AAI Limited t/as GIO v Krayem
[2025] NSWPICMP 277
•23 April 2025
| DETERMINATION OF REVIEW PANEL | |
CITATION: | AAI Limited t/as GIO v Krayem [2025] NSWPICMP 277 |
CLAIMANT: | Ahmed Krayem |
INSURER: | AAI Limited t/as GIO |
REVIEW PANEL | |
MEMBER: | Jeremy Lum |
MEDICAL ASSESSOR: | Sophia Lahz |
MEDICAL ASSESSOR: | Christopher Oates |
DATE OF DECISION: | 23 April 2025 |
CATCHWORDS: | MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); permanent impairment dispute; claimant’s stationary car rear-ended at speed; lumbar spine injury requiring subsequent fusion surgery; Medical Assessor (MA) found 20% whole person impairment (WPI) and attributed entire impairment to the motor accident; insurer sought review arguing MA did not refer to extensive pre-existing history of lumbar spine complaints including injections; Held – Review Panel accepted motor accident caused an aggravation of pre-existing lumbar pathology requiring lumbar fusion surgery; pre-existing impairment due to non-verifiable radicular complaints; Review Panel found 15% WPI; MAC revoked and new certificate issued. |
DETERMINATIONS MADE: | CERTIFICATE OF DETERMINATION Certificate issued under Division 7.5 of the Motor Accident Injuries Act 2017 1. The Review Panel revokes the certificate of Medical Assessor Drew Dixon dated (a) the Review Panel certifies the following injuries were caused by the motor accident: · cervical spine – soft tissue injury; · left shoulder – referred symptoms from cervical spine; · lumbar spine – L4/5 disc prolapse and nerve decompression requiring a fusion; · thoracic spine – soft tissue injury; · hip (bilateral) – referred symptoms from lumbar spine, and · skin: post-surgical scarring. (b) The Review Panel finds that the above injuries result in a whole person impairment of 15% which is greater than 10%. |
STATEMENT OF REASONS
BACKGROUND
Ahmed Krayem (the claimant) was involved in a motor accident on 28 October 2020. He was the driver of a stationary dual cab utility waiting to do a right-hand turn when a following utility rear-ended the left rear section of his vehicle at high speed. The claimant’s vehicle was pushed forward more than one metre but with no subsequent impact, as there was no other vehicle in front of him. He had a seatbelt on and the airbags did not deploy.
The claimant says he had neck, mid and lower back pain which radiated into his left shoulder and right leg. He also had bilateral hip pain. He was conveyed by ambulance to Bankstown Lidcombe Hospital.
The claimant made a claim for personal injury benefits with the insurer (GIO), the third-party insurer of the vehicle that he says caused the accident.
A medical dispute arose about whether the degree of the claimant’s whole person impairment (WPI) is greater than 10% WPI. This is important because if there is a dispute about the degree of a claimant’s WPI, damages for non-economic loss[1] cannot be awarded and disputes must be referred to a Medical Assessor/s for determination.
[1] See Division 4.3 of the Motor Accident Injuries Act 2017 (MAI Act).
On 8 October 2024, Medical Assessor Drew Dixon assessed the claimant’s injuries as having a WPI of 26% which results in a WPI of greater than 10%.
GIO lodged an application with the Personal Injury Commission (Commission) seeking a review of Medical Assessor Dixon’s assessment.
On 9 January 2025, a delegate of the President (Mr Kenneth Ho) accepted the application for review and referred the matter to this Review Panel (the Panel) to conduct the Review proceedings.
MEDICAL ASSESSMENT UNDER REVIEW
Medical Assessor Dixon accepted that the claimant sustained a whiplash injury to his neck with trapezial muscle pain and post traumatic stiffness of the shoulders. More significantly, there was an injury to the lumbar spine with an L5/S1 disc protrusion and L4/5 disc bulge which led to the L5/S1 anterior lumbar interbody fusion (ALIF) and post-surgical scarring. There was no direct hip injury on either side, rather the claimant had buttock radiation from his back. There were also no residual signs of any thoracic back strain.
The WPI assessment was as follows:
· lumbar spine – ALIF with loss of motion segment – diagnostic related estimate (DRE) IV, 20%;
· right shoulder – loss of range of motion – 4%;
· left shoulder – loss of range of motion – 3%, and
· skin – surgical scarring – 1%.
