Camejo v Homebush Bay Foods Pty Ltd

DETERMINATION OF APPEAL PANEL
CITATION:	Camejo v Homebush Bay Foods Pty Ltd [2023] NSWPICMP 571
APPELLANT:	Leonardo Camejo
RESPONDENT:	Homebush Bay Foods Pty Ltd
APPEAL PANEL
PRINCIPAL MEMBER:	John Harris
MEDICAL ASSESSOR:	Roger Pillemer
MEDICAL ASSESSOR:	Tommasino Mastroianni
DATE OF DECISION:	14 November 2023
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; the worker suffered an accepted right leg (hip, knee and ankle) and back injury in 2021 with surgical scar; a previous back injury in 2015 was assessed at 12% permanent impairment; the Medical Assessor (MA) assessed right lower extremity loss and deducted 30% pursuant to section 323 for the right knee; right lower extremity assessed at 7% and skin at 1%; assessment of 7% for the lumbar spine with a 100% deduction pursuant to section 323; reasons of MA disclosed basis for 30% deduction for the right knee due to prior symptoms and extensive osteoarthritis; reasons of MA for the lumbar spine showed error because there was a complete deduction based on a prior assessment; application of incorrect statutory test; Vannini v Worldwide Demolitions Pty Ltd applied; demonstrable error established for section 323 deduction of lumbar spine; Wingfoot Australia Partners Pty Ltd v Kocak applied; reassessment of section 323 deduction of lumbar spine; reference to pre-existing multilevel degeneration and symptoms; nature of pre-existing pathology made the effects of the injury and impairment worse; 1/10th statutory deduction not applied; finding made of 1/5th deduction pursuant to section 323 for the lumbar spine; Held – assessment revoked, and impairment assessed at 14%.

BACKGROUND

Mr Leonardo Camejo (the appellant) sustained injury on 9 December 2021 in the course of his employment with Homebush Bay Foods Pty Ltd (the respondent). The injury occurred when Mr Camejo was working with a high-pressure hose and detergents, slipped and twisting his right ankle, suffering injury to the right lower extremity and back.
Mr Camejo underwent internal fixation to the right ankle on 16 December 2021.
The appellant made a claim pursuant to s 66 of the Workers Compensation Act 1987 (the 1987 Act) based on the reports of Dr Bodel dated 14 February 2023. The claim included an assessment for the lumbar spine, right lower extremity and scarring as a result of surgery to the right ankle.
Proceedings in the Personal Injury Commission (Commission) were commenced as a medical dispute had arisen following the exchange of relevant correspondence. As there were no liability issues, the assessment of permanent impairment was referred by the President to a Medical Assessor.
The medical dispute was assessed by Medical Assessor Kuru who issued a Medical Assessment Certificate dated 14 August 2023 (MAC).
The assessment of permanent impairment is undertaken in accordance with the fourthedition of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (fourth edition guidelines).[1] The fourth edition guidelines adopt the 5^th edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA 5). Where there is any difference between AMA 5 and the fourth edition guidelines, the fourth guidelines prevail.[2]
[1] The fourth edition guidelines are issued pursuant to s 376 of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act).
[2] Clause 1.1 of the fourth edition guidelines.

