Wilson v Secretary, Department of Communities and Justice

DETERMINATION OF APPEAL PANEL
CITATION:	Wilson v Secretary, Department of Communities and Justice [2024] NSWPICMP 602
APPELLANT:	Darren Wilson
RESPONDENT:	Secretary, Department of Communities and Justice
APPEAL PANEL
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	Professor Nicholas Glozier
MEDICAL ASSESSOR:	John Lam-Po-Tang
DATE OF DECISION:	26 August 2024
CATCHWORDS:	WORKERS COMPENSATION - Whether Medical Assessor erred in his assessments under two categories of the psychiatric impairment rating scale (PIRS), namely social and recreational activities and concentration, persistence and pace; Held – error found regarding social and recreational activities but no error in respect of concentration, persistence and pace; Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 17 June 2024 Darren Wilson (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Gerard Walsh, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 3 June 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 it was not necessary for the worker to undergo a further medical examination because none was requested, and we consider that we have sufficient evidence before us to enable us to determine this appeal for reasons that will be addressed in due course.

EVIDENCE

Documentary evidence

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

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the Medical Assessor erred in his assessments under two categories of the Psychiatric Impairment Rating Scale (PIRS), namely Social and Recreational activities and Concentration, Persistence and Pace (cpp).
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 whole person impairment (WPI) in respect of a primary psychological injury on a deemed date of injury of 11 July 2022.
The Medical Assessor obtained the following history:
“In summary of the documentation provided:
The documentation indicated that the Claimant joined the Corrective Services NSW (CSNSW) in 1994. He documented having witnessed many traumatic scenes during his employment, including deaths in custody, deaths by suicide, hangings, and cutting as well as instances of grievous harm from inmates to one another. In the documents, he described a fatal incident in which an officer died at the Silverwater Correctional Centre. As part of his role, he had to document violent scenes from video footage and provide recommendations about incidents in which he may not have been involved. He was involved in riots and was authorised the use of chemical restraint and other forms of control of violent inmates. He described being frequently afraid for his safety in his work role. On 15 July 2022, an inmate assaulted him, hitting him with a cocktail of bodily fluids. It was documented that after the incident, he experienced anxiety and depressive symptoms. He last worked in August 2022 for Corrective Services NSW at the rank of Senior Assistant Superintendent at Lithgow Correctional Centre.
The Claimant’s report of the injury of 11/07/2022 (as dated in the PIC documentation):
The Claimant said that on the day of the injury, he was speaking through a grill to the inmate who was in his cell. After 5 minutes the inmate grabbed a container containing faeces and poured it over him. The Claimant said he went immediately to shower and changed his clothing. The Claimant said his manager told him the same inmate set fire to his cell and that he should go and attend to it. The Claimant therefore went and extinguished the fire. He said he had to deploy a chemical to subdue the inmate. He did not have further contact with the inmate after these events. The Claimant said the inmate had tried to assault him 10 days before that incident and had intentionally targeted him on the day of the injury.
The Claimant talked about the traumatic event in 2007 where an officer at Silverwater was beaten to death by an inmate. The Claimant said he did not have problems with his mental health and did not experience PTSD symptoms following that incident. However, he said the event of July 2022 brought all those previous traumatic events back to him.
Since leaving work at CSNSW, his mood has remained low. He said that the longest that he has felt happy since then has only been days. A few months before he left employment, his sleep became disturbed, and he began experiencing nightmares. Around that time, his concentration began to be decreased and he said it has got progressively worse since. The Claimant said trauma symptoms began a few months before leaving work and included unwanted intrusive distressing thoughts about the workplace incidents.
A few weeks before leaving his employment he began to experience gastrointestinal issues due to anxiety. He said this has continued since and that on days when he is particularly anxious, he goes to the toilet several times a day.
For the past 2 years, he had thoughts about how life would be better if he was not around. He has never been suicidal. He said his anxiety symptoms began around 2 years ago and have only marginally improved over the years. He thought he increased his weight by 15 kg over the past 2 years.”
Current symptoms were noted as follows:
“Mood Symptoms:
Mood – He described his mood as feeling depressed and worthless. He said that this has been since leaving work. Anhedonia – He reported reduced pleasure in activities. Appetite - He reported having a good appetite but thought it was related to his medication, quetiapine. Sleep – He described his sleep as poor. He wakes 3 times during the night every night and still experiences nightmares. He did not know what the content of the nightmares. Fatigue – He stated that he has fatigue and naps most days for an hour or more. Worthlessness – He said he feels worthless and that he has lost his role in life. Concentration – He said he cannot concentrate when reading or watching television for more than a few minutes. He said that he could only manage a few lines of text as his mind wandered, and he lost track of the storyline. Suicidal – He said the last time he had thoughts of life not worth living was a few days ago but he had no plan to harm himself.
Anxiety Symptoms:
Frequency and Duration – He said anxiety is present all the time every day. Triggers – He stated that anxiety episodes were triggered by going to medical appointments because he must leave the house. Other triggers can be seeing prison vans on the road or seeing people he used to work with. He said seeing people he knows makes him anxious as they ask too many questions. Improved by – The Claimant said there was nothing that improved the anxiety The Claimant reported that symptoms of anxiety include increased heart rate, hot and cold sweating, trembling and shaking, choking, rarely chest discomfort, gastrointestinal issues, and dizzy spells. He said that anxiety causes gastrointestinal motility such that on days when he is particularly anxious, he goes to the toilet a few times a day.
Trauma Symptoms:
Intrusive thoughts – He said he spends around 50% of the day thinking about the traumatic events that happened at work. Dreams – As described already, he experiences nightmares, but he was unsure if it was related to these workplace events. Flashbacks – He does not experience flashbacks. Psychological distress – He said it makes him upset thinking about what he was exposed to at the workplace. He said he was on a pathway for promotion and had lost that. He said thinking about the index incident causes him distress. Physiological distress – Physiological anxiety symptoms experienced when exposed to triggers of the injury are described in the anxiety section above. Avoidance of thoughts – He said he avoids engaging with ex-colleagues from the prison. He said that even going past a prison where he never worked can be upsetting and he would look in the other direction.