There was 0% WPI for the injuries to the cervical spine, thoracic spine, left hip and right hip.
The claimant’s total combined WPI was assessed as 26%.
ISSUES FOR DETERMINATION
Insurer’s submissions
The insurer provided a total of six sets of submissions – R1 to R6 in its Panel bundle.
The insurer submits the claimant had a history of symptomatic lumbar L5/S1 radiculopathy which was treated in the months before the subject motor accident. The insurer says Medical Assessor Dixon made no reference to any of the following pre-accident treating evidence:
(a) a CT scan of the lumbosacral spine dated 30 December 2019;
(b) a referral to Dr Kahil, orthopaedic surgeon, dated 6 February 2020;
(c) an MRI scan of the lumbar spine dated 8 May 2020;
(d) a CT guided injection of the right L5 nerve root dated 15 May 2020, and
(e) treating records of Dr Kahil, orthopaedic surgeon.
It is further submitted that the Medical Assessor did not refer to the insurer’s submissions dated 5 March 2024, updated submissions dated 22 August 2024 and the insurer’s further updated submissions dated 10 September 2024.
The insurer therefore submits that it was incorrect for the Medical Assessor to rely on the claimant’s given history of “…he reports no major illnesses and has not had any prior problems with his neck, shoulders or back” without putting to the claimant the above documented pre-accident history of lumbar spine complaints and pathology.
It is submitted the claimant had pre-existing impairment to the lumbar spine. This should have been calculated in accordance with the Motor Accident Guidelines and deducted from the current permanent impairment.
In addition, the insurer refers to Quantumcorp desktop reports dated 9 February 2021 and 3 March 2022. These were online investigation reports commissioned by the insurer. The insurer refers to an image dated 24 August 2021 of the claimant posing with deceased deer that have presumably been shot during a hunting trip. The insurer says the engagement of hunting activities is inconsistent with the claimant’s reports of injury.
The Panel also noted the insurer’s further submissions dated 5 February 2025 provided “for the benefit of the Panel”. These submissions included a further summary of the documentation on file with specific reference to the pre-accident evidence of lumbar spine complaints and notations of “radiculopathy” in the clinical records.
Claimant’s submissions
The claimant submits that in circumstances where the claimant had surgery which was never necessary before the motor accident, the prior symptoms are irrelevant. The motor accident need only materially contribute to the need for surgery and the ALIF qualifies for DRE IV or 20% WPI.
The claimant submits that there was no error in Medical Assessor Dixon’s assessment and that the claimant has an WPI of greater than 10%.
REVIEW OF THE EVIDENCE
General observations
On 20 January 2025, the Panel issued a direction to the parties requiring indexed and paginated bundles of the information they relied upon. The Panel stated that unless documents are uploaded to the Review file, the Panel would not be able to read and consider those documents. The parties duly responded with the insurer’s bundle comprising of pages 1-579 and the claimant’s 1-198.
The Panel’s direction also attempted to narrow the issues in dispute. The parties indicated that while causation is disputed for all injuries, it was agreed that the WPI for the injuries to the cervical spine, thoracic spine and bilateral hips are all 0%.
The Panel has read and discussed the documentation with the relevant material referred to in the Panel examination report and Panel findings below.
RE-EXAMINATION REPORT
At the preliminary conference on 24 March 2025, the Panel determined that the claimant be re-examined. The re-examination report of Medical Assessor Oates is as follows:
“AHMED KRAYEM
Birth year: 1984
Date of Accident: 28/10/2020
Details of who attended the Assessment
Mr Krayem attended for Medical Review Panel re-examination assessment by Medical Assessor Oates at the PIC Medical Suites on 3/4/2025 as arranged. He was 15 minutes late because he was given the wrong address.
There was some confusion about whether an Arabic interpreter had been booked by PIC, however Mr Krayem did not have any requirement for an interpreter, as his English was very good.
An interpreter did arrive about 25 minutes late, but after reporting in, he was discharged by me because he was not required.
I advised Mr Krayem to amend his record with his solicitor regarding the need or not for an official interpreter.
HISTORY
Pre-accident medical history and relevant personal details
He was born in Lebanon and came to Australia in 2009 when he stayed for three months and tried stonemason work. He had worked in retail work in Lebanon. He returned to Lebanon and then returned to Australia in 2012.
