Apollo Window Blinds Pty Ltd v Callus

DETERMINATION OF APPEAL PANEL
CITATION:	Apollo Window Blinds Pty Ltd v Callus [2023] NSWPICMP 288
APPELLANT:	Apollo Window Blinds Pty Limited
RESPONDENT:	Michael Callus
Appeal Panel
MEMBER:	Paul Sweeney
MEDICAL ASSESSOR:	Neil Berry
MEDICAL ASSESSOR:	Drew Dixon
DATE OF DECISION:	10 May 2023
DATE OF amendment:	22 June 2023
CATCHWORDS:	wORKERS cOMPENSATION - Lead assessor mistakenly certifies all body parts/systems referred for assessment without reference to Medical Assessment Certificate (MAC) of non-lead assessor who certified body parts referred to him for assessment had not reached maximum medical improvement (MMI); conflicting MACs issued by two assessors; Aircons Pty Ltd v Registrar considered; re-examination by member of Panel of all body parts; Held – both MACs revoked and new MAC issued.

BACKGROUND TO THE APPLICATION TO APPEAL

On 10 October 2022, Apollo Window Blinds Pty Limited (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Cyril Wong, a Medical Assessor (MA) as lead assessor and Dr Mark Burns, an MA. Dr Wong issued a Medical Assessment Certificate (MAC) on 13 September 2022.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (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 grounds of appeal on which the appeal is made.
Rule 128 of the Personal Injury Commission Rules 2021 (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

Michael Callus (the respondent) was formerly employed by the appellant as a branch manager at its premises at Silverwater. On 2 November 2018, he suffered a right inguinal hernia when lifting a bundle of blinds in the course of his employment. He sought treatment from his general practitioner (GP), Dr Chow, who referred him to a general surgeon, Dr Thomas Oh.
On 10 December 2018, Dr Oh carried out a laparoscopic mesh repair of the right inguinal hernia at Westmead Private Hospital. The respondent continued to experience symptoms in his right groin and leg following surgery. He was diagnosed with a deep vein thrombosis (DVT) and a right lower lobe pulmonary embolism.
In March 2019, the respondent was referred to the Northern Pain Clinic for further treatment of his continuing pain but he was unable to undertake the travel necessary to undergo that treatment. He continues to experience pain in his right groin and leg. He has developed symptoms in his low back and has been unable to return to work.
On 3 March 2020, the respondent saw Dr Dias, an occupational physician, at the request of his solicitors for the purpose of assessing permanent impairment resulting from the injury. By a report of that date, Dr Dias expressed the opinion that the respondent had 35% whole person impairment (WPI). Dr Dias assessed 25% WPI as a result of the right inguinal hernia, 5% as a result of injury to the right ilioinguinal, 2% WPI of the right calf as a result of DVT, and 8% for the consequential medical condition of the lumbar spine.
On 9 November 2020, Dr Truskett, a surgeon, saw the respondent at the request of the appellant’s solicitors. By a report of that date he expressed the opinion that the respondent had 6% WPI as a result of the injury. He awarded 5% in respect of an injury to the inguinal nerve and 1% for the DVT. He did not accept that the respondent’s lumbar symptoms resulted from injury.
On 28 June 2022, a member of the Personal Injury Commission (Commission) determined that the respondent suffered a consequential medical condition of the lumbar spine as a result of the injury to his right groin and the consequential DVT. As there remained a medical dispute, as that term is defined in s 319 of the 1998 Act, a delegate of the President referred the dispute for medical assessment.
By a Referral for Assessment of Permanent Impairment pursuant to s 293 of the 1998 Act, the delegate requested medical assessment in respect of the digestive system (right inguinal hernia), right lower extremity (right calf deep vein thrombosis), nervous system (right ilioinguinal neuralgia) and consequential injury to the lumbar spine.
The Referral, which is dated 27 July 2022, recorded that the delegate had chosen Professor Cyril Wong as the lead assessor to assess the digestive system (right inguinal hernia) and Dr Burns as the non-lead assessor to assess the right lower extremity (right calf deep vein thrombosis), nervous system (right ilioinguinal neuralgia and consequential injury to the lumbar spine).
It is from the certification of the lead assessor, Dr Wong, that the appellant brings this appeal.