Irritable – He said that minor issues cause irritability and his is irritable most of the day most days. He said that he does not act out violently. Reckless – He does not experience recklessness. Hypervigilance – He reported being hypervigilant. He said that he always looks over his shoulder. In waiting rooms, he must have sight of all the entries and exits otherwise he would feel uncomfortable. He said this has been a problem whilst still working and unsure if he was hypervigilant as part of his job or if it was worsened by injury. Startle - He said he is startled twice a week. Concentration - He said that he cannot concentrate when reading or watching television for more than a few minutes. He said that he could only manage a few lines of text as his mind wandered, and he lost track of the storyline He reported that he never had any issues with his concentration pre-injury. Sleep - He described his sleep as poor. He wakes 3 times during the night every night and still experiences nightmares. He did not know what the content of the nightmares [was].”
The Medical Assessor then set out details of the appellant’s treatment regime.
The Medical Assessor then turned to consider the impact of Mr Wilson’s injury on his social activities and activities of daily living (ADL’s) and said:
“Self-care and personal hygiene:
Bathing: He said his wife must help him showering. He said he becomes unsteady on his feet. He said he does not have interest or energy in showering. He said he requires prompting as he becomes malodorous after a few days. Grooming: He stated that he used to be well-shaven. He gave up because he was shaking with anxiety and was cutting himself. Cooking: The Claimant said he cut himself in the kitchen one day and has not gone into the kitchen since then. He said he leaves items out of the fridge or does not turn appliances and the stove off because he forgets about them. Household chores: He reported that he has not done any chores for the past 2 years. He said he lacks motivation, and experiences trembling. He said he used to share chores with his wife. Shopping: He stated that he does not go shopping because he does not leave the house. He stated that before the injury, he was completely independent in bathing, grooming, household chores and shopping.
Social and recreational activities:
Hobbies: He said he does not do any activities except watch television. Exercise: He stated that he used to go for walks. The last time he went for walks for the past 2 years (sic).Frequency of socialising: He said he last socialised with family and friends when his mother died in 2023. He said did not attend her funeral in person for fear that the gastrointestinal issues associated with anxiety would cause him to soil himself during the service. He stated that before the injury, he used to enjoy gardening, renovating and photography.
Travel:
The Claimant said a support person is required to travel and so he relies on his wife. Holidays: He said he went away to Port Macquarie on his 50th birthday. He said they had cut the trip short because of his mental health. He stayed in the rented house and did not get involved with the activities. He stated that before the injury, he could travel anywhere without any problem.
Social functioning:
Relationship with his wife: He said he has a poor relationship with his wife now as she is his carer rather than a spouse. He said there are arguments every day. there has been a gradual deterioration in the relationship over the past 2 years There have not been periods of separation.
Relationship with children: He stated that he has two daughters 18 and 17 years of age. He said his relationship has been difficult as they think that he is not interested as he does not remember things they tell him.
Relationship with siblings: The Claimant said he has an older sister and rarely contacts her as he does not have anything to say. His relationship with her has not changed after the injury.
Relationship with parents: He said his relationship with his father has not changed. He speaks to him every week. He reported that his mother died aged 75 in April 2023.
Relationship with friends: He does not have any friends nowadays. He lost friends after he left work 2 years ago because he did not have anything to say to them. He stated that before the injury, he used to have 5 friends.
Concentration persistence and pace:
He said he cannot concentrate when reading or watching television for more than a few minutes. He said that he could only manage a few lines of text as his mind wandered, and he lost track of the storyline.
Employability:
He has not been able to work at all or do voluntary work since leaving employment. He reported having been able to work full-time pre-injury.”
Findings on mental state examination were reported as follows:
“Appearance: The Claimant appeared his stated age and was poorly groomed. His mid-length grey hair was in disarray, and he had a long greying beard. Behaviour: There was no psychomotor disturbance and he appeared relaxed in his chair. At one point, he became tearful talking about how his life trajectory had been impacted. He was able to modulate this affect change well. There was good eye contact with the videoconference camera. Speech: Speech was spontaneous and was normal in volume, rate, rhythm, and prosody. Mood: He described his mood as feeling depressed and worthless. He said that this has been since leaving work. Affect: His affect was warm, reactive, and appropriate, with a restricted range. Thought form: The thought form was logical with no formal thought disorder noted. Thought content: The main themes were about the effects of the injury on his life and that he was missing out on potential promotions and progress from no longer being employed. He reported feeling useless. There were no delusions noted. Regarding suicidal thoughts, he said the last time he had thoughts of life not worth living was a few days ago but he had no plan to harm himself. Perceptions: There was no perceptual abnormality described. He did not appear to be responding to any abnormality on observation. Cognition: Formal testing of cognition was not performed. The Claimant attended the assessment with his wife, Nicole. He attended at the correct time. He managed without a break for an hour and 15 minutes. A reasonable history was obtained.”
The Medical Assessor diagnosed:
“Post-Traumatic Stress Disorder - as the circumstances of the subject accident, are sufficient to meet Criterion A, and there are sufficient symptoms to meet Criterion B to E, with sufficient duration longer than a month, causing significant distress and impairment.
Major Depressive Disorder with anxiety – as there have been depressive symptoms which include low mood, anhedonia, poor sleep, and poor concentration.”
The Medical Assessor assessed 24% WPI.
He then turned to consider the other medical opinions and material before him.
We do not intend to set out in detail all that material but relevant to the issues in dispute, we note the following regarding the Medical Assessor’s review of the IME opinions:
“13/06/2023 - IME Report, Dr Glen Smith, Consultant Psychiatrist:
PIRS classes were 4,3,4,3,3,5 thus the aggregate was 22 and 47% WPI with 0% adjustment for pre-existing impairment and 0% for treatment effect. The final WPI was 47%.
23/10/2023 - IME Report, Dr Bisht, Consultant Psychiatrist:
Maximum medical improvement was not considered to have been reached and so a PIRS was not completed. It was opined that maximum medical improvement would not occur until after mid- 2024.
My assessment of 24% WPI% is much less than Dr Smith’s assessment of 47%. Dr Bisht did not think that maximum medical improvement had occurred. My reasoning for each specific domain is to be found within the PIRS.”