MEDICAL ASSESSMENT

It is unnecessary to refer to the MAC in detail given the scope of the grounds of appeal which were limited to the assessment of the s 323 deduction for the lumbar spine and the right knee.
The Medical Assessor assessed the lumbar spine at 7% permanent impairment with a 10/10th deduction pursuant to s 323 of the 1998 Act. In respect of the right lower extremity, the Medical Assessor assessed the right hip at 5% lower extremity impairment, the right knee at 10% lower extremity impairment and the right ankle at 7% lower extremity impairment. The scar was assessed at 1% permanent impairment. The Medical Assessor made a 3/10th deduction pursuant to s 323 of the 1998 Act for the right knee. There was no deduction for the other parts of the right lower extremity.
The Medical Assessor record of the previous history were:
“Details of any previous or subsequent accidents, injuries or conditions:
Mr Camejo denies any previous injuries to his ankle, knee or hip. He has had a previous injury to his lumbar spine. He described he had an injury at work in 2015, pulling a trolley at work. He was treated with some steroid injections. I note from the records from Mr Camejo’s GP starting in 2018 entries, Mr Camejo is taking celecoxib for low back pain and also that he had been complaining of right knee pain “On and off for a long time”. The consultation notes a swollen right knee with osteoarthritis. I note a copy of the MAC 002923/17 dated 19 July 2017 by Dr Holland [sic] assessing the lumbar spine as DRE Category III with 12% whole person impairment on the basis of there being clinical evidence of an L3 and L4 radiculopathy.”
The reasons provided by the Medical Assessor for the s 323 deduction were:
“a. In my opinion the worker suffers from the following relevant previous injuries, pre-existing conditions or abnormalities:
(i)Degenerative spondylosis lumbar spine.
(ii) Osteoarthritis right knee.
b. The previous injury, pre-existing condition or abnormality directly contributes to the following matters that were taken into account when assessing the whole person impairment that results from the injury, being the matters taken into account in 10a, and in the following ways:
(i) Both injuries represent aggravation of pre-existing conditions.
c. Whilst the extent of the deduction is difficult or costly to determine the available evidence is that the deductible proportion is large and a deduction of one tenth is at odds with the available evidence. In my opinion the deductible proportion is one third for the following reasons:
(i) Mr Camejo had established osteoarthritis in his knee and had been on anti-inflammatory agents long term. The pain in his knee subsequent to the fall represents progression of the natural history of the arthritis, rather than aggravation related to the fall.
(ii) With respect to the lumbar spine it has previously been assessed in the MAC 002923/17 as 12% whole person impairment. There are no longer examination findings consistent with radiculopathy. The lumbar spine is now assessed as DRE Lumbar Category II with 2% restrictions of activities of daily living, which represents a 5% reduction in whole person impairment for the lumbar spine.”
The one-third deduction only applied to the assessment of the lower extremity of the knee. Accordingly, the assessable impairment of the right lower extremity was 7% because the other lower extremity impairment (hip and ankle) was unaffected by any s 323 deduction.
Accordingly, the Medical Assessor assessed the right lower extremity at 7% permanent impairment, the lumbar spine at 0% and the skin at 1%. This produced a combined permanent impairment of 8%.

APPLICATION TO APPEAL THE MEDICAL ASSESSMENT

On 4 September 2023 Mr Camejo lodged an Application to Appeal Against the Decision of a Medical Assessor.
The appellant relied on the ground of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act) that the MAC contained a demonstrable error.
On 27 September 2023 the respondent filed a Notice of Opposition to Appeal Against a Decision of the Medical Assessor.
The delegate of the President was satisfied that a ground of appeal has been made out.
We are required to only address the subject matter of the ground of appeal. In Queanbeyan Racing Club Ltd v Burton[3] Basten JA stated:[4]
“The Appeal Panel was correct in the present case to address the subject matter of the ground of appeal, set aside the medical assessment certificate and issue another certificate including the amended assessments and the original unchallenged assessment. In doing so it neither purported to reassess the unchallenged finding nor to adopt the medical assessors’ reasoning with respect to that finding; neither course was part of its statutory function.”

SUBMISSIONS

[3] [2021] NSWCA 304 (Burton).

[4] At [35], Leeming and McCallum JJA agreeing.

Appellant’s submissions

The appellant noted that he had a work injury on 4 September 2015 to the low back which caused a L3/4 lesion and was assessed at 12% permanent impairment.
In respect of the subject accident the appellant noted that he was injured on
9 December 2021 which resulted in internal fixation surgery to the right ankle and further right knee surgery in April 2022.
The appellant’s submissions were limited to alleged demonstrable errors for the s 323 deduction of the right knee and the lower back.
The appellant submitted that, consistent with the authorities, a conclusion was required as to the extent to which the pre-existing condition caused or contributed to the impairment. It was submitted that the Medical Assessor appeared to proceed on the assumption that because the applicant had a 12% impairment resulting from injury in 2015 as assessed in 2017, that all of the present 7% resulted from the 2015 injury.
The appellant submitted that no reasons were provided to explain the basis for the deduction in respect of the impairment of the lumbar spine.
The appellant also submitted that the Medical Assessor failed to explain or provide any reasons why there should be a one-third deduction for the right knee when other conclusions were open such as the one-tenth deduction provided by s 323(2) of the 1998 Act.

