Cameron v Secretary, Department of Education
[2022] NSWPICMP 64
•24 February 2022 (amended 31 March 2022)
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Cameron v Secretary, Department of Education [2022] NSWPICMP 64 |
| APPELLANT: | Jane Cameron |
| RESPONDENT: | Secretary, Department of Education |
| APPEAL PANEL: | Member Deborah Moore Dr Douglas Andrews Professor Nicholas Glozier |
| DATE OF DECISION: | 24 February 2022 (amended 31 March 2022) |
| CATCHWORDS: | WORKERS COMPENSATION- Appellant challenged the Medical Assessor’s assessment in respect of 3 Psychiatric Impairment Rating Scale categories, namely Self-care and personal hygiene, concentration, persistence and pace (cpp) and employability and adaptation; Panel confirmed assessment in relation to self-care and personal hygiene and cpp but revoked the assessment regarding employability; appellant’s symptoms and difficulties in public places together with her failed attempts at voluntary work meant that she was more properly assessed as a Class 5; Held- Medical Assessment Certificate revoked. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 8 December 2021 Jane Robin Cameron (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by
Dr Michael Hong, a Medical Assessor (MA) who issued a Medical Assessment Certificate (MAC) on 23 November 2021.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 pursuant to s 327(3) of the 1998 Act.
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, 4th ed 1 April 2016 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th 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, although one was requested, no specific reasons were given other than in the context of the nominated grounds of appeal. In any event, 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 MA 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.
The appellant submits that the MA erred in his assessment of three of the categories in the Psychiatric Impairment Rating Scale (PIRS), namely Self-care and personal hygiene, concentration, persistence and pace (cpp) and employability and adaptation.
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 MA for assessment of whole person impairment (WPI) in respect of a primary psychiatric/psychological injury resulting from a deemed date of injury of 22 February 2021.
The MA obtained the following history:
“Since Ms Cameron started working for the department, there had been various stressors and she reported that she had always worked with socially challenging populations, such as the South Coast or Moree. Intermittently when she felt stressed, she had sought help and had counselling, and she believes the department then used that against her later and claimed there must be something mentally wrong with her, because she has had counselling.
She described that Glenroi Heights Public School has a disadvantaged population with 97% unemployment rate. She had always loved the job and won numerous awards; however, in October 2017, she was suddenly referred to EPAC for investigation and she did not understand why. Ms Cameron related this to issues in 2017 when she had three challenging families, who had substance use and forensic issues. One of the fathers constantly called Ms Cameron an ‘f****ing whore’ and made violent threats, because his child had needed a lot of help, and that she had suspended them due to behavioural problems at times. She said the final crunch was when she had to call the father about the 20-day suspension, which was decided according to the department guidelines.
He turned up to the school with four or five friends and a knife, and made threats to kill her and had pushed her in the process. Police was contacted. Two weeks later, she was told that she was under EPAC investigation and her employer claimed that she was a risk to the staff and community, and that the allegations would be given to her soon. She said she was not allowed to talk to anybody and her staff were told to not contact her. She recalled when she went in to the school to hand in her things, the director took a photograph of her. She was told there was no place for her in the department anymore.
Ms Cameron further stated that she had worked at that school for many years, but her belongings at the school were never returned to her, and that no one from the department called her to see if she was okay.
The EPAC allegation related to claims she interfered with children at school and when the police investigated her, she said they laughed at the allegations and said there was simply no proof.
She also reported that her house had been graffitied and vandalised. Her courtyard was painted with words like bully, paedophile. During the Anzac celebration, people called her a paedophile. The people living across the street would not talk to her for the same reason.
2017, Ms Cameron reported that she almost attempted suicide twice. The first time her son called at a fortunate time and she did not proceed. The second time she was taking Kalma, and recalled she had a weird side effect and said she simply could not go through with the suicide plan.
She told me what made it worse about the whole affair was not knowing why it happened to her.”
After documenting Ms Cameron’s present treatment, the MA then set out present symptoms as follows:
“Since Ms Cameron stopped working and having treatment, she does not feel any different. She said that she is ‘super vigilant’, she is easily startled and has a lot of dread and panic, she feels that she is displaced from life and that she lost her credibility. She said her husband said to her that she is either flat or explosive.
