DETERMINATION OF APPEAL PANEL	
	
CITATION:	McIntyre v State of New South Wales (NSW Police Force) [2024] NSWPICMP 64	
		
APPELLANT:	Kristin Fiona McIntyre	
		
RESPONDENT:	State of New South Wales (NSW Police Force)	
		
Appeal Panel		
		
MEMBER:	Carolyn Rimmer	
		
MEDICAL ASSESSOR:	Michael Hong 	
		
MEDICAL ASSESSOR:	Ash Takyar	
		
DATE OF DECISION:	12 February 2024	
		
CATCHWORDS: 	wORKERS cOMPENSATION - Claim for primary psychiatric injury; Medical Assessor (MA) assessed 9% whole person impairment; appellant submitted that the MA erred in his assessments of self-care and personal hygiene, travel, social and recreational activities and concentration, persistence and pace; Panel satisfied that there was no error in the assessments in those Psychiatric Impairment Rating Scale categories nor any application of incorrect criteria; Held – Medical Assessment Certificate confirmed. 

BACKGROUND TO THE APPLICATION TO APPEAL
1.	On 12 November 2023 Kristin Fiona McIntyre (the appellant)  lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Douglas Andrews, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 20 October 2023.
2.	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.
3.	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. 
4.	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.
5.	The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th issued 1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5). 
RELEVANT FACTUAL BACKGROUND
6.	The appellant developed a primary psychological injury in the course of her employment with NSW Police Force (the respondent). 
7.	The appellant commenced proceedings in the Personal Injury Commission (Commission) claiming 22% whole person impairment (WPI) pursuant to s 66 of the Workers Compensation Act 1987 (the 1987 Act) in respect of a primary psychiatric injury deemed to have occurred on 4 May 2021.
8.	The Medical Assessor examined the appellant on 18 October 2023 through video link. The Medical Assessor assessed 7% WPI and then added 2% WPI for treatment effect. Therefore, the total WPI assessed was 9% as a result of the injury deemed to have occurred on 
4 May 2021.
PRELIMINARY REVIEW
9.	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.
10.	The appellant did not request that she be re-examined by a Medical Assessor who is a member of the Appeal Panel.  
11.	As a result of that preliminary review, the Appeal Panel determined that it was unnecessary for the appellant to undergo a further medical examination because there was sufficient evidence on which to make a determination.
EVIDENCE
Documentary evidence
12.	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.  
Medical Assessment Certificate
13.	The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision. 
SUBMISSIONS 
14.	Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel. 
15.	The appellant’s submissions include the following: 
(a)	self-care and personal hygiene - the Medical Assessor stated that the appellant’s self-care and personal hygiene is class 2;
(b)	the appellant has gained significant weight, as noted by the Medical Assessor. Furthermore, as a result of the excessive weight, she has gained subsequent diseases, such as fatty liver disease. The examples within the Guidelines are simply examples, and ought to take into consideration the appellant’s assessment for self-care and personal hygiene. The appellant submits she should be class 3;
(c)	travel -  the Medical Assessor mentioned the appellant’s back pain, and the incorporation of this mention suggests that Medical Assessor has discounted the appellant’s assessment to travel on the basis that the back pain poses a limitation on her ability to travel;
(d)	in Dr Andrew Fraen’s report, occupational physician, it was reported that she is able to sit for around 40 minutes. In light of the restrictions, she ought to have the physical capabilities of driving beyond her local area, and suggestion that travel to be discounted in the assessment is not applied;
(e)	the Medical Assessor erred in the assessment by rating the appellant as class 1. On page 3 of the Medical Assessor’s assessment, he states the appellant is “anxious when away from home”. This reported symptom is contrary to the assessment of travel, and suggests that it has some impairment to the capabilities of travel. The appellant should be class 2;
(f)	social and recreational activities -  the Medical Assessor seems to have misunderstood or misinterpreted the nature of the appellant's social activities as  her social interactions primarily involve family members and her children's activities. Contrary to the Medical Assessor's assessment, her engagement in activities like going to cafes, restaurants, and the beach is not indicative of a broad and diverse social life. Instead, these activities are limited to the occasional family-related events. She has also avoided many social outings with family. Given the clarification that her social activities predominantly revolve around family, it would be more accurate to place her in class 3 rather than class 2;
(g)	concentration, persistence and pace -  the appellant communicated to the Medical Assessor that she experiences significant problems with concentration and persistence and reported difficulties, including exhaustion after a relatively short task. The Medical Assessor's evaluation seems to heavily rely on the appellant's ability to engage in certain activities like watching television shows and listening to podcasts. The appellant believes she doesn’t have to concentrate greatly on these and they can be quite mind-numbing. These activities may not accurately represent the cognitive demands and challenges faced by the appellant in real-world situations, such as business correspondence and important tasks. Her statement about being slow at most tasks and finishing them only if absolutely necessary points to a struggle with persistence and pace. The need for breaks and the reliance on external assistance for proof-checking indicate a level of impairment that aligns more with class 3 than class 2, and
(h)	in conclusion, the appellant has appealed their psychiatric impairment rating on the basis of incorrect criteria and a demonstrable error in the MAC. Therefore, the appellant seeks a correction to their impairment rating.