He attended a trade school. He went into the workforce in 2012 with Decostone as a trainee stonemason, learning the trade on the job. He became self-employed as a sole trader from 2016 in stonemasonry. He mainly worked alone, but would employ a casual labourer when required.
His general health is good. He has had no operations and was on no regular medications.
Before the accident he liked fishing from the beach.
He is married and has three children; eight years, six years and three years old. His wife does not work. They live in a home.
Before the accident he did all the yard work and his wife did the housework. He also helped out with some of the house chores.
In December 2019, he had back and right buttock pain, and saw a GP and was sent for CT scan and treatment with anti-inflammatories. The CT showed mild S1 nerve root compression bilaterally from a broad-based L5/S1 disc bulge. He told me the symptoms settled with medications.
Thereafter, he would have some recurrences of low back pain and right buttock pain extending into the lower extremity, and he was referred to Dr Kahil, orthopaedic surgeon, on 7/5/2020. Bilateral radicular complaints in the lower extremities are documented, with the mention of ‘radiculopathy for a few months’ in the referral of Dr Alhashem to Dr Kahil dated 6 February 2020, but there were not two or more signs present to diagnose lumbar radiculopathy.[2] He had an MRI scan showing a right L5/S1 posterolateral disc extrusion compressing the right S1 nerve root. He was sent for a CT-guided right L5 nerve root injection and had a good result and was able to return to his normal work and off work activities.
[2] As required under cl 6.138 of the Guidelines.
At one stage, he had swelling and pain in the small joints of both hands. He had blood screen tests which were negative for rheumatological disorders. He was treated with anti-inflammatories. The joint pains and swellings last occurred about three months ago and pain had been intermittent prior to that.
At the time of the motor vehicle accident, he was working normally but did have mild aching periodically in the low back and right leg, which he could settle down on a temporary basis with the anti-inflammatory, Mobic.
The right leg pain radiated down the posterolateral thigh and calf into the foot. This represents non-verifiable radicular complaints.
History of the motor accident
Mr Krayem said on 28/10/2020 at 4.30pm, he was the driver of a stationary Nissan Navara dual cab utility with a workmate as front seat passenger. They were waiting to do a right-hand turn when a following Toyota Hilux utility rear-ended the left rear section of Mr Krayem’s vehicle at high speed. His car was pushed forward more than 1 metre but there was no other vehicle in front of him. He had a seatbelt on. The airbags did not deploy.
He self-extricated through the driver’s door. He says his chair was twisted on its axis after the impact. The other driver got out of the car and absconded. He was sitting on the side of the gutter and was attended by a bystander who told him she was a nurse until the paramedics arrived. His vehicle was written off.
He was conveyed by ambulance to Bankstown Lidcombe Hospital and recalled pain in the right side of the lower back, thoracic pain and then developed neck pain radiating towards the left shoulder.
History of symptoms and treatment following the motor accident
After the motor vehicle accident, he attended the hospital and when imaging had cleared him of significant injury, he then tried to keep working but as he continued, his pain increased so he eventually had to see a general practitioner on 2/12/2020.
He had a CT scan of the neck and x-ray of the spine and chest, and was found to have no fractures and was considered fit for follow-up with a GP, Dr Zaky, whom he saw on 2/12/2020 after worsening pain in the neck to the left arm, and low back pain to the right leg, followed by Drs Assem and Youssef both on 10/12/2020. Dr Zaki ordered. CT scan cervical spine and Dr Youssef ordered MRI scan cervical spine. The CT scan cervical spine on 2/12/2020 and MRI cervical spine on 15/12/2020 showed mild multi-level cervical spondylotic changes.
At the initial general practice assessment, he was certified for suitable duties with no lifting over 20kg. About three months after the accident, he had to stop work altogether because of worsening low back pain and sciatic pain affecting the right leg.
He has not returned to work since but his sole trader company still exists. His insurance benefits have ceased and he used his savings and sold some tools and now his family members help him out financially.
He received a Centrelink benefit during the COVID lockdown period as part of the income support scheme at that time. He was certified for suitable duties with no lifting over 20kg but could not cope and eventually had to cease work approximately three months after the accident.
He was referred to a rheumatologist but did not attend. He was referred to Dr Al Khawaja at Penrith, a neurosurgeon, whom he saw on 12/1/2021[3] regarding the neck, left arm, low back pain and right sciatica.