On specific enquiry, Ms Cameron reported experiencing the following symptoms:
·Depressed mood.
·Reduced enjoyment and motivation.
·Distracted concentration – her mind often wanders back to the work issues.
·Memory problems.
·Being easily fatigued.
·Fleeting suicidal thoughts.
·Disrupted sleep and intermittent nightmares.
·Being anxious and excluded [sic] vigilant.
·Being irritable.
She avoids social situations due to ‘trust’ issues
In the first 12 months off work, she gained 30 kg which was due to a combination of Mirtazapine side effects, a poor diet, and being inactive. In the past 12 months she lost 25 kg successfully.
Ms Cameron denied having self-harmed, a change in alcohol consumption, or ever having experienced symptoms of psychosis. She described hypnogogic experiences and no true hallucination.”
In setting out details of Ms Cameron’s previous or subsequent accidents, injuries or condition the MA said:
“Around 2007, Ms Cameron's daughter suffered a brain injury and she recalled she attended Dudley Private Hospital and attended a mindfulness course for eight weeks. She took her medication for a number of weeks in 2007.
She made a full recovery and did not suffer other mental health difficulties.
Ms Cameron reported that normally she enjoyed doing Pilates and meeting up with her friend for coffee. She would go to a sewing club doing patch work. She belonged to two book clubs and she travelled a lot during school holidays.”
After documenting information about Ms Cameron’s general health and work history the MA then turned to consider the impact on her social activities and activities of daily living (ADL’s) saying:
“Ms Cameron is 68 years old. She is living with her husband who had retired early, she said, in order to care for her. He started reducing his work in 2018 and only worked briefly in 2019.
They have two adult children living in Sydney.
In 2019, Ms Cameron recalled her husband took her to Ireland for an eight-week holiday; however, they returned after only two weeks because she was having nightmares and panic attacks and woke up crying.
She reported she does a lot of physical activity, which helps her manage her worrying thoughts. She will wake up in the morning and go to the pool and swim for 2 or 3 km every day.
She said she has a small supportive group but she is scared to open up to them. Her husband is her main support. One sister calls her regularly and another friend calls her regularly. She said her children are supportive, but they are not comfortable with how she is acting different to how she used to be.
She said she spends a lot of time in the garden daydreaming and only does a little bit of gardening
Ms Cameron likes to read books and previously read a lot of professional journals and historical dramas. She said she reads simpler books now, things that are ‘easy to read, escapism and mummy fiction’. She can read half an hour to an hour. She would read only a chapter at a time but says she is forgetful, and when she picks up the book again she often does not remember what she had read. She reads the Sydney Morning Herald newspaper every day but again described problems remembering what she read.
Ms Cameron walks her dog in the afternoon. She generally does not drive and only drives to the local swimming pool, which is only 3 km away.
She does shopping with her husband weekly. She buys things online for Christmas. She does most of the online banking and paying the bills, and she said she has to use the calendar to remind herself to pay the gas and the rates.
Ms Cameron's husband does the cooking. She bakes, usually once a week. Sometimes she will bake with her 8-year-old twin grandsons. She makes cookies and follows the recipe to make things like apple cake. She attends to some household chores, such as washing clothes and ironing.
In early 2021, Ms Cameron and husband went to the Sunshine Coast for a two-week holiday and to see her husband’s sister.
When COVID restrictions allow, they go to Bowral every few weeks to visit her mother who is in a nursing home. She is 91 years old.
Ms Cameron has one local friend and she stays in contact with some of her friends via e-mail, but does not tell them about what happened to her because she is embarrassed.
When Ms Cameron and her husband goes out to do the weekly shopping they usually eat out for lunch, although they have not done this for a few weeks because of the COVID lockdown. She has a close friend and they had started teaching together, they might meet up every two or three weeks at the café.
Normally Ms Cameron said she is organised and usually planned Christmas gathering and birthdays, but now she does not do this anymore.
Her husband and her have been talking about moving away from the area, but COVID has delayed the plan. In 2020, they did some preparation around the home such as painting to prepare for sale, but have not yet put it on the market.
I asked Ms Cameron whether she could do some work once she moved away from Orange. She said she is not sure but she would like to think that she could, but she does not know what she would be able to do.”
