Szilagyi v Blacktown City Council

DETERMINATION OF APPEAL PANEL
CITATION:	Szilagyi v Blacktown City Council [2025] NSWPICMP 230
APPELLANT:	Ildiko Szilagyi
RESPONDENT:	Blacktown City Council
APPEAL PANEL
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	John Lam-Po-Tang
MEDICAL ASSESSOR:	Douglas Andrews
DATE OF DECISION:	2 April 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether Medical Assessor (MA) erred in whole person impairment (WPI) assessment of four of the psychiatric impairment rating scale (PIRS) categories namely self-care and personal hygiene, travel, concentration, persistence and pace, and employability; Held – insufficient history from MA; re-examination required; errors in some categories; MAC revoked; new certificate issued.

BACKGROUND TO THE APPLICATION TO APPEAL

On 22 October 2024 Ildiko Szilagyi (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ankur Gupta, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on
15 October 2024.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· the assessment was made on the basis of incorrect criteria, and
· the MAC contains a demonstrable error.
The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the ground(s) of appeal on which the appeal is made.
Rule 128 of the Personal Injury Commission Rules 2021 (the PIC Rules) and Procedural Direction PIC7 - Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes set out the practice and procedure in relation to the medical appeal process under s 328 of the 1998 Act. An Appeal Panel determines its own procedures in accordance with r 128(1) of the PIC Rules.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

PRELIMINARY REVIEW

The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
As a result of that preliminary review, the Appeal Panel determined that the worker should undergo a further medical examination because we concluded that the Medical Assessor erred in his whole person impairment (WPI) assessment of some of the psychiatric impairment rating scale (PIRS) categories.

EVIDENCE

Documentary evidence

The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment and has taken them into account in making this determination.

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the Medical Assessor erred in in his WPI assessment of four of the PIRS categories, namely Self-care and personal hygiene, Travel, Concentration, persistence and pace (cpp) and Employability.
In reply, the respondent submits that no errors were made.