16.	The respondent‘s submissions include the following:
(a)	self care and personal hygiene -  the Medical Assessor has correctly assessed the appellant with class 2 impairment noting she is “independent in activities of daily living, including hygiene, housework and meal preparation”. Moreover, as at page 5 of the MAC, the appellant showers and wears clean clothes daily and manages to wake up at 8:00am to help prepare her youngest son for school. She is also able to do the shopping and has recently started weeding the garden;
(b)	social and recreational activities - Dr Alan Doris reported that the appellant “is now able to experience enjoyment and joy in some activities” and that since moving to the mid-north coast, the appellant “is starting to socialise again and meet new people. She is due to start swimming at the local pool three times per week from next week”;
(c)	the activities identified by the Medical Assessor, including visits to the beach, attendance to her children’s sporting events, and enjoying outings to cafes and restaurants with family and friends, along with the appellant’s engagement in her new community as reported by Dr Doris, collectively showcase the appellant's active efforts and ability to involve herself in some type of social engagement.The Medical Assessor has correctly assessed the appellant with class 2 impairment;
(d)	travel - the full reference on page 3 of the MAC states that the appellant “is anxious when away from home, especially if she needs to interact with others”, which is more attributable to her impairment relating to social activities rather than travel. The Medical Assessor has considered this symptom in his assessment and reasoning for the PIRS category of “social and recreational activities”, stating that “she is more anxious in social situations”;
(e)	Dr Alan Doris reported that the appellant is able to travel independently without difficulty and that over the holiday period, she had a number of family and friends visit and “enjoyed the role of tour guide taking visitors around a number of locations in the region”, including areas “up to one and a half hours away from her home”;
(f)	at page 5 of the MAC, the Medical Assessor reported that the appellant stated “I really like driving” and has travelled from Maclean to Newcastle for an independent medical examination and beyond Newcastle to visit her mother, noting that these trips are more than five hours each way;
(g)	in light of the above, the Medical Assessor has correctly assessed the appellant with class 1 impairment noting that “she is independent with local travel and can travel further afield”;
(h)	concentration, persistence and pace - in the Medical Assessor’s reasoning for assessing the appellant with class 2 impairment, he states “She has subjective problems with concentration and attention and struggles to read business correspondence and emails. However, she engages well with serial television shows, listens to podcasts and audiobooks and can read novels and biographies”. Moreover, the Medical Assessor reported that “there were no significant problems with concentration, attention or memory in my 100-minute assessment”;
(i)	similarly, Dr Alan Doris reported that despite the appellant having poor concentration at times, she “feels that her thinking is significantly clearer now compared to a few months ago and she is reading for pleasure up to 30 minutes”, which we consider fits the criteria for class 2 impairment;
(j)	the Medical Assessor’s assessment was based on his clinical judgement, having regard to the history obtained, available evidence and his own clinical examination of the appellant, during which the Medical Assessor found no significant problems with the appellant’s concentration, attention or memory;
(k)	as held in Schulz v Staffpower Pty Ltd [2021] NSWPICMP 223 at [29], a Medical Assessor is entitled to rely on his clinical findings on the day of examination as well as his clinical assessment of the available medical evidence before him;
(l)	the Medical Assessor has provided a medical assessment based on his clinical skill and judgment and that the conclusions reached by the Medical Assessor were available to him based on the material provided to him and the appellant’s presentation on assessment, and
(m)	in those circumstances,the assessment contained in the MAC be confirmed.