Respondent’s submissions

The appellant noted that he had sustained a prior injury to the lumbar spine which resulted in radiculopathy from the L3/4 disc. A previous medical assessment certificate issued by
Dr Holland [sic Holman] assessed impairment at 12% for that injury.
The respondent noted that the appellant took issue with the one third deduction assessed by the Medical Assessor for the right lower extremity [sic – knee] which he noted only involved a deduction of 10% by the Medical Assessor.
The respondent’s submissions in respect of the one third deduction for the right lower extremity incorrectly assumed that the Medical Assessor made the deduction to the entire right lower extremity as opposed to the right knee. The submissions made on this ground of appeal were therefore directed to the assessable impairment of the right lower extremity as opposed to the assessable impairment of the right knee.
The respondent accordingly based on an incorrect assumption, submitted that the Medical Assessor meant to make a finding of a 1/10th deduction for the right lower extremity.
The respondent accepted that the Medical Assessor was “within his rights to apply a 10% deduction … with respect to the right lower extremity.”
The respondent submitted that the Medical Assessor had erred in making the deduction he made under s 323 for the lumbar spine. After referring to Cole v Wenaline Pty Ltd,[5] Elcheikh v Diamond Formwork (NSW) Pty Ltd[6] and Secretary, Department of Communities & Justice v Lewandowski.[7]
[5] [2010] NSWSC 78 (Cole).
[6] [2013] NSWSC 365.
[7] [2023] NSWSC 334.
The respondent noted that the previous medical assessment was dated 1 August 2017 some six years previously and the findings related to a disc lesion at L3/4. It was submitted that the previous assessment was a binding determination at the time it was made and there was no appeal from that assessment.
The respondent submitted:
“In the foregoing circumstances, it is submitted that the PIC appointed MA in this matter, Dr Kuru, had before him evidence which was both compelling and relatively recent in terms of the assessed degree of WPI suffered by the appellant as a consequence of his prior back injury which he sustained whilst working for his previous employer, Tankworks, on 4 September 2015. The previous MAC was also a biding determination at the time it was made.”
The respondent otherwise submitted that the appellant was seeking to “cavil” with matters that were within the clinical judgement of the Medical Assessor. Matters of clinical judgement are beyond the scope of any appeal pursuant to s 327(3)(c) and (d) of the 1998 Act.

EVIDENCE

The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment.
The grounds of appeal are limed to the deduction assessed by the Medical Assessor for the lumbar spine and the right knee. Accordingly, the discussion is limited to the narrow grounds of appeal.
A CT scan of the lumbar spine dated 15 February 2016 showed similar appearance to the prior MRI scan with central disc bulge at L3/4 possibly irritating the L4 nerve roots and abutting the L3 nerve root, and right sided disc bulge at L5/S1 with annular tear.[8]
[8] Reply, p 217.
Dr James Bodel, orthopaedic surgeon, provided a report dated 10 January 2017.[9] The doctor then assessed impairment of the 2015 work injury based on the disc lesion at L3/4 level and to a lesser extent at the L5/S1 level with clinical signs of radiculopathy in the left leg. Dr Bodel assessed permanent impairment lumbar spine at 12%.
[9] Reply, p 13.
Dr Peter Holman, orthopaedic surgeon, was the appointed Medical Assessor for the 2015 injury and provided a medical assessment certificate dated 1 August 2017.[10] The doctor concluded that the appellant sustained a L3/4 disc lesion with radiculopathy into the left lower extremity in the distribution of the L3 and L4 dermatomes. The appellant was assessed at 12% permanent impairment for the lumbar spine.
[10] Reply, p 336.
The clinical notes of the general practitioner (GP) in November 2018 noted “right knee pain – on and off a long time” with a reference to no-fault direct trauma. It was noted that the appellant had osteoarthritis with an inflammatory component and was taking Celebrex. Subsequent clinical notes refer to ongoing right knee pain, arthritis and physical symptoms relevant to that issue.[11] The appellant underwent a CT guided right knee injection in December 2018.[12]
[11] Application, p 46.
[12] Application, p 68.
On 19 February 2020 the GP noted that the appellant complained of low back pain with radicular symptoms, “had it a few times before” and recommended a CT guided steroid injection.[13] The appellant underwent a CT guided left L3 nerve root injection on 21 February 2020.[14]
[13] Application, p 51.
[14] Application, p 149.
On 29 June 2020 the GP noted that the low back pain was much better after steroid injection.[15]
[15] Application, p 52.
An MRI scan of the right knee dated 11 January 2022 showed tricompartmental osteoarthritic changes, marked in degree in the medial compartment with near complete chondral loss. There was also a displaced radial tear of the posterior horn of the medial meniscus.
The appellant underwent a right knee arthroscopy on 26 April 2022.[16] The operation report disclosed grade 4 chondral wear in the patellofemoral joint, grade 3 changes in the medial femoral condyle with chondroplasty carried out and grade 4 changes involving the lateral tibial plateau with a tear of the posterior horn of the medial meniscus which was debrided to clear margins.
[16] Application, p 170.
Dr James Bodel, orthopaedic surgeon, was qualified by the appellant and provided a report dated 14 February 2023. The doctor noted a past medical history of back injury in September 2015 which was treated with block injections and physiotherapy with good progress over time, returning to work on light duties. The doctor noted that that injury was aggravated by the work accident.
Dr Bodel opined that the work injury caused an aggravation of the disease program process in the right knee and an aggravation of previously relatively asymptomatic this pathology in the lumbosacral region. The doctor noted that there was evidence of prior degenerative changes in the right knee region. He also opined that the back was asymptomatic at the time of the injury and this incident caused a new musculoligamentous injury.
Associate Professor Waller, orthopaedic surgeon, was qualified by the respondent and provided a report dated 12 May 2023.[17] The doctor noted that the appellant was diagnosed with osteoarthritis in both knees about seven years previously. He noted that the appellant advised that pre-injury, the pain was 5/10 in the right knee with some disability and restrictions. The doctor also noted the prior back injury in 2015 before the appellant returned to work with restrictions.
[17] Reply, p 3.
Associate Professor Waller opined that the injury caused a fracture to the right ankle, jarring to the right hip and aggravation of the pre-existing lumbar spine condition. The doctor opined that the appellant had largely recovered from the effects of the injury although the aggravation of the right knee osteoarthritis had not completely settled.
In respect of his assessment of deductions pertinent to the grounds of appeal, Associate Professor Waller opined that there should be a 60% deduction in respect of the assessable lower extremity impairment for degeneration in the right knee. The doctor stated that the entire whole person impairment was pre-existing and not included in the current permanent impairment.

