Bennett v AAI Limited t/as AAMI
[2024] NSWPICMP 818
•3 December 2024
| DETERMINATION OF REVIEW PANEL | |
| CITATION: | Bennett v AAI Limited t/as AAMI [2024] NSWPICMP 818 |
| CLAIMANT: | Alyce Bennett |
| INSURER: | AAI Limited trading as AAMI |
| REVIEW PANEL | |
| MEMBER: | Terence Stern OAM |
| MEDICAL ASSESSOR: | Shane Maloney |
| MEDICAL ASSESSOR: | Mohammed Assem |
| DATE OF DECISION: | 3 December 2024 |
| CATCHWORDS: | MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident on 7 August 2017; on 11 June 2023 Medical Assessor (MA) Gorman determined the claimant’s permanent impairment at 6% only considering the right wrist in his report; the Review Panel conducted its own examination and considered the Claimant’s injuries to both wrists in the accident; the Panel confirmed the injuries caused by the accident gave rise to a 14% whole person impairment; the Certificate of MA Gorman was revoked. |
| DETERMINATIONS MADE: | CERTIFICATE OF DETERMINATION 1. The Review Panel revokes the certificate of Medical Assessor David Gorman, dated 11 June 2023, and substitutes the determination that the injuries referred to the Panel and caused by the accident, gave rise to a whole person impairment of 14%. |
STATEMENT OF REASONS
INTRODUCTION
Alyce Bennett (Ms Bennett), the claimant, was born in 1988.
On 7 August 2017, Ms Bennett was injured in a motor vehicle accident (the accident).
Ms Bennett has brought a claim for common law damages for the injuries she sustained under the Motor Accident Injuries Act 2017 (the MAI Act).
AAI Limited, ABN 48 005 297 807, trading as AAMI (AAMI) is the relevant insurer.
A medical dispute about the degree of Ms Bennett’s whole person impairment (WPI) has arisen. This constitutes a medical assessment matter under Schedule 2, cl 2(a) of the MAI Act.
A medical assessment matter is determined in accordance with Division 7.5 of the MAI Act by a Medical Assessor: s 7.20 of the MAI Act.
The dispute was referred to the Personal Injury Commission (Commission) and assigned to Medical Assessor David Gorman for assessment.
On 11 June 2023, Medical Assessor Gorman issued a certificate under s 7.23(1) of the MAI Act.
REVIEW PROCEDURE
Ms Bennett sought a review of the Medical Assessment under s 7.26 of the MAI Act (the Review).
A delegate of the President of the Commission determined there was reasonable cause to suspect that the medical assessment was incorrect in a material respect and referred the matter to the Review Panel (the Panel).
The review provisions provide that a review panel consists of two Medical Assessors and a Member assigned to the Motor Accidents Division of the Commission: s 7.26(5A) of the MAI Act. The President’s delegate has convened this Panel to conduct the review of the medical assessment.
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. The Review is by way of a new assessment of all matters with which the medical assessment is concerned: s 7.26(6) of the MAI Act. Section 7.25 of the MAI Act provides that the review of a medical assessment can be made on the basis of any agreement by the parties as to the degree of permanent impairment from a particular injury and whether a particular injury was caused by the accident, without those matters having to be the subject of assessment.
Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the Personal Injury Commission Act 2020 (PIC Act). A review panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application: Rule 128 of the PIC Rules.
LEGISLATIVE FRAMEWORK
General provisions
14.Sections 5D and 5E of the Civil Liability Act 2002 (the CLA) apply to the MAI Act: s 3B(2) of the CLA.
Ms Bennett’s claim and entitlements to compensation are governed by the provisions of the MAI Act. An injured person can make a claim for both economic losses and non-economic loss damages.
However, s 4.11 of the MAI Act provides that no damages for non-economic loss may be awarded in respect of injury unless the degree of permanent impairment of the injured person as a result of the injury caused by the motor accident is greater than 10%.