[3] This was most likely incorrectly dated as 12 January 2020 in the report and in the insurer’s review panel bundle index.
He was sent for an MRI scan cervical spine and lumbar spine which were done on 18/1/2021, and this showed an L5/S1 disc protrusion to both the right and left sides contacting and potentially irritating the descending S1 nerve roots, particularly on the right side.
Dr Al Khawaja recommended an epidural injection and an L5/S1 facet joint block injection.
He also had some right buttock pain and was sent for an ultrasound scan and MRI scan of the right hip to exclude pathology there, and no treatment was required for the hip.
He found that the spine injections did not help, in fact they made the low back pain worse. He found that the right leg pain also became worse. He developed an increasing limp on the right leg to keep his weight off this and developed left leg symptoms, presumably from his altered gait.
His sleep was disturbed and he wasn’t comfortable either sitting, standing or lying.
He tried medications and physiotherapy but there was no benefit. He continued to be reviewed by Dr Al Khawaja and eventually reached the point where surgery was his last option.
He tells me the CTP insurer paid for an L5/S1 anterior lumbar interbody fusion, correction of lordosis and rhizolysis on 31/8/2022 at Norwest Private Hospital, performed by Dr Al Khawaja. The specialist told him there would be a 1.5 – 2 year recovery time. His last surgical review was one year post-operatively.
He did notice improvement in both the low back pain and right leg pain after he had started to recovery from the surgery, but he still gets pain in the back although his legs are better.
Details of any relevant injuries or conditions sustained since the motor accident
Nil relevant.
Current symptoms
He has continuing low back pain which is present the majority of the time and is 5/10 at its best and goes to 7/10 at its worst on a visual analogue scale of pain. He can handle some of the pain without taking medications, as he doesn’t want to be dependent on them for the rest of his life.
The low back pain is worse with prolonged sitting, bending and walking, and he can’t sit on the floor too long to play with his young sons, as he can barely get up.
His right leg will play up if the low back pain is more severe. He has to be careful how he moves then.
His neck, left arm and thoracic symptoms settled down OK.
He does get some pain in the hips at times. There is intermittent tingling in the posterior right thigh to the knee and the lateral foot. The right leg pain, when present, radiates from the buttock down to the foot.
After the accident his wife has helped him with the yard work and sometimes his nephew comes over to assist him, and she continues with the housework. He does what he can, avoiding heavy lifting and bending.
He walks for exercise.
Current and proposed treatment
He has Tramal 50mg as required and Panadeine Forte as required. He obtains a packet of 20 of each medication per month from his GP, Dr Youssef, Greenacre.
He is not having any other form of treatment now.
CLINICAL EXAMINATION
General presentation
He had a muscular build and says he inherited this from his father and that he does not go to the gym. His height was 175cm and weight 82.4kg.
Cervical spine (cervicothoracic)
There was full range of movement in the cervical spine in flexion, extension, lateral flexion and rotation. There was no spasm, guarding or local tenderness.
Reflexes, power and sensation in the upper limbs were normal. There were no non-verifiable radicular complaints.
Upper arm girth; right 32.5cm, left 32.5cm at 5cm above the elbow crease.
Forearm girth; right equals left equals 31cm at 5cm below the elbow crease.
Thoracic spine (thoracolumbar)
There was no tenderness or guarding. Sensation over the trunk was intact bilaterally. There was full range of movement of the thoracic spine in rotation.
Lumbar spine (lumbosacral)
He did show some pain behaviour when he was noted to sit in back discomfort and had to get up twice during the interview after sitting for about 30 minutes continuously.
He could squat three-quarters of normal and walk on the heels and toes, and his gait was not antalgic.
Flexion and extension were two-thirds of normal range. Lateral flexion was three-quarters of normal range bilaterally. There was discomfort in the lower back centrally at the end of flexion.
Sitting straight leg raising showed negative slump test bilaterally.
Reflexes were symmetrical with plantar responses both flexor. Power and sensation in the lower limbs were normal.
Supine straight leg raising was to 70° bilaterally with negative nerve stretch test.
Thigh girth; right 49cm, left 50cm at 10cm above the superior patellar pole.
Leg girth; right 38cm, left 38.5cm at 14cm below the inferior patellar pole (maximal circumference).
Upper extremity
Shoulder range of movement measured with a goniometer.