PRELIMINARY REVIEW

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.
As a result of that preliminary review, the Appeal Panel determined that it was necessary for the worker to undergo a further medical examination. The Appeal Panel concluded that there was error in Dr Wong’s certification. The panel gives reasons for its finding of error under the heading “Findings and Reasons” below.

EVIDENCE

Documentary evidence

The Appeal Panel has before it all the documents which were sent to the MA for the original medical assessment and has taken them into account in making this determination.

Medical Assessment Certificate

The parts of the MAC given by the MA which are relevant to the appeal are set out in the body of this decision.

SUBMISSIONS

Both parties made written submissions. They are not repeated here in full, but have been considered by the Appeal Panel.
The appellant observed that by his MAC Dr Burns certified that the respondent had not reached maximum medical improvement (MMI) in respect of his lumbar spine and right ilioinguinal neuralgia. As Dr Garvey had recommended a non-mesh hernia repair, it was possible that the respondent’s right groin pain and ilioinguinal neuralgia might improve following successful surgery. That may also lead to an improvement of the respondent’s chronic low back strain. Dr Burns also found that WPI could not be assessed in respect of the DVT. It was not fully ascertainable as he had not had access to the recent Doppler ultrasound results and ultrasounds which had recently been obtained by the respondent’s GP.
By his MAC dated 13 September 2022, Dr Wong made no reference to the MAC of Dr Burns. He made no reference to the possible hernia repair surgery recently recommended by Dr Garvey. Dr Wong proceeded to assess not only the recurrent inguinal hernia which had been referred to him for assessment but the body parts which had been referred for assessment to Dr Burns. He assessed 17% WPI.
The appellant argued that:
“The respondent was referred to Dr Burns for assessment of his right calf DVT, right ilioinguinal neuralgia and lumbar spine. Dr Burns found that permanent impairment from the DVT is not fully ascertainable, and that the respondent had not reached MMI in relation to the latter two conditions. He declined to assess WPI on that basis. The respondent was referred to A/Prof Wong for assessment of his inguinal hernia; however, A/Prof Wong also assessed the right DVT, right ilioinguinal neuralgia and lumbar spine without reference to Dr Burns MAC. A/Prof Wong found that the respondent had reached MMI and provided an assessment of 17%.
The MA’s conclusions are therefore inconsistent with each other and with the MA referral. This constitutes a demonstrable error pursuant to s 327(3)(d) of the WIM Act.
In the alternative, we say that A/Prof Wong’s assessment was made on the basis of incorrect criteria noting that Dr Burns found that the respondent had not reached maximum medical improvement. This constitutes an appealable error pursuant to s 327(3)(c) of the WIM Act.”
By his submission, the respondent acknowledged that Dr Oh and Dr Garvey had recommended further surgery at the site of his hernia. He asserts that it was not initially approved by the insurer. Subsequently, he formed the view that he did not wish “to proceed with any surgery even if it was again proposed.” He says that at the arbitration hearing and at the time of his referral to a MA, he did not wish to undertake further surgery and was “stable for assessment of his injuries.”
By his submission, the respondent submits that he did not inform Medical Assessor Burns that he wished to proceed with further surgery.
The respondent argues that both Medical Assessor Wong and the qualified doctors for each party, Dr Dias and Dr Truskett found that his injuries were stable for WPI assessment. He argues that as Dr Wong correctly calculated the final degree of permanent impairment, his MAC is does not contain a demonstrable error. Accordingly, his certificate should not be “revoked or amended.”

