, avoidance behaviours, panic attacks, and sleep disturbance. The psychological burden intensified…particularly as he attempted to return to work, where he encountered increased workplace surveillance, lack of support, and eventual dismissal. His sense of isolation and perceived betrayal…compounded his distress, reinforcing the development of…PTSD.
His engagement in psychological treatment has been consistent, yet his symptoms have remained persistent and functionally impairing…he continues to avoid environments resembling his former workplace, struggles with concentration and decision-making, and has difficulty maintaining steady employment. His part-time role…serves as evidence of ongoing functional impairment…
There is no evidence of pre-existing psychiatric illness, nor any indication that his symptoms are influenced by non-work-related factors. His impairment is permanent and stable, with no realistic expectation of significant recovery beyond minor symptom fluctuations.
This assessment is based on psychiatric evaluations, mental state examination, and a review of all provided documentation.”
Under the heading, “reasons for assessment”, at pp 8 and 9 of the MAC, the Medical Assessor recorded:
“a. My opinion and assessment of whole person impairment
…His symptoms are consistent with…PTSD as the primary diagnosis, with major depressive disorder with anxious distress as a secondary condition. His clinical presentation demonstrates persistent functional impairments across social, occupational, and cognitive domains, which have remained stable despite ongoing psychological intervention.
His whole person impairment has been calculated at 11% WPI, based solely on PTSD as the primary psychiatric injury. The secondary major depressive disorder, while contributory, does not factor into the final impairment rating under assessment guidelines. His symptoms are chronic and entrenched…
He remains incapable of returning to his pre-injury occupation and continues to experience significant workplace avoidance, emotional detachment and cognitive inefficiencies…he is unable to sustain full-time hours or engage in tasks involving machinery without psychological distress.
…
b. An explanation of my calculations
The Permanent Impairment Rating Scale (PIRS) was used…His ratings across key functional domains resulted in a median score of 3 and an aggregate score of 17, corresponding to…WPI of 19%. Given that PTSD accounts for 60% of his impairment, while major depressive disorder contributes 40% as a secondary condition, the final WPI calculation is adjusted to 11%, based solely on the primary psychiatric injury.
His impairment rating reflects functional limitations in self-care, social interactions, employability, and cognitive endurance. He struggles with consistent workplace attendance, avoids machinery-based environments, and experiences persistent psychological distress linked to trauma-related triggers.
…
c. My brief comments regarding the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs
The opinions…demonstrate a consistent pattern of impairment…Reports from Dr Abdul Virk and Dr Frank Chow, as well as assessments from treating psychologist Ms Viviana Lee, all highlight the persistence of trauma-related symptoms, avoidance behaviours, and functional impairments consistent with…PTSD and secondary major depressive disorder.
…Dr Abdul Virk on 23 February 2023…diagnosed adjustment disorder with mixed anxiety and depression, concluding that Mr Shahin did not meet the criteria for PTSD…However…on 7 May 2024 Dr Virk revised his opinion, diagnosing both PTSD and major depressive disorder with anxious distress. He calculated a…WPI of 17%, but after adjusting for what he considered a secondary psychological injury, he determined a final WPI of 10%. In a supplementary report dated 21 May 2024, he reaffirmed his PTSD diagnosis.
Dr Frank Chow [on] 2 January 2024 also diagnosed PTSD…He calculated a whole-person impairment of 17%, adding 1% for the treatment effect, leading to a final WPI of 18%. He stated that Mr Shahin was only capable of partial work in lower-stress roles with reduced responsibility…
The psychological treatment history from Reid Clinical Psychology…further supports this diagnosis. Reports from his treating psychologists…detail persistent PTSD symptoms…His difficulty engaging in exposure-based interventions, despite structured psychological treatment, demonstrates the chronic and entrenched nature of his impairment.
My assessment does not deviate significantly from these findings but does take a more definitive stance on the primary versus secondary nature of his psychiatric injuries. While earlier assessments…. attempted to attribute 40% of his psychological distress to secondary psychosocial stressors, the evidence suggests that PTSD symptoms were present immediately following the workplace accident and have been the dominant cause of his impairment. His intrusive memories, heightened startle response, and avoidance…were evident before any workplace disputes or financial difficulties emerged, indicating that these were not secondary issues but a direct consequence of the trauma…
The argument that a portion of his impairment stems from workplace disputes and financial stress does not align with his ongoing symptoms of hypervigilance, emotional numbing, and physiological reactivity to trauma-related stimuli – symptoms that are hallmarks of PTSD rather than a generalised stress response. While secondary factors such as job loss and financial strain have exacerbated his depressive symptoms, they do not account for the core PTSD symptomatology, which has remained stable across multiple assessments.
My assessment confirms that Mr Shahin’s primary psychiatric condition is PTSD, with major depressive disorder contributing to, but not overshadowing, his impairment. Given the duration of his symptoms, limited treatment response, and entrenched avoidance behaviours, it is clear that his impairment is permanent and has reached Maximum Medical Improvement (MMI).
