DETERMINATION OF APPEAL PANEL	
	
CITATION:	Kasmaei v Roads and Maritime Services [2024] NSWPICMP 403	
		
APPELLANT:	Reza Kasmaei	
		
RESPONDENT:	Roads and Maritime Services	
		
Appeal Panel		
		
MEMBER:	Deborah Moore	
		
MEDICAL ASSESSOR:	Michael Hong	
		
MEDICAL ASSESSOR:	John Baker	
		
DATE OF DECISION:	25 June 2024	
		
CATCHWORDS: 	wORKERS cOMPENSATION - Self-represented appellant; fresh evidence considered; re-examination required; Medical Assessor (MA) erred in providing an extremely brief certificate with limited contents in the Medical Assessment Certificate’s (MAC) body; Held – MA erred with respect to his assessments with respect to the Psychiatric Impairment Rating Scale categories of travel, self-care and personal hygiene, social and recreational activities, social functioning, and employability; MAC revoked.

BACKGROUND TO THE APPLICATION TO APPEAL
1.	On 15 November 2023 Reza Kasmaei (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Gerald Chew, a Medical Assessor (MA), who issued a Medical Assessment Certificate (MAC) on 23 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): 
•	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.
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 ed 
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).
PRELIMINARY REVIEW
6.	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.
7.	As a result of that preliminary review, the Appeal Panel determined that the worker should undergo a further medical examination because the MA erred in conducting an extremely brief assessment, failing to provide any or any adequate reasons for his assessment and failing to consider the whole of the evidence. 
Fresh evidence
8.	Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in addition to or in substitution for the evidence received in relation to a medical assessment appealed against may not be given on an appeal by a party unless the evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before that medical assessment.
9.	The appellant seeks to admit the following evidence:
(a)	medical report of Dr Bennett dated 14 May 2023 received on 8 November 2023.
(b)	Medical report of Dr Bennett dated 4 August 2023 received on 8 November 2023.
(c)	Medical report of Dr Bennett dated 10 October 2023 received on 8 November 2023.
(d)	Clinical notes of Dr Bennett various, received on 8 November 2023.
(e)	Medical report Dr Khan dated 9 October 2023 received on 16 October 2023.
(f)	Certificate of Capacity of Dr Dickson dated 24 October 2023 received on 26 October 2023.
(g)	Medical Retirement TfNSW dated 27 October 2023 received on 27 October 2023.
10.	The appellant submits that the evidence is relevant because of the following matters:
(a)	the reports elaborate on multiple categories of functioning and draw a picture that is significantly different from the ones the medical examiner has reported. 
(b)	Although, the evidence existed prior to the medical examination, their significance would not be as significant as it is if the MA conducted the Medical Assessment properly and according to the Guideline and the 1998 Act. 
(c)	Therefore, to avoid injustice, Mr Kasmaei seeks leave to adduce these medical notes and reports as new evidence.
11.	The appellant concedes that most of the evidence was available prior to the assessment however, for reasons that will become apparent in due course, the Appeal Panel accepted that the MA erred in conducting an extremely brief assessment, failing to provide any or any adequate reasons for his assessment and failing to consider the whole of the evidence. 
12.	Roads and Maritime Services (the respondent) submits that the appellant had ample opportunity to request the documents from Dr Bennett ahead of the examination with the MA and produce these documents to the Personal Injury Commission (Commission) prior to being examined. There would be significant prejudice to the respondent if admitted and there is no explanation why they could not have been included in the documents initially forwarded to the MA.
13.	In addition, the respondent objects to the admission of the documents noted in (f) and (g) above as they have little probative value to the issues in dispute. 
14.	We note that Mr Kasmaei was initially legally represented but is now self-represented, and in the interests of justice it is appropriate to consider his submissions on this issue.