REASONS

Demonstrable error

The Panel can analyse the evidence when determining whether the certificate contains a demonstrable error: Vannini v Worldwide Demolitions Pty Ltd.[18] In Vannini Gleeson JA observed that, consistent with the observations of Basten JA in Mahenthirarasa v State Rail Authority of New South Wales, a “demonstrable error must be apparent in findings of fact or reasoning contained in the medical assessment certificate, although the error may be established in part by reference to materials that were before the approved medical specialist”.[19]
[18] [2018] NSWCA 324 (Vannini) at [90].
[19] Vannini at [86].
Section 323 of the 1998 Act relevantly provides:
“(1) In assessing the degree of permanent impairment resulting from an injury, there is to be a deduction for any proportion of the impairment that is due to any previous injury (whether or not it is an injury for which compensation has been paid or is payable under Division 4 of Part 3 of the 1987 Act) or that is due to any pre-existing condition or abnormality.
(2) If the extent of a deduction under this section (or a part of it) will be difficult or costly to determine (because, for example, of the absence of a medical evidence), it is to be assumed (for the purpose of avoiding disputation) that the deduction (or the relevant part of it) is 10% of the impairment, unless this assumption is at odds with the available evidence.
(3) The reference in subsection (2) to medical evidence is a reference to medical evidence accepted or preferred by the approved medical specialist in connection with the medical assessment of the matter.”
A deduction pursuant to s 323 of the 1998 Act is required if a proportion of the permanent impairment is due to previous injury or due to pre-existing condition or abnormality: Vitaz v Westform (NSW) Pty Ltd (Vitaz).[20]
[20] [2011] NSWCA 254.
In Vannini Gleeson JA stated that an Appeal Panel, when considering the reasoning of an Approved Medical Specialist on the question of causation under s 323, was required to determine “whether any proportion of the impairment was due to any previous injury, or pre-existing condition or abnormality” and if so, “what was that proportion”.[21] In relation to the answer to this question, his Honour stated:[22]
“The first question involved an assessment by the Panel, substantially of fact by reference to the evidence, although in part informed by the exercise of a clinical judgment. Such an assessment may be characterised as an evaluative judgment or conclusion based on findings of fact. Nonetheless, the legal criterion applied to reach that conclusion on causation demands a unique outcome, rather than tolerates a range of outcomes. Accordingly, the reasoning and finding of the medical specialist attracts the correctness standard of review by a Panel.”
[21] Vannini at [90].
[22] Vannini at [91].