The…impairment of 11% based on PTSD alone is an accurate reflection of his functional limitations, and there is no justification for further deduction based on secondary factors. His condition remains chronic and functionally impairing, reinforcing the legitimacy of the impairment rating.
d. I certify that the impairment is permanent, and that the degree of permanent impairment is fully ascertainable
Yes…Given the chronicity of his condition, resistance to treatment, and stable impairment levels across multiple assessments, there is no expectation of significant recovery beyond minor symptom management.”
Under the heading “deduction (if any) for the proportion of the impairment that is due to previous injury or pre-existing condition of abnormality”, at p 10 of the MAC, the Medical Assessor recorded:
“a. In my opinion the worker suffers from the following relevant previous injuries, pre-existing conditions or abnormalities:
There is no evidence of any previous psychiatric injury, pre-existing mental health condition, or abnormality that could have contributed to Mr Shahin’s current impairment.
b. The previous injury, pre-existing condition or abnormality directly contributes to the following matters that were taken into account when assessing the whole person impairment that results from the injury, being the matters taken into account in 10a, and in the following ways:
Not applicable.”
Under the heading “answers to specific questions”, at p 10 of the MAC, the Medical Assessor recorded:
“…
· The Degree of Permanent Impairment of the Worker as a Result of an Injury (s 319(c))
…
His…WPI has been determined at 11%, based on the primary diagnosis of PTSD. The secondary depressive disorder, while contributing to his distress, does not factor into the final impairment rating under assessment guidelines. His symptoms continue to restrict his capacity to function in occupational, social, and cognitive domains, and he has reached…MMI…
· Whether Any Proportion of Permanent Impairment is Due to Any Previous Injury or Pre-Existing Condition or Abnormality, and the Extent of That Proportion (s 319(d))
There is no evidence of a pre-existing psychiatric condition or any prior psychological impairment that would have contributed to his current level of dysfunction.
Whether Impairment is Permanent (s 319(f))
Yes…
· Whether the Degree of Permanent Impairment of the Injured Worker is Fully Ascertainable (s 319(g))
Yes…”
The Medical Panel reviewed the history recorded by the Medical Assessor, his findings on examination, and the reasons for his conclusions, as well as the evidence to which he referred.
Appellant’s evidence
The appellant’s statement is dated 10 July 2023.
On 23 November 2021, one of the operating machines had issues that would cause it to stop, due to an imperfect drink bottle.
When the machine stopped again, he opened the door to retrieve the bottle, when the machine restarted.
His hand got jammed. A blunt metal rod penetrated his left forearm, while the mould of the press crushed his left wrist. He had to wait about 30 seconds for the machine to recommence until he was able to move his arm forward and dis-impact the rod.
A colleague placed a bandage around his arm, and he drove himself, in agonising pain, to Campbelltown Hospital.
He attended his general practitioner the following day and was referred back to the hospital.
About a week after the accident, he returned to work. It was around then that he started to experience symptoms of anxiety.
He had to pull over on his way to work, as he would panic and have shortness of breath, heart palpitations, worry excessively, and start hyperventilating. He didn’t really want to be there but felt pressured to return to work.
He lost sleep, as he would dream of the incident and feared a similar incident.
He felt a shift in the workplace. They denied the incident occurred and had put up cameras to monitor the floor. He had no one to talk to and was not offered any help or counselling.
He continued at work as best he could until he was retrenched on 17 February 2022. He had been unable to return to work.
He experienced low mood, anxiety and irritability. He struggled to concentrate for long periods and had difficulties with memory.
He felt triggered when driving past his workplace as he relived the incident.
He had become socially withdrawn.
The appellant made a supplementary statement on 1 July 2024.
He did not understand how his symptoms could be attributed to a secondary condition.
His psychological symptoms began once he returned to work in December 2021. He became more and more concerned leading up to returning to work, worried about being back where he suffered injury.
He would have to pull over on the drive in, as he had panic attacks at the thought of going back.
He did not understand what was happening and thought he was having heart problems. At Campbelltown Hospital he was informed it was anxiety related.
When he was retrenched, he was worried about his future finance and career prospects. He was already experiencing significant psychological symptoms before he became concerned about their finances and his career.
Before he ceased employment, he had recurring dreams about the incident and was unable to sleep.
There was pressure from the employer to continue at work. He had no one to talk to and was not offered help or counselling.
He was experiencing anxiety, panic attacks and flashbacks with the mere thought of returning to work, and how the incident occurred, within a week of the incident.
He continued to see his psychologist fortnightly and was taking Sertraline.
He had flashback nightmares of the accident. He rarely slept for an hour straight, waking every 20 to 30 minutes or so.
He felt anxious in public and had socially withdrawn. He had feelings of worthlessness and hopelessness at times.
