Westpac Banking Corporation v Albertsen

DETERMINATION OF APPEAL PANEL
CITATION:	Westpac Banking Corporation v Albertsen [2025] NSWPICMP 790
APPELLANT:	Westpac Banking Corporation
RESPONDENT:	Susie Albertsen
APPEAL PANEL
MEMBER:	Marshal Douglas
MEDICAL ASSESSOR:	Graham Blom
MEDICAL ASSESSOR:	Michael Hong
DATE OF DECISION:	14 October 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether a report on surveillance the appellant had done of the respondent established the ground for appeal provided in section 327(3)(a); whether the ratings the Medical Assessor (MA) made for the respondent’s impairment in social and recreational activities and social functioning were based on a correct history; Held – the surveillance report was not additional relevant information and accordingly did not establish the ground for appeal provided in section 327(3)(a); the MA’s ratings of the respondent’s impairment in social and recreational activities and social functioning were not supported by the evidence; respondent re-examined; MAC revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 1 July 2025 Westpac Banking Corporation, the appellant, 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
3 June 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):
·        availability of additional relevant information (being additional information that was not available to, and that could not reasonably have been obtained by, the appellant before the medical assessment appealed against);
·        the assessment was made on the basis of incorrect criteria, and
·        the MAC contains a demonstrable error.
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).

RELEVANT FACTUAL BACKGROUND

The appellant employed Susie Albertsen, the respondent, as a business relationship manager, commencing on 11 November 2021. The respondent last worked for the appellant on 8 February 2023. Due to events on that occurred in her workplace between October 2022 and the respondent’s last day of work, the respondent suffered a psychological injury.
The respondent claimed compensation from the appellant for permanent impairment she said had resulted from her injury. She relied on a report her solicitors obtained from psychiatrist Dr Abdal Khan dated 24 April 2024, who advised within his report that he had assessed the degree of the respondent’s permanent impairment from her injury is 19% whole person impairment (WPI).
The appellant rejected her claim for compensation, leading to the respondent initiating proceedings in the Personal Injury Commission (Commission). A delegate of the President of the Commission issued a referral to the Medical Assessor on 6 January 2025 to assess the medical disputes between the parties arising from the respondent’s claim for compensation. The referral was subsequently amended on 8 January 2025 and again on 25 March 2025.
The Medical Assessor examined the respondent on 16 May 2025 to conduct his assessment and, as said above, issued the MAC in response to the referral on 3 June 2025. In that he certified that he assessed the degree of the respondent’s permanent impairment from her injury is 19% WPI. He made that assessment by reference to the criteria of Chapter 11 of the Guidelines, and specifically the psychiatric impairment rating scale (PIRS) detailed within paragraphs 11.11 and 11.12 of the Guidelines.
The Medical Assessor made clear both within part 9 and part 10 of the MAC that his assessment was based on his examination of the respondent, the history he obtained and the documentation the Commission had provided to him. That documentation included records from the clinicians who had treated the respondent, also reports Dr Khan had prepared, including the report in which he advised his assessment of the respondent’s permanent impairment, and reports of psychiatrist Dr John Roberts whom the appellant had retained to advise on the respondent’s injury, and wherein Dr Roberts had raised issues regarding diagnostic uncertainty about the respondent and questioned the authenticity and severity of the respondent’s presentation based on observed social interactions. The material that the Commission provided the Medical Assessor, and which consequently the Medical Assessor considered, also included what the Medical Assessor described as “surveillance materials”. That was a reference to a report that an employee of ProCare had prepared for the appellant’s solicitors on 23 July 2024 on surveillance the employee conducted of the respondent on 12 June 2024 and 29 June 2024 and 6 July 2024 and 8 July 2024.
The appellant in its appeal against the medical assessment has challenged the Medical Assessor’s ratings of the respondent’s impairment in the PIRS categories of social and recreational activities and social functioning, for both of which the Medical Assessor rated the respondent’s impairment as Class 3, that is a moderate impairment.
The reasons the Medical Assessor provided in the PIRS rating form within the MAC for rating the respondent’s impairment in social and recreational activities as Class 3 are:
“Her social activities have significantly diminished, and she rarely engages in social outings unless strongly prompted by healthcare professionals or supportive neighbours. She describes clear avoidance, anxiety, and distress when interacting socially, markedly isolating herself. Therapeutically recommended social engagements are sporadic, structured, and occur in highly controlled contexts (e.g., meeting neighbours at local cafes). She remains quiet, withdrawn, and passive in these interactions. Thus, her functional impairment here is moderate, clearly more than mild, but not reaching severe or total isolation.”
Within the history the Medical Assessor detailed in the MAC, the Medical Assessor recorded under the subheading “social activities/ADL” that the respondent’s daily life and social interactions are restricted by her psychiatric symptoms, and that previously she was sociable and engaged but is now isolated with her social activities being severely limited and occurring mostly under therapeutic guidance or encouragement from health professionals. The Medical Assessor recorded that the respondent is largely homebound, limiting her outings to occasional structural brief interactions that typically involved trusted individuals and were in familiar settings. The Medical Assessor recorded that the respondent is unable to maintain previous routines or activities and finds ordinary social interactions overwhelming, with the respondent often preferring the security and routine of her home environment especially in the company of her dog.
Within Part 9 of the MAC the Medical Assessor recorded that he observed from the “surveillance materials”, and which he said he had reviewed and interpreted within a clinical context, that the respondent’s limited social interactions “are explicit therapeutic, professional recommended attempts to reduce her profound isolation, not indicative of improved general functioning of inconsistency in her impairment”. The Medical Assessor said that “these actions demonstrate her compliance and genuine effort to following therapeutic guidance”.
The Medical Assessor provided the following reasons in the PIRS rating form for rating the respondent’s impairment as Class 3 in social functioning:
“Significant deterioration of previous relationships and notable breakdown of romantic relationships directly linked to work-related psychological stressors have been reported. Ms Albertsen describes considerable difficulty maintaining and forming new interpersonal connections, relying almost exclusively on her neighbours for social support. Despite having some supportive social contacts (notably neighbours Sonja Woodhouse and Christian Stadler), the extent of interpersonal strain and social withdrawal constitutes moderate impairment. There is no documented severe
relationship dysfunction, such as domestic violence or complete estrangement from her remaining support network, hence not meeting criteria for severe impairment.”

