Burkin v Secretary Ministry of Health - [2021] NSWPICMP 13

DETERMINATION OF APPEAL PANEL
CITATION:	Burkin v Secretary Ministry of Health [2021] NSWPICMP 13
APPELLANT:	Janet Burkin
RESPONDENT:	Secretary Ministry of Health
APPEAL PANEL:	Deborah Moore Dr Patrick Morris Dr Michael Hong
DATE OF DECISION:	9 March 2021
CATCHWORDS:	WORKERS COMPENSATION- challenge to the assessments in a number of PIRS categories; Panel accepted the evidence supported the AMS’ assessments for all categories except self-care and personal hygiene; AMS failed to provide adequate reasons and did not appear to have assessed current impairment, rather based his assessment on the appellant’s past situation; MAC revoked.

STATEMENT OF REASONS FOR DECISION OF THE APPEAL PANEL IN RELATION TO A MEDICAL DISPUTE

BACKGROUND TO THE APPLICATION TO APPEAL

On 15 December 2020, Janet Burkin lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Graham Blom, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 30 November 2020.
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,
· 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.
The WorkCover Medical Assessment Guidelines 2006 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 the WorkCover Medical Assessment Guidelines 2006.
The assessment of permanent impairment is conducted in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed 1 April 2016 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

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 WorkCover Medical Assessment Guidelines 2006.
As a result of that preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because none was requested, and we consider that we have sufficient evidence before us to enable us to determine the appeal.

EVIDENCE

Documentary evidence

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

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the Medical Assessor erred in his assessment with respect to a number of the Psychiatric Impairment Rating Scale (PIRS) categories, namely Self-Care and Personal Hygiene, Social and Recreational Activities, Travel, and Concentration, persistence and pace (CPP).
In reply, the respondent submits that no errors were made.