In around mid-November 2023, he commenced employment with Darrell Lea. He spent his time stacking pallets.
The role was a considerable downgrade from what he did previously. He did not see how he could work in a similar role again, as he could no longer work with machines for fear of re-injury.
He was working 8 to 12 hours per day, three days per week. His hours were dependent on how he felt. He had not worked a 12-hour day for a few months. He was struggling to maintain these hours due to pain in his left arm and psychological condition.
He was forced to return to work when the insurer cut off his payments. He tried to push through as best he could, as they relied on the added income.
Medical evidence
Dr Abdul Virk – psychiatrist
Dr Virk was qualified by the respondent and reported first on 23 February 2023.
Dr Virk recorded a history that at around Christmas (2021), the appellant noticed resentment towards him by his boss, Mr Adam de Manincor. He received a warning prior to the onset of his symptoms that indicated Mr de Manincor did not want him there.
The appellant was feeling anxious about his job, which was partly why he was looking for new employment. Mr de Manincor spoke to him about using the computer to search for other jobs, and having food delivered during his lunch break in February 2022.
The appellant suspected Mr de Manincor was targeting him. He subsequently developed anxiety attacks, would have palpitations and trouble breathing, and would become overwhelmed with anxiety.
Mr de Manincor terminated the appellant’s employment over the phone, summoning him to his office with paperwork.
The appellant felt betrayed by his colleagues, who stopped communicating with him after he ceased employment. He became increasingly depressed, as two of his fingers would not work and he was struggling to even drive.
The appellant was aware that Mr de Manincor had accused him of fabricating the incident. He was shocked to hear the other worker did not witness it as he recalled looking him in the eye when it occurred.
Dr Virk recorded that the appellant’s mood had been very depressed. He was experiencing sleep difficulties due to ruminations about his future employment prospects.
The appellant had become anxious about being around machines. His appetite was diminished. He lacked energy and motivation. He had lost confidence and felt worthless. He had difficulty with concentration.
The appellant had anticipatory anxiety about driving. After a near collision, he worried he would lose focus and crash. He had become socially withdrawn, stating he had not gone fishing for a long time, or seen his friends. His relationship with his wife was strained, as she was required to work longer hours.
Dr Virk diagnosed the appellant with adjustment disorder with mixed anxiety and depression.
Dr Virk disagreed with the diagnosis of post-traumatic stress disorder. The appellant did not describe any significant intrusion symptoms related to the incident. Rather, he had marked anticipatory anxiety about his future employment prospects, and depressive symptoms in the context of chronic pain and limited mobility.
Dr Virk agreed with the diagnosis of “anxiety and depression”, while noting they were not proper DSM-5 diagnoses. With regard to DSM-5, the appellant’s condition was best accounted for by a diagnosis of adjustment disorder with mixed anxiety and depression, secondary to his left upper limb injury.
Dr Virk opined that the appellant described sub-threshold anxiety symptoms upon returning to work following the injury, due to his perception that he was being targeted with the installation of CCTV. However, he described clinically distressing symptoms of anxiety following his termination, as well as depressive and anxiety symptoms in the context of his injury.
Dr Virk further opined that the appellant had developed anxiety and depressive symptoms secondary to the limitations and chronic pain associated with his injury, as well as the termination of his employment, which he perceived to be unjust.
Dr Virk again reported on 7 May 2024.
The appellant remained depressed most of the time, and he had experienced middle insomnia. He had anxious ruminations about his future employment and providing for his family. His appetite was diminished. He had decreased energy and motivation. He described losing confidence and feelings of worthlessness; and feeling restless and agitated.
The appellant had been experiencing flashbacks of the incident, including the way the rods went into his hand, nightmares, and night sweats. He was unable to recall the date of onset, but they had considerably worsened since he recommenced work. He avoided working near machines.
The appellant reported marked alteration in arousal and reactivity, including increased irritability, hypervigilance, difficulties with concentration, exaggerated startle response, and negative alterations in cognitions and mood.
Dr Virk diagnosed the appellant with the primary diagnosis of post-traumatic stress disorder and secondary MDD with anxious distress. This was secondary to chronic pain and functional limitations associated with his left arm injury.
Dr Virk opined that the appellant’s secondary psychological condition had been significantly impacted by his return to work. He had been struggling with pain and felt undervalued and unprotected in his new role, which lacked his previous managerial responsibilities. This had led to feelings of worthlessness and loss of confidence.
The appellant described increased psychological distress on returning to work, including crying due to exhaustion and worsening pain, which correlated with an increased severity of depressive symptoms. His emotional state of being aggrieved by the lack of safety precautions at his new job mirrored the circumstances of his injury, reinforcing the traumatic memory and contributing to his post-traumatic symptoms.
Based on the medical evidence and the appellant’s current presentation, Dr Virk considered the primary psychological injury to be responsible for 60% of Mr Shahin’s WPI and the secondary psychological condition to be responsible for 40%.