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 respondent should undergo a further medical examination. This is because the Appeal Panel found that the MAC contained a demonstrable error, which the Appeal Panel would need to correct. The Appeal Panel considered that it required further data from the respondent to correct the error, which it could only obtain from further examination of her. Medical Assessor Blom, a member of the Appeal Panel, was appointed to conduct that examination, which he did on
30 September 2025. His report to the Appeal Panel is copied below.

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.
The appellant’s submissions regarding the ground for departure listed in s 327(3)(b) of
the 1998 Act, on which it relies, included that evidence it had obtained is additional relevant information. That evidence is firstly, a report ProCare investigations provided the appellant’s solicitors on 21 May 2025 relating to surveillance undertaken of the respondent on
9 May 2025, 10 May 2025, and 16 May 2025, and, secondly, the video footage of that surveillance. The appellant submitted that this evidence shows the respondent regularly and actively engaging in social gatherings with different individuals. The appellant submitted that this evidence ought to be considered by the Appeal Panel to accept that there is a pattern of behaviour inconsistent with the ratings the Medical Assessor made regarding the respondent’s impairment in social and recreational activities and in social functioning.
The appellant submitted that the Medical Assessor erred by rating the respondent’s impairment in social and recreational activities as Class 3 rather than Class 2. The appellant, in support of this submission, relied on what it contends is the additional relevant information contained within the report of ProCare Investigations dated 21 May 2025.
The Appeal Panel observes, as an aside, that for the Appeal Panel to consider this evidence to determine whether it establishes either the grounds for appeal that are listed in s 327(3)(c) and (d) of the 1998 Act, on which the appellant has also relied, this evidence needs to meet the terms of s 328(3) of 1998 Act, for otherwise the Appeal Panel cannot receive this evidence. The Appeal Panel notes that the appellant made no submission regarding whether the report of ProCare Investigations meets the terms of s 328(3), but nevertheless the Appeal Panel has considered that and expressed its reasons relating to it below.
The appellant submitted that the respondent does not need a support person when she leaves her house. The appellant submitted that the fact that she does not need a support person is not consistent with a Class 3 rating in social and recreational activities. The appellant submitted that the additional relevant information within the ProCare report reveals that the respondent is not quiet and withdrawn and, that being the case, her impairment is more consistent with a mild impairment.
The appellant submitted that the respondent engaging in social activities under therapeutic guidance or at the encouragement from health professional does not preclude a finding that she is engaged and actively involved in social outings.
The appellant submitted that the Medical Assessor erred by rating the respondent’s impairment in social functioning as Class 2 rather than Class 3. The appellant again referred to the report of ProCare Investigations dated 21 May 2025 to support this submission.
The appellant noted that the Medical Assessor confirmed that there had been no violence in the respondent’s domestic relationships. The appellant submitted that the Medical Assessor ought to have placed greater consideration or emphasis on whether the respondent’s previous relationships were severely strained as opposed to just strained. The appellant highlighted that the Medical Assessor noted that there was no documented severe relationship dysfunction.
The appellant also highlighted that the Medical Assessor described the respondent experiencing deterioration of previous relationships and breakdown of romantic relationships which he concluded were related to work related psychological stressors. The appellant submitted that the Medical Assessor did not provide any further detail to explain this link.
The appellant submitted that in the statement the respondent signed on 26 February 2023, the respondent said she was single and lived alone with a pet dog, did not support anyone with her income, and that she had relationship breakups in the past two years. The appellant noted that Dr Khan in his report of 24 April 2024 recorded that the respondent was not in an intimate relationship at the time of her injury.