15.	We agree with the respondent as regards the documents in (f) and (g) above
16.	The Appeal Panel determines that the following evidence should be received on the appeal: 
(a)	medical report – Dr Bennett – 14 May 2023;
(b)	medical report – Dr Bennett – 4 August 2023;
(c)	medical report – Dr Bennett – 10 October 2023;
(d)	clinical notes – Dr Bennett various, and
(e)	medical report –  Dr Khan – 9 October 2023.
EVIDENCE
Documentary evidence
17.	The Appeal Panel has before it all the documents that were sent to the MA for the original medical assessment and has taken them into account in making this determination.  
Further medical examination
18.	Dr John Baker of the Appeal Panel conducted an examination of the worker on 14 June 2024 and reported to the Appeal Panel.
SUBMISSIONS 
19.	Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel. 
20.	In summary, the appellant submits that the MA erred in a number of respects as follows:
(a)	the assessment was conducted via Teams and lasted around 15 minutes, during which the initial third went by with no assessment happening due to log-in and technical difficulty on Mr Kasmaei’s part. The second third covered general topics like medication and the names of medical practitioners. The last third of the assessment was allocated for taking history and dealing with medical examination, which was approximately five minutes.
(b)	The MA issued an extremely brief certificate with limited contents in the MAC’s body.
(c)	Paragraph 1.46 of the Guidelines states that “A report of the evaluation of permanent impairment should be accurate, comprehensive and fair”.
(d)	The medical assessment’s duration, lack of details in the MAC, and the MA’s reliance on previous IME’s reports without sufficient reasoning, as to why he agrees with either IMEs, demonstrates that the MA was clearly unaware of significant factual matters and employed unsupportable reasoning process to form his decision.
(e)	The MA erred with respect to his assessments with respect to the psychiatric impairment rating scale (PIRS) categories of Travel, Self-Care and Personal Hygiene, Social and Recreational Activities, Social Functioning, and Employability.
21.	In reply, the respondent submits that no errors were made, and that the MAC of Dr Chew should be confirmed.
FINDINGS AND REASONS 
22.	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. 
23.	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.
24.	The appellant was referred to the MA for assessment of whole person impairment (WPI) in respect of a primary psychological/psychiatric injury occurring on a date of injury of 22 February 2022. 
25.	The MA obtained the following history:
“He began working for Transport NSW in November 2016. He reports difficulties in the workplace with clashes with management and ‘bullying and harassment’ beginning early on in his employment. 
He first started noticing effects on his mental health in 2021. He said that in the context of this he developed low mood, poor sleep, irritability, social avoidance, poor concentration. He also developed some paranoia however this has improved. 
He was previously trialled on dothiepin, agomelatine and sertraline but did not tolerate them. He was on an increased dose of 100mg of desvenlafaxine but reduced back because of side effects.”
26.	The MA continued as follows:
“Present treatment: GP, psychologist monthly, psychiatrist every 2 months. There are no plans for further significant changes to his treatment. He takes desvenlafaxine 50mg and quetiapine 100mg daily. 
Present symptoms: He reported low mood, irritability, poor sleep, poor appetite, poor energy. There were no psychotic symptoms. 
Details of any previous or subsequent accidents, injuries or condition: Nil – there is no convincing evidence of past psychiatric history that has had long lasting effect on function.
General health: nil significant. 
Work history including previous work history if relevant: he has not worked since 22 February 2022.
Social activities/ADL: he does not shower daily. He is more socially withdrawn. He is able to live independently. He sees friends regularly on a weekly basis. He has been able to listen to audiobooks. He speaks to his family in Iran regularly.”
27.	Findings on mental state examination were reported as follows:
“Appeared his stated age. Flat affect. Nil abnormal psychomotor activity. Depressed and anxious mood. Oriented to time, place and person. Speech of normal rate, rhythm, volume and prosody. Nil formal thought disorder. Nil delusions or hallucinations. No thoughts of harm to others. No suicidal ideation today or immediate plan.”
28.	The MA summarised the injury as “Persistent Depressive Disorder.”
29.	He assessed 17% WPI.
30.	He then summarised the evidence before him and said:
“Dr Saboor WPI 24%.