Shoulder Movements
Active ROM Measured
RIGHT
Active ROM Measured
LEFT
Flexion
180°
180°
Extension
50°
50°
Adduction
40°
40°
Abduction
180°
180°
Internal Rotation
90°
90°
External Rotation
90°
90°
Lower extremity
There was mild tenderness over the greater trochanter bilaterally. There was no visible swelling over the lateral aspect of the hips. There was no other tenderness about the hips.
Hip Movements
Active ROM Measured
RIGHT
Active ROM Measured
LEFT
Flexion
100°
120°
Extension
Normal
Normal
Abduction
40°
40°
Adduction
20°
20°
Internal Rotation
15°
20°
External Rotation
30°
30°
Scarring
There was a 6cm midline lower abdominal vertical scar with some widening of the distal part of the scar to 5mm. There was no adherence, no trophic changes and there were visible suture marks.
Consistency of presentation
The claimant presented in a straightforward manner and was fully co-operative in demonstrating his genuine best effort during the physical examination, in my opinion.
IMAGING
The claimant did not bring any additional imaging to the examination.”
FINDINGS
The review of the medical assessment is not limited to a review of only that aspect of the assessment that is alleged to be incorrect and is to be by way of a new assessment of all the matters with which the medical assessment is concerned.[4]
[4] Section 7.26(6) of the MAI Act.
The Panel should only consider the impairment as it is at the time of the Panel assessment.[5]
[5] Clause 6.21 of the Guidelines.
The Panel may confirm the certificate of assessment or revoke that certificate and issue a new certificate as to the matters concerned.[6]
[6] Section 7.26(7) of the MAI Act.
The Panel refers to the above re-examination report of Medical Assessor Oates and adopts the findings in their entirety. The Panel reconvened on 8 April 2025 and discussed the re-examination report findings before collectively making the below determinations.
Diagnosis, causation and reasons
Causation is dealt with at cls 6.5-6.7 of the Guidelines. An abridged form of the requirements is contained in cl 6.7 which states:
“6.7 There is no simple common test of causation that is applicable to all cases, but the accepted approach involves determining whether the injury (and the associated impairment) was caused or materially contributed to by the motor accident. The motor accident does not have to be a sole cause as long as it is a contributing cause, which is more than negligible. Considering the question ‘Would this injury (or impairment) have occurred if not for the accident?’ may be useful in some cases, although this is not a definitive test and may be inapplicable in circumstances where there are multiple contributing causes.”
Further, the provisions of the Civil Liability Act 2002 apply, in particular ss 5D and 5E.
Cervical spine
Soft tissue injury. This injury is related to the accident, as it is mentioned in the Application for Personal Injury Benefits dated 19 January 2021 (APIB), ambulance records, hospital records, general practitioner (GP) visit of 2 December 2020 to Dr Zaky, medical certificate of 5 December 2020, and in Dr Al Khawaja’s report of 12 January 2021.
It was mentioned that the neck pain radiated towards the left arm and hand.
Thoracic spine
Soft tissue injury. This injury is related to the accident, as it is mentioned in the APIB which covered upper and middle back pain, and also in the ambulance and hospital records.
Lumbar spine
Soft tissue injury with aggravation of pre-existing symptomatic lumbar spine condition with radicular symptoms affecting the right lower extremity, and radiculopathy documented after the accident, which was not present before the accident.
This aggravation injury is related to the accident, as it was mentioned in the APIB, the ambulance records noted right lower back pain as did the hospital records. Dr Al Khawaja noted low back pain with decreased right straight leg raising and decreased right ankle jerk (S1) which correlated with the result of the MRI scan. The symptomatic lumbar radiculopathy persisted despite extensive non-surgical treatment, including spinal injections. Surgery was the last treatment option available. The question of lumbar surgery was not in play before the accident, because conservative treatment had been effective in reducing symptoms to a manageable level and restoring function allowing the claimant to return to a manual occupation. Lumbar surgery would not have been required but for the motor accident.
The Panel also considered the online investigation reports by Quantum Corp dated 9 February 2021 and 3 March 2022. The photographs show the claimant posing crouched or standing with dead deer. There is also a photograph of the claimant posing in a standing position holding a rifle. While the Panel infers that the claimant may have accompanied his brother and others on a hunting trip, there is no evidence to suggest the claimant dragged or lifted the deer carcasses into position for the photographs. As mentioned, the photographs only show the claimant in a standing or couched position. The Panel therefore cannot draw any conclusion from the pictures that the claimant was participating in arduous physical activity beyond the limits imposed by the musculoskeletal injuries sustained in or aggravated by the motor accident.