FINDINGS AND REASONS

The procedures on appeal are contained in s 328 of the 1998 Act. The 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
In Campbelltown City Council v Vegan [2006] NSWCA 284 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 appellant was referred to the Medical Assessor for assessment of whole person impairment (WPI) in respect of a primary psychological injury resulting from a deemed date of injury of 8 February 2017.
The Medical Assessor obtained the following detailed history:
“Ms Burkin started working at Tweed Heads Hospital approximately six months prior to the incident leading to her injury. During this time she was working as a casual working less than twenty hours/week. She also acted as a carer for her aged mother and received a carer’s pension for this.
On the day of the injury she had been called in for a special shift at 6AM. She was asked to work in the Emergency Department that day, something that was unusual. Her role was to ‘special’ an 86 year old man… Prior to her starting nursing the patient she was told by one of the male nurses that had been caring for the patient during the night that he had been difficult and violent and had required significant sedation. Soon after Ms Burkin began attending him the patient attempted to get out of bed. The Registered Nurse (RN) who was in the ward called to Ms Burkin to prevent him from doing this. When she tried to do this however he flung his arms out in an aggressive fashion and hit Ms Burkin in the chest. She half fell and half jolted backwards with the result that she fell and hit her back on a chair as she was falling. She said that she felt extremely frightened by this and was fearful of being seriously harmed. She was not sure the patient would not further assault her.
Eventually two security guards and four male nurses were required to restrain the man and sedate him. Ms Burkin remained very frightened following the event and found it difficult to calm herself. She felt unable to continue the shift…She went home but on arrival home became extremely distressed. She described feeling tearful, shaky, anxious and experienced a sense of feeling overwhelmed and ‘not sure where to turn’. That night when she went to bed she experienced nightmares and woke up and was unable to return to sleep. She contacted the hospital for support and they offered a referral to what I assume was the Employee Assistance Program but Ms Burkin felt unable to engage in this.
Generally she said that she felt abandoned by the hospital and felt vulnerable and alone. She attempted to obtain an appointment with her General Practitioner but was unable to get one for several weeks. During this time she stayed at home. She remained extremely anxious describing regular tremor, palpitations and gastrointestinal symptoms such as vomiting and diarrhoea. She also described hypervigilance in that she was very easily startled if surprised in any way. She continued having nightmares on a very regular basis and would wake feeling anxious and very sweaty…As her anxiety continued her mood dropped and she said that she felt flat, amotivated and lacking in energy. Nevertheless she was able to continue caring for her elderly mother. This involved organising her meals, taking her to various appointments as well as generally assisting her during the day although her mother was able to perform her own hygiene.
Besides the loss of motivation and energy she said her concentration was poor and she struggled to focus. Generally she became more withdrawn and avoidant…
After about one month she eventually obtained her appointment with her General Practitioner who following his consultation initiated the antidepressant medication Sertraline at a dose of 50mg/day. This is a relatively low dose, used for initiation of therapy. She did not however increase the dose as she experienced palpitations which were so severe that at one point she was taken to hospital and was found to have some form of cardiac arrhythmia. This was thought to be related to the antidepressant medication and so it was ceased. She appears not to have had any further antidepressant medication…Her General Practitioner also referred her to a psychologist at the Shrink Company…She saw Ms Amy Castle through till approximately March of this year. At that time the insurer withdrew funding for this service. She has not continued with a psychologist since then…
At some stage she was also referred to a psychiatrist, also at the Shrink Company, Dr Ben Hadikusumo. She only consulted him she thought on one or two occasions for review. She continued to see her General Practitioner on a regular basis for support and medication review when appropriate.
During this time she was concomitantly having treatment for a back injury. She was reviewed by several orthopaedic surgeons and I gather the general consensus was that she had inflammation and bulging of the L4-5 disc and that at this stage conservative management was most appropriate…Over the past three years she said that her symptoms have really not changed very much.
I asked her why she continued with the psychologist at such an intensive rate if she did not feel it was very helpful in that her symptoms did not improve. She said that whilst she did not feel that her symptoms overall had improved she did find the sessions helpful in that they supported her and that she felt better after them although this impact tended to wear away very quickly. During 2018 Ms Burkin was involved in a rehabilitation program organised by her employer which included a Return to Work Program. She said she worked briefly in support services. This essentially involved her driving a vehicle to pick up elderly patients and drop them to appointments and then take them back home. She said that she usually only worked a few hours/week at this and did not continue at it for a long period of time. When I asked her why it stopped she said that there was insufficient work available for her.”