The appellant submitted to the effect that because the Medical Assessor failed to provide sufficient detail regarding how the respondent’s previous relationships and romantic relationships are linked to respondent’s injury that the parties are unable to identify the Medical Assessor’s path of reasoning in reaching his assessment. In other words, the appellant submitted the Medical Assessor failed to provide adequate reasons for his assessment.
The appellant submitted that the weight of the evidence demonstrates that the respondent is able to sustain friendships and other relationships.
The appellant observed that both Dr Khan and Dr Roberts considered the respondent’s impairment in social functioning is Class 2 and the appellant submitted that should have provided some guidance to the Medical Assessor as to the appropriate classification. The appellant submitted that the Medical Assessor did not address the discrepancy between his assessment and the assessments of those medical experts and thereby failed to address the medical dispute between the parties.
In reply, the respondent submitted that the Medical Assessor’s assessment of the medical dispute that was referred to him occurred when he issued the MAC in accordance with s 325(1) of 1998 Act. The respondent referred to authority that she contended supports that the date of the MAC is the date of assessment. The respondent submitted that consequently the appellant’s appeal based on the ground for appeal listed in s 327(3)(b) must fail because the ProCare Investigation of 21 May 2025 was available to the appellant before the medical assessment.
The respondent submitted, in the alternative, that the activities she is shown in the surveillance as doing are the same activities that the prior surveillance revealed her doing, which the Medical Assessor had considered.
The Appeal Panel notes that the respondent sought to rely upon further evidence in the event the Appeal Panel admitted into evidence and took into account the ProCare Investigation report of 21 May 2025. That additional evidence comprised a statement she signed on 22 July 2025, a statement Christian Stadler signed on 3 March 2025 and a statement that Sonja Woodhouse signed on 4 March 2025.
With respect to the appellant’s submission that the MAC contains a demonstrable error because of the Medical Assessor’s rating of her impairment in social and recreational activities, the respondent submitted that the appellant’s complaint is based upon new material that is not admissible and that the Medical Assessor’s failure to consider material that was not before him cannot constitute a demonstrable error. The respondent submitted that the appellant otherwise does not identify any basis for finding that there has been a demonstrable error.
With respect to the Medical Assessor’s rating of her impairment in social functioning, the respondent contended that the Medical Assessor set out the factual matters that formed the basis of his assessment and exposed his path of reasoning to the extent he was required to do so.
The respondent noted that her injury was a result of events that occurred in her workplace from October 2022 and she submitted that the period in which she suffered relationship breakups was within that period.
The respondent highlighted that the examples provided in Table 11.4 for the several Classes at which a worker’s impairment can be rated, do not limit relationships to romantic relationships but apply to all relationships. The respondent noted that she provided a history to Dr Khan that she is withdrawn from friends and needs to be pushed to meet up.
The respondent noted that at the time of her injury she was neither in an established romantic relationship nor had children. The respondent submitted that it cannot be the case that only those people in established relationships or with children can be moderately impaired. The respondent submitted that the Medical Assessor considered whether her impairment is moderate as opposed to mild or severe by looking at the effect of her injury on her relationships and concluded that her impairment is moderate.
The respondent submitted that the appellant has not identified what error was made with respect to her other relationships.
The respondent submitted that the Medical Assessor was not required to explain why his opinion differed from the opinion of other specialists and that his tasks was to examine her and to reach his own assessment.
The appellant provided further submissions in response to the respondent’s submission regarding the date of the medical assessment. The respondent contended that a medical assessment and medical assessment certificate are distinct. The appellant contented that the respondent’s interpretation of the ground for appeal provided in s 327(3)(b) involved reading words into the legislation, specifically the word “certificate” after the term “medical assessment”. The appellant contended that the authorities on which the respondent relied related to the reckoning of time rather than when a medical assessment was 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.