FINDINGS AND REASONS

The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made.
In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
The appellant was referred to the Medical Assessor for assessment of WPI in respect of a primary psychological/psychiatric injury occurring on a deemed date of injury of
18 December 2023.
The Medical Assessor obtained a history of the circumstances of the injury as follows:
“Ms Szilagyi was working as a team leader for animal welfare on a full-time basis for Blacktown Council. She supervised thirteen staff members and says that euthanising animals was part of her job. She says that includes selecting animals who need euthanasia to make space for new animals. This was a daily routine for her. She says that she looked after them during the day but then had to select thirty to forty of them for euthanasia. She also assisted in euthanising the animals, which added to her trauma. She says that during the COVID lockdown, they could not take new animals, and euthanasia stopped. She says that it was then that it dawned on her that it was impacting her mental health. She says she stopped working on April or May 22 and has not returned since. She has not resigned from her job either.”
Present treatment was noted as follows:
“Ms Szilagyi is currently on Melatonin and Fluoxetine 20mg. She says she has been on this combination "for a long time". She says that she started treatment for mental health two years ago under the care of her psychiatrist and has been tried on several other tablets before this combination. She has not been admitted to a psychiatric facility and has not been treated with neurostimulation. She has been seeing a psychologist for more than two years and has had fortnightly sessions since. She does not feel that the treatment has been helpful for her.”
Present symptoms were described as:
“Ms Szilagyi says that she cries a lot and feels depressed all the time. She says that no one wants to do anything with her because of this. She feels that people look at her and judge her when she goes out. She says she feels anxious when going out but not at home. She says that she has experienced panic attacks, but not for a while, as she avoids going out.
She says that her place of work moved to a new place after she stopped working. She says she drives past the old facility and gets ‘reminded every time.’ She states that this is not a flashback and describes it as a thought. She does not sleep well and experiences nightmares regularly. She says that she feels exhausted most of the time. She is hypervigilant and jumpy. She easily gets angry and can be irritable with her pet dogs. She says that she has become overprotective of her pets and her children. She worries about their safety all the time. She feels that her confidence and self-esteem are dramatically reduced.’ She does not think that she is able to lead a team anymore.
She denies misusing alcohol and drugs. She says that she feels uncertain about her future. She says she fears the council and does not think she can work for them. She says she is reminded of the culture whenever she thinks about the Council. She has not thought about re-training or work opportunities. She says that she is motivated to get better and return to work. She has had suicidal thoughts but denies any current planning. She has not attempted suicide either.”
The Medical Assessor then turned to consider the impact of the injury on her social activities and activities of daily living (ADL’s) and said:
“Ms Szilagyi lives with her two sons and gets along well with them. She is also close to her third son, who visits her sometimes. She says she cooks sometimes but not as much as she used to. She eats takeaways or the food that her sons cook. She eats regularly but has put weight on since the injury. She says that she has not cleaned her room for a while. She misses showering several times per week. She only cleans her teeth when she showers. She looks after her three dogs well. She does not leave the house much but can walk to her local shops. She says that she takes her dogs for a walk. She can drive to the shops for bigger shops. She says that she can drive to her local places and does not have GPS to go to new places. She did drive her car to a mechanic recently. She could use public transport if needed. She says that she finds it difficult to focus on things. She usually takes her medications regularly and manages her finances independently. She does not keep in touch with her friends and says she does not socialise. She spends her time with her dogs. She watches TV sometimes but says that she gets fidgety. She can watch an episode for forty five minutes. She says that her memory is ‘not that good.’ She says that she has become forgetful.