Medical examination

Dr Berry of the Appeal Panel conducted an examination of the respondent on 4 April 2023. To the extent that it is relevant, his report is as follows:
“1.     WORKER’S DETAILS INCLUDING
·        Date of examination: 4 April 2023
·        Date of birth and age at examination: 25 May 1970, Aged 52
·        Hand dominance: Right hand dominant
·        Details of who attended the examination: Attended unaccompanied
·        Date of injury: 2 November 2018
·        Employer and occupation: Apollo Windows Blinds Pty Ltd as a Branch Manager
2.     HISTORY RELATING TO THE INJURY
·        Brief history of the incident/onset of symptoms and of subsequent related events, including treatment:
Mr Callus told me that he had been employed by Apollo Windows Blinds Pty Ltd for six years. He had moved from his office to the factory based at Silverwater to prepare blinds and shutters and other items for the installers as they were understaffed. He recalls that he was lifting bundles of blinds from the floor and placing them on a ledge for about 15 minutes and he experienced excruciating pain in the right groin and fell to the ground.
He was able to get back to his office and sat there for about half an hour using an icepack. Mr Callus then attended his general practitioner who prescribed analgesics and referred him for an ultrasound which showed a right inguinal hernia.
Mr Callus confirmed that the right groin was swollen. He was referred to a general surgeon, Dr Ho and underwent laparoscopic surgery on the right groin at Westmead Private Hospital. Post-operative he had severe pain and still had swelling in the groin, the pain extended down into the right thigh and when he consulted his treating surgeon he was prescribed Targin for the pain and told there was nothing else that could be done.
Subsequently about a month later, he developed cramping pain in the right calf which became swollen and when he became breathless he attended his general practitioner who referred him to Concord Hospital where he was kept for one or two days, Mr Callus did not recall the exact events but he recalls that he was placed on thinning agents.
Mr Callus subsequently developed low back pain but he could not recall when it came on.
·        Present Situation:
Mr Callus confirmed that he has not worked since the time of the injury. He continues to suffer pain in the right groin and in the front of the right thigh. He experiences occasional cramps in the calf and his back is very sore and he walks with a right-sided limp due to groin pain.
·        Present treatment:
Mr Callus takes:
§Endone
§Nexium
§Temazapam
§Xarelto
§Prestiq
§Mesasal for Crohn’s disease
·        Details of any previous or subsequent accidents, injuries or condition:
Mr Callus underwent a laparoscopic repair of a left inguinal hernia approximately 15 years ago and he made a complete recovery.
·        General health:
Mr Callus has suffered from Crohn’s disease since he was 19 years of age. He is on appropriate medication and suffers occasional diarrhoea but no bleeding.
·        Work history including previous work history if relevant:
Mr Callus left school after completing Year 10 and then attended TAFE for a year. He then worked in sales for Tandy Electronics for 20 years until they were bought out by Woolworths. He then worked for a number of different companies until he obtained employment with Apollo Window Blinds Pty Ltd.

· Social activities/ADL:
Mr Callus is a separated man but is sharing the same house with his separated wife and their two children. He is unable to carry out any of the household maintenance.
3. FINDINGS ON PHYSICAL EXAMINATION
Mr Callus was 165 cm in height and 63 kgs in weight.
He walked with a significant right-sided limp and he was unable to sit throughout the interview and had to stand from time to time.
Cervical Spine
The cervical spine was normal.
Upper Extremities
The upper limbs were normal in all respects.
Lumbar Spine
The claimant was tender in the low back and he demonstrated less than one third of the normal range of flexion, no extension and minimal rotation. He was unable to get onto the examination couch for examination.
Lower Extremities
It was noted that there was wasting of the right leg. The circumference of the thigh, 10 cm above the patella was 42 cm on the right, were as the left thigh was 46 cm and in the calves, 10 cm below the patella the calf was 32 cm on the right side and 36 cm on the left side.
Mr Callus had to be assisted to remove his tracksuit pants. He was noted to have long big toenails which had not been cut and the others all nails appeared to have been cut but the claimant told me that they had not grown and his son refused to cut his nails.
As noted above, the claimant was unable to get on the examination couch and reflexes were unable to be determined.
Examination of the abdomen and groins
The claimant was acutely tender in the right groin but there was no palpable mass. The left groin was normal. There was sensory dysaesthesia affecting the groin and in the inguinal ligament into the right thigh consistent with the area of the ilio-inguinal nerve.
No other abnormality was detected in the abdomen. Mr Callus was helped to get dressed.

