Psychiatric Injury from Workplace Bullying: Were Medical Assessor's WPI Calculation and Functional Impairment Classification Erroneous for Non-Economic Loss?

Workers Compensation Appeal: Was the Medical Assessor’s 7% Psychiatric Injury Assessment Erroneous Due to Miscalculation and Incorrect Application of Impairment Guidelines?

Introduction
Based on the authentic Australian judicial case Lord v State of New South Wales (Northern Sydney Local Health District) [2025] NSWPICMP 30, this article disassembles the Court’s judgment process regarding evidence and law. It transforms complex judicial reasoning into clear, understandable key point analyses, helping readers identify the core of the dispute, understand the judgment logic, make more rational litigation choices, and providing case resources for practical research to readers of all backgrounds.

Chapter 1: Case Overview and Core Disputes

Basic Information

Court of Hearing: Personal Injury Commission (Appeal Panel)
Presiding Judge: John Wynyard
Medical Assessors (Original Assessment): Dr Ankur Gupta
Judgment Date: 13 January 2025
Cause of Action: Appeal against a Medical Assessment Certificate for psychiatric/psychological disorders under the Workplace Injury Management and Workers Compensation Act 1998 (NSW).

Core Keywords

Keyword 1: Authentic Judgment Case
Keyword 2: Psychiatric Injury Assessment
Keyword 3: Permanent Impairment (WPI)
Keyword 4: PIRS Guidelines
Keyword 5: Medical Assessor Error
Keyword 6: Workers Compensation Appeal

Background

The appellant, Kirsten Jane Lord, was engaged as a Drug and Alcohol Counsellor by the respondent, the State of New South Wales (Northern Sydney Local Health District). Ms Lord alleged that she experienced bullying and harassment from her Acting Team Manager, which commenced in 2019. This environment led to an accusation of dating a client, initiating an internal investigation. Ms Lord was stood down from her position on 21 October 2021, assigned to administrative duties, and subsequently transferred to another hospital. Despite the transfer, she was still required to report daily to the Acting Team Manager. This situation ultimately led to her cessation of work in May 2022. The investigation concluded in October 2022, finding the accusations against Ms Lord to be baseless. Following this, Ms Lord sought an assessment of her Whole Person Impairment (WPI) for the psychiatric/psychological disorders she experienced.

Core Disputes and Claims

The core dispute revolved around a Medical Assessment Certificate issued by Medical Assessor Dr Ankur Gupta, which assessed Ms Lord’s WPI at 7% for psychiatric injury. Ms Lord appealed this assessment, alleging several errors by the Medical Assessor. Specifically, her claims focused on:
* A mathematical miscalculation in the final WPI percentage.
* Erroneous assessment of the “Social and recreational activities” category under the Psychiatric Impairment Rating Scale (PIRS).
* Erroneous assessment of the “Travel” category under PIRS.
* Erroneous assessment of the “Concentration persistence and pace” category under PIRS.
* Erroneous assessment of the “Employability” category under PIRS.

Chapter 2: Origin of the Case

Kirsten Jane Lord’s professional life as a Drug and Alcohol Counsellor took a distressing turn when she became the target of bullying and harassment by her Acting Team Manager. This hostile environment escalated dramatically after she met a client in a park, an innocent encounter that her manager twisted into an accusation of a romantic involvement. This baseless allegation triggered an internal investigation that profoundly impacted Ms Lord.

The consequences were swift and severe. On 21 October 2021, Ms Lord was summarily stood down from her counselling role and reassigned to administrative duties. The ordeal continued as she was transferred to another hospital, yet the torment persisted; she was still obligated to check in daily with the very manager who had instigated her professional downfall. The relentless pressure and ongoing stress forced Ms Lord to cease work entirely in May 2022. The internal investigation, a year in the making, finally concluded in October 2022, unequivocally clearing Ms Lord of all accusations. However, the emotional and psychological toll had already been inflicted.