Findings on examination were reported as follows:
“Ms Cameron was assessed by videolink. She was at home and her husband was also at home during the assessment. I assessed her from my Sydney office. I have completed a full psychiatric assessment with consent. I have taken handwritten notes, and there was no audio-visual recording of the assessment.
Ms Cameron was bespectacled and had short greying hair. She engaged well with the video assessment process. There was no psychomotor slowing or abnormal movements. She was moderately restricted in her affect range and smiled appropriately.
She spoke spontaneously and readily. She gave long and detailed answers, and generally spoke without interruptions. She was not thought disordered and the provided history was easy to follow.
Ms Cameron provided a coherent history and elaborated on various aspects of her history. She was consistently focused throughout the assessment. She demonstrated reasonable processing speed and pace.
At the end of the 55 minutes assessment, I asked Ms Cameron for additional information that she thought may be relevant and she had no further comments to make.”
In summarising the injuries and diagnoses, the MA said:
“Ms Cameron described having suffered stress symptoms and intermittently sought help through the school or Employee Assistance Program, and in 2007 she developed some depression and anxiety symptoms in the context of her daughter’s health problem. She made a full recovery and there was no ongoing psychiatric impairment.
The current episode started in 2017 due to the behaviour of the students, the parents and also an EPAC investigation that flowed on from those issues. She was suspended and developed significant anxiety and depressive symptoms, which were sufficient to stop her from working.
Since Ms Cameron stopped working, she has had treatment but has not felt improved and described ongoing problems with her ability to function. Overall, my view is that she had developed Post-traumatic stress disorder with depressive symptoms and panic attacks and I do not believe her condition has remitted.
In terms of WPI rating, Dr Frukacz rated Ms Cameron’s self-care as 2 and explained there are days when she does not want to get up, she always has a shower and if the husband is not home she does not have dinner. Dr Lee rated 1. In my assessment,
I noted that Ms Cameron eats and showers regularly and does not require prompting. She said she lost about 25 kg in the last one year from regular swimming and having a healthy diet, and overall I believe the described functioning is consistent with minor deficit seen in the general population and I rated 1.Dr Frukacz rated Ms Cameron's social recreational activity as a 3 and advised that she does not have dinner parties or go to Pilates, whereas Dr Lee rated 2 and advised that she goes swimming and out for coffee, overall less frequently. In my assessment, I noted that Ms Cameron went on holidays but she struggled and needed support from her husband. She goes out for coffee with one friend and eats out with her husband when they do their weekend shopping. I do not believe she could do these without a support person. She does not engage in social and recreational activities with more than one support person. In my view, a rating of 3 is more appropriate.
In terms of travel, Dr Frukacz rated 2 and Dr Lee rated 1. My view is that a rating of 2 is more appropriate given that Ms Cameron has significant anxiety, particularly when in crowded places and where she thinks she may be subjected to offensive language, such as being called paedophile, and she would avoid those places.
Both Dr Frukacz and Dr Lee both rated Ms Cameron's concentration, persistence and pace as 3 and noted her memory problems. Memory problem is a different concept over time concentration, persistence and pace. In my assessment, I took the history that she can read one chapter or read a book for half an hour to an hour. She reads the newspaper every day. She does some online banking. She follows a recipe to do some baking and her concentration, persistence and pace is overall more consistent with a rating of 2.
There is no addition for treatment effects, as Ms Cameron has not achieved substantial or total elimination of impairment with treatment.”
The MA assessed 7% WPI.
The MA then turned to consider the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs stating:
“Ms Cameron’s statement has been noted. She provided similar history in relation to the problems at the school generally and difficult parents, and particularly since 2017 with the behaviourally disturbed student who was aggressive and had been suspended, and subsequently problems with the parents. She was then referred to EPAC and had been investigated. After this, rumours started in the community about her. She felt devastated and described the loss of her identity and given no recognition by the department.
Toni Smith, Treating Psychologist, provided treatment reports including 11 December 2017 outlining Ms Cameron had acute stress reaction on initial presentation due to the problems at work.
Rehabilitation management report and Konekt assessment report from 2007 had been noted.
MindSpot, 12 February 2019 report noted severe generalised anxiety.
GP certificates of capacity continued to certify Ms Cameron unfit for work with diagnosis of PTSD and anxiety from workplace harassment.