Permanent impairment assessment
Section 7.21 of the MAI Act provides that the degree of permanent impairment of an injured person is to be assessed in accordance with the Motor Accident Guidelines (the Guidelines).
The Guidelines were issued pursuant to Division 10.2 of the MAI Act and adopt the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA 4 Guides). The Guidelines are definitive in respect of the matters they address but where they are silent on an issue, the AMA 4 Guides should be followed: cl 6.2 of the Guidelines.
Permanent impairment is assessed in accordance with Chapter 6 of the Guidelines.
Causation of injury is addressed in cls 6.5, 6.6 and 6.7 of the Guidelines.
Clause 6.6 of the Guidelines notes:
“6.6 Causation is defined in the Glossary at page 316 of the AMA4 Guides as follows:
‘Causation means that a physical, chemical or biologic factor contributed to the occurrence of a medical condition. To decide that a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has, in fact, done so, it is necessary to verify both of the following:
(a)The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination.
(b)The alleged factor did cause or contribute to worsening of the impairment, which is a non-medical determination.'
This, therefore, involves a medical decision and a non-medical informed judgement.”
Clause 6.7 of the Guidelines states:
“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.”
Pre-existing impairment is addressed in cls 6.31, 6.32 and 6.33 of the Guidelines.
The 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: cl 6.31 of the Guidelines.
Clause 6.32 of the Guidelines states:
“The 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 AMA 4 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.”
Pre-existing impairments should not be assessed if they are unrelated or not relevant to the impairment arising from the motor accident: cl 6.33 of the Guidelines.
ASSESSMENT UNDER REVIEW
Medical Assessor David Gorman examined Ms Bennett on 16 February 2023 and issued a certificate on 11 June 2023 under s 7.23 of the MAI Act.
The following injuries were referred by the Commission for assessment:
(a) wrist – displaced fracture pf the right lower radius styloid process and fracture of the right capitate bone with severe ligamentous injuries to the right wrist and post-traumatic ganglion;
(b) cervical spine – soft tissue injury;
(c) lumbar spine – soft tissue injury, and
(d) leg – haematoma of the right thigh with visible deformity and pain.
Medical Assessor Gorman took a detailed history and relevant personal details at [7]-[12]:
“[7] Pre-accident medical history and relevant personal details;
Ms Bennett is 34 years of age. She completed Year 12 then continued her education at TAFE College for 12 months obtaining a Diploma in Child Care. She commenced working with the Medford Early Learning Centre for approximately 7 years, before transferring to the Ripples Early Learning Centre at Warabrook where she was employed for three years full-time. She has been working in childcare for 10 years.
Ms Bennett has a previous medical history of the following:
She had the diagnosis of anxiety and depression diagnosed and ongoing since 2008. As well, she has had the following noted in her records:•She attended East Maitland Physiotherapy in or around May 2009 for treatment of her thoracic spine and right shoulder.
•In or around 2013 she complained of left wrist symptoms, her general practitioner opined she suffered a soft tissue injury.
•On 12 May 2015, Mr Brendan Wilson, physiotherapist, reported she suffered from chronic neck pain. She had a full active range of motion in her cervical spine however demonstrated poor motor control during movement. She had hypermobility of the right upper cervical facet joints and significant tenderness on palpation through the sub occipital muscles.
•She was diagnosed with serotonin syndrome due to right hand tremors in 2016.
•In or around April 2017, she injured her right third finger when whilst gardening She reported the medial aspect of her right third finger PIP joint was tender. She continued to report symptoms in July 2017. She was referred for scans of her right hand. It is no longer a problem.
She has a 4-month-old baby and she is now on maternity leave.
She does not smoke and only has occasional alcohol.[8] History of the motor accident: -
On 7 August 2017, Ms Bennett was riding her motorcycle near the intersection of Huntingdale Road and Thornton Road when a Ute pulled out in front of her. Ms Bennett was unable to avoid colliding with the back section of the Ute landing heavily on the roadway.
Ms Bennett was transported to the Maitland Hospital by ambulance. Police did not attend the accident.