Chapter 3: Key Evidence and Core Disputes

Appellant’s Main Evidence and Arguments

Ms Lord presented her own detailed account of her condition and how it impacted her life. She reported experiencing a persistently low mood, with only occasional minor improvements through activities like walks or socialising. Her anxiety was described as constant and more debilitating than her low mood, frequently culminating in panic attacks several times a day. She suffered from flashbacks and nightmares related to Macquarie Hospital and Royal North Shore Hospital, leading to an active avoidance of these triggering locations, even for a follow-up breast cancer scan. She had difficulties with sleep, which medication only partially alleviated.

Her social life had diminished significantly, her long-term relationship had ended due to her irritability and loss of interest in intimacy, and while she maintained some close friendships, her recreational activities were largely reduced to watching crime series on television “all day,” a habit during which she often “vagues out” or struggled to follow plots. She also described difficulties with concentration, leading to mistakes in cooking and missed psychology appointments. Despite this, she managed her finances independently with support from her father and maintained her psychologist registration, though she expressed a complete loss of confidence in her ability to work.

Medical reports supporting Ms Lord’s position included:
* Dr Assad Saboor (Consultant Psychiatrist): Diagnosed a chronic major depressive illness with anxious distress, assessing a 22% WPI. He rated her as Class 3 for “Social and recreational activities”, Class 2 for “Travel”, and Class 3 for “Concentration persistence and pace”.
* Ms Anita George (Treating Psychiatrist): Noted partly resolving social anxiety and agoraphobia, and opined that Ms Lord had no capacity to work as of 3 July 2023.
* Mr Anthony J. Piqnataro (Treating Psychologist): Documented Ms Lord’s symptoms of depression and anxiety, her initial improvement and consideration of returning to work, followed by a decline in social engagement and fear of returning to any form of employment.

Respondent’s Main Evidence and Arguments

The respondent primarily relied on reports from Associate Professor Gordon Davies, who initially diagnosed an adjustment disorder and later a moderate depression. Associate Professor Davies assessed Ms Lord’s WPI at 9%. His reports also contained observations regarding Ms Lord’s personal hygiene (showering a “couple of times per week” then “several times per week”). He noted her ability to travel by air to Noosa to visit her father.

Core Dispute Points

The core dispute points before the Appeal Panel were precisely the specific PIRS categories in which Ms Lord contended the Medical Assessor had erred, in addition to an overarching mathematical error in the WPI calculation:
1. Mathematical Calculation: Whether the Medical Assessor miscalculated the final WPI percentage from his own assigned class scores.
2. Social and Recreational Activities: Whether the Medical Assessor’s Class 1 rating (no or minor deficit) was an incorrect application of criteria, given Ms Lord’s reported symptoms and reduced activities.
3. Travel: Whether the Medical Assessor’s Class 1 rating (no or minor deficit) was erroneous, particularly considering Ms Lord’s anxieties and avoidance behaviours related to driving and public transport, especially concerning critical medical appointments.
4. Concentration persistence and pace: Whether the Medical Assessor’s Class 2 rating (mild impairment) was too low, given her reported difficulties with memory and task completion.
5. Employability: Whether the Medical Assessor’s Class 4 rating (severe impairment) was appropriate, or if a Class 5 rating (totally impaired) was warranted given her complete loss of confidence and inability to work.

Chapter 4: Statements in Reports

The Appeal Panel considered Ms Lord’s comprehensive statements, including her account of pre-injury social and recreational activities. These statements were crucial in establishing the baseline against which post-injury impairments were measured. The various medico-legal and treating practitioner reports from Dr Saboor, Ms George, and Mr Piqnataro for the appellant, and Associate Professor Davies for the respondent, provided expert opinions and further details of Ms Lord’s condition and functional abilities.

The Medical Assessor’s initial assessment explicitly relied on Ms Lord’s presentation on the day of assessment, 21 August 2024, as well as the documentary evidence submitted. The strategic intent behind the appellant’s submissions was to demonstrate that while the Medical Assessor might have observed Ms Lord’s presentation on the day, his interpretation and classification of her impairments within the PIRS categories failed to adequately consider the context and pervasive impact of her symptoms, leading to an understated assessment of her WPI. This approach sought to identify the boundary where the Medical Assessor’s clinical judgment moved from a permissible difference of opinion to a demonstrable error or an application of incorrect criteria under the Workplace Injury Management and Workers Compensation Act 1998 (NSW).