Section 327(3)(b)

The Appeal Panel agrees with the respondent’s submission that the report of ProCare Investigations dated 21 May 2025, which relates to surveillance that this organisation conducted of the respondent on 9 and 10 and 16 May 2025, and the film on which that surveillance is recorded, does not contain additional relevant information that was not available to and could not reasonably have been obtained by the appellant before the medical assessment. Consequently, the appellant’s appeal relying on the ground for appeal listed in s 327(3)(b) of the 1998 Act fails.

Additional relevant information is information that is not merely quantitively different from the information that is already before a Medical Assessor, but information that is qualitatively different and that was not otherwise available.[1] The appellant was aware of the respondent’s claim for compensation on 21 May 2024. To be able to respond to the respondent’s claim it organised Procare to conduct surveillance of the respondent over several days in June and July 2024. Procare reported to it on 23 July 2024. That surveillance, the report of which was before the Medical Assessor, showed the respondent walking with her dog, and meeting with other people and having a coffee over the course of an hour.
[1] State of New South Wales v Ali [2018] NSWSC1783 at [32]; CSR Limited v Ewins [2020] NSWSC511 at [47].
The initial referral issued to the Medical Assessor was dated 6 January 2025. The final amended referral that was issued to him was dated 25 March 2025. The parties were consequently aware from that date that the assessment the Medical Assessor would be imminently examining the respondent and assessing the medical dispute referred to him.
The ProCare Investigation report provided to the appellant’s solicitors dated 21 May 2025 reveals that the appellant’s solicitors requested further surveillance of the respondent on
8 May 2025. That is several weeks after the parties were aware that the referral had been issued to the Medical Assessor and consequently aware that the medical assessment was imminent. The further surveillance of the respondent was done on 9 May 2025, 10 May 2025 and 16 May 2025.
The instructions the appellant’s solicitors provided to ProCare were to conduct further surveillance to determine whether the claimant is partaking in any activities beyond her current capacity. In substance they were the same instructions that the appellant’s solicitors provided ProCare on 4 June 2025 in response to which ProCare produce its report of
23 July 2024. Essentially the instructions provided on both occasions were to reveal what the respondent is able to do.
The report of ProCare dated 21 May 2025 does not therefore, in the Appeal Panel’s view, add any qualitative information to that contained in its prior report. It essentially, as the respondent submitted, reveals the respondent doing the same activity.
Further, the information contained in the report of 21 May 2025 is information that the appellant could reasonably, and indeed readily, have obtained before the medical assessment. It seems to the Appeal Panel that is does not matter whether the date of the medical assessment is the date of examination or the date of MAC, because the appellant could have organised for that further surveillance of the respondent to be conducted at any time before either date, and being aware at least from 25 March 2025 that the Medical Assessor would be conducting his assessment of the medical dispute referred to him at time shortly thereafter, the respondent could reasonably have organised for that further surveillance to be done well prior to either date.

Section 328(3)

Section 328(3) of the 1998 Act permits the Appeal Panel to receive fresh evidence or evidence in addition to a substitution for evidence received in relation to a medical assessment appeal against provided that evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before the medical assessment. As noted when paraphrasing the appellant’s submissions, the appellant seeks to rely upon the ProCare Investigation report of 21 May 2025 to support its case based on the grounds for appeal listed in ss 327(3)(c) and (d) of the 1998 Act.
The Appeal Panel does not receive that report into evidence. This is because, as was discussed above, the evidence could reasonably have been obtained by the appellant before the medical assessment.