She was in a relationship for seven years, but it ended two years ago. She says that her partner was unable to deal with her mental state, which led to the breakdown.
She says that she is really scared of returning to her pre-injury role.”
The Medical Assessor did not set out his findings on examination.
The Medical Assessor diagnosed “Post Traumatic Stress Disorder and Major Depressive Disorder.”
The Medical Assessor assessed 13% WPI.
He then set out a summary of all the medical and other evidence he had before him and said:
“Dr Alyosha Jacobson provided an independent medical examination report dated 03 December 22. She opined that Ms Szilagyi was suffering from severe major depressive disorder and needed treatment under the care of a psychiatrist as an inpatient. She noted that Ms Szilagyi's partner of nine years had left because of her mental state, and she was unable to work in any capacity.
Dr Jacobson provided a supplementary report dated 07 June 23, advising that
Ms Szilagyi needed to be treated with adequate medication as soon as possible and was unfit for any kind of employment.
Psychiatrist Dr Glen Smith provided an independent medical examination report dated 02 November 23. He noted that the treating psychiatrist, Dr Padmini Howpage, provided a report dated 21 November 22 in which she had advised that the diagnosis was major depressive disorder and alcohol use disorder, but in a follow-up report dated 27 March 23, advised that there was no alcohol use disorder and that Ms Szilagyi was suffering from major depressive disorder only. In a follow-up report dated 05 July 23, Dr Howpage had described a motor vehicle accident that Ms Szilagyi had sustained on 05 May 23 where she was driving a car and a truck hit her on the driver's side. She had denied any posttraumatic stress symptoms, but her mental state had not improved with treatment. Dr Smith advised that the diagnosis was post-traumatic stress disorder and major depressive disorder with anxious distress. He advised that Ms Szilagyi was unfit for employment and had sustained a 24% impairment of the whole person.
Patient health summary from Orana medical practice, printed on 16 August 23…
Psychiatrist Dr Inglis Synnott provided an independent medical examination report dated 05 May 22. He advised that Ms Szilagyi was suffering from a major depressive disorder related to her workplace. He advised that she was capable of participating in her usual employment with the restriction of not being involved in euthanasia.
Psychiatrist Dr Padmini Howpage provided a letter dated 21 November 22 in her capacity as treating psychiatrist. She noted that Ms Szilagyi was consuming more than 30 g of alcohol daily as a coping mechanism. She advised that Ms Szilagyi was suffering from a major depressive disorder. Dr Howpage's next letter dated 05 April 23. She advised that Ms Szilagyi was not improving in her mental state despite being concordant with medication. She also stated that Ms Szilagyi had been abstinent from alcohol.
Psychiatrist Dr John Roberts provided an independent medical examination report dated 09 May 24. He noted that although Ms Szilagyi had been diagnosed with post-traumatic stress disorder and major depressive disorder, there were inconsistencies in her presentation and history. He advised that she was not avoiding taking her dog for walks, which, in his view, was inconsistent with the avoidance criteria for diagnosing posttraumatic stress disorder. He noted that Ms Szilagyi had significant tremor involving the head, hands and lower limbs, which could not be linked to any condition. He also noted that she had changed her stance regarding problems with memory and concentration. He advised that a conclusive diagnosis of any psychiatric condition could not be made and that she needed further investigation. Dr Roberts provided a supplementary report dated 07 June 24, where he was asked to provide a permanent impairment rating notwithstanding his comments regarding diagnosis. He advised that Ms Szilagyi was suffering from a 5% impairment of the whole person.”