Dr Virk’s basis for the division was that the appellant’s arousal and reactivity symptoms associated with his post-traumatic stress disorder were the predominant contributors to his impairment in the domains of travel, social functioning, concentration, and employment. The depressive symptoms, particularly loss of motivation and energy associated with chronic pain and functional limitations, appeared to be limiting the appellant’s ability to participate in social and recreational activities, self-care and personal hygiene, and diminishing his persistence and pace.
Dr Virk assessed the appellant’s WPI as 17%. The appellant’s WPI for primary psychological injury was therefore 17% - 6.8% = 10.2% = 10% (rounded).
Dr Virk reported on 21 May 2024 on a file review, having been provided with clinical records.
The documents provided to Dr Virk did not cause him to alter his views or assessments.
Dr Frank (Kai Tai) Chow – consultant psychiatrist and psychogeriatrician
Dr Chow was qualified by the appellant and reported on 2 January 2024.
Dr Chow recorded a history that the appellant still had pain and restriction. He was not able to do physically demanding work with his left hand.
The appellant had been traumatised from the accident. He returned to work after a week. He thought there would be some kind of help, but was offered nothing.
After a week, the appellant started having escalated anxiety. He pulled over on the road to work. He had palpitations and escalated worries at work. He had a lot of anxiety even in the carpark. He thought he was having heart problems. He did not understand it was in his head. He gradually became more anxious at work, especially as he felt there was a lack of support and he felt he was being monitored.
The appellant was still having sleeping problems. He had reduced flashback nightmares of the accident. He avoided working with machines, by which he was triggered easily. He was anxious with the thought of working with any machine.
The appellant was anxious in public. He had reduced interest in hobbies and continued to have fluctuating motivation and energy. He felt guilty, worthless, and hopeless at times.
The appellant had applied for over 50 jobs and attended four to five interviews. He had been applying for logistics and transport roles.
Dr Chow diagnosed the appellant with post-traumatic stress disorder. He assessed the appellant’s WPI as 18%.
Ms Viviana Lee – clinical psychologist
Ms Lee reported to the appellant’s solicitors on 23 August 2024.
Ms Lee had begun to treat the appellant on 2 May 2023, when her colleague, Paiche Hartley, commenced leave.
Ms Hartley had diagnosed the appellant with post-traumatic stress disorder with anxiety and depression.
The appellant had re-experienced pain symptoms. He had experienced worries, low mood, difficulty with sleep, inability to engage in previously enjoyable activities, anxiety/panic attack like symptoms, irritability, lack of concentration, brain fog, and lack of confidence.
The appellant’s post-traumatic stress symptoms included repeated and unwanted memories of the accident, feeling or acting as if the stressful experience were happening again, feeling very upset when reminded of the incident, heart pounding, trouble breathing, sweating and panic like symptoms when reminded of the incident. He avoided people and situations related to accidents, such as when people were injured and recounted the stories. He blamed the company for the accident, experienced negative feelings such as horror and fear of the unknown, felt distant and cut off from people, had trouble experiencing positive feelings, was super alert, jumpy, easily startled, had difficulty concentrating, and trouble staying asleep.
Ms Lee opined that the primary diagnosis was post-traumatic stress disorder. She did not believe the appellant’s symptoms were a secondary condition. Re-experiencing symptoms indicated an acute psychiatric condition, rather than a secondary condition such as depression, due to loss of functioning/pain/inability to work.
Ms Lee opined that the appellant had the secondary diagnosis of major depression, with the symptoms experienced concurrently to the post-traumatic stress disorder.
In the appellant’s presentation, depressive symptoms were experienced within both the diagnosis of post-traumatic stress disorder and MDD. Ms Lee opined that, as symptoms resolved, the appellant may recover from one condition before the other.
Ms Lee opined that disentangling can be difficult, but this can be possible. Cognitions may revolve around the trauma event, or around loss of work or insecurity of income.
Ground one
The appellant has grouped his submissions under the headings, “apportionment of whole person impairment”, “causation”, and “failure to provide adequate reasons”.
It is convenient to deal with the first three headings under ground one; and the failure to provide reasons under ground two.
Section 65A of the 1987 Act provides:
“65A Special provisions for psychological and psychiatric injury
(1) No compensation is payable under this Division in respect of permanent impairment that results from a secondary psychological injury.
(2) In assessing the degree of permanent impairment that results from a physical injury or primary psychological injury, no regard is to be had to any impairment or symptoms resulting from a secondary psychological injury
…”
The appellant submitted there was no legal, jurisdictional, or factual basis for the Medical Assessor to apportion the final WPI; and the only basis on which the impairment could be divided was if the Medical Assessor determined there was a novus actus interveniens.
The appellant included in this ground that it was not apparent why the impairment assessed by the Medical Assessor was not causally related to the primary psychological injury. The “failure to provide reasons” will be considered under ground two.