In relation to the s 323 deduction for the lumbar spine, the Medical Assessor has not applied the correct test. He has assumed, consistent with the deduction made under the motor accidents legislation that there is a complete deduction for the previous symptomatic assessment. That is not the correct test under the 1998 Act which requires the Medical Assessor to determine the matter based on the statutory language in s 323 as discussed in the above authorities. We agree with the appellant’s submissions on this issue set out earlier[23] and accept that demonstrable error is established for the s 323 deduction made for the lumbar spine.
[23] See particularly at [21]-[22] herein.
The respondent’s submissions on the deduction for the lumbar spine are not in accordance with the legislation and are rejected. It is not to the point that there was a prior assessment of 12% for the lumbar spine, particularly in circumstances where the radiculopathy assessed by Medical Assessor Holman is no longer present. The respondent’s submission that the error was purportedly “clinical judgment” by the Medical Assessor and not reviewable is also rejected as the error was a failure to apply the terms of s 323.
In relation to the deduction for the right knee, we note that the respondent’s submissions do not appreciate what was determined by the Medical Assessor. The Medical Assessor did not make a one-tenth deduction for the right lower extremity and otherwise did not record an incorrect figure of 30%. What the Medical Assessor determined was that there should be a 30% deduction of the right knee (based on a lower extremity impairment) and made the deduction for that particular body part. His reasons are clear and consistent with the table at the end of the reasons which specified under the heading “deductions pursuant to S323” the words “1/3 of knee impairment”.
The reasons to do not set out the precise basis for the final calculation of the impairment of the right lower extremity based on a deduction only applying to the knee. However, if the right knee assessment based on lower extremity impairment is reduced by 30%, then that figure becomes 7% lower extremity impairment. When this figure is combined with the lower extremity impairments of the hip (5%) and ankle (7%), the combined lower extremity impairment is 18% which equates to 7% permanent impairment. This is the final assessment made by the Medical Assessor for the right lower extremity which represents a 30% deduction for the right knee only, with the other parts of the right lower extremity not subject to any deduction. Accordingly, the Medical Assessor correctly assessed the final impairment of the right lower extremity based on the application of a 30% deduction for the right knee.
The issue is whether there are sufficient reasons provided by the Medical Assessor to explain the deduction for the right knee.
Earlier in his reasons the Medical Assessor noted right knee pain in 2018 which had been “on and off for a long time” with reference to a consultation note of a swollen right knee with osteoarthritis.
Further reasons were provided by the Medical Assessor for the deduction for the right knee which are repeated as follows:
“Whilst the extent of the deduction is difficult or costly to determine the available evidence is that the deductible proportion is large and a deduction of one tenth is at odds with the available evidence. In my opinion the deductible proportion is one third for the following reasons:
(i) Mr Camejo had established osteoarthritis in his knee and had been on anti-inflammatory agents long term. The pain in his knee subsequent to the fall represents progression of the natural history of the arthritis, rather than aggravation related to the fall.”
The Medical Assessor has a statutory obligation to provide reasons (s 325 of the 1998 Act). Those reasons must be adequate and disclose the reasons sufficient to show the “actual path of reasoning”[24] by which the opinion was formed and in sufficient detail such that an Appeal Panel and the parties can determine whether, in the context of the medical appeal provisions under the 1998 Act, either the MAC contained a demonstrable error, or the assessment was made based on incorrect criteria.
[24] Wingfoot Australia Partners Pty Ltd v Kocak [2013] HCA 43 (Wingfoot) at [48].
The above reasons, whilst brief, explain why the Medical Assessor rejected the one-tenth deduction under s 323(2). The Medical Assessor referred to the established osteoarthritis in the knee and the fact that the appellant had been on anti-inflammatory agents. He otherwise noted prior knee pain in 2018 with a history at that time of being “on and off for a long time”.
Finally, the Medical Assessor made a finding that there was a contribution by the pre-existing right knee osteoarthritic condition to the level of impairment. The Medical Assessor stated:
“The pain in his knee subsequent to the fall represents progression of the natural history of the arthritis, rather than aggregation related to the fall.”
This finding is that the current symptoms are due to the “progression of the natural history of the arthritis”.
The appellant otherwise submitted that the Medical Assessor failed to explain or provide any reasons why they should be a one-third deduction for the right knee when other conclusions were open such as the one-tenth deduction provided by s 323(2) of the 1998 Act.
We disagree with the appellant’s submissions noting that we have referenced the findings made by the Medical Assessor who found both pre-existing right knee symptoms in 2018 and “established osteoarthritis” which pre-existed the injury. The Medical Assessor stated that he did not apply the statutory deduction due to the “established osteoarthritis in his knee and had been on anti-inflammatory agents long term”. That finding was based on the clinical notes of the GP in 2018 which we have set out earlier in these reasons.[25]
[25] See [38] herein.
There was no contrary submission to those factual findings made by the Medical Assessor as the appellant submitted that there was a failure to “provide any reasons”. For the reasons given, that submission is incorrect and rejected.
We otherwise note the observations by Gleeson JA in Vannini of alleged demonstrable error based on the extent of the proportion. Gleeson JA noted:[26]
“The position may be different in relation to the second question. A finding as to the proportion of permanent impairment due to previous injury, pre-existing condition or abnormality involves matters of degree and impression. The applicable standard of the “proportion” of contributory contribution under s 323 permits some latitude of opinion such as to admit of a range of legally permissible outcomes. That is not to say that such a conclusion is necessarily beyond review by an Appeal Panel on the ground of demonstrable error.”
[26] Vannini at [92].
The appellant had established osteoarthritis throughout all three compartments in the right knee. Indeed, on one view, the 30% deduction made by the Medical Assessor could be seen as favourable to the appellant give the clinical notes of the GP of prior symptoms and the extensive degenerative findings in the MRI scan which clearly pre-dated the injury.
We reject the submission that the 30% deduction for the right knee was a demonstrable error. That conclusion was based on factual findings of pre-existing symptoms and extensive pathology and was within a range which permits “some latitude of opinion such as to admit of a range of legally permissible outcomes”.