FINDINGS AND REASONS 
17.	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. 
18.	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.
19.	Section 327(2) was amended with the effect that while the appeal was to be by way of review, all appeals as at 1 February 2011 were limited to the ground(s) upon which the appeal was made. In New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales [2013] the form of the words used in 
s 328(2) of the 1998 Act being, SC 1792 Davies J considered that ‘the grounds of appeal on which the appeal is made’ was intended to mean that the appeal is confined to those particular demonstrable errors identified by a party in its submissions.
Psychiatric impairment rating scales categories 
20.	The appellant alleged error in respect of the assessment of the psychiatric impairment rating scales (PIRS) categories of self care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace. 
21.	The concept of a demonstrable error as utilised under s 327(3)(d) of the 1998 Act was discussed at length by Gleeson JA in Vannini v WorldWide Demolitions Pty Ltd [2018] NSWCA 324. In dealing with the authorities, his Honour observed that for an error to be demonstrable it needed to be material, apparent on the face of the certificate and an error for which there is no information or material to support the finding made, rather than a difference of opinion.
22.	In Jenkins v Ambulance Service of NSW [2015] NSWSC 633 Garling J said at [73]:
“It was a matter for the clinical judgment of the AMS to determine whether the impairment with respect to employability was at the moderate level, as he did, or at some other level. But, in seeking judicial review, a mere disagreement about the level of impairment is not sufficient to demonstrate error of a kind susceptible to judicial review.”
23.	In Ferguson v State of New South Wales (2017) NSWSC 887 (Ferguson), Campbell J was Campbell J in Ferguson v State of New South Wales [2017] NSWSC 857, where his Honour in dealing with whether there was error in the application of the categories and classes of the PIRS identified the following as relevant: 
	(a)	was the categorisation glaringly improbable; 
	(b)	was the AMS unaware of significant factual matters; 
	(c)	was there a clear misunderstanding by the AMS, and 
	(d)	was the AMS’s reason process unable to be made out?
24.	In Parker v Select Civil Pty Ltd [2018] NSWSC 140 (Parker) Harrison AsJ at [66] said:
“66.In relation to Classes of PIRS there has to be more than a difference of opinion on a subject about which reasonable minds may differ to establish error in the statutory sense… 
70.To find an error in the statutory sense, the Appeal Panel’s task was to determine whether the AMS had incorrectly applied the relevant Guidelines including the PIRS Guidelines issued by WorkCover. Even though the descriptors in Class 3 are examples not intended to be exclusive and are subject to variables outlined earlier, the AMS applied Class 3. The Appeal Panel determined that the AMS had erred in assessing Class 3 because the proper application of the Class 2 mild impairment is the more appropriate one on the history taken by the AMS and the available evidence.
71.The AMS took the history from Mr Parker and conducted a medical assessment, the significance or otherwise of matters raised in the consultation is very much a matter for his assessment. It is my view that whether the findings fell into Class 2 or Class 3 is a difference of opinion about which reasonable minds may differ. Whether Class 2 in the Appeal Panel’s opinion is more appropriate does not suggest that the AMS applied incorrect criteria contained in Class 3 of the PIRS. Nor does the AMS’s reasons disclose a demonstrable error…”
25.	The Medical Assessor is required to interview the worker and provide his assessment of WPI and opinion based upon his own findings as at the date of the examination. 
26.	The Appeal Panel reviewed the history recorded by the Medical Assessor, his findings on examination, and the reasons for his conclusions as well as the evidence referred to above.
Self care and personal hygiene
27.	The appellant asserts that she has gained significant weight, as noted by the Medical Assessor. She argues that as a result of the excessive weight, she has gained subsequent diseases, such as fatty liver disease. The appellant submits she should be class 3.
28.	Clause 11.12 of the Guidelines for the evaluation of permanent impairment states: "The examples of activities are examples only. The assessing psychiatrist should take account of the person's cultural background. Consider activities that are usual for the person's age, sex and cultural norms."