Sections 327(3)(c) and (d)

The Appeal Panel considers that the Medical Assessor erred with respect to his ratings of the respondent’s impairment in both social and recreational activities and social functioning, such that the MAC contains a demonstrable error.
With respect to the respondent’s engagement in social and recreational activities, the fact that she participates in such activity in accordance with recommendations provided by her clinicians is not, in the Appeal Panel’s view, determinative of the class rating to be made. What is relevant is what activities the respondent can engage in and what her capacity is for social and recreational activities, irrespective of whether it forms part of her therapy. The fact that the Medical Assessor placed weight on this matter when evaluating the class of impairment of the respondent in social and recreational activities, rather than considering the respondent’s capacity to engage in activity, was an error on the Medical Assessor’s part.
The respondent’s submission that the appellant’s case regarding whether the Medical Assessor made an error when rating her impairment in social and recreational activities is limited to whether the ProCare report of 21 May 2025 revealed error, is incorrect. The appellant clearly raised in its submissions that the respondent engaging in social and recreational activities under therapeutic guidance does not mean that she is not engaging in activity.
Regarding the Medical Assessor’s rating the respondent’s impairment in social functioning, the Appeal Panel notes that the respondent in her statement of 26 February 2023 said that she had relationship breakups over the last two years. She also revealed that at as at
26 February 2023 she was single and lived alone with her pet dog. The circumstances to which she was exposed in her employment from which her injury arose occurred over a four to five month period between October 2022 and 8 February 2023.
As the appellant noted in its submission in April 2024 the respondent provided a history to
Dr Khan that at the time Dr Khan examined her, she was then single.
A key factor in the Medical Assessor rating the respondent’s impairment in social functioning as Class 3 is that the respondent had “notable breakdown of romantic relationships directly linked to work-related psychological stresses have been reported”. The Medical Assessor did not within the MAC detail what romantic relationships the respondent had formed that had broken down as a consequence of her psychiatric injury, which injury occurred due to events over the period October 2022 to 8 February 2023. It is unclear from the MAC or the evidence whether the respondent was in a romantic relationship during the time her injury arose. It is unclear what romantic relationships if any she formed after that and how it was, if any were formed, the breakdown of them related to her injury.
Given that dearth of detail within the evidence and the history detailed in the MAC, and bearing in mind that the Medical Assessor placed weight on the respondent experiencing breakdown of romantic relationships that were directly linked to the respondent’s work injury, the Appeal Panel agrees with the appellant’s submissions to the effect that the Medical Assessor’s reasoning for his rating of the respondent’s impairment in social functioning was inadequate. The history he detailed was simply insufficient to justify the rating he made.
The Appeal Panel does not accept the appellant’s submission to the effect that the Medical Assessor made an error by not addressing the discrepancy between his assessment of the respondent’s impairment in social functioning and the ratings Dr Khan or Dr Roberts made, and by not doing so did not address the medical dispute between the parties.
The medical dispute between the parties related to the degree of the permanent impairment the respondent had from an agreed injury. That is the exactly the medical dispute [BG1] that the Medical Assessor addressed, and assessed.
Further, the obligation of a Medical Assessor under s 325(2)(c) of the 1998 Act to set out the reasons for an assessment requires the Medical Assessor to expose his or her path of reasoning such that a Medical Appeal Panel can determine whether there is error in the reasoning.[2] That obligation does not require a Medical Assessor to “opine on the correctness of other opinions”,[3] but rather to articulate his or her reasons for the degree of permanent impairment she or he assessed a worker has from an injury.
[2] Wingfoot Australia Partners Pty Ltd v Kocak [2013] HCA43; Tradieh v LM Hayter & Sons Pty Ltd [2025] NSWSC840 at [33] – [42].
[3] Wingfoot at [47].
Hence in this case the Medical Assessor was not required to explain or address why his opinion differed from the opinion Dr Khan or the opinion of Dr Roberts. In any event, insofar as the Medical Assessor detailed his reasons for his assessment, it is apparent why his assessment differed from the assessments Dr Khan and Dr Roberts made.
As noted above, because the Appeal Panel found the MAC contained error, the Appeal Panel is required to correct the error. To do that the Appeal Panel considered it required the respondent to be examined again by one of its members, namely Medical Assessor Blom. Medical Assessor Blom to the Appeal Panel follows:
“PERSONAL INJURY COMMISSION