As the respondent submitted, the presence of both a primary and secondary psychological injury had been determined by Member Strachan. It was a matter for the Medical Assessor to determine the degree of permanent impairment resulting from the primary psychological injury.
As the respondent also submitted, in Kiely, Harrison AsJ said at [95] and [96]:
“…s 65A of the Workers Compensation Act … requires a distinction to be drawn between primary psychological injury and secondary psychological injury. Under s65A(1), no compensation is payable for permanent impairment that results from a secondary psychological injury. When an AMS (or Appeal Panel) assesses the degree of permanent impairment resulting from a primary psychological injury, no regard can be had to any impairment or symptoms resulting from a secondary psychological injury in accordance with s 65A(2).
The statutory scheme comprising of the WIM Act and the Workers Compensation Act creates a two-step approach in assessing the degree of WPI for a psychological injury. The assessor must first calculate the entire degree of psychological injury in line with the PIRS categories. The secondary psychological injury must then be assessed and deducted in accordance with s65A of the Workers Compensation Act, leaving the primary psychological injury remaining.” (Emphasis added).
The Appeal Panel agrees with the respondent’s submission, that, once Member Strachan had determined the appellant suffered from a secondary psychological injury, the Medical Assessor was required to consider whether the secondary psychological injury was in any way contributing to the impairment. If he found it did so contribute, then, in accordance with s 65A(2), he was obliged to disregard the extent of the impairment that he considered was attributable to the secondary psychological injury.
In Matheson v Baptistcare NSW & ACT [2025] NSWSC 213, Basten AJ said, at [50]:
“As can be seen from s 65A(2), impairment resulting from a secondary psychological injury is not so much a basis for a deduction as a matter to be disregarded in assessing the permanent impairment resulting from the primary psychological injury. One consequence of this approach is that both must be assessed on the correct basis, namely by application of the Guidelines.”
Basten AJ went on to say, at [55]:
“In stating that ‘no regard is to be had to any impairment or symptoms resulting from a secondary psychological injury’, s 65A(2) is badly worded: it does not require the medical assessor to have no regard to such impairment or symptoms; on the contrary, they are to be identified so as to exclude them from the assessment process. That exercise must be undertaken in conjunction with the assessment of the degree of permanent impairment attributable to the primary psychological injury the subject of the claim. Thus, a secondary psychological injury is to be identified and then disregarded in calculating the degree of permanent impairment arising from the injury the subject of the claim.” (Emphasis in original).
It is evident on the face of the MAC that the Medical Assessor considered that both the primary and secondary psychological injuries contributed to the appellant’s impairment. Therefore, the Medical Assessor was required by the legislation to identify the impairment that resulted from the secondary psychological injury, and disregard it in assessing the impairment that resulted from the injury that was the subject of the claim. That is the “legal, jurisdictional, or factual” basis on which the Medical Assessor apportioned the appellant’s final impairment. The Medical Assessor would have erred had he failed to carry out this exercise.
Ground one fails.
Ground two
The appellant submitted the Medical Assessor failed to give adequate reasons why the appellant’s impairment was not causally related to the primary psychological injury; and without reasons, the appellant did not know why the Medical Assessor reached his conclusions.
It is evident from the reasoning of the High Court of Australia in Wingfoot that it is only necessary for the MAC to explain the actual path of reasoning of the Medical Assessor in sufficient detail to enable a court or an appeal panel to determine whether there is an error in its findings.
In Wingfoot, it was said that:
“The function of a medical panel is neither arbitral nor adjudicative: it is neither to choose between competing arguments, nor to opine on the correctness of other opinions on that medical question. The function is in every case to form and give its own opinion on the medical question referred to it by applying its own medical experience and its own medical expertise.”
The reasoning in Wingfoot has been applied to medical assessments under the New South Wales workers compensation legislation, for example in El Masri v Woolworths Ltd [2014] NSWSC 1344.
As canvassed above, Wingfoot instructs that in reaching conclusions, it is only necessary for the Medical Assessor to demonstrate the actual path of his reasoning.
The Medical Panel has determined that the path by which the Medical Assessor in this case reached the conclusion that 60% of the appellant’s impairment resulted from the primary psychological injury, and 40% of the appellant’s impairment resulted from the secondary psychological injury, is insufficient for the Panel to determine whether there is an error in the Medical Assessor’s findings.
The Medical Assessor has not explained why “[T]he secondary major depressive disorder, while contributory, does not factor into the final impairment rating under assessment guidelines…”
The Medical Assessor has stated that “Given that PTSD accounts for 60% of his impairment…the final WPI calculation is adjusted to 11%, based solely on the primary psychiatric injury.”
There is no explanation of how the Medical Assessor determined that 60% of the appellant’s impairment was caused by post-traumatic stress disorder. Once again, the actual path of his reasoning is not demonstrated.