IME Psychiatrist, Dr Andrew Frukacz, provided a report dated 8 February 2021 and noted similar work history and that Ms Cameron suffered depression, anxiety attack, having a lack of concentration and poor memory. She would read a chapter of books and not remember what she read. He diagnosed PTSD and major depressive disorder and provided WPI of 17% with a 2% uplift due to effects of medication and treatment totalling 21%.
Dr Olivia Lee, IME psychiatrist reported on 27 September 2021 noted the problems at work started about 2017 and that Ms Cameron developed a range of symptoms after she received death threats from the parent and complaints from a teacher. She went to Sunshine Coast where sister-in-law was. She went to Ireland but returned early because of her mood. Ms Cameron goes out for coffee once a week with a close friend. She lost 30 kg through diet and exercise. She writes letters to her mother, and went swimming every day. She enjoys baking and gardening. Dr Lee advised
Ms Cameron suffered major depressive disorder, now in remission, rather than PTSD and she had residual symptoms but not functionally significantly impairing. She also provided WPI with a rating of 7%.Ms Cameron’s statement addressed Dr Lee’s report and advised that there were a number of inaccuracies in that report. She swims every day to help with anxiety. She does not use Facebook several times a week. Her memory is very poor and therefore Ms Cameron did not agree with the rating that Dr Lee provided.”
Dealing firstly with the assessment of self-care and personal hygiene, the MA assessed a Class 1, stating:
“Ms Cameron successfully lost weight. She has a healthy diet and showers daily, and does not need prompting with her self-care or personal hygiene.”
The appellant submits:
“MA Hong refers to ‘Ms Cameron eats and showers regularly and does not require prompting.’ This is not recorded anywhere in the MAC nor in any of the material before the MA and is a demonstrable error.”
This is the only submission made with regard to this category.
As we read it, the MA was simply referring to his own assessment.
When commenting on the other medical opinions, the MA said: “In my assessment, I noted that Ms Cameron eats and showers regularly and does not require prompting”. This is consistent with his findings in his PIRS rating form.
The MA clearly explained his reasons why he disagreed with the assessment of Dr Frukacz who saw Ms Cameron on 22 October 2020, more than 12 months prior to the MA.
We note also that the MA’s assessment was consistent with that of Dr Lee who saw the appellant in September 2021, again almost 12 months after Dr Frukacz.
The appellant’s description to the MA of her functioning in this category is entirely consistent with a Class 1 rating, and we cannot see any error in his assessment.
Turning now to the category of cpp, the MA assessed a Class 2, adding:
“Ms Cameron reported having reduced concentration.
She can read books for 30 minutes and reads the newspaper daily. She follows recipes when baking. She forgets what she read and has to re-read.
Her mental state examination during the assessment is consistent with 2.”
The descriptor for a Class 2 rating reads:
“Mild impairment, can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding task for periods of up to 30 minutes, then feels fatigued or develops headache.”
The descriptor for a Class 3 reads:
“Moderate impairment: unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.”
The appellant submits as follows:
“The MA fails in his reasons for decision to refer to the appellant’s history that: ‘she would read only a chapter at a time but says she is forgetful, and when she picks up the book again she often does not remember what she has read. She reads the Sydney Morning Herald newspaper every day but again described problems remembering what she read.’
MA Hong fails to refer to the appellant’s history that ‘She has to use the calendar to remind herself to pay the gas and the rates.’
MA Hong fails to refer to the appellants statement dated 7 October 2021 that: ‘The rating for concentration, persistence and pace is inaccurate. I do read the newspaper but I do not remember anything from it. This is the only reading I do and it is more like
I am in a trance and it is more of a habit than anything’.”The MA both in his rating form and in the body of the MAC made several references to
Ms Cameron’s ability to concentrate. For example, he said:“Ms Cameron likes to read books and previously read a lot of professional journals and historical dramas. She said she reads simpler books now, things that are ‘easy to read, escapism and mummy fiction’. She can read half an hour to an hour. She would read only a chapter at a time but says she is forgetful, and when she picks up the book again she often does not remember what she had read. She reads the Sydney Morning Herald newspaper every day but again described problems remembering what she read.”
We certainly accept that Ms Cameron’s concentration is impaired, but in our view her presentation to the MA is consistent with a Class 2 for reasons that follow.