Chapter 5: Court Orders

The procedural history of this matter began with its referral to the Medical Assessor, Dr Ankur Gupta, on 1 August 2024. The purpose of this referral was for Dr Gupta to conduct an assessment of Ms Lord’s Whole Person Impairment (WPI) resulting from psychiatric/psychological disorders, which were deemed to have occurred on 27 May 2002. This initial assessment culminated in the issuance of a Medical Assessment Certificate (MAC) on 2 September 2024, certifying Ms Lord’s WPI at 7%.

Following Ms Lord’s application to appeal the MAC, the Appeal Panel undertook a preliminary review of Dr Gupta’s original medical assessment. The Panel, in the absence of the parties, determined that at least one ground of appeal had been made out. Consequently, the Appeal Panel decided to proceed with a review limited to the identified grounds of appeal. Ultimately, the Appeal Panel concluded its review by revoking the original MAC and issuing a new Medical Assessment Certificate, reflecting its revised findings.

Chapter 6: Hearing Scene: Ultimate Showdown of Evidence and Logic

The Appeal Panel meticulously reviewed the Medical Assessor’s (MA) original assessment, applying established legal principles to determine whether demonstrable error or incorrect criteria had been applied. The Panel acknowledged that overturning a MA’s clinical judgment required more than a mere difference of opinion, as reiterated in cases such as Ferguson v State of New South Wales [2017] NSWSC 887 and Glenn William Parker v Select Civil Pty Ltd [2018] NSWSC 140.

The Appeal Panel’s examination focused on the specific PIRS categories challenged by Ms Lord:

Mathematical Error
The Appeal Panel swiftly identified a clear demonstrable error in the MA’s calculation of the final WPI percentage.

The Appeal Panel noted: “Ms Lord submitted that in determining the median class score pursuant to Chapter 11.4 the Medical Assessor had erred by identifying a Class 2 as the median class, whereas he should have assessed a Class 3. This would have resulted in a 13% WPI finding and not the 7% that was certified.”
The Appeal Panel found this to be a straightforward arithmetic mistake, indicating that based on the MA’s own assigned class scores across the PIRS categories, the correct median class score should have led to a 13% WPI, not 7%. This constituted a demonstrable error.

Social and Recreational Activities
The MA had ascribed a Class 1 rating, indicating “No deficit, or minor deficit attributable to the normal variation in the general population.” The Appeal Panel reviewed the MA’s own documented history of Ms Lord’s symptoms and activities.

The Appeal Panel held: “The Medical Assessor made no attempt to explain why he had reached that conclusion, and we are satisfied he has made accordingly a demonstrable error. … The assessor’s description of occasional social and recreational activities without prompting clearly matches the description of a mild impairment. A Class 2 rating is appropriate to her situation.”
The Appeal Panel found that Ms Lord’s reported constant anxiety, panic attacks, low mood, sleep difficulties, and substantial reduction in recreational activities (such as watching television “all day”) were inconsistent with a Class 1 rating. The MA failed to adequately contextualize these symptoms against the “normal variation” expected for a Class 1 rating. The Appeal Panel concluded that a Class 2 rating, denoting mild impairment, was more appropriate.

Travel
The MA also assigned a Class 1 rating for “Travel,” suggesting Ms Lord could “travel to new environments without supervision.” The Appeal Panel considered Ms Lord’s reported anxieties.

The Appeal Panel reasoned: “It is difficult to conceptualise as a normal variant a situation where a person is not able to travel in a given area for investigations for a potentially life threatening condition because she is ‘triggered’ by going near her workplace. … Accordingly, the reasons given by the Medical Assessor were not adequate to explain the Class 1 rating in this category.”
The Panel further noted the MA’s failure to acknowledge “the effect of extraneous factors on Mr Lord’s behaviour,” specifically her avoidance of important medical appointments near her former workplace due to psychological triggers. While Ms Lord could fly to Noosa, this was to a familiar place (her father’s residence) and involved Ubers, not public transport which caused anxiety. The Appeal Panel determined that the MA’s Class 1 rating was a demonstrable error and substituted a Class 2 rating.