The appellant’s submissions

These are as follows:
(a)    Medical Assessor Gupta misinterpreted and/or failed to adequately acknowledge the category of self-care. In particular, by reference to the reasons enunciated in Table 11.8, the doctor acknowledges that the appellant does not care for her personal hygiene but does eat regularly looks after her three dogs.
(b)    The reference to her three dogs is irrelevant to the question of selfcare. The Medical Assessor has patently misinterpreted this category as encompassing other than personal care. In particular it is of no relevance that she may continue to care for her dogs.
(c)    Additionally, it is submitted that the body of his report particularly at page 3 “social activities/ADL”, the Medical Assessor acknowledges what are very significant matters pertaining to a deficit in self-care, in particular, including failing to clean her room and missing showering several times per week, cleaning her teeth only when she showers and cooking less than she used to and consequently eating takeaway food. It is submitted that the categorisation of “mild impairment” is not consistent with, what is submitted should be at the very least, moderate impairment for the reason of her deficits in cooking, house cleaning and to ensure an acceptable level of hygiene.
(d)    Medical Assessor Gupta concludes that there is nil impairment with respect to travel. It is submitted that this is entirely inconsistent with the observations that he has made in the body of his report. In particular, in his report he notes in section 4 (page 3) “Social Activities/ADL” that the Appellant does not leave her house much. He indicates that she does travel to local places but does not have a GPS to go to new places. It is submitted that the Medical Assessor failed to acknowledge or reconcile the relationship between reluctance of the appellant to leave her house and her propensity for not going to “new places". It does not address this issue by way of an investigation and in particular does not address as to the question of why she does not travel to "new places” other than to note that she does not have a GPS. It is submitted that this shortcoming is a demonstrative failure in the reasoning process.
(e)    The Medical Assessor fails to reconcile the opinion of Dr Smith in his report at page 29 of the ARD in which the doctor notes that the appellant is unable to drive in the local area and subsequently at page 34 of the ARD, classifies the appellant as suffering a Class 2 level of impairment with respect to travel.
(f)    Medical Assessor Gupta also failed to acknowledge in any way the matters detailed in the appellant's supplementary statement, in particular at page 4 of the ARD in which she describes "I feel comfortable in going to locations in my immediate vicinity because I'm familiar with these locations” and furthermore, additionally, at paragraph 7 in which she states: “I feel very nervous if I'm required to drive a motor vehicle outside my local area. Additionally because I’m forced on the public transport to go to see my GP, I find this extremely unnerving. However, I feel as though I have to do it. If I’m travelling in this way, I only do it when it is absolutely essential."
(g)    There is a failure on the part of Medical Assessor Gupta to properly interrogate the appellant in relation to this question and at the very least, acknowledge and address the matters contained within the appellant's statement which do provide the explanation.
(h)    Medical Assessor Gupta concludes that the appellant’s deficits with respect to concentration, persistence and pace fall within Class 2 (mild impairment) on the basis that despite memory and concentration difficulties, she can watch TV up to 45 minutes and apparently manage her finances independently. However, nowhere in the report is there an acknowledgement of profound difficulties that the appellant encounters on a day-today basis and no attempt has been identified in the assessment of Medical Assessor Gupta that indicates any attempt to interrogate the appellant to obtain a detailed and adequate analysis in relation to this category. In particular, Dr Smith in his report describes the appellant as not being able to read, “the TV is on most of the time to keep me company". Furthermore, in the Appellant's supplementary statement at page 4 of the ARD commencing at paragraph 2 where she describes what are profound memory and concentration problems including planning things and then forgetting what she was doing halfway through. Additionally, she misses appointments and becomes flustered and "hopelessly confused”. Additionally, at paragraph 5, consistent with the description provided to Dr Smith the TV is “… turned on as a kind of background noise. However, I'm not really concentrating on what is being said. I find it very difficult watching TV programs and following the plot, for example, in a movie.”
(i)    Medical Assessor Gupta classifies the appellant as suffering from moderate impairment with respect to employability. In particular, he justifies his opinion by assessing the Appellant as having a capacity to undertake 15 hours of work per week in a less stressful environment. However, nowhere in his report does he provide any adequate justification for drawing this conclusion. He notes in the body of his report that the Appellant has a fear of returning to work at the Council and that she is motivated to get better and return to work. However he does not address the question at all in the body of his report as to whether or not she has a capacity to engage in any employment in the open labour market. There is no analysis whatsoever in relation to this question. It is submitted that the conclusion that he has drawn that she has a capacity to work 15 hours a week in an alternative role has no basis whatsoever and is contrary to the conclusions that he has drawn in other parts of his report and with the statement of evidence and the report of Dr Smith.
(j)    It is noted that Medical Assessor Gupta acknowledges the significant difficulties that the appellant has with respect to memory and concentration. Additionally, he acknowledges the fact that she has become withdrawn from social relationships and has difficulty leaving the house. It is submitted that all of these matters are inconsistent with the appellant having a capacity to engage in any work at all in the labour market. It is submitted that in order to hold a position in the open labour market, it would be necessary to remain focused and to have the capacity to interact with workmates and members of the public. The evidence demonstrably indicates that she does not have such a capacity.
(k)    The appellant should properly have been classified as falling within Class 5 – totally impaired as to employment.
The appellant added: “it is reasonable and appropriate and in the interests of justice for a member of the Appeal Panel to conduct a further examination of the Appellant”.