29.	The examples under Table 11. 1 for “self care and personal hygiene” in the Guidelines are: 
“Class 2: Mild impairment: able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food.
Class 3: Moderate impairment: Can’t live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit) 2-3 times per week to ensure minimum level of hygiene and nutrition.” 
30.	The Medical Assessor assessed the appellant as class 2 for self care and personal hygiene. In the PIRS Rating Form, the Medical Assessor wrote: 
“Self-care and personal hygiene - Class 2
Ms McIntyre is independent in activities of daily living, including hygiene, housework and meal preparation. She takes less exercise, has gained significant weight, and is now obese, posing risks to her health”.
31.	Under “Social Activities/ADL”, the Medical Assessor noted:
“Ms McIntyre rises at about 8 a.m. and helps prepare her youngest son for school. She has breakfast, watches the news and usually gets dressed between 10:30 and 11 a.m.
She will do housework, shopping and meal preparation. She has recently started weeding the garden.
She is less attentive to her appearance, for example, having fewer haircuts. She showers and wears clean clothes daily.”
32.	Associate Professor Michael Robertson, in his report dated 13 September 2022, assessed the appellant as class 3 for self care and personal hygiene giving the following reasons:
“She consumes a poor diet and has gained a significant amount of weight. She frequently omits to shower and neglects her appearance.”
33.	Dr Alan Doris in a report dated 23 February 2023 wrote: 
“Kris is now in a much better situation in her life and is improving in her mental health. It is likely that she will continue to make progress over the next 3 to 6 months and during that time should enter full remission. It is also possible that she will have some long term unresolved symptoms.”
34.	Dr Doris assessed the appellant as class 1 for self care and personal hygiene giving the following reasons: “As Kris has improved in her general mental health her self-care has improved”.
35.	The appellant submits that the evidence suggested a greater impairment of self care and personal hygiene and a moderate impairment.
36.	The Appeal Panel did not accept that the evidence supported a greater impairment of self care and personal hygiene. The Medical Assessor accepted that the appellant is independent in activities of daily living, including hygiene, housework and meal preparation. The Medical Assessor noted that the appellant takes less exercise, has gained significant weight, and is now obese, posing risks to her health. The Appeal Panel considered that the appellant had improved since her assessment by Associate Professor Robertson who had assessed her as class 3 noting that she frequently omitted to shower and neglected her appearance. At the time of assessment by the Medical Assessor, it was clear that although she was less attentive in terms of appearance, she showered daily,  did housework, shopping and meal preparation. 
37.	The appellant submits that a class 3 score would be more appropriate in the category of self care and personal hygiene. However, the history taken by the Medical Assessor made it clear thay the appellant does not meet the descriptors for a class 3 rating which include, for example, the need to be  prompted to shower daily and wear clean clothes. 
38.	Based on the evidence before the Appeal Panel, and for the reasons provided by the Medical Assessor in the MAC, the Appeal Panel agrees with the Medical Assessor that an assessment of class 2 for self care and personal hygiene is appropriate. 
39.	The Appeal Panel is satisfied that there is no demonstrable error in the MAC in relation to the rating in the PIRS categories of self care and personal hygiene and the assessment in this class is not made on the basis of correct criteria. The categorisation of class 2 for self care and personal hygiene is not glaringly improbable; the Medical Assessor was not unaware of significant factual matters, there is no clear misunderstanding by the Medical Assessor and his reasoning process is sufficiently clear. 
Social and recreational activities 
40.	The appellant submits that the Medical Assessor seems to have misunderstood or misinterpreted the nature of the claimant's social activities which primarily involve family members and her children's activities. The appellant argues that contrary to the Medical Assessor's assessment her engagement in activities like going to cafes, restaurants, and the beach is not indicative of a broad and diverse social life as these activities are limited to the occasional family-related events. The appellant argues that as her social activities predominantly revolve around family, it would be more accurate to place her in class 3 rather than class 2.
41.	The examples under Table 11.2 for “Social and recreational activities” in the Guidelines are: 
“Class 2: Mild impairment: occasionally goes out to such events eg without needing a support person, but does not become actively involved (eg dancing, cheering favourite team). 