Concentration persistence and pace
The MA awarded a Class 2 rating for this category (“Mild impairment”). Ms Lord contended this was too low, citing difficulties with memory and task completion (e.g., re-watching TV, missing appointments, making cooking mistakes).

The Appeal Panel concluded: “We find no error in the Class 2 rating given for this category.”
The Appeal Panel upheld the MA’s assessment. It reasoned that Ms Lord’s ability to maintain her psychologist registration requirements, coupled with the MA’s observation of her ability to focus throughout the medical assessment itself, provided a sufficient basis for the Class 2 rating. The Panel, drawing on the expertise of its psychiatric members, noted that maintaining professional registration implies a functional level of concentration incompatible with a Class 3 rating.

Employability
For “Employability,” the MA assessed a Class 4 rating (“Severe impairment”), while Ms Lord argued for a Class 5 (“Totally impaired”).

The Appeal Panel stated: “We do not however agree that Ms Lord is totally impaired, as she asserted. Were that so, there would be no point in her maintaining her registration as a psychologist. The qualification for a Class 4 rating is not onerous, restricted as it is to an ability to work for only one or two days at a time, and for less than 20 hours per fortnight. There is no requirement for a Medical Assessor to identify the nature of the work a claimant could do…”
The Appeal Panel affirmed the MA’s Class 4 rating. It rejected the argument for total impairment, emphasizing that Ms Lord’s maintenance of her psychologist registration implied some residual capacity. The Panel clarified that the MA is not obligated to identify a “real role” for the claimant, distinguishing this WPI assessment from criteria for weekly compensation.

Chapter 7: Final Judgment of the Court

The Appeal Panel, having conducted a comprehensive review limited to the grounds of appeal, announced its final judgment. The Panel determined that the Medical Assessment Certificate (MAC) issued by Medical Assessor Dr Ankur Gupta on 2 September 2024 was erroneous in certain respects.

Accordingly, the Appeal Panel issued the following orders:
* The Medical Assessment Certificate dated 2 September 2024, issued by Medical Assessor Dr Ankur Gupta, is hereby revoked.
* A new Medical Assessment Certificate is issued, attached to this statement of reasons, which certifies a Whole Person Impairment of 17% for the psychiatric and psychological disorders sustained by Kirsten Jane Lord.

Chapter 8: In-depth Analysis of the Judgment: How Law and Evidence Lay the Foundation for Victory

Special Analysis

This judgment is highly significant within Australian workers compensation jurisprudence. It underscores that an Appeal Panel will intervene and correct a Medical Assessor’s (MA) assessment not only for straightforward mathematical errors but also for demonstrable errors arising from a flawed application of clinical judgment and contextual understanding of a claimant’s impairment. The Panel’s ability to revise the MAC without requiring a further re-examination of Ms Lord demonstrates a robust appellate review mechanism designed for efficiency and fairness. The emphasis on the contextual impact of psychiatric symptoms, particularly in the social, recreational, and travel domains, highlights a nuanced approach to the PIRS Guidelines. This decision provides critical guidance on how psychological triggers and avoidance behaviours, especially concerning vital health matters, must be properly considered by MAs.