APPEAL AGAINST MEDICAL ASSESSMENT

REPORT OF THE EXAMINATION BY MEDICAL ASSESSOR

MEMBER OF THE APPEAL PANEL

Matter Number:	M1-W29320/24
Appellant:	Westpac Banking Corporation
Respondent:	Susie Albertsen
Date of Determination:	30 September 2025

Examination Conducted By:	Graham Blom
Date of Examination:	30 September 2025

1.   The workers medical history, where it differs from previous records
Ms Albertsen confirmed the ‘History Related to the Injury’ taken by Dr Gill. In summary, she worked as a Relationship Manager at Westpac bank for several years. In late 2022 she began to experience increasing stress in the workplace, related to an increased workload and what she experienced as insufficient support from her manager, Ms Wood. As well she increasingly believed that Ms Wood was being harsh and dismissive toward her. This situation was made worse in November 2022 when her older brother died unexpectedly in Indonesia. On her return from his funeral, she felt that management were lacking in empathy and understanding and continued to be excessively demanding. This culminated on February 8, 2023, when she felt belittled, humiliated and attacked in a videoconference call organised by Ms Wood. She felt overwhelmed, was crying uncontrollably and experienced panic and significant anxiety. She rapidly developed suicidal ideation and appears to have experienced a dissociative episode, describing a feeling of emotional numbness and disconnection. She was briefly admitted to Gosford Hospital Emergency Department, for a few hours and subsequently reviewed over several days by the Central Coast mental health team.
Following this she was referred, buy her GP, to a psychologist, Ms Simpson, whom she initially consulted on a fortnightly basis. She was also regularly consulted by her general practitioner for the first 18 months of her disorder. Around August 2024, she was referred to a psychiatrist, Dr Simonelli, whom she has continued to consult. Dr Simonelli initiated the antidepressant medication, venlafaxine at a dose of 75 mg/day and increased the prazosin, which had been started earlier by her GP, from 2 mg/night to 4 mg/night. He also later introduced quetiapine, 25 mg/night for situations where Ms Albertsen was unable to sleep or was excessively agitated. He also prescribed diazepam, 5 mg/night, also to be taken as needed for difficulties with sleep and agitation. There have been no other changes in her medication.
Despite both her psychological and psychiatric treatment, Ms Albertsen says that she has only had modest overall improvement in her symptomatology and level of impairment.
Ms Albertsen currently lives in an apartment in Waterloo that she moved into in 2023 partly on the advice of her psychologist. The psychologist, and Ms Albertsen felt that she was somewhat isolated in her previous residence in Central Coast and that she would do better living in the city. She subsequently purchased the apartment in Waterloo and has lived there since about mid-2023.
2.   Additional history since the original Medical Assessment Certificate was performed.
There have been no significant changes in Ms Albertsen’s personal circumstances since the Medical Certificate issued on 3 June 2025. There has been no significant change in her overall symptomatology or level of impairment. She denies any further injuries or other significant disruptions.
3.   Current Symptoms.
Ms Albertsen continues to experience persistent low mood. She describes feeling sad and worthless. She feels that she has lost the purpose in her life and at times feels like life is not worth living. She has occasional suicidal ideation, she said, although this appeared to be passive and not high risk certainly at the time of this interview.
She complained of sleep disturbance, waking 2 – 3 times/night, most nights. She regularly has vivid dreams and approximately on a weekly basis will wake from nightmares feeling anxious and panicky. Normally she can return to sleep but tends to experience daytime fatigue and rarely wakes refreshed. She often has a nap in the afternoon. Overall, her motivation and energy are reduced. She struggles with concentration although said that she was able to watch movies, such as thrillers, through till the end. She also plays arcade like games on her phone for up to one or two hours/day. Her appetite is reasonable, although she has gained some weight from inactivity. She does however take her dog for a walk for up to 30 minutes most days. She also complained of a reduction in capacity for pleasure.
She continues to experience episodic anxiety especially when she has contact with the Workers Compensation process or with anything that reminds her of work. Sometimes, approximately, on average, once/month she will have a panic attack but has panicky feelings more frequently.
4.   Current Treatment.
She attends her psychologist Ms Simpson monthly. Ms Simpson appears to be using evidence-based treatment for mood disorders and trauma-based anxiety.
She consults her psychiatrist, Dr Simonelli, approximately every three months although he is available to consult her if she experiences a significant disruption. Currently she continues to be prescribed:
Venlafaxine, 75 mg/day.
Prazosin, 4 mg/night.
Quetiapine, 25 mg/night, as required.
Diazepam, 5 mg/night, as required.