Present treatment was noted as follows:
“Currently Ms Burkin is not undertaking any active treatment. She has ceased contact with her psychologist. As mentioned she has said she is on the waiting list to restart sessions but this has not occurred. It is approximately eight months since her last psychology sessions. She does however continue to see her General Practitioner on an approximately monthly basis and he provides support and reassurance. She does not take any antidepressant medication and has ceased the Oxazepam. She does take Propranolol 10mg/day for tremor. This appears to be primarily related to a tremor of her head which she said only began after the incident although in observing the tremor, admittedly via zoom it did appear to be not a primarily anxiety based tremor but probably related to other organic disorder.”
Present symptoms were described as follows:
“Ms Burkin continues to have nightmares although they are less frequent than previously. She says that they occur approximately three times/week. Following the nightmares she wakes anxious and usually is unable to return to sleep. She will often remain awake for the rest of the night. She said she feels fatigued but does not nap during the day. Generally she experiences early morning waking and says she wakes about 4AM and cannot return to sleep. She said that this has only been present since the injury. She describes feeling anxious throughout the day particularly focusing on worrying thoughts especially about what is going to happen to her financially and how she will be able to return to work again. She regularly experiences palpitations. She has ongoing tremors both of her hands and head. I gather she has been investigated for possible Parkinson’s disease for this although testing suggested that it was negative. Whilst anxiety may be making this worse I doubt that this is primarily an anxiety based tremor. She is quite hypervigilant and is easily startled. Her concentration is poor she said and she struggles with focus although she did say that she enjoys reading books on another occasion. She does watch documentaries on television particularly David Attenborough documentaries which she can watch throughout – that is from 45 to 60 minutes. Her mood is low and she says that she feels amotivated and has low energy. Generally she feels quite distressed and worried. She described a feeling of loss of purpose in life and sometimes wonders about what will become of her. She has reduced capacity for pleasure but is able to enjoy some things. Her appetite remains okay. She does not drink alcohol heavily and has not used alcohol to manage her symptoms. She has not used illicit drugs to manage her symptoms. She has always been a smoker and her tobacco intake has increased as a result of her anxiety – she says she now smokes up to 40 cigarettes/day where as previously she only smoked about 20 cigarettes/day.”
As regards her activities of daily living (ADL’s) the Medical Assessor said:
“In March of this year Ms Burkin’s mother was admitted to a nursing home. Prior to that Ms Burkin had been her full-time carer preparing meals, doing the shopping and taking her to doctor’s appointments. In caring for her mother she was also able to generally care for herself preparing meals and looking after her personal hygiene. Since her mother has been in hospital and she is not responsible for her full-time care Ms Burkin has been able to engage more in social activities although she still remains somewhat avoidant and withdrawn. Nevertheless she said that she occasionally goes to the cinema at times when it is not busy. She has always been able to visit a friend whom she has in Brisbane since restrictions have been lifted. She has no difficulty travelling and as mentioned she occasionally visits her friend in Brisbane and is able to drive to Brisbane and back from Tweed Heads. She has generally been more withdrawn and this has resulted in some loss of contact with friends. When she was caring for her mother full-time she was more tense and irritable and this occasionally caused conflict with her mother. Generally she has some difficulties in focusing and remembering although this seems to fluctuate. She said she is able to watch documentaries for up to 45 minutes although struggles more with reading which she can only manage for 15 minutes. During the interview with me that lasted slightly over an hour she was able to retain focus and give a history in a reasonable chronological order. She is not currently employed although part of this is due to availability of employment. When I discussed this she said she would like to return to some form of employment and in fact needs to although it is unlikely that she would be able to work more than twenty hours/week and she would need to be in a position that was less demanding and did not involve excessive contact with others.”
Findings on mental examination were reported as follows:
“Ms Burkin was seen via Zoom Professional. She had no difficulty operating the system. She appeared neatly coifed. She was able to attend throughout a sixty minute interview. She had a noticeable tremor of her head which appeared to be primarily of an organic rather than an anxiety based nature. When I asked her to show me her hands she had a similar moderate resting tremor of her hands. Ms Burkin presented as a truthful witness who actively attempted to engage in the interview and to answer questions factually. She did not appear overtly depressed although she clearly was somewhat anxious. Her anxiety was punctuated by very evident frustration and considerable concerns for her financial future. There was no evidence of psychosis particularly there was no evidence of formal thought disorder, delusions or hallucinations. There was no evidence of significant cognitive impairment.”
The Medical Assessor summarised the injuries and diagnoses as follows:
“Ms Burkin was working as an AIN at Tweed Heads Hospital when struck quite hard in the chest by an elderly man. The man appears to have been in a delirium and certainly was aggressive and she was fearful that she may be seriously harmed. She injured her back in the fall. Subsequently she has developed symptoms consistent with Post Traumatic Stress Disorder characterised by nightmares, daytime anxiety and hypervigilance and to some degree withdrawal and avoidance and associated depressive symptomatology although not sufficient to meet the criteria for Major Depressive Disorder.
Her diagnosis is Post Traumatic Stress Disorder.”
The Medical Assessor assessed 5% WPI.
He then commented on the other medical opinions as follows:
“The Report of Dr Trevor Lotz dated 26th February 2020.
Dr Lotz provides a history of symptoms consistent essentially with what Ms Burkin described to me although perhaps not as complete. He makes an initial diagnosis of ‘(?) Post Traumatic Stress Disorder in near full remission’. He said that residual anxiety appears only related to hospitals and no other situations. He did not assess Whole Person Impairment as he did not believe that she had a significant psychological disorder. This does not accord with the history that I took nor does it accord with other medical opinions. Ms Burkin continues to experience mild to moderate symptoms of Post Traumatic Stress Disorder as I have described in my report. I believe that this warrants a psychiatric diagnosis and that it is possible to assess Whole Person Impairment.
The Report of Dr Mark Scurrah dated 27th November 2019.
Dr Scurrah diagnoses chronic Post Traumatic Stress Disorder with depressive symptoms with which I agree. He rates her overall Whole Person Impairment however at 15%. I disagree with a couple of his Class ratings. For Self-Care and Personal Hygiene he rates her as Class 2. This rating is despite the fact that in his report he notes that she has been receiving a Carer’s Pension and has been caring for her elderly mother. This suggests to me that Ms Burkin is able to care for herself and she confirmed this in my interview, I think Class 1 is clearly appropriate. He also rates a Class 3 for Social and Recreational activities. This does not accord with the history that I took. Ms Burkin specifically said that she is able to drive to Brisbane to visit friends and that she occasionally goes to the cinema and coffee. She is unquestionably more withdrawn than she previously was and sometimes is less engaged but nevertheless is able to undertake these activities alone. Class 2 is more appropriate. For Travel Dr Scurrah rates Class 2. Ms Burkin as previously mentioned noted that she drives to Brisbane occasionally to visit her friends. I suspect she was not driving previously mainly because of her need to care for her elderly mother who has been subsequently admitted to a nursing home. Nevertheless she has the capacity to drive lengthy distances. Class 1 is appropriate. I agree with his rating for Social Functioning but rate her a Class 2 for concentration. Whilst she is only able to focus for a reasonably short time whilst reading, she says – about 10 to 15 minutes she did say that she could watch documentaries for up to between 45 minutes and one hour. She is also able to focus and concentrate throughout the interview with me which lasted over an hour. I believe Class 2 rating is more appropriate. Dr Scurrah rates her Class 2 for Employability saying she appears capable of doing up to and including twenty hours/week. Whilst I accept that this may be a possibility the reality is that since her injury she has worked at most for a few hours/week. She is keen to return to work and I suspect she may be able to do this but I would think that it is likely she would struggle to a degree and she certainly could not work in the same position as previously and it is likely that she would work less than twenty hours/week in a position involving much less stress. Therefore I think Class 3 is actually more appropriate.”
Dealing firstly with the appellant’s challenge to the assessment with respect to Self-Care and Personal Hygiene, the appellant submits that the Medical Assessor erred in assigning a Class 1, stating:
“He disagreed with Dr Scurrah’s finding of Class 2 on the basis that ‘She has been receiving a carer’s pension’; and ‘She has been caring for her elderly mother’.
He goes on to say: ‘this suggests to me that Ms Burkin is able to care for herself and she confirmed this in my interview, I think Class 1 is clearly appropriate.’
Assessor Blom has relied upon three findings of fact to arrive at his Class 1 categorisation.
Firstly, Assessor Blom’s interview with the Appellant took place on the 23 November 2020. A deterioration in her psychological condition led to the Appellant being unable to care for her mother in February 2020. Her mother was admitted into a nursing home. Assessor Blom has relied upon the Appellant’s ability in the past to care for her mother where he is in fact obliged to assess her capacity and impairment in the present. In 11.6 of the Guidelines he is obliged to conduct an evaluation of impairment which needs to take into account variations in the level of functioning over time which clearly dictates that making an enquiry into her level of functioning 10 months prior is not relevant to her level of functioning in the present. The only other basis upon which Assessor Blom relied upon to arrive at a finding of Class 1 is the Appellant allegedly saying to him that she was able to care for herself however, he does not state what in fact she said to him. In other words, he has not provided reasons for arriving at this conclusion that she was able to ‘care for herself’ especially in circumstances where the Appellant’s evidence is that she skips meals and does not shower on many days. His conclusion is reached without providing any reasons and is clearly inconsistent with the Appellant’s evidence.”