Judgment Points

Correction of Mathematical Error: The Appeal Panel directly corrected a clear arithmetical mistake made by the MA in calculating the Whole Person Impairment (WPI), affirming that such errors constitute a demonstrable error under the Workplace Injury Management and Workers Compensation Act 1998 (NSW).
Contextual Application for Social and Recreational Activities: The Panel found the MA’s Class 1 rating for “Social and recreational activities” to be erroneous. It was determined that Ms Lord’s reported low mood, constant anxiety, panic attacks, and significant reduction in pre-injury activities, leading to watching television “all day,” warranted a Class 2 rating, as these impairments extended beyond a “minor deficit attributable to the normal variation in the general population.”
Trigger Avoidance and Travel Limitations: The MA’s Class 1 rating for “Travel” was overturned. The Appeal Panel highlighted the MA’s failure to adequately consider Ms Lord’s avoidance of travel to areas associated with her workplace due to psychological triggers, particularly for a critical breast cancer scan. The Panel deemed it inconsistent with a Class 1 rating for a person to be unable to travel for potentially life-threatening medical investigations due to psychiatric impairment. A Class 2 rating was deemed appropriate.
Upholding Clinical Judgment on Concentration: The MA’s Class 2 rating for “Concentration persistence and pace” was upheld. The Appeal Panel agreed that Ms Lord’s ability to maintain her psychologist registration and to focus during the assessment itself provided a reasonable basis for this rating, even with reported difficulties in daily tasks.
Upholding Clinical Judgment on Employability: The MA’s Class 4 rating for “Employability” was also upheld. The Panel rejected the argument for total impairment (Class 5), reasoning that maintaining professional registration implied some work capacity, and the MA is not obligated to identify a specific “real role.”

Legal Basis

The legal foundation for the Appeal Panel’s decision rests primarily on the Workplace Injury Management and Workers Compensation Act 1998 (NSW), specifically sections 327(3) and 328(2) concerning grounds for appeal (incorrect criteria or demonstrable error) and the review process. The assessment of permanent impairment is governed by Chapter 11 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed (the Guides). The Appeal Panel rigorously applied these guidelines, particularly noting that the PIRS descriptors are flexible “examples only” (Chapter 11.12), allowing for clinical judgment, but this discretion must be exercised contextually and reasonably. Judicial guidance from Ferguson v State of New South Wales [2017] NSWSC 887, Glenn William Parker v Select Civil Pty Ltd [2018] NSWSC 140, and Jenkins v Ambulance Service of New South Wales [2015] NSWSC 633 informed the standard for demonstrating error in clinical assessments, requiring “more than a mere difference of opinion.” The principle from Kitanovska v Coles Group Limited [2016] NSWWCCMA 90 regarding the presumption of regularity for a Medical Assessor’s actions was also acknowledged but deemed insufficient to overcome clear demonstrable errors.

Evidence Chain

The Appeal Panel’s revised determination was built upon a compelling evidence chain:
* Appellant’s direct testimony: Ms Lord’s consistent reporting of severe psychiatric symptoms, including low mood, constant anxiety, daily panic attacks, flashbacks, sleep disturbances, and a significant decline in pre-injury social and recreational activities.
* Medical evidence: Supporting diagnoses of chronic major depressive illness with anxious distress, social anxiety, and agoraphobia from Dr Saboor and Ms George, validating the severity of her condition.
* Documented functional limitations: Specific instances like avoiding a crucial breast cancer scan due to workplace triggers, difficulties with household chores due to lack of motivation, memory issues leading to mistakes in cooking and missed appointments, and anxiety around public transport.
* Objective observations by MA: The MA’s own notes on Ms Lord’s presentation during the assessment and her maintaining professional registration.
* Contrast of pre- and post-injury functioning: The stark difference between Ms Lord’s active pre-injury life (Pilates, running, yoga, dance fitness, frequent socialisation) and her post-injury sedentary lifestyle and limited social engagement.
* The undeniable mathematical error: A straightforward miscalculation of WPI based on the MA’s own PIRS scores.

Judicial Original Quotation

In assessing the grounds of appeal, the Appeal Panel provided clear reasoning for its conclusions:

On the correction of demonstrable error, the Panel noted Ms Lord’s submission and held:

“Ms Lord submitted that in determining the median class score pursuant to Chapter 11.4 the Medical Assessor had erred by identifying a Class 2 as the median class, whereas he should have assessed a Class 3. This would have resulted in a 13% WPI finding and not the 7% that was certified.”
The Appeal Panel found that this mathematical error alone was sufficient to warrant a review and correction.

Regarding “Social and recreational activities,” the Appeal Panel found the MA’s reasoning inadequate:

“The Medical Assessor made no attempt to explain why he had reached that conclusion, and we are satisfied he has made accordingly a demonstrable error. … The assessor’s description of occasional social and recreational activities without prompting clearly matches the description of a mild impairment. A Class 2 rating is appropriate to her situation.”