The appellant’s submissions

As regards the category of Social and Recreational activities, the appellant submits:
(a)    the Medical Assessor’s assessment of a Class 3 rating is at odds with the evidence of near complete isolation, non-participation (at all) in pre-injury activities, not leaving the house, no friendships or social interaction at all outside of the family, strain in family relationships;
(b)    a class 4 is appropriate;
(c)    none of the history recorded by the Medical Assessor fits within a Class 3;
(d)    Class 4 is the "best fit";
(e)    for the purposes of determining "best fit" the Medical Assessor has erred by conflating attendances at a funeral and a birthday party as evidence of social and recreational activities. To fall within table 11.2 an activity must be both social (i.e. involving people) and recreational. The appellant relies upon Ballasv Department of Education (State of New South Wales) [2020] NSWCA 86 in which the issue of social and recreational activity was considered;
(f)    in relation to the appellants mother's funeral the Medical Assessor has erred by concluding that (partial) attendance at a funeral is a social and recreational activity: attendance at a funeral is not a "recreational" activity. To suggest that attendance at a funeral is both a social and recreational activity is an unsustainable conclusion;
(g)    in relation to the claimant’s 50th birthday party, the Medical Assessor notes this event was cut short, and notes the appellant did not engage in social activities at this event. It is also worth highlighting the appellants 50th birthday was some 18 months before the Medical Assessor’s assessment. There is no evidence to suggest the appellant has left home after his birthday for any social or recreational activities (or at all), and in fact evidence recorded by the Medical Assessor makes clear that he has not, and
(h)    apart from attending his mother's funeral and the failed birthday event there are no other current activities recorded by the Medical Assessor that are both social and recreational. Watching television is not characteristic of a social and recreational activity.