This is in contrast with the opinion of Dr Virk, who is the only other practitioner to have considered the degree of impairment that was attributable to primary psychological injury and secondary psychological injury.
Dr Virk explained his opinion by recording how the appellant’s symptoms contributed to his impairment in each of the various Psychiatric Impairment Rating Scale (PIRS) categories. Dr Virk’s path of reasoning was demonstrated.
Ground two succeeds.
Medical Assessor Douglas Andrews of the Medical Panel was requested to undertake a re-examination of the appellant. Medical Assessor Andrews undertook the examination and reported as follows:
“PERSONAL INJURY COMMISSION
APPEAL AGAINST MEDICAL ASSESSMENT
REPORT OF THE EXAMINATION BY MEDICAL ASSESSOR MEMBER OF THE APPEAL PANEL
Matter Number: M1-W27094/24
Appellant: Shariff Shahin
Respondent: Plaspro Enterprises Pty Ltd
Date of Determination: 16 July 2025
Examination Conducted By: Douglas Andrews
Date of Examination: 16 July 2025
The worker’s medical history, where it differs from previous records.
Mr Shahin is a 43-year-old man, married to Diana. They have four children, aged 6, 9, 11 and 14. Diana is now the breadwinner, running a cleaning business.
He commenced work with Plaspro as a night shift supervisor in October 2021. At 1 AM on 23 November 2021, a blow moulding machine shut down and needed to be reset. This machine lacked a safety switch, and when Mr Shahin opened the machine and put his hand into it, his left forearm was punctured by a rod. He was working with two young employees, one of whom helped him with bandaging the arm. Mr Shahin felt ‘more or less on his own’ and, despite severe pain, drove himself to Campbelltown Hospital. He was kept overnight and released at about 10 AM the next day.
At his employer’s request, he returned to work that evening but was unable to stay. He took about one week off work before returning. Shortly after, he developed a staphylococcus infection in his wound, requiring further treatment.
When he returned to work, he found that ‘everything had changed.’ He was still in pain and needed to change dressings daily. He felt unsupported. He said, ‘I felt no one wanted to help, no one asked about it; I couldn’t do my job properly.’ He felt isolated and started experiencing panic, including anxiety-driven chest pain. He sought support from a colleague, the day supervisor, who eventually stopped talking to him. He asked Mr Shahin not to tell his boss that they were speaking.
Mr Shahin’s emotional problems started immediately following the accident. More than 4 years have passed, and he now feels ‘stuck’; he feels there has been no improvement in his condition or functional ability.
2. Additional history since the original Medical Assessment Certificate was performed.
Mr Shahin was assessed by MA Ron Gill on 26 February 2025, who found a primary PTSD and a secondary major depressive disorder with anxious distress. Dr Gill determined a 19% WPI, attributing 60% of this to the primary condition, therefore arriving at a final 11% WPI. Due to the irregular and unclear methodology used, the appeal panel deemed it necessary to re-examine all six PIRS categories.
Mr Shahin had no history of mental health problems before the industrial accident.
General health:
Mr Shahin has obstructive sleep apnoea and has been recommended to use CPAP, but has not been able to afford to do so.
Early in 2025, he had acute appendicitis, leading to an appendicectomy and repair of an umbilical hernia.
He smokes 20 cigarettes a day, up from about five daily when he started work with Plaspro. He does not drink alcohol.
He has gained 20 kg since leaving work. At 130 kg and 170 cm, his BMI is 45.0, in the morbidly obese range. He had a single dose of semaglutide (Ozempic) but didn’t continue with it.
His injury causes persistent pain in his left forearm and hand. He occasionally uses paracetamol for this. He experiences increased pain and shooting pains when performing some physical tasks. Mr Shahin feels that this would limit him vocationally. He is a cement renderer by trade, but believes he would be unable to manage in this role.
Current treatment:
Mr Shahin is cared for by his general practitioner, Dr Qian Wang, and a psychologist, Ms Viviana Lee. He is seeking a new general practitioner because Dr Wang is only available on Saturdays. He has never sought treatment from a psychiatrist. He stated that Dr Wang suggested that he would write a referral if Mr Shahin were able to find a psychiatrist himself.
He sees Ms Lee every 2 weeks and has worked with cognitive behavioural therapy, exposure, dearousal strategies and psychoeducation.
He had a one-month trial of sertraline in 2024 but found it caused unacceptable side effects, including sweating and increased nightmares. He has not wanted other trials of medication but would consider this under the supervision of a psychiatrist.
Symptoms:
Mr Shahin has prominent anxiety with somatic symptoms such as chest pain and twitches. He avoids situations that might increase his anxiety and has limited his activities as a result.
He often has a low mood, without diurnal variation.
He is bothered by intrusive thoughts about the accident and his subsequent treatment in the workplace.
He has subjective problems with concentration, attention and memory. His wife has commented on this and now discourages him from driving because she considers him unsafe.