For “Travel,” the Appeal Panel emphasised the importance of context:

“It is difficult to conceptualise as a normal variant a situation where a person is not able to travel in a given area for investigations for a potentially life threatening condition because she is ‘triggered’ by going near her workplace. … Accordingly, the reasons given by the Medical Assessor were not adequate to explain the Class 1 rating in this category.”

Concerning “Concentration persistence and pace,” the Panel affirmed the MA’s clinical judgment:

“We find no error in the Class 2 rating given for this category.”

Finally, on “Employability,” the Panel rejected the notion of total impairment:

“We do not however agree that Ms Lord is totally impaired, as she asserted. Were that so, there would be no point in her maintaining her registration as a psychologist. The qualification for a Class 4 rating is not onerous, restricted as it is to an ability to work for only one or two days at a time, and for less than 20 hours per fortnight. There is no requirement for a Medical Assessor to identify the nature of the work a claimant could do…”

Analysis of the Losing Party’s Failure

The Medical Assessor’s initial assessment failed due to a combination of a fundamental mathematical error and a demonstrably inadequate application of the PIRS Guidelines. First, the basic miscalculation of the WPI percentage from his own class scores was an undeniable and easily correctable flaw. Second, the MA failed to sufficiently integrate and contextualize Ms Lord’s documented symptoms and the profound impact on her functional life into his clinical judgment, particularly for “Social and recreational activities” and “Travel.” His assessments in these categories were inconsistent with the severity of Ms Lord’s reported anxiety, panic attacks, avoidance behaviours, and the significant decline in her social and recreational engagement. By failing to acknowledge the “extraneous factors” and the qualitative difference between her pre-injury and post-injury life, the MA’s reasoning became unsupportable in these specific areas, leading to a demonstrable error.

Implications
1. Context is King: Understanding how a psychiatric injury impacts daily life requires more than just ticking boxes. The true measure lies in how the injury affects a person’s ability to participate in activities and navigate environments they once could, especially when psychological triggers are involved.
2. Accuracy in Assessment: Even medical experts can make errors. This case highlights the importance of rigorous review, not just of clinical judgment, but also of fundamental calculations, to ensure fairness in compensation.
3. Advocacy for the Vulnerable: For individuals dealing with complex psychological injuries, clearly articulating the context of their symptoms – for instance, how fear of a place linked to trauma affects essential activities like seeking medical care – is vital for a just assessment.
4. Beyond the Obvious: An individual’s capacity to perform certain high-level tasks (like maintaining professional registration) does not automatically negate all other impairments. A holistic view, acknowledging both strengths and significant struggles, is crucial.
5. Empowerment Through Understanding: Knowing the specific criteria and how they are applied allows injured workers to effectively challenge assessments and advocate for a more accurate reflection of their impairment, fostering a sense of control over their recovery journey.

Q&A Session
Q1: What are “PIRS Guidelines” and why are they important in this case?
A1: PIRS stands for Psychiatric Impairment Rating Scale. It is a structured rating system established by the SIRA NSW Workers Compensation Guidelines to assess psychiatric/psychological impairment. It uses six categories of behaviour, each with five classes of severity, to calculate a Whole Person Impairment (WPI) percentage. In this case, the PIRS Guidelines were crucial because the appeal centered on whether the Medical Assessor had correctly applied these guidelines when determining Ms Lord’s WPI.

Q2: Why was Ms Lord’s ability to travel to Noosa not considered a complete indicator of her travel capacity?
A2: The Appeal Panel acknowledged that Ms Lord could fly to Noosa, but critically considered the context. Her father resided there, making it a familiar destination, and she used Uber, avoiding public transport which caused her significant anxiety. The Panel emphasized that while she could manage this specific trip, it did not negate her inability to travel to other important locations, particularly her former workplace or a hospital for essential medical scans, due to psychological triggers and severe anxiety. The individual circumstances and contextual limitations were key to understanding her impairment.