Arguably some aspects of her presentation could fall into the descriptor for a Class 3, but it is noteworthy that at the time of his assessment, the MA observed that:
“She spoke spontaneously and readily. She gave long and detailed answers, and generally spoke without interruptions. She was not thought disordered and the provided history was easy to follow.
Ms Cameron provided a coherent history and elaborated on various aspects of her history. She was consistently focused throughout the assessment. She demonstrated reasonable processing speed and pace.”
In short, she did not present with any cognitive difficulties on the day of the assessment.
We note that Chapter 1.6 of the Guidelines provides:
“Assessing permanent impairment involves clinical assessment of the claimant as they present on the day of assessment taking account the claimant’s relevant medical history and all available relevant medical information…”
It is also worth noting at this point 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’(our emphasis).
[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’…”
Having regard to these principles, there is nothing “glaringly improbable” about the MA’s assessment in this category such that we cannot see any error.
Turning now to the category of employability and adaptation, the MA assessed a Class 4 stating:
“Ms Cameron is not devoid of productivity in terms of home care. However, she is erratic in undertaking productive tasks as a result of her anxiety and depressive symptoms.
She can work less than 20 hours per fortnight with erratic attendance and pace.”
The appellant submits that it is unclear on the face of the MAC from where this reasoning is applied, adding: “MA Hong does not any record history of the appellant’s employment and fitness for work but inferentially understood that she was no longer employed…”.
There are no other specific submissions with respect to this category. The appellant simply repeats the findings by the MA and asserts that a Class 5 rating is appropriate.
The MA’s assessment was consistent with the descriptor for a Class 4. A Class 5 states: “Totally impaired: Cannot work at all”.
The MA noted:
“Subsequently she tried to do volunteering work twice, firstly for the Salvation Army in a shop in Orange, but lots of people that went to the shop were part of the same community and they had heard rumours about her, and one of the customers called her a paedophile Principal. About 12 months ago she tried to work at a food bank but a similar problem happened again. People started calling her names. She has not performed other work…
I asked Ms Cameron whether she could do some work when she moved away from Orange. She said she is not sure that she would like to think that she could, but she does not know what she would be able to do.”
In our view, Ms Cameron does fall into a Class 5 for reasons that follow.
The MA did not explain why he concluded that Ms Cameron could work “less than 20 hours per fortnight with erratic attendance and pace” having regard to all of her symptoms. Her ability to function at home cannot be regarded as “productive” in terms of employment, again, having regard to all her symptoms.
Ms Cameron has clearly failed in her attempts to return to even voluntary work. Her experiences in that work as described to the MA suggest to us that she would not be capable of employment in a paid capacity.
The MA noted that: “she is ‘super vigilant’, she is easily startled and has a lot of dread and panic, she feels that she is displaced from life and that she lost her credibility”.
Her difficulties with this anxiety and panic, coupled with her fears of public spaces and her limited social interactions as described by the MA would mitigate against any employment, either full or part-time.
This in our view would be the case irrespective of where Ms Cameron resided.
This then means that the Aggregate Score Impairment will be 1,3,2,2,2,5, resulting in a total WPI of 8%, to which is added 2% for the effects of treatment as found by the MA and not challenged on appeal.
We should point out that there does seem to be an inconsistency in the MAC where the MA appears to have said that: “There is no addition for treatment effects, as Ms Cameron has not achieved substantial or total elimination of impairment with treatment” as noted in paragraph 20 above. However, it may be that he was referring to the opinion of Dr Frukacz on this issue. It is not entirely clear, but as we said, neither party has taken issue with this such that we do not intend to alter the MA’s assessment in this regard.
The final WPI is thus 10%.
For these reasons, the Appeal Panel has determined that the MAC issued on 23 November 2021 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
PERSONAL INJURY COMMISSION
APPEAL PANEL
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 Michael Hong 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. Psychiatric | 22 February 2021 (deemed) | Chap 11, p 54-60 | N/A | 8% | Nil | 8% |
| Total % WPI (the Combined Table values of all sub-totals) | +2% treatment effects 10% | |||||
Deborah Moore
Member
Douglas Andrews
Medical Assessor
Professor Nicholas Glozier
Medical Assessor
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2
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