Dr Ahmed no MMI WPI 14%.
Areas of disagreement:
 I think there has been MMI – his medication is now stable and he is unlikely to improve significantly with or without treatment. 
Social Functioning – I agree with Dr Ahmed. There is mild impairment. He maintains some meaningful relationships with some family and friends. 
Adaptation – He has severe impairment. I do not think he can work in the same capacity however his ability to live independently and follow audiobooks indicates he has some capacity.”
Discussion
31.	As stated earlier, the MAC was frankly dreadfully sparse on detail, and very little regard was had by the MA to all of the evidence.
32.	For these reasons the Appeal Panel determined that it was necessary for the appellant to be re-examined.
33.	Dr Baker examined him on 14 June 2024 and reported to us as follows:
“The worker’s medical history provided was ascertained over a 90-minute assessment. The examination was conducted using MS TEAMS. The certificate under review was extremely brief.
Due to the extremely brief assessment documented by Assessor Gerald Chew this medical review, differs markedly in history, findings and reasons. The differences in the appellant’s history were due to the increased time the appellant was examined. The provision of time provided to the appellant with opportunity explain his primary psychological injury as well as have the appellant’s primary psychological injury fully defined in accordance with guidelines.
He identified himself as of Zoroastrian heritage. His first language was Persian (Farsi.) He was an Australian citizen. He did not require an interpreter as his English was fluent. He was the only member of his family of origin living in Australia. The appellant was aged 44 years, born on 9 June 1980.
The appellant last had contact with his family about one year ago. He was using the application, ‘Telegram’ to keep in contact with them. He reported uninstalling the app as he was fearful of the conversations he was having might be recorded by another government.
The appellant reported that at school he was identified as a gifted student. He was a member of a small group of 20 students chosen to study advanced mathematics and physics in senior government high school. He reported his interest in international football (soccer) as a child and he continued this interest in Australia prior to the onset of this primary psychological injury. He was interested in writing songs and lyrics that he would share with others whilst making music and songs with his group of friends. He had last released his lyrics for use in the non-commercial sector of Iranian music in 2021. He said he was an amateur aviator and had flown light aircraft in Australia and abroad. He had stopped flying due to this primary psychological injury.
The appellant attended Azad University in Tehran, Iran. He studied mathematics and physics. He specialised in statistics. His focus was on Dynamic Mechanics, engineering and vibrational forces.
The appellant entered Australia in 2010. He attended the University of Western Australia. He studied and completed a Master of Business Administration (MBA). He worked in Perth for 6 years in the mining industry. The appellant found employment working as a senior planner for ADCO in construction, Perth Western Australia between 2010 and 2012 working in construction. He transferred to work with Atlas – Iron as a mining project control officer until 2015. He returned to work in construction for about 1 year.
The appellant transferred to Canberra to work with Ernst and Young during 2016 for about one year, prior to commencing his employment with this employer in Sydney. He applied to Roads and Maritime Services, Sydney in 2017. He was successful and was employed as a senior project control officer for intercity NSW passenger trains. The role included the construction of railway stations and the manufacture of trains.
The appellant married his first wife in Iran in 2001. She was a trained pastry chef. They both immigrated to Australia. The marriage ceased in 2018.
The appellant met his second wife whilst on an adventure holiday touring Chernobyl in 2019. She was of Russian heritage.
They lived together in Sydney in 2019. They married in 2020.
They divorced after the onset of the appellant’s primary psychological injury in 2022. He had lost contact with his second wife and had not contact with her for about one year.
The appellant reported he became verbally abusive towards his second wife. He reported this wife notified the NSW Police. He said he was drinking large amounts of Vodka. The attending police issued him with a Domestic violence order (DVO). He attended the local court and said that he had the DVO ‘dismissed’ as he was psychiatrically ill at the time of this event. The appellant reported that about one year later he was again intoxicated with vodka. He said he had increased in his consumption and had tolerance to drink up to 700mls per day. He said that an argument occurred. His second wife threw drinking glass at his head. He sustained as superficial laceration from the glass striking his forehead. There was loud yelling between them. The building security, local police and paramedics were called. He said his wife was charged with assault and had an apprehended violence order (AVO) issue to her. She left the relationship and commenced making threatening phone and text messages to the appellant.