Q3: What does “demonstrable error” mean in the context of this judgment, and how was it proven?
A3: In this judgment, “demonstrable error” refers to a flaw in the Medical Assessor’s (MA) assessment that is so clear and evident that it cannot be dismissed as a mere difference of opinion. It was proven in two main ways: firstly, through a straightforward mathematical miscalculation in the WPI percentage derived from the MA’s own scores; and secondly, through the MA’s failure to adequately consider the context of Ms Lord’s symptoms and functional limitations when applying the PIRS categories. This involved overlooking significant factors (like avoiding a cancer scan due to triggers) that directly contradicted a low impairment rating, indicating an unsupportable reasoning process.

Appendix: Reference for Comparable Case Judgments and Practical Guidelines

1. Practical Positioning of This Case

Case Subtype: Personal Injury and Compensation – Psychiatric Injury Permanent Impairment Assessment.
Judgment Nature Definition: Final Judgment (of the Appeal Panel).

2. Self-examination of Core Statutory Elements

Core Test (Negligence under the Civil Liability Act 2002 (NSW)):
- Duty of Care: Did a legal obligation exist for the respondent to prevent harm to Ms Lord? Generally, employers owe a duty of care to provide a safe working environment.
- Breach of Duty: Did the respondent fail to meet the standard of care owed? This involves assessing whether a reasonable person in the respondent’s position would have taken precautions against the risk of harm, considering factors such as the foreseeability of the risk, the magnitude of the risk, and the burden of taking precautions.
- Causation: Did the breach of duty directly cause Ms Lord’s psychiatric injury? This requires establishing both factual causation (the “but for” test) and scope of liability (whether it is appropriate for the scope of the negligent person’s liability to extend to the harm so caused).
Core Test (Damages under the Workers Compensation Act 1987 (NSW) and Workplace Injury Management and Workers Compensation Act 1998 (NSW)):
- Whole Person Impairment (WPI): Does the psychiatric injury result in a permanent impairment that exceeds the statutory threshold for non-economic loss (e.g., 10% WPI in NSW for physical injuries, and specific thresholds for psychiatric injuries as defined in the SIRA Guidelines)? The assessment of WPI must be conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed (the Guides) and, where applicable, the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).
- Non-Economic Loss: Compensation for non-economic loss (such as pain, suffering, and loss of amenities of life) is only payable if the WPI exceeds a certain threshold. For psychiatric injuries, this threshold is determined by specific provisions and guidelines.
- Contributory Negligence: Did Ms Lord’s own actions contribute to her injury or the extent of her impairment? If so, the amount of damages may be reduced.

3. Equitable Remedies and Alternative Claims

While the present case primarily deals with statutory workers compensation, in other scenarios where statutory avenues may be exhausted or provide inadequate relief, equitable principles or alternative common law doctrines can offer recourse.
* Promissory / Proprietary Estoppel:
* Promise or Representation: Did the employer (or another party) make a clear and unequivocal promise or representation regarding Ms Lord’s employment security or future prospects (e.g., that she would be safe from harassment, or that her position was secure despite the baseless accusations)?
* Detrimental Reliance: Did Ms Lord act in detrimental reliance on that promise or representation (e.g., by remaining in employment, foregoing other opportunities, or undertaking tasks believing her position was secure)?
* Unconscionability: Would it be unconscionable for the employer to resile from that promise, causing Ms Lord significant detriment?
* Result Reference: If these elements are met, equity may “estop” the employer from denying the promise, potentially leading to orders for compensation or specific performance, even in the absence of a formal contract breach.
* Unjust Enrichment / Constructive Trust:
* Benefit at Expense: Has the employer received a benefit (e.g., continued labour from Ms Lord during the investigation, or retaining her services at a lower cost or under adverse conditions) at Ms Lord’s expense?
* Against Conscience: Is it against good conscience for the employer to retain that benefit without providing fair compensation or redress for the detriment suffered by Ms Lord?
* Result Reference: While less common in pure psychiatric injury claims, if there were clear tangible benefits unjustly obtained, the Court might order restitution or, in property-related contexts, declare a constructive trust over assets if Ms Lord could prove a beneficial interest.