He has had thoughts of suicide but said, ‘I believe I wouldn’t ever act on these.’
He described his sleep as ‘terrible’ and now sleeps on the couch. He falls asleep easily, even during the day, but has middle insomnia and is disturbed by nightmares.
He is eating a good diet, has an intact appetite and has gained weight.
His libido is ‘pretty bad to be honest.’
Mental state examination:
I interviewed Mr Shahin alone for 90 minutes in his home via an audiovisual link. The link was adequate to do a comprehensive assessment.
He presented as an overweight man, casually attired in a T-shirt. He had a medium beard and a shaved head.
He was cooperative during the interview, but often digressed off topic. My impression was that he was open and honest in relating his history.
He spoke with normal prosody. There is no evidence of any disorder of thought form or perception.
He acknowledged thoughts of suicide.
There were no significant problems with memory, but he tended to get off track and occasionally needed redirection.
At the end of the interview, he agreed that we had covered everything necessary and restated his distress. He said, ‘I have never come across a situation like the one I am in.’ He reiterated that he had worked hard for 25 years and expressed his regret for leaving his previous job to take the one at Plaspro. He told me that he was worried about his future.
Activities of daily living:
Mr Shahin lives in a freestanding house in Eagle Vale with his wife and four children. Because he sleeps on the couch, he gets up when the children do. The children are self-sufficient, and he does not assist them in getting ready for school or other activities.
He has coffee and will spend some time in his backyard. During the morning, he often watches a movie on Netflix but struggles to follow the narrative and frequently falls asleep. His obstructive sleep apnoea contributes to his daytime fatigue.
He does minimal housework but may occasionally clean the dishes or help with the housework. He mentioned that he recently weeded the garden.
He had previously been the primary breadwinner, and his wife had been responsible for most household chores, including meal preparation. Although Mr Shahin is no longer working, she has maintained these responsibilities. She also does the shopping, a chore that he used to do.
He showers and wears clean clothes twice or three times a week, after being prompted by his wife.
Before becoming unwell, he had a hobby of building cars. He enjoyed fishing and frequent family trips to the south coast, where his extended family have properties. He was involved in his children’s sporting activities, rugby and netball. He assisted with training on his son's rugby team. He had a group of four friends, and they had regular get-togethers, such as barbecues at each other’s houses.
Mr Shahin has a large extended family. His parents are alive; he has seven siblings and many nephews and nieces. They have regular family celebrations.
Mr Shahin has given up most of these activities. He no longer builds cars, participates in his children’s sporting activities, goes fishing or travels to the South Coast. Although he keeps in touch with friends, they no longer have get-togethers.
They have extended family get-togethers, often at his house, about once a month. Last weekend, a large gathering took place to celebrate the 14th birthday of his son. His siblings visit so that the cousins can play together.
He no longer goes to restaurants or cafés. He has no other community involvement.
Mr Shahin no longer feels safe driving. He has been inattentive, and his wife has expressed concern about his driving competence. He has let the registration on the second family car lapse because his wife usually drives him now. He last drove by himself two months ago to visit his doctor, a venue located about 500 metres from his house. His wife now takes time off work to drive him to appointments. He has not left the local area in the last 2 years.
He described strain in his relationship with Diana and a loss of physical intimacy. However, their relationship remains intact; there has been no discussion of separation and no domestic violence. His relationships with his extended family are also intact. He has not lost friends but has less contact with them.
He has enjoyed reading historical and cultural books, but can no longer persist for more than about 5 minutes. His psychologist has suggested using podcasts, but he has not taken this suggestion up. He has no ongoing hobbies or projects.
He had worked as a packager for Darrell Lea for 4 or 5 months in the first part of 2024. Nominally, he worked 3 days a week, 8 hours a day. He said they were understanding of his situation, ‘They were good to me, I opened up to them.’ However, by August, he felt unable to continue. He had irregular attendance because of his anxiety
3. Findings on clinical examination
Diagnoses:
My diagnoses are based on criteria outlined in the DSM-5. They concur with the diagnoses of the MA.
· post-traumatic stress disorder
· major depressive disorder with anxious distress
Mr Shahin suffered an industrial accident in the middle of the night with little practical support, requiring that he take himself to the hospital. He feared that he had suffered a serious injury. He has ongoing intrusion symptoms and recurring distressing dreams. He has significant avoidant behaviours aimed at reducing distressing memories and external reminders of his injury. He has negative alterations in cognition and mood with a markedly diminished interest and participation in significant activities. He has reduced ability to experience positive emotions. He has problems with concentration and significant sleep disturbance. His symptoms have persisted for more than one month. This supports a diagnosis of PTSD.
He described all nine criteria for major depressive disorder. His anxiety is prominent, warranting an anxious distress descriptor.