4. DETAILS AND DATES OF SPECIAL INVESTIGATIONS
The claimant brought in the following ultrasound reports:
§Renal tract ultrasound dated 2 February 2022 of his renal tract which was a normal study.
§Scrotal ultrasound dated 2 February 2022 which showed a 5mm left epididymal head cyst, otherwise normal scrotal appearance.
§Groin ultrasound dated 2 February 2022 which showed a right indirect inguinal hernia which contains fat. No bowel is seen. This is non-reducible and no fluid is seen within the hernial sac. No surgical mesh identified.

5. SUMMARY
· consistency of presentation
Mr Callus was co-operative throughout the assessment and showed no exaggeration or illness behaviour.”

DISCUSSION AND FINDINGS

Section 328(2) of the 1998 Act provides that an 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. This subsection was considered by Davies J in New South Wales Police Force v Registrar of the Workers Compensation Commission of New South Wales [2013] SC 1792 (11 December 2013). Davies J considered that the form of the words used in s 328(2) of the 1998 Act ‘the grounds of appeal on which the appeal is made’ was intended to convey that the appeal is confined to those particular demonstrable errors identified by a party in its submissions. The Appeal Panel has only considered those grounds specifically raised by the appellant in its application.
In Campbelltown City Council v Vegan [2006] NSWCA 284 (Vegan), 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.
The role of the medical appeal panel was considered by the Court of Appeal in Siddik v WorkCover Authority of NSW [2008] NSWCA 116. An appeal by way of review may, depending upon the circumstances, involve either a hearing de novo or a rehearing. Such a flexible model assists the objectives of the legislation. However, in Versace vAustralia Best Tyres & Auto Pty Limited [2016] NSWSC 1540 (2 November 2016) Schmidt J, held that the 1998 Act did not permit the panel to review the determination of the MA without first identifying error.
Though the power of review is far ranging it is nonetheless confined to the matters which can be the subject of appeal. Section 327(2) of the 1998 Act restricts those matters to the matters about which the MAC is binding. In considering the submissions of the appellant, it is necessary to bear in mind the nature of the statutory obligation of the MA to provide reasons. It is evident from reasoning of the High Court of Australia in Wingfoot that it is only necessary for the MAC to explain the actual path of reasoning of the MA in sufficient detail to enable a court or an appeal panel to determine whether there is error in its findings. In Wingfoot Australia Partners Pty Ltd v Kocak[1] it was said that:
“The function of a medical panel is neither arbitral nor adjudicative: it is neither to choose between competing arguments, nor to opine on the correctness of other opinions on that medical question. The function is in every case to form and give its own opinion on the medical question referred to it by applying its own medical experience and its own medical expertise.”
[1] 252 CLR 480
The reasoning in Wingfoot has been applied to medical assessments under the NSW Workers Compensation legislation: see, for example, El Masri v Woolworths Ltd [2014] NSWSC 1344 (26 September 2014).
Dr Burns saw the respondent on19 August 2022. By his MAC, he recorded that the body parts referred to him for assessment were the right lower extremity (right-calf deep vein thrombosis), the nervous system (right ilioinguinal neuralgia) and a consequential injury to the lumbar spine. After examining the respondent and considering the medical evidence, he concluded that the severe pain in the respondent’s right groin and his consequential low back condition might improve if he underwent the further surgery proposed by Dr Garvey. He certified that the respondent’s condition had not reached MMI in accordance with Guideline 1.15. Dr Burns also certified that the degree of permanent impairment arising from the respondent’s DVT was not fully ascertainable as he did not have access to recent investigations.
In accordance with the terms of the Referral, Dr Burns referred his MAC to Professor Wong “as Lead Assessor for issue of a consolidated Medical Assessment Certificate.”