She had an x-ray of her left wrist and chest which reported:
There is a comminuted intra-articular fracture of the distal radius with significant volar displacement and impaction at the fracture site. There is also volar angulation. There is an associated fracture of the ulnar styloid.
X-Ray Chest: Cardiomediastinal contour is within normal limits. The lungs and pleural spaces appear clear. There is no pneumothorax seen.
Her left wrist fracture was reduced under a Narcolept anaesthetic, and the wrist was placed in a backslab cast with a post-operative x-ray taken at 7.45pm on the same day reporting:
Comparison is made with the study of 7 August 2017. The alignment has improved although there is still volar displacement at the fracture site of the distal radius.
Her right wrist was not examined or x-rayed on her arrival. She was discharged later that day to the care of her parents, with a referral to be reviewed by the hand surgeon, Dr Thomas Thorvaldson the following day. She attended the Maitland Private Hospital the following day to consult with that specialist, and by that time recognised severe pain also in her right wrist.
Later investigations of the right wrist were performed as outlined below.
Ms Bennett suffered:• Left wrist comminuted displaced fracture of the lower radius involving the joint surface and post-traumatic ganglion on the left wrist.
• Undisplaced fracture of the right lower radius styloid process and fracture of the right capitate bone with ligamentous injuries in the right wrist and a post- traumatic ganglion.
[9] History of symptoms and treatment following the motor accident: -
On the 10 October 2017 she was operated upon for a 2nd time by Dr. Tom Thorvaldson in the form of debridement of the extensor carpi ulnaris tendon and excision of the ganglion on the right side.
On the 13 April 2018 she had removal of an internal plate and screws and excision of a ganglion from the left wrist.In late June 2018 she had excision of a recurrent ganglion from the right wrist.
On the 11th June 2019 she had arthroscopic surgery and removal of a recurrent ganglion from the right wrist.
She attended a psychologist fortnightly, had hand therapy fortnightly and physiotherapy fortnightly. She has also started seeing a chiropractor twice a week for treatment for her neck and back.[10] Details of any relevant injuries or conditions sustained since the motor accident: -
She had cortisone injections which made her pain worse.
She had further surgery to the right wrist and hand by Dr. Tanya Burgess as follows:
13th May 2021 - Right De Quervain 's release.
14th December 2021- CMC joint arthroscopy and release of De Quervain's scar to
correct her right thumb instability.She underwent 7 operative procedures in total to her wrists.
[11] Current symptoms: -
On the right she has soreness in the thumb. On the left her wrist is sore.
She is right-handed and has trouble opening jars and bottles. She has trouble cutting fruit such as watermelons.
Because she cannot fully extend her wrist, she has trouble washing the car or walls. She has trouble getting up from the floor.
She cannot do push ups.
She gets discomfort when typing or writing.
Cold weather aggravates her wrist symptoms.
With her new baby she is getting some increased back pain.Her neck has also been aggravated and she is getting headaches.
[12] Current treatment: -
She is on Zoloft for anxiety and depression as well as PTSD.”
Medical Assessor Gorman performed a clinical examination at [14]-[18]:-
“[14] Cervical spine (cervicothoracic)
•Dysmetria? - there is a normal range of cervical spinal movements in all planes.
•Non-verifiable radicular complaints? - there is no radiation to the arms.
•Muscle guarding? - there is no muscle guarding.
•Neurological examination of both upper limbs - power, sensation and reflexes in the upper limbs is normal.
[15] Lumbar spine (lumbosacral)
•Dysmetria? - there is no dysmetria with normal range of movement in all planes.
•Non-verifiable radicular complaints? - there is no radiation of symptoms to the legs.
•Muscle guarding? - there is no muscle spasm.
•Neurological examination of both lower limbs - power, sensation and reflexes were normal.
•There were no sciatic nerve root tension signs.
[16] Upper extremity
The shoulder range of motion was normal.
The elbow had normal range of motion except on the right supination was only to 70 degrees and on the left it was normal at 80 degrees.