The appellant without the financial support of his second wife was unable to afford the mortgaged apartment they were buying. The apartment was sold. He commenced renting his current accommodation in about 2022. He has not worked since 22 February 2022.
He recommenced smoking in about 2022. He was now smoking 20 cigarettes daily.
The appellant reported he first started drinking alcohol socially on rare occasions. He reported that in about 2021 he commenced drinking alcohol more frequently with his second wife. His tolerance to alcohol increased rapidly. He was drinking hazardous amounts of alcohol during 2021 until 2022. He reported that he was aware that his alcohol consumption was causing him social problems, financial and legal problems. He reported that he was in sustained remission at the time of this assessment.
The appellant reported he was the focus of bullying and harassment from his first day of work for this employer. He described bullying and harassment by his directors and executives. He described being isolated and told that he had no future with the department, that he must leave his job. He said he believed that his senior managers wanted his employment terminated. They did not want him to work in his assigned role. He reported that he was unable to manage in overload of work he was directed to perform by his senior managers.
The appellant reported having invented a ‘cash flow algorithm’. He told his senior managers. He said that he was been pressured to hand-over his ‘information property rights’ to his employer. He refused. He reported his workplace environment became more deleterious. He lost about 50% of his staff and his workload doubled without support, during 2020 to 2021.
The appellant said he was directed to train new staff. He said he was not relieved from other duties whilst having to perform urgent duties that would result in him becoming depressed in his mood. He became irritable, agitated and depressed in his mood. He began to drink alcohol and argue with his second wife when he was at home. He reported his energy levels became poor. He would ruminate about the bullying and harassment he experienced. His concentration became poor. He began to miss deadlines. He began to suffer from ideas of hopelessness and worthlessness. He commenced drinking hazardous amounts of alcohol. He reported his employer to Safe Work NSW.
The appellant notified his general practitioner and saw a psychologist and a psychiatrist. He said the psychiatrist organised for him to be admitted to a private psychiatric hospital in February 2022. He failed his return-to-work plan. He suffered from further depression, loss of appetite, loss of weight and increased marital discord resulting in divorce from his second wife. He stopped playing soccer and socialising with his friendship circle at the Sydney FC home games.
The appellant reported he was treated with different antidepressant and antipsychotic medications. He said he was treated with Pristiq (desvenlafaxine) 150mg each morning and quetiapine 25mg tablet, two tablets at night with quetiapine XR (extended release) 50mg at night. He continued to attend his general practitioner. He also continued to attend his psychologist. He reported that he also attended his psychiatrist (Dr Bennett) about once every three months.
The appellant reported having attended Royal North Shore Public Hospital emergency after two episodes of panic attacks.
The appellant’s current symptoms at the time of this assessment were:
· 	Depressed mood.
· 	Poor quality sleep with persistent initial insomnia and middle insomnia with early morning wakening.
· 	Lots of interest in his career.
· 	Low energy with rapid onset of fatigue.
· 	Depressive ruminations about the bullying, and harassment
· 	Loss of motivation and interest in his prior social and recreational activities
· 	Social withdrawal from his general community.
· 	Loss of his friendship circle.
· 	Poor concentration with difficulty planning and persisting with complex tasks such as cooking, reading and composing song lyrics and reading.
· 	Loss of his marital relationship due to loss of libido, loss of intimacy and domestic violence.
Findings on mental state examination
The appellant presented alone via videoconference. He was on time for the assessment. He was polite and rapport was established. He was unshaven and his hair was unwashed and held in a tie. He said he had stopped shaving as he did not have any motivation to maintain his personal hygiene and self-care. He last shaved on his report over six months ago. He would not shower more than once every week. He was flat in his affect. He was orientated in time place and person. He reported he had lost his creativity and could no longer concentrate to write his song lyrics.
