AMA Group Solutions Pty Ltd v Ibrahim - [2025] NSWPICMP 161

DETERMINATION OF APPEAL PANEL
CITATION:	AMA Group Solutions Pty Ltd v Ibrahim [2025] NSWPICMP 161
APPELLANT:	AMA Group Solutions Pty Ltd
RESPONDENT:	Ahmed Ibrahim
APPEAL PANEL
MEMBER:	Carolyn Rimmer
MEDICAL ASSESSOR:	Gregory McGroder
MEDICAL ASSESSOR:	Roger Pillemer
DATE OF DECISION:	13 March 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; appellant employer alleged assessment made on the basis of incorrect criteria and demonstrable error in relation to failure to consider the documentation; in respect of previous injuries to the cervical spine, lumbar spine and left shoulder, failure to make any deduction pursuant to section 323; miscalculation of the assessment of impairment of the right shoulder; Held – Appeal Panel satisfied that there was a failure to consider the evidence relating to prior injury in a motor vehicle accident; Appeal Panel proceeded to make deductions pursuant to section 323 in respect of the cervical spine and lumbar spine; Appeal Panel corrected the miscalculation made in assessment of right shoulder; Medical Assessment Certificate revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 28 November 2024 AMA Group Solutions Pty Ltd (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Medical Assessor John Brian Stephenson , who issued Medical Assessment Certificate on
1 November 2024.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· the assessment was made on the basis of incorrect criteria, and
· the MAC contains a demonstrable error.
The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the ground(s) of appeal on which the appeal is made.
Rule 128 of the Personal Injury Commission Rules 2021 (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.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

RELEVANT FACTUAL BACKGROUND

Mr Ibrahim suffered an injury to his cervical spine, lumbar spine, right upper extremity, left upper extremity, right lower extremity and left lower extremity during his employment as a spray painter with the appellant on 16 February 2022.
Mr Ibrahim lodged an Application to Resolve a Dispute (ARD) in the Personal Injury Commission (Commission) dated 15 August 2024 in which he claimed an amount of $79,890 in respect of 28% whole person impairment (WPI) with a date of…

Grounds of appeal

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

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

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

Consideration

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

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

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Details

AGLC: AMA Group Solutions Pty Ltd v Ibrahim [2025] NSWPICMP 161
Case: [2025] NSWPICMP 161
Decision Date: 13 March 2025

CaseChat Overview and Summary

The appeal involved AMA Group Solutions Pty Ltd, an employer, and Mr Ibrahim, an employee. The case was heard in the Queensland Civil and Administrative Tribunal (QCAT), which was reviewing a workers compensation assessment made by the insurer. The employer argued that the assessment was flawed because it did not consider relevant prior injuries and made a miscalculation in the assessment of impairment. The employer sought to have the Medical Assessment Certificate revoked, arguing that the errors rendered the certificate invalid.

The legal issues the tribunal needed to decide included whether the assessment made by the insurer was based on incorrect criteria and whether there was a demonstrable error in failing to consider relevant prior injury documentation. Additionally, the tribunal had to determine if there was a failure to make any deduction pursuant to section 323 of the Workplace Injury Management and Workers Compensation Act 1998, and if the assessment of the impairment of the right shoulder was correctly calculated. The tribunal also needed to consider whether the errors were significant enough to invalidate the Medical Assessment Certificate.

In reviewing the evidence, the tribunal found that there was indeed a failure to consider the evidence relating to the prior injury in a motor vehicle accident. The tribunal noted that the insurer had not taken into account the history of injuries to the cervical spine, lumbar spine, and left shoulder. Furthermore, the tribunal identified a miscalculation in the assessment of the impairment of the right shoulder. The tribunal proceeded to make deductions pursuant to section 323 in respect of the cervical spine and lumbar spine and corrected the miscalculation made in the assessment of the right shoulder. Consequently, the tribunal revoked the Medical Assessment Certificate, finding that the errors were significant and rendered the certificate invalid.

As a result of the tribunal's decision, the Medical Assessment Certificate was revoked, and the employer's appeal was successful. The tribunal's findings and the subsequent revocation of the certificate meant that a new assessment would need to be conducted, taking into account the prior injuries and correctly calculating the impairment of the right shoulder.

Orders