Wrist Movements Active ROM Measured RIGHT Active ROM Measured LEFT Flexion 50° 60° Extension 40° 60° Radial Deviation 10° 20° Ulnar Deviation 20° 30° Over the volar surface of the left wrist there was a widened scar 5cm in length with no colour difference but with sutures visible.
Over the volar surface of the right wrist there was a 2cm ragged scar with no colour differential.
There was a 1cm scar over the radial side of the wrist also with no colour difference to the surrounding skin.
There was a fine 5cm scar on the dorsum of the right forearm. It was a fine scar with no suture marks and no colour differential to surrounding skin.[17] Lower extremity
There was no residual swelling or deformity on the right thigh.
[18] Comments on consistency
She was consistent and cooperative.”
Medical Assessor Gorman arrived at the following conclusions as to injuries caused by the accident at [23]:
“[23] The following injuries WERE caused by the motor accident:
•Wrist - Displaced fracture of the right lower radius styloid process and fracture of the right capitate bone with severe ligamentous injuries to the right wrist and post-traumatic ganglion
•Cervical spine - Soft tissue injury
•Lumbar spine - soft tissue injury
•Leg - Haematoma of the right thigh with visible deformity and pain”
Medical Assessor Gorman summarised his findings as to WPI in a chart on page 10:
Body Part or System
AMA4 Guides / Guidelines References (Chapter / page / table)
Permanent (YES/NO)
Current %WPI
%WPI from pre-existing or subsequent causes
%WPI due to motor accident
1
Right wrist
Tables 26 and 29 on pages 36 and 38 of AMA 4; Table 3 on page 20
Yes
6%
0%
6%
2
Cervical Spine
Table 73 on page 110
Yes
0%
0%
0%
3
Lumbar Spine
Table 72 on page 110
Yes
0%
0%
0%
4
Right Leg
Nil relevant
Yes
0%
0%
0%
The final degree of permanent impairment caused by the accident was 6%.
Examination by the Panel
The review was carried out by Medical Assessor Shane Maloney on 13 November 2024 at the Medical Suites of the Commission:
Ms Bennett attended the medical suites at the Commission on 13 November 2024. She was accompanied by her partner.
Pre-accident history
Ms Bennett was in good health prior to the accident and was working full-time in childcare which she had been doing for the past 10 years. She states that she had had previous physiotherapy to her cervical spine in 2015 and had occasional chiropractic adjustments since then. She had been diagnosed as having the serotonin syndrome due to right hand tremors in 2016.
At present she lives with a partner with a one-year-old baby.
History of motor accident
Ms Bennett was riding her motorcycle when a car pulled out in front of her causing a T-bone impact. This resulted in her going over the handlebars and landing on the other side of the car. She was wearing a helmet at the time and backpack. There was no loss of consciousness and an ambulance attended the scene and transported her to Maitland hospital with a splintered left wrist.
The Panel noting the forces that were involved in the accident considered that, on the balance of probabilities, the Claimant injured her back in the accident and probably sustained a tear in the lumbar disc cartilage that led to the radicular symptoms.
History of treatment since the accident
At Maitland hospital, an X-ray showed a comminuted intra-articular fracture of the distal left radius. This was reduced and the left wrist was placed in a back slab. She was discharged home and referred to a hand surgeon, Dr Thorvaldson who also recorded pain in the right wrist. The treating hand surgeon corrected the fracture with a plate and pin internally.
Six weeks later the right wrist MRI reported an undisplaced fracture of the right lower radius styloid process and right capitate bone. On 10 October 2017, the right wrist was treated surgically with some debridement and excision of the ganglion. On 13 April 2018 the left wrist had a surgical removal of the internal plate and screws and a ganglion removed. In June 2018 there was a surgical removal of recurrent ganglion on the right wrist. This was again treated in June 2019 with a further removal of a recurrent ganglion from the right wrist. The right wrist was treated for de Quervain's syndrome in May 2021.