Dr Wong saw the respondent on 8 September 2022 and issued his MAC on 13 September 2022. He stated that the body parts referred for assessment were:
“Digestive system (right inguinal hernia),
Right lower extremity (right calf deep vein thrombosis),
Nervous system (right ilioinguinal neuralgia and consequential injury to his lumbar spine).”
Dr Wong examined each of these body parts and assessed permanent impairment in respect of the right inguinal hernia, right inguinal neuralgia and the lumbar spine. It is not apparent from his MAC that he was aware of the limited terms of the medical dispute referred to him for assessment or of the appointment of Dr Burns to examine the respondent in respect of his right lower extremity and nervous system. He makes no reference to Dr Burns’s MAC or the need for a consolidated MAC to reflect the findings of both assessors. He summarised his findings as follows:
“Michael Callus is a 52-year old man who had an accident at work sustaining a right inguinal hernia injury. The hernia was repaired but there is a recurrent hernia. Mr Callus subsequently developed right deep vein thrombosis and pulmonary embolism. Mr Callus also suffers from a right groin ilioinguinal neuralgia. He continues to have impairments from his injuries affecting many aspects of his daily activities and his capacity to work.”
In Aircons Pty Limited v Registrar of the Workers Compensation Commission of New South Wales[2], Malpass J in the Supreme Court considered factual circumstances similar to the present. A delegate of the Registrar of the former Workers Compensation Commission had referred different aspects of a medical dispute to two medical assessors. The assessment of the skin was referred to Dr Fry, a plastic surgeon and the assessment of restriction of movement to an orthopaedic surgeon. By his MAC, Dr Fry assessed both the worker’s skin and the range of movement of the injured body parts. The Medical Assessment Certificate was set aside. The Judge said:
“I am satisfied that the Medical Assessment Certificate given by Dr Fry contains demonstrable error. He has addressed matters other than those referred to him for assessment. He has not given a certificate as to the matters referred for assessment. This has seen him venture outside that area and one of the consequences is that there is overlapping with the assessment made by Dr Bodel. The supplementary certificate given by Dr Bodel was founded on the correctness of the certificates that both he and Dr Fry had given. Accordingly, the supplementary certificate is infected with the error contained in the earlier certificate of Dr Fry.
It may be arguable that Dr Fry also failed to correctly identify the matters that were referred to him for assessment. He restated those matters with somewhat different terminology. His certificate does not mention the restriction imposed by the referral. Also, there is no mention of the referral to Dr Bodel. I take this matter no further as it has not been fully argued and does not need to be determined.”
[2] [2006] NSWSC 322 (28 April 2006).
It is not readily apparent why Dr Wong was unaware of the terms of the Referral or of the appointment of Dr Burns to assess aspects of the medical dispute. It seems probable, however, that in he failed to correctly identify the medical dispute referred to him for assessment and that he addressed aspects of the medical dispute which were not referred to him for assessment.[3] An examination on aspects of the medical dispute not referred to him for assessment constitutes a demonstrable error. It is not readily apparent why Dr Wong did not refer to the MAC of Dr Burns which, presumably, was referred to him by the Commission. His failure to refer to that document also constitutes error.
[3] See also Skates v Hills Industries Ltd [2021] NSWCA 142 (14 July 2021).
As the appellant submits, the result is conflicting determinations of the medical dispute referred for assessment by the two medical assessors. Dr Wong has assessed all relevant body parts and found that they were stable and capable of assessment. While Dr Burn’s assessment did not specifically address the respondent’s inguinal hernia, it inexorably follows that if further surgery is to be undertaken, as proposed by Dr Garvey, it too was not stable and capable of assessment at the time of the medical assessment. The conflicting determinations in the two MACs must lead to the conclusion that the medical dispute referred for assessment has not been determined in accordance with the Workers Compensation Legislation that and the Guidelines. Having determined that there were several errors in the MAC, the panel determined at the preliminary review, that Dr Berry, a specialist surgeon, should re-examine the respondent in respect of each of the body parts/systems referred for assessment.