Re-assessment

Based on these reasons we have found demonstrable error for the s 323 deduction of the lumbar spine. It is unnecessary to re-examine the appellant as the ground of appeal that has been accepted is limited to the issue of the pre-existing deduction under s 323 for the lumbar spine and can be determined on the papers.
The MRI scans of Mr Camejo’s lumbar spine in October 2015 and February 2016 were consistent with multiple levels of degenerative disc disease.
The previous Medical Assessor had placed Mr Camejo in DRE Category III based on radiculopathy from the L3 nerve root.
In February 2020 the GP noted that the appellant complained of low back pain with radicular complaints which had occurred previously and recommended a CT guided steroid injection.[27] Mr Camejo underwent a CT guided left L3 nerve root injection on 21 February 2020 with reported improvement in symptoms in June 2020.
[27] Application, p 51.
Mr Camejo had multi-level degenerative disease in the lumbar spine with symptoms since at least 2015. The nature of the pre-existing lumbar spine pathology was such that, upon injury, the appellant was prone to exacerbation and the effects of the injury would be worse.
Noting the history of significant ongoing problems with Mr Camejo's lumbar spine since his original injury in 2015, it is our view that a 1/10th deduction is at odds with the available evidence, specifically the pre-existing multi-level degenerative disease and pre-existing low back symptoms. The Panel finds that a 1/5th deduction would be appropriate in this situation.

CONCLUSION

For these reasons, the MAC issued on 14 August 2023 is revoked. A new Medical Assessment Certificiate is issued by the Panel.

PERSONAL INJURY COMMISSION

APPEAL PANEL

MEDICAL ASSESSMENT CERTIFICATE

Injuries received after 1 January 2002

Matter No: W4702/23

Applicant: Leonardo Camejo

Respondent: Homebush Bay Foods Pty Ltd

This Certificate is issued pursuant to section 328(5) of the Workplace Injury Management and Workers Compensation Act 1998.

The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Kuru 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 NSW Workers’ Compensation Guidelines	Chapter, page, paragraph, figure and table numbers in AMA5 Guides	% WPI	WPI deductions pursuant to S323 for pre-existing injury, condition or abnormality (expressed as a fraction)	Sub-total/s % WPI (after any deductions in column 6)
Lumbar spine	09/12/21	P 28 4.34	P 384 T 15.3	7	1/5th	6
Right lower extremity (hip, knee and ankle)	09/12/21	P 15 P 3.17	P 536 T 17.9 P 536 T 17.10 P 536 T 17.11 P 536 T 15.3	8	1/3rd of knee impairment only (see paragraph 55)	7
Skin (TEMSKI)	09/12/21	P 74 14.1	1	nil	1
Total % WPI (the Combined Table values of all sub-totals)					14

[2023] NSWPICMP 571

14 November 2023