There has been the development of de Quervain's syndrome in the left wrist which was treated with two cortisone injections in 2023 which were helpful but eventually recurred. At present, Ms Bennett is waiting for a surgical intervention of the left de Quervain's syndrome by Dr Burgess at John Hunter Hospital.
There have been no further injuries sustained since the motor vehicle accident.
Current symptoms
Ms Bennett has persistent pain in the left wrist and in particular at the base of the left thumb. The right wrist is also painful including the right thumb with sensitivity over the surgical scars. This is worse in cold weather. Computer work also aggravates both wrists particularly if the computer desk is cold despite the use of a mat.
There is a depression over the right lateral thigh which is sensitive to any bumps. The neck feels stiff with occasional referral of pain into the occipital region. She also gets tingling in the mid spine region after prolonged standing but is unsure when this commenced.
At present, Ms Bennett has returned to office/administration work on a permanent full-time basis of 32 hours per week. She is able to drive but due to wrist soreness has converted to an automatic car. Walking is no problem and she cooks but avoids cutting heavy items. She also gets pain on lifting her baby. No sports are being undertaken.
Current treatment
Present medication is Nurofen two in the morning plus when necessary as well as Panadol two in the morning. She takes Zoloft One-A-Day for anxiety and depression. No manual therapy is being undertaken at present and she is on the waiting list for a surgical treatment of the left de Quervain's symptoms.
Clinical examination
Ms Bennett walked into the medical suites and sat comfortably during the interview. She states that she is right-handed. Height was measured at 161 cm and weight of 56kg.
Cervical spine
On inspection of the cervical spine there was a normal contour and on testing range of movement, a full range of flexion/extension, side bending and rotation. On palpation no guarding or spasm was noted in the cervical musculature. There was a full pain free range of movement of the shoulders and elbows.
On neurological examination of the upper limbs, reflexes were brisk and equal with normal power and no sensory changes were noted. No muscle wasting was apparent with the circumference of the upper arms 25cm in the right and 24.5cm on the left (10cm above the olecranon process) and in the upper forearm 23cm bilaterally (5cm below the olecranon process).
Lumbar spine
Ms Bennett walked with a normal gait and a full range of flexion/extension, side bending and rotation. On palpation there was no guarding or spasm noted in the lumbar musculature. Straight leg raise was 70° bilaterally with negative sciatic nerve root tension signs.
On neurological examination of the lower limbs, reflexes were brisk and equal with normal power and no sensory changes were noted. No muscle wasting was apparent with the circumference of the upper thighs 37cm bilaterally (10cm above the superior patella pole) and at the maximum circumference of the calves 32cm bilaterally.
On inspection of the right lateral thigh, there was a slight depression of about 5cm in diameter which is sensitive to touch with no colour change. She considers that this may have been related to the impact.
Wrists
On palpation there was tenderness over the distal right radius with slight laxity of the right radio ulnar joint. On passive movement no crepitus was detected in either joint.
On testing for a carpal tunnel syndrome, there was a positive Tinel's and Phalen's test on the right which caused numbness in the thumb, index and partial middle finger. There has been an increase in right wrist pain in the past two months. There was also a positive Phalen's test on the left side involving the same fingers.
Wrist Movements Active ROM Measured RIGHT Active ROM Measured LEFT Flexion 40° = 3% UEI 40° = 3% UEI Extension 40° = 4% UEI 40° = 4% UEI Radial Deviation 10° = 2% UEI 10° = 2% UEI Ulnar Deviation 20° = 2% UEI 20° = 2% UEI
Scarring
There is a surgical scar, vertically over the left wrist of 5 cm. Ms Bennett is aware of this scar and conscious of its position. There are no pigmentary changes with slight suture marks visible with no contour or trophic changes. On the dorsum of the right wrist, there is a 2cm scar at the base of the right thumb which is pale and tender with no trophic or contour changes and no adherence. There is a larger 5cm scar over the dorsum of the right wrist which is easily located by Ms Bennett and sensitive to touch. All of these scars are clearly visible with usual clothing.