As regards cpp, the appellant submits:
(a)    Class 4 is the best fit for the appellant's condition;
(b)    the Medical Assessor records a history that: “He cannot concentrate when reading or watching television for more than a few minutes. He could only manage a few lines of text as his mind wandered, and he lost track of the storyline.” And “He leaves items out of the fridge or does not turn appliances and the stove off because he forgets about them”;
(c)    the Medical Assessor reviews the records of the appellant's general practitioner for the period 7 May 2012 to 12 May 2023 and notes the following: On 9 December 2022 "... The Claimant was struggling and requiring help with his activities of daily living. His wife was getting his clothes in the morning and preparing his meals. It was reported that his mental health was impacting his children." On 20 January 2023, the notes record: “He was experiencing incontinence 3 or 4 times a day which had been occurring over the past few weeks.” On 16 February 2023, the notes record "... He had a home help assessment. His mood continued to be low, his concentration was poor and he felt exhausted .... It was noted that he attended the BMH Emergency Department after cutting his hand on a cheese grater";
(d)    the Medical Assessor summarises records from our client's treating psychiatrist, Dr Muhammad K Malik, for the period 3 October 2022 to 12 December 2023. Relevantly, he notes the following: “On 3 October 2022, he reported broken sleep, flashbacks, depressed mood, apprehension, avoidance, isolated behaviour, exaggerated startle response and panic attacks.” On
23 January 2023, “he appeared flat in affect and dishevelled. He reported poor sleep, anergia, hopelessness and anhedonia. He was incontinent at times when under extreme pressure and was easily overwhelmed.” On 16 August 2023, "He continued to be incontinent when under stress. He was aggressive at home and had poor self-care, requiring constant prompting [emphasis added]. He struggled with cognitive deficits in focusing, registering and recalling events”;
(e)    with reference to the examples within PIRS table 11.5, it is apparent that class 3 inadequately represents the appellant's level of dysfunction noting; there is no evidence to suggest that the appellant can read "more than" newspaper articles; there is no evidence to suggest the appellant can follow instructions let alone complex instructions; there is no evidence to suggest the appellant can undertake motor vehicle repairs or similar tasks; and there is no evidence to suggest the appellant can type any document and, indeed, evidence suggests he has difficulty even with simple text messages;
(f)    the Medical Assessor appears to conclude that because the appellant was able to maintain a conversation for more than an hour, with assistance from his wife as support person, that this "rules out Class 4.” It is an error by the Medical Assessor to conclude that an inability to satisfy one example within a PIRS class necessarily excludes the appellant from that class, and
(g)    the overwhelming majority of history and evidence supports a class 4 categorisation.
The respondent submits that no errors were made, and points out the following:
(a)    Dr Glen Smith similarly assessed class 3 which is consistent with the findings of the Medical Assessor for ‘Social and Recreational Activities’;
(b)    the history taken by the Medical Assessor, which the appellant does not challenge, does not meet the criteria for a class 4 impairment rating;
(c)    the appellant has demonstrated the ability to occasionally and partially attend events of a social nature without the need for a support person, as demonstrated in his attendance to Port Macquarie for his 50th birthday;
(d)    intervention by the appeal panel will only be justified if the categorisation in the PIRS was glaringly improbable; the Medical Assessor was unaware of significant factual matters relevant to the assessment of impairment; if a clear misunderstanding could be demonstrated; or if an unsupportable reasoning process could be made out (Ferguson v State of New South Wales [2017] NSWSC 887 at [24];
(e)    the assessment of a class 3 rating is not ‘glaringly improbable’. There has also been no challenge by the appellant as to the history or factual matters taken into account by the Medical Assessor, nor a contention that there has been a clear misunderstanding. The respondent therefore does not consider intervention by the appeal panel to be justified;
(f)    the Medical Assessor provided details of the actual path of reasoning sufficient to support the classification of a class 3 impairment for ‘Social and Recreational Activities’ (Wingfoot Australia Partners Pty Limited v Kocak (2013) CLR 480;
(g)    it was open to the Medical Assessor to assess impairment as class 3;
(h)    the history and evidence before the Medical Assessor clearly indicates the appellant has the ability to maintain concentration, persistent and pace for short periods of time which is coherent to class 3. For the appellant to assert an impairment within class 4 would be inconsistent with the evidence;
(i)    Dr Glen Smith similarly assessed class 3 which is consistent with the findings of the Medical Assessor, and
(j)    we make the same comments in this category in reliance on the authorities referred to above.

