Wingecarribee Shire Council v Wilson - [2025] NSWPICMP 72

DETERMINATION OF APPEAL PANEL
CITATION:	Wingecarribee Shire Council v Wilson [2025] NSWPICMP 72
APPELLANT:	Wingecarribee Shire Council
RESPONDENT:	Marie Wilson
APPEAL PANEL
MEMBER:	Marshal Douglas
MEDICAL ASSESSOR:	Douglas Andrews
MEDICAL ASSESSOR:	Professor Nicholas Glozier
DATE OF DECISION:	7 February 2025
CATCHWORDS:	WORKERS COMPENSATION - Whether when assessing the degree of the respondent’s permanent impairment from her injury the Medical Assessor (MA) erred by taking into account matters that occurred in respondent’s work subsequent to the factors that gave rise to her injury; whether MA failed to take into account relevant evidence when rating the respondent’s impairment in all of the psychiatric impairment rating scale (PIRS) categories; Held – MA assessed the degree of the respondent’s permanent impairment from her injury and the matters that occurred subsequent to her injury had no impact on the respondent’s impairment from her injury; Appeal Panel held that with the exception of Social Functioning the MA’s ratings of the respondent’s impairment in the PIRS categories did not involve any error and the appellant’s submissions amounted to cavilling with the MA’s clinical judgement; Appeal Panel held that the MA’s rating of the respondent’s impairment in Social Functioning could not be justified on the evidence and his rating was wrong; Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 30 October 2024 Wingecarribee Shire Council lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr John Baker, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 2 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 (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 (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

Marie Wilson was employed by the appellant between 20 April 2015 and 1 July 2021 in the position of human resources business partner. She suffered a psychological injury due to her employment. She claimed compensation from the appellant for permanent impairment she said she had from her injury. She relied on a report of psychiatrist Dr Glen Smith dated 17…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2025] NSWPICMP 72
Decision Date: 7 February 2025

CaseChat Overview and Summary

In the case of Wingecarribee Shire Council v Wilson, the dispute involved the assessment of the respondent's permanent impairment due to an injury she sustained. The case was heard in the New South Wales Civil and Administrative Tribunal, where the appeal was made against the decision of the Medical Assessor (MA). The primary issue was whether the MA erred in assessing the degree of the respondent's permanent impairment by considering events that occurred after her injury, and whether the MA failed to consider relevant evidence when rating her impairment according to the Psychiatric Impairment Rating Scale (PIRS).

The court needed to determine if the MA's assessment was influenced by subsequent events unrelated to the injury and if the MA had properly evaluated the evidence across all categories of the PIRS. The Appeal Panel found that the MA correctly assessed the respondent's impairment and that the subsequent events had no impact on her injury-related impairment. Regarding the MA's clinical judgment, the Appeal Panel held that the MA's ratings were not erroneous, except for the category of Social Functioning, where the rating was unjustified based on the evidence provided.

The Appeal Panel concluded that the MA's ratings in all categories other than Social Functioning did not involve any error, and the appellant's criticisms amounted to questioning the MA's clinical judgment. However, the rating for Social Functioning was deemed incorrect and not supported by the evidence, leading to the revocation of the Medical Assessment Certificate. The final orders of the tribunal reflected the revocation of the certificate and the recognition of the MA's accurate assessment in most categories, except for the specific issue of Social Functioning.

Orders