Class 3: 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.” 
42.	Clause 11.11 of the Guidelines classified social and recreational activities as an activity of daily living.
43.	The Medical Assessor assessed the appellant as class 2 for social and recreational activities. In the PIRS rating form, the Medical Assessor wrote: 
“Social and recreational activities - Class 2
She is more anxious in social situations but has maintained some social activity. She had visits to her home from a friend and extended family early in 2023. They went out to cafés and restaurants and local sites. She enjoys attending her children’s sporting activities and going to the beach. She has some interaction with other parents but tends to keep to herself. She planned to go out to dinner with her wife on the day of the assessment to celebrate a birthday.” 
44.	Under “Social activities/ADL” the Medical Assessor noted: 
“She and Courtney have relocated and did not have a social network at Maclean. Her best friend visited in January for a holiday, and some members of her extended family also came to stay earlier in the year. During these visits, they went out together, for example, to restaurants and cafés. She visited a person’s home for dinner in March of this year. Today is Courtney’s birthday, and they plan to go to a restaurant together.
Ms McIntyre attends her children’s sporting activities, including soccer and nippers. She also enjoys going to the beach. Although she enjoys watching the children participate, she keeps to herself, even avoiding people she knows.”
45.	Associate Professor Robertson, in a report dated 13 September 2022, assessed the appellant as class 3 for social and recreational activities giving the following reasons:
“She does not go out. She does not socialise. She does not accept invitations to social occasions. She is reluctant to go into the town.”
46.	Dr Doris, in his report dated 23 February 2023 noted: “Following the move to Maclean, Kris is starting to socialise again and meet new people.” He assessed the appellant as class 2 for social and recreational activities giving the following reasons:
“Kris can feel anxiety on attending social events though is actively trying to make new relationships and get involved in more activities in the community she has recently moved to. She is due to start swimming at a local pool three days per week from next week.”
47.	The appellant submits that as her social activities predominantly revolve around family, it would be more accurate to place her in class 3 rather than class 2.
48.	The Appeal Panel does not accept that the evidence supported a greater impairment of social and recreational activities. The Medical Assessor reported that the appellant is more anxious in social situations but has maintained some social activity. He noted that the appellant had visits to her home from a friend and extended family early in 2023 and they went out to cafes and restaurants and local sites. The Medical Assessor noted that the appellant enjoys attending her children’s sporting activities and going to the beach. He reported that she has some interaction with other parents but tends to keep to herself. He noted that she planned to go out to dinner with her wife on the day of the assessment to celebrate a birthday.
49.	The appellant submits that a class 3 score would be more appropriate in the category of social and recreational activities. The fact that many of the appeallant’s social activities revolve around her family does not detract from the fact that she engages in some social activity and is able to go out without a support person.
50.	Based on the evidence before the Appeal Panel, and for the reasons provided by the Medical Assessor in the MAC, the Appeal Panel considers that it was open to the Medical Assessor on the evidence to make an assessment of class 2 for social and recreational activities considering the evidence available and the history taken during the assessment by the Medical Assessor. 
51.	The appellant’s submission “these activities are limited to the occasional family-related event”, that is, she engages in occasional activities, is also consistent with a rating of class 2. 
52.	The Appeal Panel is satisfied that there was no demonstrable error in the MAC in relation to the rating in the PIRS categories of social and recreational activities and the assessment in this class was not made on the basis of correct criteria. The categorisation of class 2 for social and recreational activities is not glaringly improbable; the Medical Assessor is not unaware of significant factual matters, there is no clear misunderstanding by the Medical Assessor and his reasoning process is sufficiently clear. 
Travel 
53.	The appellant submits that the Medical Assessor mentioned that she had back pain and this suggests that he discounted the appellant’s assessment to travel on the basis that the back pain poses a limitation on her ability to travel.
54.	The appellant consides that the Medical Assessor had erred in the assessment by rating the appellant as class 1.
55.	The examples under Table 11.3 for “Travel” in the Guidelines are: 
“Class 1 No deficit, or minor deficit attributable to the normal variation in the general population: Can travel to new environments without supervision.
Class 2 Mild impairment: Can travel without support person, but only in a familiar area such as local shops, visiting a neighbour.