These scars have been previous assessments by Medical Assessor Curtin at 2% WPI using the Table for the Evaluation of Minor Skin Impairment (Temski) chart which seems an accurate assessment.
Radiological studies
An X-ray dated 19 September 2017 showed the plates and screws of the left wrist in a good anatomical position.
An MRI of the right wrist with dated 26 September 2017. This showed a ganglion and tear of the volar aspect of the scapholunate ligament with mild bone bruising of the radial styloid process.
Causation and WPI
Cervical spine and lumbar spine
The Panel considers that Ms Bennett sustained a soft tissue injury to her cervical spine and a tear in the lumbar disc cartilage that lead to radicular symptoms in the lumbar spine at the time of the accident. The main initial focus was on her wrists due to the fractures but the impact of landing on her head and back after being catapulted over the car bonnet would result in a soft tissue injury to the spine which was treated with physiotherapy later.
A WPI assessment of the cervical spine was a diagnosis-related estimate (DRE) I which is 0% WPI. This was due to no dysmetria on testing range of movement, no guarding on palpation and no signs of radiculopathy or non-verifiable radicular complaints in the upper limbs.
The lumbar spine was assessed as DRE I which is 0% WPI. No dysmetria was noted on testing range of movement, no guarding was noted on palpation and no signs of radiculopathy or non-verifiable radicular complaints in the lower limbs.
Wrists
The initial fracture was noted to the left wrist but the right wrist also had an undisplaced fracture due to the motor vehicle accident. The treating hand surgeon diagnosed both injuries and subsequent surgical treatments.
Both wrists were assessed using range of movement using figures 26 and 29 of AMA 4 Guides. Both wrists had 11% upper extremity impairment (UEI) which converts to 7% WPI using Table 3 of AMA 4 Guides. This gives a total of 14% WPI for the wrists.
How the Panel dealt with the insurer’s submissions
The Insurer submitted that at [14]:
“[14] Moreover, at page 10 of the certificate, the Medical Assessor made the following comment: ‘The left wrist, while injured and symptomatic, has a normal range of motion and does not have any assessable impairment’” [emphasis added]
and continued at [15]:
“[15] It is the Insurer’s respectful submission that although the left wrist was not referred for assessment, the error is not material. Had the left wrist been assessed by the Medical Assessor, the left wrist would have not given rise to any degree of whole person impairment.”
The Panel noted the history set out by Dr Kesby [13 October 2017]:
“She described a car pulling out in front of her resulting in her landing heavily on both of her outstretched hands. She had severe pain in the left wrist but also had pain within her right wrist.”
The Insurer in its submissions at [13] submitted that the left wrist had improved and had a good range of movement. Although the left wrist may not have been expressly referred, it was specifically addressed by the Insurer.
The claimant, in the submissions of 18 April 2024, submitted at [22] that the Application and Reply clearly identify that the injuries to the claimant’s left wrist are for assessment. It noted that the Commission referral of 9 February 2023 appeared to have omitted the left wrist.
All of these submissions were brought to the attention of the President’s Delegate.
It was her determination at [7]-[8] that:
“[7] The claimant submitted that her left wrist injury was not considered by Medical Assessor Gorman despite the injury being in dispute between the parties.
[8] The insurer submitted that Medical Assessor Gorman did assess the claimant's left wrist and documented his finding that there was no restriction in the claimant's range of motion in the left wrist.”
At [9], the President’s Delegate was satisfied that the WPI of the claimant’s left wrist was in dispute between the parties.
The Panel sets out in its chart its findings on clinical examination on the active range of movement of the wrists. The Panel noted that the initial fracture was noted to the left wrist, but the right wrist also had an undisplaced fracture due to the motor vehicle accident. Both wrists were assessed using ROM, both had 11% UEI, converting to 7% WPI using Table 3 of AMA 4 Guides, giving a total of 14% WPI for the wrists.
Determination
The Panel revokes the certificate of Medical Assessor David Gorman, dated 11 June 2023, and substitutes the determination to certify that the injuries referred to the Panel and caused by the accident, gave rise to a WPI of 14%.
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