We make the following observations on this submission.
The “evidence” to which the appellant refers is only in the information she gave Dr Scurrah. There is nothing in her statement that assists the Panel on this issue.
Having said that, we do agree that the Medical Assessor appears to have based his assessment on the appellant’s functioning prior to March 2020, and does not seem to have addressed her current level of self-care and personal hygiene.
We also agree that he has not provided satisfactory reasons for his assessment.
In short, it seems to us that the Medical Assessor has considered her functioning in the past tense, that is, in the context of the time she was caring for her mother.
Doing the best we can on all the evidence, we have no reason to reject the appellant’s evidence that at times, she skipped meals and did not shower regularly.
In our view, this is consistent with a Class 2 rating as submitted by the appellant.
Turning now to Social and Recreational Activities. The Medical Assessor assessed a Class 2, stating:
“Since her mother has been in hospital and she is not responsible for her full-time care Ms Burkin has been able to engage more in social activities although she still remains somewhat avoidant and withdrawn. Nevertheless she said that she occasionally goes to the cinema at times when it is not busy. She has always been able to visit a friend whom she has in Brisbane since restrictions have been lifted. She occasionally goes out to coffee.”
The appellant submits:
“Assessor Blom also disagreed with Dr Scurrah in the category of Social and Recreational Activities, finding that she should be categorised as Class 2 and not Class 3. It may not be an error in taking a different history to that taken by Dr Scurrah however, it is an error if facts assumed by Assessor Blom are incorrect to the extent that it allows him to erroneously place the Appellant in Class 2 instead of Class 3. As a demonstration of this, Assessor Blom stated that Ms Burkin is ‘able to drive to Brisbane to visit friends…’. He clearly relied upon this in order to place the Appellant in Class 2. The Appellant resides in northern NSW. The border was closed between NSW and QLD from 25 March 2020 until very recently. Again, Assessor Blom has made a finding based on information which clearly must be incorrect. In the distant past, the Appellant was, very occasionally, able to drive to Brisbane however, this certainly has nothing to do with her level of function now or in fact over the last 9 months.”
To begin with, the Medical Assessor clearly did not rely solely upon the fact that the appellant was able to drive to Brisbane on occasions in making his assessment. He also noted that she went to the cinema and goes out to coffee.
The Medical Assessor explained why he disagreed with Dr Scurrah, adding: “She is unquestionably more withdrawn than she previously was and sometimes is less engaged but nevertheless is able to undertake these activities alone.”
Mere disagreement with the findings of an Medical Assessor is not a proper basis for appeal.
In summary, the appellant simply submits that the Medical Assessor should have adopted the assessment of Dr Scurrah, who it is noted examined the appellant in 2019, well prior to the assessment by the Medical Assessor.
The Guidelines are clear in that assessing permanent impairment “involves clinical assessment…on the day of assessment, taking into account the claimant’s relevant medical history and all available relevant medical information…”
It is perhaps timely at this point to set out the task of an Appeal Panel as stated in Ferguson v Stateof New South Wales [2017] NSWSC 887 where Campbell J said:
“[23] By reference to NSW Police Force v Daniel Wark [2012] NSWWCCMA 36, the Appeal Panel directed itself that in questions of classification under the PIRS: ‘... the pre-eminence of the clinical observations cannot be underrated. The judgment as to the significance or otherwise of the matters raised in the consultation is very much a matter for assessment by the clinician with the responsibility of conducting his/her enquiries with the applicant face to face’.
[24] The Appeal Panel accepted that intervention was only justified: if the categorisation was glaringly improbable; if it could be demonstrated that the AMS was unaware of significant factual matters; if a clear misunderstanding could be demonstrated; or if an unsupportable reasoning process could be made out. I understood that all of these matters were regarded by the Appeal Panel as interpretations of the statutory grounds of applying incorrect criteria or demonstrable error. One takes from this that the Appeal Panel understood that more than a mere difference of opinion on a subject about which reasonable minds may differ is required to establish error in the statutory sense.
[25] The Appeal Panel also, with respect, correctly recorded that in accordance with Chapter 11.12 of the Guides ‘the assessment is to be made upon the behavioural consequences of psychiatric disorder, and that each category within the PIRS evaluates a particular area of functional impairment’…