4. Access Thresholds and Exceptional Circumstances

Regular Thresholds:
- WPI Threshold for Non-Economic Loss: In many Australian jurisdictions, compensation for non-economic loss in workers compensation claims (including psychiatric injury) requires the WPI to meet or exceed a specific statutory threshold (e.g., 10% or 15%, depending on the state and specific injury type). For psychiatric injury in NSW, the relevant SIRA Guidelines dictate how WPI is assessed using the PIRS.
- Limitation Period: Workers compensation claims generally have strict time limits for lodging claims (e.g., within three years of the date of injury or when the injury becomes apparent).
Exceptional Channels (Crucial):
- Medical Appeal Process (s 327, s 328 of the Workplace Injury Management and Workers Compensation Act 1998 (NSW)): This case itself exemplifies an exceptional channel where an initial Medical Assessment Certificate can be appealed. Grounds for appeal include demonstrable error or the MA having applied incorrect criteria. The Appeal Panel can correct errors or, if necessary, send the matter for re-examination.
- Discovery of Latent Damage: If an injury (including psychological injury) is not immediately apparent, the limitation period may be extended to run from the date of discovery of the injury.
- Legal Incapacity: Minors or persons with a mental incapacity may have their limitation periods suspended until their capacity is restored or they reach adulthood.
- Suggestion: Do not abandon a potential claim simply because you do not meet the standard time or conditions. Carefully compare your circumstances against the exceptions above, as they are often the key to successfully filing a case.

5. Guidelines for Judicial and Legal Citation

Citation Angle: This case is recommended for citation in legal submissions or debates involving appeals against Medical Assessment Certificates for psychiatric injury, particularly where there are allegations of:
* Mathematical errors in WPI calculation.
* Demonstrable errors or application of incorrect criteria by a Medical Assessor in applying PIRS Guidelines.
* Failure by a Medical Assessor to adequately consider the contextual impact of psychiatric symptoms on a claimant’s functional abilities (e.g., social activities, travel, avoidance behaviours linked to triggers).
* Situations where the Appeal Panel corrects an MA’s assessment without requiring a re-examination.

Citation Method:
* As Positive Support: When arguing that a Medical Assessor’s clinical judgment, even when supported by observation, can be overturned if it fails to account for the claimant’s full contextual history of impairment, or where there is a clear arithmetic error. This authority supports the Appeal Panel’s power to intervene beyond a mere difference of opinion.
* As a Distinguishing Reference: If the opposing party cites this case to assert that a MA’s assessment is difficult to overturn, one should emphasize the specific demonstrable errors identified here (e.g., failure to consider psychological triggers for critical activities, or clear miscalculation) to argue that those specific flaws are present in the current matter, making this precedent applicable.

Anonymisation Rule: In all citations and references, strictly use procedural titles such as Appellant / Respondent.

Conclusion
This pivotal judgment reinforces the rigorous standards expected of Medical Assessors in Australia’s workers compensation scheme, emphasizing that assessments of psychiatric impairment must be both mathematically accurate and contextually nuanced. It unequivocally demonstrates that clear errors in calculation, or a failure to adequately interpret a claimant’s symptoms within the full scope of their real-life impact, constitute demonstrable errors warranting intervention by an Appeal Panel. Everyone needs to understand the law and see the world through the lens of law. The in-depth analysis of this authentic judgment is intended to help everyone gradually establish a new legal mindset: True self-protection stems from the early understanding and mastery of legal rules.

Disclaimer
This article is based on the study and analysis of the public judgment of the Personal Injury Commission (Lord v State of New South Wales (Northern Sydney Local Health District) [2025] NSWPICMP 30), aimed at promoting legal research and public understanding. The citation of relevant judgment content is limited to the scope of fair dealing for the purposes of legal research, comment, and information sharing.
The analysis, structural arrangement, and expression of views contained in this article are the original content of the author, and the copyright belongs to the author and this platform. This article does not constitute legal advice, nor should it be regarded as legal advice for any specific situation.

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