Discussion

To begin with, we agreed that a re-examination was appropriate in this case given the lack of detail provide by the Medical Assessor with regards to his assessments.
Medical Assessor John Lam-Po-Tang of the Panel re-examined Ms Szilagyi and reported to us as follows:
“1.Additional history since the original Medical Assessment Certificate was performed
Ms Szilagyi was initially assessed by Dr Gupta, consultant psychiatrist, for a Medical Assessment Certificate (MAC) on 2 October 2024.
At Christmas 2024, Ms Szilagyi and her family hosted her brother for a meal: ‘My brother brought most of the stuff. I think I made potatoes or rice or something’. She said her son who lives out of home also came to the meal. She advised she may have had a little alcohol to drink at this time, but was unable to recall any specific details.
In January 2025, Ms Szilagyi was invited by a friend to go out, but she declined to do so. She advised she has consistently refused such invitations by friends to socialise.
Ms Szilagyi consumes 2 - 3 cups of tea per day, and 2 - 3 cups of coffee. She consumes alcohol less than once a month, consuming modest amounts on these occasions. She advised she drank 2 small glasses of champagne on the night before the assessment, and had something to drink during the Xmas / New Year period. She reported no cigarettes, nicotine produce or illicit substances.
Ms Szilagyi reported no substantial change to her mental state or function since October 2024, nor any change to her treatment. She reported no significant change to her social situation or living arrangements over this time.
Ms Szilagyi advised she had had no new medical conditions diagnosed since the original MAC was performed. Similarly, she reported no new surgical conditions or procedures, or head or other injuries. She reported no changes to medications since October 2024.
Findings on clinical examination
Ms Szilagyi presented as a European woman of stated age, with dark brown hair and glasses, casually dressed. Some psychomotor agitation was noted intermittently, with Ms Szilagyi rocking back and forwards at times. She was co-operative with the interview.
Ms Szilagyi's speech was spontaneous, but hesitant, with frequent pauses prior to answering questions. Her proficiency in English was fluent; an accent was noted in passing. Her affect was predominantly anxious, and restricted in range. At times she was tearful; her affect was congruent with subject matter. Her mood was subjectively depressed and anxious. Her thought form was logical and sequential, and there was no formal thought disorder. Her responses varied in the degree of elaboration and detail - no consistent poverty of ideation was noted. No delusional thought content was expressed or observed.
Ms Szilagyi demonstrated difficulty recalling some details of her history, for example, she looked up her mobile phone number when asked for it, and could not recall her medication dose. She was not drowsy, and no fluctuation in level of consciousness was noted. She was able to persist with the interview, which lasted 75 minutes.
Current psychiatric symptoms
Ms Szilagyi described her mood as depressed and anxious at the time of the evaluation, rating it at 2/10 on a 10-point scale, where 0/10 represents a very depressed mood, and 10/10 a very cheerful mood. That said, she commented, ‘Yesterday, I was happy’. She denied any diurnal mood variation. She reported some irritability, for example, towards her dogs.
Ms Szilagyi reported being able to enjoy her food. She estimated her weight had increased 15 kg since ceasing work, and thought it was still increasing. She reported anergia: ‘I'm tired most of the time’. She reported variable motivation. She reported retiring to bed at different times, however, reported consistent difficulty in falling asleep, then falling asleep for 1 - 2 hours before waking up. She reported distressing dreams, but was unable to estimate a frequency thereof. The most recent dream she could recall was being bitten by a snake; she added, ‘I have dreams about work’.
Recurrent thoughts of work were reported by Ms Szilagyi, and she recalled, ‘We worked there like a second family because I worked there 7 days’. She reported catastrophising about safety, including her own and that of her sons. She reported increased anxiety when her sons were out of the family home. She did not report attempts to suppress distressing thoughts about her work. She did not report hypervigilance, and whilst she reported periods of becoming anxious, she did not report an extreme or exaggerated startle response. She did not report intrusive re-living experiences of her work.
Ms Szilagyi reported persistent avoidance symptoms and situational anxiety. She advised that when she drives to her general practitioner, she drives past her former workplace. She explained the building has been pulled down, but still feels very emotional. She reported, ‘It just brings back memories’.