[37] The descriptors, or examples, describing each class of impairment in the various categories are ‘examples only’…”
The Medical Assessor’ assessment was consistent with the evidence and we cannot see any error in his assessment.
The appellant next challenges the assessment with respect to Travel.
The Medical Assessor assessed a Class 1, adding:
“She has no difficulty travelling and as mentioned she frequently visits her friend in Brisbane and is able to drive to Brisbane and back from Tweed Heads.”
Again, we point out that the Medical Assessor must make an assessment on the day, and in our view, his rating was not only consistent with the evidence but also with the relevant descriptor.
The appellant submits:
“With regards to Travel, Assessor Blom has made a finding of Class 1 which is different to Dr Scurrah’s finding of Class 2. For the reasons given above, clearly he has made assumptions which are not correct.”
We repeat our comments made above. As the Medical Assessor noted:
“Ms Burkin as previously mentioned noted that she drives to Brisbane occasionally to visit her friends. I suspect she was not driving previously mainly because of her need to care for her elderly mother who has been subsequently admitted to a nursing home. Nevertheless she has the capacity to drive lengthy distances. Class 1 is appropriate.”
We note that restrictions were imposed on and off over the past 12 months or so, but travel on occasions was certainly permitted.
In addition, in our view the Medical Assessor makes a valid comment that travel may well have been restricted due in part to the duties imposed on the appellant as carer for her elderly mother.
Once her mother was admitted to a nursing home (well after she saw Dr Scurrah) she clearly had more freedom.
We do not agree that the Medical Assessor based his assessment on “incorrect assumptions.”
For these reasons, we cannot see any error in his assessment.
Finally, the appellant submits that the Medical Assessor erred in his assessment with regards to CPP.
The Medical Assessor assigned a Class 2 stating:
“Generally she has some difficulties in focusing and remembering although this seems to fluctuate. She said she is able to watch documentaries for up to 45 minutes although struggles more with reading which she can only manage for 15 minutes. During the interview with me that lasted slightly over an hour she was able to retain focus and give a history in a reasonable chronological order.”
The appellant submits:
“In regards to concentration Assessor Blom categorised the Appellant in Class 2 however, his findings are inconsistent and actually are supportive of Class 3 where he states ‘she can only read for a reasonably short time’. A moderate impairment (Class 3) is recommended where the injured person is unable to read more than newspaper articles. The sole other reason that he relies upon to make a finding of Class 2 is that the Appellant can watch documentaries for up to between 45 minutes and 1 hour. The Appellant’s evidence in this regard is that she can watch a documentary of this length of time however, she in fact has to watch it over 2 or 3 days.”
We re-iterate our previous comments with respect to the appellant’s submissions.
The evidence supported a Class 2 rating, and the relevant descriptor.
Reduced ability to concentrate does not of itself mean there is an automatic limited ability to follow complex instructions. In any event, the degree of activities undertaken by the appellant as noted by the Medical Assessor were indicative of mild impairment of function. There was certainly no suggestion that the appellant was “unable to read more than newspaper articles” as set out in the descriptor for this category.
In short, there is no evidence that the assessments made by the Medical Assessor were “glaringly improbable” or that the Medical Assessor “was unaware of significant factual matters” nor that “an unsupportable reasoning process could be made out.”
In our view, the MAC demonstrates the thoroughness of the Medical Assessor’ assessments following, as he said, “a lengthy interview process” and we cannot see that he has erred in his assessment in any of the PIRS categories raised by the appellant save for that of self-care and personal hygiene.
For these reasons, the Appeal Panel has determined that the MAC issued on 30 November 2020 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.

APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

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 Certificate of Dr Graham Blom 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. 1. Psychologi cal/Mind	8th February 2017	Chapter 11, Pages 60-68	AMA5 is replaced by Workcover Guidelines Chapter 11	6%	0	6%
2.
3.
4.
5.
6.
Total % WPI (the Combined Table values of all sub-totals)					6%

Deborah Moore

Member
Dr Patrick Morris

Medical Assessor

Dr Michael Hong

Medical Assessor

9 March 2021