Discussion
Social and recreational activities

The descriptor for a Class 3 rating reads: “Moderate impairment: rarely goes out to such events, and mostly when prompted by family or close friend. Will not go out without a support person. Not actively involved, remains quiet and withdrawn.”
For a Class 4 it reads: “Severe impairment: never leaves place of residence. Tolerates the company of family member or close friend, but will go to a different room or garden when others come to visit family or flat mate.”
The descriptors are just that: a general overview of the types of behaviour relevant to each class, and are not intended to be exclusive (Parker v Select Civil Pty Ltd [2018] NSWSC 140 at [68]). The Medical Assessor is not required to directly refer to these examples in providing his assessment.
In this case, in our view, the Medical Assessor’s findings and reasons in this category fit well with a Class 4 as submitted by the appellant.
The Medical Assessor said:
“Hobbies: He said he does not do any activities except watch television. Exercise: He stated that he used to go for walks. The last time he went for walks for the past 2 years [sic]. Frequency of socialising: He said he last socialised with family and friends when his mother died in 2023. He said did not attend her funeral in person for fear that the gastrointestinal issues associated with anxiety would cause him to soil himself during the service. He stated that before the injury, he used to enjoy gardening, renovating and photography.”
To begin with, as the Medical Assessor noted, Mr Wilson does nothing except watch television. Essentially, he does not leave his house, doesn’t go for walks as he previously did and “last socialised with family and friends when his mother died in 2023.”
As the appellant correctly pointed out:
“In relation to the claimants 50th birthday party, the MA notes this event was cut short, and notes the appellant did not engage in social activities at this event. It is also worth highlighting the appellants 50th birthday was some 18 months before the MA’s assessment. There is no evidence to suggest the appellant has left home after his birthday for any social or recreational activities (or at all), and in fact evidence recorded by the MA makes clear that he has not.”
The respondent was at pains to point out that section 1.6a of the Guidelines provides that “assessing impairment involves clinical assessment of the claimant as they present on the day of the assessment taking into account the claimant’s relevant medical history and all available relevant medical information.”
Mr Wilson’s presentation on the day of his assessment, as recorded by the Medical Assessor, was entirely consistent with a Class 4 rating.
The Medical Assessor in fact described very well Mr Wilson’s limitations in this category. He has not socialised for the past 18 months. He was unable to attend his mother’s funeral.
For these reasons, we agree with the appellant’s submissions and conclude that a Class 4 rating in this category is both appropriate and consistent with all the evidence.

Cpp

The descriptor for a Class 3 rating reads:
“Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.”
For a Class 4 it reads:
“Severe impairment: can only read a few lines before losing concentration. Difficulties following simple instructions. Concentration deficit obvious even during brief concentration. Unable to live alone or needs regular assistance from relatives or community services.”
The Medical Assessor noted that Mr Wilson:
“cannot focus for long. However, he was able to maintain a conversation for more than an hour which rules out Class 4. He has moderate impairment. He said that he cannot concentrate when reading or watching television for more than a few minutes.”
The assessment process is cognitively demanding and requires a significant degree of persistence and pace.
Mr Wilson’s ability to focus for more than an hour does not suggest that any concentration deficit “was obvious even during brief concentration.”
This category by its very nature requires an objective assessment of a person’s cognitive ability.
A Medical Assessor is particularly best placed to make that assessment when a claimant is present and his or her presentation can be observed throughout the entire assessment period.
Clause 1.6 of the Guidelines notes that the task of a Medical Assessor is to assess a claimant as they present on the day of the assessment. (our emphasis).
In our view, Mr Wilson’s presentation does not fit with a Class 4 rating as submitted by the appellant.
For these reasons, we cannot see any error by the Medical Assessor in his assessment in this category.
This means that the total WPI is now 26%.
For these reasons, the Appeal Panel has determined that the MAC issued on 3 June 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:	W658/24
Applicant:	Darren Wilson
Respondent:	Secretary, Department of Communities and Justice

This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act1998.

The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Gerard Walsh 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)
1. Psycholo gical Injury	11/07/2022 (deemed)	Chapter 11 Guidelines 11.1-11.3 11.4-11.6	Guidelines 11.11,11.12 Table: 11.1, 11.2, 11.3, 11. 5, 11.5, 11.6	26%	Nil	26%
Total % WPI (the Combined Table values of all sub-totals)					26%

[2024] NSWPICMP 602

26 August 2024