Ms Szilagyi commented, ‘I feel broken in my heart, in my soul - I wasn't like this before’.
Current level of functioning
Ms Szilagyi advised she attends to bathing daily: ‘I try to do it every day’. She was not able to estimate how frequently she brushes her teeth. She does not change into fresh clothes every day. She washes her hair ‘maybe once a week’. She advised she has not had her hair cut for some years. She does not require any assistance from her sons or others to attend to dental hygiene.
Two of Ms Szilagyi's 3 sons live with her. She advised they both work, and when they are at work, she remains at home alone. She advised that they rarely spend time away from home, such as weekends away. Ms Szilagyi is currently single, and commented that her last relationship ended in 2022 after 7 or 8 years: ‘He said I was very moody and he couldn't adjust’.
Ms Szilagyi could not estimate how many meals or snacks she has in a typical day. She advised she cooked at least once a week. She cooked dinner on the night before the assessment: ‘I made mashed potatoes and a stew. The boys enjoyed it. Also [I] made a nice pudding’. Other meals are cooked by one of her sons, and sometimes the household buys takeaway food.
Around the home, Ms Szilagyi does laundry once a week, and cleans the bathroom less frequently. She is able to do shopping, typically spending around 10 minutes when doing so, and can do this alone.
Ms Szilagyi advised she is able to leave home alone, but does so less frequently than in the past. She is able to drive herself alone, for example to local shops or to her doctor. Her son often drives her to various places. She is able to use public transport, such as a bus or train, alone, and has travelled to her doctor by this mode of transport. She has not travelled domestically for many years, and last travelled internationally in 2005.
Ms Szilagyi is able to manage her own finances, and can access her accounts using a phone application. She explained that most of her bills are paid via automatic debit. She has a smart phone; she is able to use her son's laptop. She advised she is able to send and receive emails.
For leisure, Ms Szilagyi advised she accesses YouTube ‘every day... [for] maybe a few hours’, watching ‘videos... whatever comes up’. She has a FaceBook account, and her son sends her messages via this platform. She said she accesses her FaceBook account to ‘check whatever comes up’, but does not post photos or comments. She advised she does not watch TV, programs via streaming services, listen to the radio, or listen to podcasts. She advised she doesn't read at all at present. She commented, ‘My TV is not working’ at present. She does not play any sport or exercise regularly. She has 3 pet dogs, and provides care for them. She takes her dogs for a walk ‘a few times a week [walking] maybe about 2 km, but it depends’.
Ms Szilagyi advised she rarely went to dinner with family, last doing so in August 2024. She advised she never went to coffee with family or friends.
Ms Szilagyi maintains relationships with her 3 sons, and sees the 2 with whom she lives on a frequent basis. She sees the son who lives out of home much less frequently. She maintains a relationship with her brother, who lives in Croydon Park, but they see each infrequently, in part due to his ill-health. She maintains regular contact with one friend, who calls her once a month, and they speak for around 10 minutes. Another female friend has invited her to go out, but Ms Szilagyi has refused. She occasionally receives messages from relatives overseas.
Ms Szilagyi reported subjectively impaired concentration and attention. When asked to provide an example of this, she paused, and replied, ‘I don't know’. On specific questioning, she confirmed she remembered how to cook a stew from memory, the night before the assessment. That said, she advised she had burnt dishes whilst cooking ‘a fair few times’. She commented she has begun to cook, but then gone to see her dogs, and forgotten she was still cooking.
She reported no accidents or near-misses whilst driving a car. She reported forgetting one medical appointment, but her psychologist calls her at the time of the scheduled appointment. She uses a list when shopping, written by one of her sons.
Ms Szilagyi is not working in any paid or unpaid capacity; she is not undertaking any formal or informal study. She advised she last worked around 2 years prior to the current evaluation. She expressed the belief she was still employed by the council.
Current treatment
Ms Szilagyi advised she was on the following medications:
fluoxetine 40 mg daily (unchanged from October 2024)
melatonin 2 mg nightly (unchanged from October 2024)
Ms Szilagyi consults the following clinicians:
Dr Gayathir Subendran, general practitioner: Ms Szilagyi consults Dr Subendran monthly, in person, for consultations of around 15 minutes. The focus of consultations is to complete workers' compensation documentation. Ms Szilagyi added, ‘She does ask me how I'm going’.