Class 3 Moderate impairment: Cannot travel away from own residence without support person. Problems may be due to excessive anxiety or cognitive impairment”.
56.	The Medical Assessor assessed class 1 in relation to travel noting: 
“She is independent with local travel and can travel further afield. She said she enjoys driving but likes to have company on longer trips because she can share the driving. This limitation is due to her back pain, which is not part of the psychological impairment..”
57.	On page 3 of the MAC, the Medical Assessor stated: “She is anxious when away from home, especially if she needs to interact with others. She has had occasional panic attacks, once in the last month”. 
58.	The appellant submits that this reported symptom is contrary to the assessment of travel, and suggests that she has some impairment to the capabilities of travel. The appellant submits she should be class 2.
59.	Under “Social activities/ADL”, the Medical Assessor wrote:
“She said, “I really like driving; I listen to audiobooks.” She acknowledged limitations due to her physical discomfort. She is independent with local travel and has travelled from Maclean to Newcastle for an IME (with Courtney to share the driving) and visited her mother, who lives further than Newcastle. These trips are more than 5 hours each way.”
60.	The appellant, in her statement dated 9 September 2022, wrote: “I suffer from general anxiety, which at times stops me from leaving the house to do simple tasks”.
61.	Associate Professor Robertson, in a report dated 13 September 2022, assessed the appellant as class 2 for travel giving the following reasons: “She can only go on focused outings and is reluctant to travel in unfamiliar areas”.
62.	Dr Doris in his report dated 23 February 2023 assessed the appellant as class 1 for travel giving the following reasons:
“Kris is able to travel independently without difficulty. Over the holiday period she enjoyed taking friends and family around the region including to areas up to 1 1/2 hours away from her home.”
63.	Dr Andrew Fraen, occupational physician, provided a report dated 28 May 2021, to the respondent for the purpose of assessing fitness for duty. He reported that the appellant is able to sit for around 40 minutes. Dr Fraen wrote: “From a physical perspective, I consider it a reasonable expectation that Senior Constable (SCON) McIntyre  will be able to return to full duties in the foreseeable future.”
64.	The appellant submits that the Medical Assessor mentioned that she had back pain and this suggested that the Medical Assessor had discounted the appellant’s assessment to travel on the basis that the back pain poses a limitation on her ability to travel. The Appeal Panel did not accept this submission. The Medical Assessor noted that the appellant acknowledged limitations due to her physical discomfort, but she was clearly independent with local travel and had made two trips which were more than five hours each way. The Medical Assessor noted that the appellant liked to have company on longer trips because she can share the driving. The Appeal Panel considered that the appellant’s functioning in travel had improved considerably since the assessment by Associate Professor Robertson on
13 September 2022. 
65.	The Appeal Panel noted that reference was made to the appellant’s anxiety, however, that seemed to  be mainly related to when she needed to interact with others. In any event, the fact that the appellant can be anxious when travelling  does not detract from the fact that she can travel.
66.	Based on the evidence before the Appeal Panel, and for the reasons provided by the Medical Assessor in the MAC, the Appeal Panel considers that it was open to the Medical Assessor on the evidence to make an assessment of class 1 for travel considering the evidence available and the history taken during the assessment by the Medical Assessor. 
67.	The Appeal Panel is satisfied that there was no demonstrable error in the MAC in relation to the rating in the PIRS categories of travel and the assessment in this class was not made on the basis of correct criteria. The categorisation of class 1 for travel is not glaringly improbable; the Medical Assessor is not unaware of significant factual matters, there is no clear misunderstanding by the Medical Assessor and his reasoning process is sufficiently clear. 
Concentration, persistence and pace 
68.	The appellant submits that she communicated to the Medical Assessor that she experiences significant problems with concentration and persistence, and reported difficulties, including exhaustion after a relatively short task. The appellant argued that the Medical Assessor's evaluation seems to heavily rely on the appellant's ability to engage in certain activities like watching television shows and listening to podcasts, but she doesn’t have to concentrate greatly on these and they can be quite mind-numbing. The appellant submitted that these activities may not accurately represent the cognitive demands and challenges faced by the appellant in real-world situations, such as business correspondence and important tasks. 