She also consults her general practitioner for medical review as required.
She does not have any significant physical illnesses, although she complained that her overall health was worse since her injury.
5.   Findings on clinical examination
Ms Albertsen was seen via teleconference, using the Teams app. She had no difficulty managing the application. The quality of the streaming was good, and I was able to undertake a satisfactory interview.
Ms Albertsen was a woman who appeared approximately her stated age of 46 years of age. She had black hair held back in a bun. She was dressed in a casual T-shirt. She was clearly somewhat anxious, especially early in the interview, but also became quite distressed, in a somewhat extravagant manner when work was mentioned and especially Ms Woods name. On my first mention of Ms Wood, she cried out and covered her ears.
She had a reactive affect although overall her presentation was one of sadness and anxiety. She was clearly angry and distressed at the perceived injustice that she felt that she had experienced and the profound impact it has had on her life. She did not appear to be actively suicidal although did express a sense of purposelessness.
There was no evidence of psychotic phenomena, in particular, she did not display delusions, hallucinations or formal disorder of thought.
She persisted throughout a 65-minute interview and was able to attend to my questions and maintain focus. She occasionally had clear difficulties with her memory of events that had occurred since her injury.
6.   Diagnosis.
Using DSM 5 – TR, Ms Albertsen meets the diagnostic criteria for Major Depressive disorder with anxious distress. It is likely that this disorder has been present for over two years thus meeting the diagnostic criteria for Persistent Depressive Disorder with persistent Major Depression.
7.   Review of ADLs Under Appeal.
Two PIRS categories were appealed.
1.   Social and Recreational Activities. Ms Albertsen was very clear that her overall social activity has substantially reduced since her injury. Prior to her injury she said that she had many friends and often socialised with them, going to dinner, parties and other activities such as after work events. Since her injury she said that she no longer goes out socially except when accompanied. She did acknowledge that she walks her dog, alone, most days, sometimes twice/day for up to 30 minutes at a time. She said that she sometimes meets neighbours whom she knows and greets them, but that is as far as her social interaction with them goes, except for one neighbour, Christian with whom she will sometimes have coffee. She said that she only goes to coffee when he is there. I raised the issue in the Surveillance Evidence from June 2024, asking about times when she appeared to be in the café alone. She said that Christian had colonic cancer and often had to leave to go to the toilet but that she only went to coffee with his support. She denied other social activities.
I raised with her that she had gone on dates, since her injury, according to the documentation. She was uncomfortable talking about this saying that she had only been on a couple of dates but that they had been very unsuccessful because of her depression and anxiety. She also said that she became distressed as most people tended to talk about work on dates. I asked her how she had arranged the dates, and she said that a friend of hers had organised one and that she had organised a couple of others through a dating app. She said that she has stopped going on dates now because of the distress that it causes her.
2.   Social Functioning. Ms Albertsen is the youngest child in a family of originally nine children – two boys and seven girls. She was raised by her mother, who was a sole parent. Her mother died in about 2018. As noted in the history of the injury, a brother died in 2022. Prior to this her other brother had died in around 2017 and a sister had died about a year or so after this. She visited her family approximately once every couple of years prior to his injury and had occasional other contact with her sisters. This has reduced since her injury although there has never been any substantial disruption or conflict with them.
She has never been married and had not been in a long-term relationship for about
10 years prior to her injury. She said that the longest intimate relationship that she had, was around 2010 and lasted about three years. She has not had any long-term intimate relationships since then although during this time she went on occasional dates. She said that she had been “a career woman” and had spent her time attempting to advance her career which meant that that her loss of career and future prospects was even more distressing. Since her injury she has been on a couple of dates, but the relationship has not continued. There has been no violence or conflict in her intimate relationships.
As she has significant anxiety related to anything to do with her work, she has lost contact with colleagues with whom she used to previously socialise. She however continues to have some friends with whom she has contact. These are friends from her previous residence in the Central Coast as well as friends that she has made, since moving to her current location in Waterloo. They call her and she talks to them by phone, and occasionally they visit and will have coffee with her usually at her house. Very occasionally they will go out to coffee but do not engage in other socialising, she said. She said that visitors are relatively irregular, occurring about once every four or five weeks.