Primary and secondary psychological disorders:
In his certificate of determination, member Mitchell Strachan said
‘2. The applicant sustained a primary psychological injury in the course of his employment with the respondent on 23 November 2021.
3. The applicant also sustained a secondary psychological injury consequent on physical injuries sustained on 23 November 2021.’
Mr Shahin’s impairment is such that all of it can be attributed to his primary injury. To put this another way, if the secondary psychological injury had not occurred, his impairment would now be the same.
Mr Shahin’s PTSD can be solely attributed to the injury. The major depressive disorder arose because of the poor support he received in his employment, and as a consequence of the physical injury and pain. There is a significant overlap in the symptoms of the primary and secondary conditions. They cannot be disentangled.
For these reasons, the entirety of Mr Shahin’s current impairment should be attributed to his primary injury.
Table 11.8: PIRS Rating Form
| Name | Shariff Shahin | Claim reference number | W27094/24 |
| DOB | X X XXXX (omitted) | Age at time of injury | 39 |
| Date of Injury | 23 November 2021 | Occupation at time of injury | Night Supervisor |
| Date of Assessment | 16 July 2025 | Marital Status before injury | Married |
| Psychiatric diagnoses | PTSD |
| major depressive disorder with anxious distress | |
| Psychiatric treatment | Psychotherapy |
| Is impairment permanent? | Yes |
| PIRS Category | Class | Reason for Decision |
| Self-care and personal hygiene | 3 | Mr Shahin does minimal housework, leaving most chores for his wife. He does not prepare meals or do the shopping. He showers 2 or 3 times a week after being prompted by his wife. He has increased his cigarette use and has gained 20 kg in weight, posing a risk to his health. He relies on his wife for support and encouragement with hygiene. |
| Social and recreational activities | 2 | He has given up previously enjoyed activities such as building cars, fishing and participating in his children’s sporting activities. He no longer has barbecues or events with his friends. However, he has regular (approximately monthly) family get-togethers with extended family, usually at his house. |
| Travel | 3 | He has significant anxiety about driving, fearing an accident because of inattention. He now rarely goes anywhere without his wife driving him. He has let the registration on his personal car lapse. He infrequently drives himself to his doctor, a distance of half a kilometre, but he avoids this whenever possible. Usually, his wife takes time off work to drive to appointments. He has not left the local area for 2 years. |
| Social functioning | 2 | There is strain in his marriage, but no separations or domestic violence. His children have begun to comment on his avoidant withdrawal, but their relationship remains intact. He has reasonable relationships with his extended family. Although he has less contact with friends, there have been no falling outs. |
| Concentration, persistence and pace | 3 | Mr Shahin has subjective problems with concentration, persistence, and pace. He can read for only about 5 minutes before losing attention. He cannot watch a full movie without losing attention or falling asleep. He attributes his limitations and driving difficulties to poor concentration. He showed some lack of focus during my 90-minute interview. |
| Employability | 4 | Mr Shahin is not working in any capacity. He returned to work in 2024, working nominally 24 hours a week. However, he struggled in his role and took frequent sick leave. He could likely function in an undemanding role, less than 20 hours a fortnight and with erratic attendance. |
Score
| 2 | 2 | 3 | 3 | 3 | 4 |
Median Class
| = 3 |
Aggregate Score Impairment 17 Total 19%
There is no pre-existing condition.
Mr Shahin has not shown any improvement symptomatically or functionally since leaving work. No adjustment for treatment effect is warranted.
4. Results of any additional investigations since the original Medical Assessment Certificate
No additional investigations have been done.”
The Medical Panel agrees with the assessment of Medical Assessor Andrews. He has diagnosed both the primary and secondary psychiatric injuries and provided reasons for his ascertainment of the impairment can be attributable to the symptoms and impairment of the primary injury. There is no additional impact or effect on the current Whole Person Impairment arising solely from the secondary psychiatric injury that requires disregarding.
For these reasons, the Appeal Panel has determined that the MAC issued on
26 February 2025 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
WORKERS COMPENSATION DIVISION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter number: | W27094/24 |
Applicant: | Shariff Shahin |
Respondent: | Plaspro Enterprises Pty Ltd |
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 Ronald Gill and issues this new Medical Assessment Certificate as to the matters set out in the Table below:
Table 2 – Assessment in accordance with AMA5 and NSW workers compensation guidelines for the evaluation of permanent impairment for injuries received after 1 January 2022
This Certificate is issued pursuant to section 325 of the Workplace Injury Management and Workers Compensation Act 1998.
Matter Number: W27094/24
Applicant: Shariff Shahin
| 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 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) |
| Psychiatric | 23 November 2021 | Chap 11, p 54-60 | N/A | 19% | Nil | 19% |
| Total % WPI (the Combined Table values of all sub-totals) | 19% | |||||
The above assessment is made in accordance with the SIRA NSW Guidelines for the Evaluation of Permanent Impairment for injuries received after 1 January 2002.
0
17
0