The appellant reported that he had experienced unexplainable things in his new unit. He said without prompting, ‘when I look in the mirror, I can’t see myself.’ He was unable to elaborate on this experience. He did not report either negative emotions or positive emotions when having this experience. He did not use the mirror any more due to this repeated experience. He was aware that the experience was abnormal. He did not spontaneously report the same problem when his reflection was reflexed from other surfaces. He reported suicidal thoughts without intent to self-harm. He was insightful. His judgment was fair. He was alone and could organise himself to use videoconferencing without difficulty. He said he was self-represented and had no lawyer.
The appellant reported he had experienced ongoing depressed mood most days for a long time. He reported he was unable to experience happiness, pleasure or joy. He was insightful into his condition. He did report improvement in his condition with stopping of his alcohol use.
Diagnosis
The appellant’s diagnosis at this assessment was DSM5TR Major depressive disorder with mood congruent psychotic features in partial remission F32.4. This depressive disorder had improved in its severity as the appellant’s intercurrent DSM5TR Alcohol use disorder in sustained remission F10.20, had remained in remission for over 1 year and have enable the claimant to stabilise his level of functioning and reach maximum medical improvement prior to this review.
DSM5TR Major depressive disorder with mood congruent psychotic features in partial remission F32.4
The appellant has suffered from his initial episode of major depressive disorder caused by this primary psychological injury. The major depressive disorder because of the bullying and harassment the appellant experienced whilst working in his assigned role for this employer. At the time of this assessment his depressive disorder was defined by the following:
Criterion A.
· 	The appellant experienced depressed mood most of the day, nearly every day.
· 	The appellant had markedly diminished interest in all his prior activities including his career, marriage and social network.
· 	The appellant had persistent difficultly initiating and sustaining sleep.
· 	The appellant experienced fatigue with loss of energy nearly every day.
· 	The appellant had a diminished ability to concentrate and think resulting in marked indecisiveness during the assessment.
Criterion B. The disturbance caused clinically significant distress, resulting in an inability to perform his role with the employer, loss of his second marriage by divorce.
Criterion C. The disturbance is not attributable to the appellant’s past medical history. The appellant substance use disorder was in sustained remission before the making of this diagnosis. He was not using illicit substances.
Criterion D. This major depressive episode is not attributable to schizo-affective disorder, schizophrenia, schizophreniform disorder, delusional disorder or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
Criterion E. The applicant had never had a manic or hypomanic episode.
The appellant’s Alcohol us disorder was defined by the following criteria:
DSM5TR Alcohol use disorder in sustained remission (F10.20)
Criterion A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following occurring within a 12-month period:
1. 	Alcohol is often taken in larger amounts or over longer periods than was intended.
This criterion is met by the appellant drinking more than he intended with him drinking up to a single 700ml bottle of vodka in one session.
2. 	Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
3. 	This criterion is met by the appellant’s report of the verbal arguments and domestic violence between him and his second wife, that required police attendance and local court attendance.
4. 	Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
This criterion is met by the appellant due to his insight into suffering from a depressive disorder and having knowledge that alcohol consumption can exacerbate a depressive disorder.
5. 	Tolerance, as defined by either of the following:
a. 	A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
This criterion is met by the appellant who initially was drinking smaller volumes of alcohol but as he developed tolerance to alcohol, the amount and concentration of alcohol in his beverages increased to a single bottle 700 ml bottle of vodka in a single session to achieve his desired effect.
Consistency of presentation
The appellant’s presentation at the time of this review was consistent with the assessment made by his treating psychiatrist. The report of the visual illusion of not been able to see his reflection whilst unusual, is best understood as a resolving residual perceptual abnormality that may present as more sever psychotic symptoms resolve.