Following, Dr Berry’s re-examination of the applicant the panel reconvened to consider the body parts/systems referred for assessment. The panel noted the respondent’s submission that he did not intend to undergo further surgery proposed by Dr Garvey. While the panel does not accept that Dr Burns did not accurately record what the applicant said on examination, the panel concluded that the recent history of the matter was only consistent with the applicant not intending to undergo the proposed surgery. As the respondent submitted, following Dr Garvey’s appointment, he has pressed on with his permanent impairment claim rather than requesting surgery. Given the stance of the respondent and the time that has elapsed since the injury and surgery, the panel concluded that the applicant’s condition was well stabilised and unlikely to change substantially over the next year with or without medical treatment. The panel then considered each body parts/systems referred for assessment in the context of Dr Berry’s findings.
Dr Berry considered that the respondent’s lumbar condition was well entrenched and unlikely to improve within the next several years even with more active treatment than the worker appears to have undergone since the onset of backpain. The asymmetric restriction of movement on his examination was consistent with a finding of DRE Lumbar Category II. Given his continuing pain and restriction of movement, the panel agreed with the opinion of Dr Berry that he was entitled to a further 3% WPI to reflect the impact of his back condition on the activities of daily living in accordance with Guidelines 4.33-4.35. Dr Berry confirmed on his examination that the respondent had sufficient restrictions on his capacity to undertake personal care activities to justify this conclusion.
Dr Berry reported to the panel that on repeated examination of the respondent’s right groin he was unable to confirm a palpable defect in the supporting structures of the and abdominal wall in the region of the groin. Table 6.9 of AMA 5, which sets out the criteria for rating permanent impairment due to herniation, dictates that absent a palpable defect there can be no rating for permanent impairment. The panel noted the findings of Dr Wong and Dr Dias on their examinations of the groin. It also noted that Dr Garvey and Dr Truskett could not confirm any palpable defect in the groin on their respective examinations.
Dr Truskett recorded that:
“On examining his abdomen there was no organomegaly or abdominal masses. There was a 17cm right lower paramedian scar which was pale and not tethered with no suture marks. It was slightly widened.”
Similarly, Dr Zaidi, the applicant’s general practitioner, recorded on 24 February 2020 that there was no recurrent mass on his examination of the respondent.
The panel concluded that Dr Berry’s examination of the respondent’s abdomen was the most recent and dependable of these examinations. In the absence of a palpable defect in the supporting structures of the groin on Dr Berry’s repeated examination, the respondent had no entitlement to WPI in accordance with Table 6.9 for his inguinal hernia. He did not fulfil the criteria in Class 1 of Table 6-9. While the ultrasound evidence is ambiguous, the medical specialists on the panel concluded that it was likely that the ultrasound of the 21 February 2020 demonstrated a lipoma and not a hernia.
Given the finding of a dyesthesia in the distribution of the inguinal nerve Dr Berry expressed the opinion that the respondent should be awarded 5% WPI in accordance with the Table 5.1 of the Guidelines. However, on examination of the right leg, he was unable to find any sign of peripheral vascular disease which would permit a finding of permanent impairment in accordance with AMA 5 for the consequences of his deep vein thrombosis. On his examination, the right leg was entirely normal and displayed no intermittent claudication or pain at rest. There was no evidence of oedema or dilated veins. The absence of symptoms and signs, which mirrored the findings of other specialists, is completely incompatible with presence of vascular problems in the respondent’s right leg.
The panel adopted these findings. Thus, the panel concluded that the respondent should be awarded 13% WPI in respect of the injuries referred for assessment.
For these reasons, the Appeal Panel has determined that the MAC issued on 13 September 2022 and, if necessary, the undated MAC of Dr Burns, should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.

PERSONAL INJURY COMMISSION

APPEAL PANEL

AMENDED MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter Number:	W2487/22
Applicant:	Michael Callus
Respondent:	Apollo Window Blinds Pty Ltd

This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act1998.

The Appeal Panel revokes the Medical Assessment Certificates of Medical Assessors Wong and Burns 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 WorkCover Guides	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. Digestive system (right inguinal hernia)	2/11/18	Chapter 16	Chapter 6 Table 6-9	0%	0%	0%
2. Right lower extremity (right calf deep vein thrombosis)	Chapter 15	Chapter 4 Table 4-5	0%	0%	0%
3. Nervous system (right ilioinguinal neuralgia)	2/11/18	Chapter 16	Section 6.6, ‘Hernias’ Page 136	5%	0%	5%
4. Consequential medical condition of the lumbar spine	Chapter 4 pages 24-30	Chapter 15 Table 15-3	8%	0%	8%
Total % WPI (the Combined Table values of all sub-totals)					13%

[2023] NSWPICMP 288

10 May 2023