69.	The appellant argued that her statement about being slow at most tasks and finishing them only if absolutely necessary points to a struggle with persistence and pace. Further, the need for breaks and the reliance on external assistance for proof-checking indicate a level of impairment that aligns more with class 3 than class 2.
70.	The examples under Table 11.5 for “concentration, persistence and pace” in the Guidelines are: 
“Class 2: Mild impairment: can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache. 
Class 3: 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.” 
71.	The Medical Assessor assessed class 2 in relation to concentration, persistence and pace noting: 
"She has subjective problems with concentration and attention and struggles to read business correspondence and emails. However, she engages well with serial television shows, listens to podcasts and audiobooks and can read novels and biographies. There were no significant problems with concentration, attention or memory in my 100-minute assessment.”
72.	Under “Present symptoms”, the Medical Assessor wrote:
“She has subjective problems with concentration and attention. She described having to reread documents and emails”.
73.	Under “Social Activities/ADL” the Medical Assessor noted: 
“She spends much of the day watching television shows, favouring “dramas… serious types “of shows” on Netflix or the SBS. She said that she engages well with the plot and characters.
Although she struggles to read legal documents and emails. She said she “loves reading” but now often focuses on audiobooks or podcasts. She said she has recently read books by Hillary Clinton and John Grisham.
….
She has several projects, including woodworking. However, she procrastinates and has struggled to complete them. She said that she had 5 or 6 projects partly completed.”
74.	On mental health examination, the Medical Assessor noted:
“She gave a detailed account without apparent signs of cognitive difficulties. It wasn’t necessary to redirect or restate questions.”.
75.	In her statement dated 9 September 2022, the appellant wrote: 
“I have an impaired memory and struggle to recall the simplest things.
I struggle with concentration and this has affected my ability to conduct daily tasks and engaging in activities that I once enjoyed such as reading books, watching TV, communicating with others and doing volunteer work in the community.”	
76.	Associate Professor Robertson, in a report dated 13 September 2022, assessed the appellant as class 3 for concentration, persistence and pace giving the following reasons: “She is forgetful, inattentive, reads a few lines before losing focus, procrastinates and works in a much lower pace”.
77.	Dr Doris, in his report dated 23 February 2023, noted:
“Kris feels that her thoughts are “clearer” though can still struggle with concentration at times. She recently finished reading a biography which she enjoyed, though this took her several weeks. Typically she can read for between 15 and 30 minutes”.
78.	Dr Doris assessed the appellant as class 2 for concentration, persistence and pace giving the following reasons:
“Kris can have times when her concentration is poor though in general feels that her thinking is significantly clearer now compared to a few months ago and she is reading for pleasure for up to 30 minutes.”
79.	The Appeal Panel considered that the appellant’s condition and ability to focus and concentrate had improved since her assessment by Associate Proofessor Robertson in September 2022. The appellant is now able to read for up to 30 minutes at a time and reads biographies and novels. The appellant told the Medical Asessor that when she watches television shows she engages well with the plot and characters. The Appeal Panel noted that on examination by the Medical Assessor, the appellant was able to give a detailed account without apparent signs of cognitive difficulties during the 100 minute interview.
80.	Based on the evidence before the Appeal Panel, and for the reasons provided by the Medical Assessor in the MAC, the Appeal Panel considers that it was open to the Medical Assessor on the evidence to make an assessment of class 2 for concentration, persistence and pace considering the evidence available and the history taken during assessment by the Medical Assessor. 
81.	The Appeal Panel is satisfied that there was no demonstrable error in the MAC in relation to the rating in the PIRS categories of travel and the assessment in this class was not made on the basis of correct criteria. The categorisation of class 2 for concentration, persistence and pace is not glaringly improbable; the Medical Assessor is not unaware of significant factual matters, there is no clear misunderstanding by the Medical Assessor and his reasoning process is sufficiently clear. 
Summary
82.	The Appeal Panel concluded there was no error, nor any application  of incorrect criteria in the Medical Assessor’s assessment of the appellant’s impairment in the PIRS categories of self care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace. 
83.	For these reasons, the Appeal Panel has determined that the MAC issued on 
20 October 2023 should be confirmed.