The diagnosis of persistent depressive disorder is not preferred as this diagnosis does not explain all of the reported symptoms documented in the forwarded documents when considered with the presentation of the appellant at this review.
The diagnosis of adjustment disorder with mixed anxiety and depressed mood is not preferred as this diagnosis does not explain all of the reported symptoms documented in the forwarded documents when considered with the presentation of the appellant at this review.
The diagnosis of Binge eating disorder was not confirmed by the appellant at the time of this assessment.
Whilst there are variations of diagnosis reported by different medical, and psychological clinicians and authors, this is often seen when the appellant’s primary psychological injury is assessed in cross-sectional interview prior to the primary psychological injury reaching maximum medical impairment.
Assessment of whole person impairment.
The assessment of whole person impairment was performed at the time of this assessment.
Self-care and personal hygiene
The appellant reported that one friend who had a wife working in the disability sector would bring food for him each week. He would place the food in the fridge to be used during the week. He reported that the same friend would prompt him to shower each week. His friend would organise for his wife to launder his clothes and clean his floors, kitchen and bathroom. He was assesses as having a moderate impairment for this table of functioning.
Social and recreational activities
The appellant had stopped attending Sydney FC home games. He had stopped following soccer. He was not interested in attending the flying club as he had been prior to the onset of this primary psychological injury. He was not interested in the non-commercial music industry as he had been prior to this injury. He was assesses as having a moderate impairment for this table of functioning.
Travel
The appellant reported he had not flown outside of Australia for about two years. he was able to travel familiar routes alone such as to his mother’s unit in Istanbul. He was able to leave his unit alone. He preferred to remain in his unit and for essential face-to-face meeting with his psychiatrist, he would have the support of his friend to drive him to these meetings, as he would become too agitated after talking. He was assesses as having a mild impairment for this table of functioning.
Social functioning
The appellant was divorced from his second wife at the time of this review. He had been issued with a DVO at the time of one incident between him and his now ex-wife. His ex-wife was charged with assault and issued with a DVO for throwing a drinking glass at his face, causing a cut above his eye. He had lost his soccer friendship circle when he would attend the Sydney FC home games. He was assesses as having a moderate impairment for this table of functioning.
Concentration, persistence and pace
The MA assessed a Class 3 and this was not appealed.
Employability
The appellant was unable to work at the time of this assessment. He was not fit for any employable role due to the symptoms of this primary psychological injury alone. He was assesses as having a total impairment for this table of functioning.
Ascending class scores: 2, 3, 3, 3, 3, 5
Median class score: 3
Aggregate class scores in ascending order: +2, +3, +3, +3, +3, +5 = 19
Total whole person impairment: 24% WPI
Pre-existing condition: Nil.
Treatment effect: Nil.
The appellant had a total impairment of functioning score of 24%WPI. The claimant did not have any adjustment for pre-existing condition as he did not have a history of psychiatric or psychological condition prior to the onset of this primary psychological injury. Pre-existing deduction was assessed as nil.”
34.	The Appeal Panel has had regard to the additional evidence filed by the appellant which we admitted in the interests of justice given that he was self-represented.
35.	However, we note that Clause 1.6 of the Guidelines provides: “Assessing permanent impairment involves clinical assessment of the claimant as they present on the day of assessment…” (our emphasis).
36.	As stated earlier, Dr Chew issued an extremely brief MAC with very little detail such that the Appeal Panel confirmed that it was necessary for Mr Kasmaei to be re-examined.
37.	The Appeal Panel agrees with the thorough and comprehensive examination and assessment carried out by Dr Baker.
38.	For these reasons, the Appeal Panel has determined that the MAC issued on 23 October 2023 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:	W5674/23		
Applicant:	Reza Kasmaei		
Respondent:	Roads and Maritime Services		
This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act 1998.
The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Gerald Chew 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.Psychological	22 February 2022	Chapter 11	Chapter 11	24%	Nil
	24%	
Total % WPI (the Combined Table values of all sub-totals)	24%