Ms Christina Dib, psychologist: Ms Szilagyi has phone-based fortnightly hour-long consultations. She has never met Ms Dib in person. Consultations focus on ‘what's happened in those last 2 weeks - we just talk’. She commented about Ms Dib, ‘She is so nice and understanding - I feel better when I talk to her’. That said, she did not report that this feeling was persistent or cumulative.
Ms Szilagyi is not currently consulting a psychiatrist, and has not done so since early 2024. She is not currently referred to a psychiatrist.
Summary
Ms Szilagyi is a 56 year old woman who has not worked in any capacity since May 2022.
Ms Szilagyi describes symptoms emerging in the context of her employment with Blacktown City Council, specifically, having to euthanise dogs that had been surrendered after the end of the Covid-19 lockdowns. She reported progressive deterioration in mental state and function from 2021 onwards.
The symptoms described by Ms Szilagyi are consistent with Major Depressive Disorder and an Adjustment Disorder with Mixed Anxiety and Depressed Mood, though symptoms that overlap with those of Posttraumatic Stress Disorder are present. It is noted that previously Ms Szilagyi has been diagnosed with Posttraumatic Stress Disorder. This diagnosis has not been made in the current evaluation, due to the nature of the precipitating events, which involve death of animals, rather than humans, and thus DSM-5 criterion A is not met.”
Medical Assessor Lam-Po-Tang made the following assessments:
“Self-care & Personal Hygiene:
This was rated as a Class 3 by Dr Gupta. Based on the history provided by
Ms Szilagyi, a Class 2 is the appropriate rating in the current assessment. It is noted that Ms Szilagyi lives with 2 of her sons, and has done so for many years. There was no evidence that she relied on her sons for assistance with personal hygiene, in particular, that she relied on them to prompt her to shower and change her clothes. It was further noted she spends most days per week at home alone whilst they are working. She is able to make meals for herself and her sons.
Travel:
This was rated as a Class 1 by Dr Gupta. Based on the history provided by
Ms Szilagyi, a Class 2 rating is appropriate. There is clear evidence of a mild impairment, however, she is able to leave her place of residence without a support person, but does so less frequently than usual, and within familiar locations.
Concentration, Persistence & Pace:
Ms Szilagyi reported subjective impairment in concentration, and provided several examples of this in her day-to-day life, including burning food and forgetting conversations. She could not recall her mobile phone number, and had to look it up. That said, she was able to make a stew from memory within days of the assessment, and was able to persist with the interview, which lasted 75 minutes. Dr Gupta rated this as a class 2, which implies Ms Szilagyi would be able to undertake a basic retraining course or a standard course at a slower place. Based on the examination, I did not think her capable of doing so. Concentration deficits would not have been obvious in a brief conversation, which would warrant a class 4. As such a class 3 rating was appropriate.
Employability:
Ms Szilagyi reported being able to care for her pet dogs and walk them several times per week, for up to 2 km walks. These would be considered transferrable skills, and as such as Class 4 would be applied in this case. This was rated as a class 3 by Dr Gupta.”
The Panel agrees with the assessments of Medical Assessor Lam-Po-Tang because of the considerable detail he elicited from the appellant as regards the contested PIRS categories.
This then means that the ratings are:
(a)    Self-care and personal hygiene – Class 2;
(b)    Social and recreational activities – Class 2;
(c)    Travel – Class 2;
(d)    Social functioning – Class 2;
(e)    Concentration, persistence and pace – Class 3, and
(f)    Employability - Class 4.
This then means that the aggregate scores are 2, 2, 2, 2, 3, and 4, a total of 16 with a median class value of 3 resulting in 17% WPI.
For these reasons, the Appeal Panel has determined that the MAC issued on
15 October 2024 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:	W25432/24
Applicant:	Ildiko Szilagyi
Respondent:	Blacktown City Council

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 Ankur Gupta and issues this new Medical Assessment Certificate as to the matters set out in the table below:

Table - whole person impairment (WPI)

Body Part or system

Date of Injury

Chapter, page and paragraph number in WorkCover Guides

Chapter, page, paragraph, figure and table numbers in AMA 5 Guides

% WPI

Proportion of permanent impairment due to pre-existing injury, abnormality or condition

Sub-total/s % WPI (after any deductions in column 6)

Psychological

18/12/2023

(deemed)

Chapter 11

Chapter 14

17%

Nil

17%

Total % WPI (the Combined Table values of all sub-totals)

17%

[2025] NSWPICMP 230

2 April 2025