Her only recreational interests are movies on TV and playing arcade like phone games.
8. Results of any additional investigations since the original Medical Assessment Certificate
Nil.”

The Appeal Panel accepts and adopts the history that Medical Assessor Blom obtained and detailed in his report. That of course includes what he detailed in part 7 of his report relating to the respondent’s function in social and recreational activities and in social functioning.
The Appeal Panel also accepts and adopts the detail Medical Assessor Blom provided in his report relating to the respondent’s present treatment and present symptoms.
The Appeal Panel considers that the examination Medical Assessor Blom conducted of the respondent is thorough. The Appeal Panel considers Medical Assessor Blom’s diagnosis is correct.
The Appeal Panel considers that the additional information Medical Assessor Blom obtained and his findings from his examination are sufficient to correct the errors the Appeal Panel found in the MAC. The correction of those errors requires, in substance, the Appeal Panel to consider and rate the respondent’s impairment in social and recreational activities and in social functioning by reference to the information Medical Assessor Blom obtained, his findings from his examination and also the relevant clinical information contained in the documentation that was provided to the Medical Assessor.
The respondent had an active social life before the occurrence of this injury. She went to dinners and parties and work events. Her engagements in social and recreational activities has reduced significantly. She goes on daily walks with her dog and will have coffee if she meets her friend and neighbour Colin. The surveillance that was done in June and July of 2024 also reveals that others may join her and her neighbour in that activity. Further, very occasionally a friend from the Central Coast will visit her and they will have coffee.
She has been on a few dates since her injury, one of which was a blind date organised by a friend and the other she organised through a dating app. Those were unsuccessful because ultimately the discussion during the dates turned to work and symptoms from her injury would then manifest. She no longer engages this activity.
Her engagement in social and recreational activities is otherwise limited to watching movies alone and playing phone games.
The examples provided in Table 11.2 of the Guidelines are, as stipulated by paragraph 11.12, exactly that – examples only. They are illustrative of how a Medical Assessor, or an Appeal Panel, may rate the severity of a worker’s impairment. Whilst the respondent walks her dog without prompting, she only has coffee if she meets her neighbour and friend. In that regard, he can be characterised as a support person with respect to the respondent engagement in having a coffee. Having coffee when meeting her neighbour or very occasionally when one of her friends from the Central Coast visits, is the only activity in which she engages that has a social component. Other recreational activities consist of her watching TV, walking her dog, and playing phone games, which she does alone. When compared to her capacity pre-injury, the Appeal Panel considers that the severity of her impairment best correlates with what is described by the examples provided for Class 3 impairment, and consequently the Appeal Panel rates her impairment in social and recreational activities as Class 3.
With respect to social functioning, the respondent maintains a relationship with her family. She maintains a relationship with her friends from her previous residence on the Central Coast as well as friends she has made since moving to her new residence in Waterloo. She has not been in any long-term relationship with a partner for more than 10 years prior to the occurrence of her injury.
She has lost relationships with some of her work friends, but neither the history Medical Assessor Blom obtained nor the other material before the Appeal Panel reveals that there has been a breakdown of any romantic relationship in which the respondent was involved as a consequence of her injury.
Based on those circumstances, the Appeal Panel considers that the severity of the respondent’s impairment in social functioning is best encapsulated by the examples provided for a Class 2 impairment and not a Class 3 impairment.
Accordingly, the median the respondent’s scores remain at three but the total of her scores decreases to 16, which converts to 17% WPI.
For these reasons, the Appeal Panel has determined that the MAC issued on 3 June 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:	W29320/24
Applicant:	Susie Albertsen
Respondent:	Westpac Banking Corporation

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 Ronald Gill and issues this new Medical Assessment Certificate as to the matters set out in the Table below:

Table - whole person impairment (WPI)

Body Part or system	Date of Injury	Chapter, page and paragraph number in NSW workers compensation guidelines	Chapter, page, paragraph, figure and table numbers in 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/ psychological disorder	9/02/2023	Chapter 11	17%	-	17%
Total % WPI (the Combined Table values of all sub-totals)					17%

[BG1]check

[2025] NSWPICMP 790

14 October 2025