It was therefore the Panel’s view that the causation provisions of the Guidelines were satisfied – namely the lumbar spine condition was aggravated by the motor accident and the resulting impairment is assessed as it is at the time of the Panel examination, including the operative procedure, but minus any pre-existing impairment component.
Right and left hips
It is more likely than not that the hips were not injured directly, noting the mechanics of the accident, however both hips were affected by radiating pain from the lumbar spine distally towards the lower extremities, more particularly on the right side.
The Panel noted that investigations were done of the right hip but they showed no local pathology.
Right and left shoulders
Though the APIB did mention shoulder symptoms, there is no record of a direct shoulder injury in any of the other contemporaneous medical records.
The left shoulder was affected through referred symptoms on the left side from the cervical spine. The Panel accepted causation of the left shoulder injury.
There is no indication that the right shoulder was affected either directly or by referred symptoms.
Skin – scarring
There is post-surgical scarring in the central mid-line lower abdomen from the anterior lumbar interbody fusion, and this is the result of surgery done for a condition of the lumbar spine related to the accident, and therefore it is also related to the accident.
PERMANENT IMPAIRMENT
The assessment of the degree of permanent impairment is to be made in accordance with the Motor Accident Guidelines (the Guidelines).[7]
[7] See section 7.21 of the MAI Act.
Version 9.3 of the Guidelines applies to the Review. Part 6 deals with the assessment of permanent impairment.
The claimant has undergone lumbar spinal fusion. This is an example of multi-level structural compromise pursuant to cl 6.145[8] of the Guidelines.
[8] Clause 6.145: Multilevel structural compromise also includes spinal fusion and intervertebral disc replacement.
From American Medical Association's Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA 4), Table 72, this gives a DRE IV which gives 20% WPI.
The cervical spine and thoracic spine soft tissue injuries have resolved, giving rise to no assessable impairment.
There was no direct injury to the left or right shoulders and there is full range of movement, hence no assessable permanent impairment.
There was no evidence of direct injury to either hip and full range of movement, hence no assessable permanent impairment.
The surgical scar of the abdomen is an uncomplicated surgical scar and does not give rise to any additional assessable impairment.
Pre-existing or subsequent impairment
The Panel noted the provisions for apportionment of current WPI due to pre-existing injuries or conditions are contained in cls 6.31 and 6.32 of the Guidelines:
6.31The evaluation of the permanent impairment may be complicated by the presence of an impairment in the same region that existed before the relevant motor accident. If there is objective evidence of a pre-existing symptomatic permanent impairment in the same region at the time of the accident, then its value must be calculated and subtracted from the current WPI value. If there is no objective evidence of the pre-existing symptomatic permanent impairment, then its possible presence should be ignored.
6.32The capacity of a medical assessor to determine a change in physical impairment will depend upon the reliability of clinical information on the pre-existing condition. To quote the AMA4 Guides (page 10): ‘For example, in apportioning a spine impairment, first the current spine impairment would be estimated, and then impairment from any pre-existing spine problem would be estimated. The estimate for the pre-existing impairment would be subtracted from that for the present impairment to account for the effects of the former. Using this approach to apportionment would require accurate information and data on both impairments.’
There is well-documented history of a pre-existing impairment affecting the lumbar spine, with evidence of radicular features affecting the right lower extremity.
There was no pre-accident documented evidence of symptoms or clinical findings to satisfy a diagnosis of lumbar radiculopathy, as per the definition in the Guidelines.
Non-verifiable radicular complaints place the claimant in DRE Lumbosacral Category II giving 5% WPI.
Apportionment
For the lumbar spine, 20% minus 5% gives 15% WPI related to the motor accident.
CONCLUSION
The claimant’s WPI as a result of the motor accident is 15% and is greater than 10%. The Panel’s impairment percentages are different to that assessed in the medical assessment under review. The Panel also found the right shoulder injury to be not causally related to the motor accident.
As such, the Panel revokes the certificate of Medical Assessor Dixon dated 8 October 2024.
A new certificate is issued at the front of the Panel’s determination.
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