Dubois v R & v Bergin Pty Ltd
[2022] NSWPICMP 432
•27 October 2022
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Dubois v R & V Bergin Pty Ltd [2022] NSWPICMP 432 |
| APPELLANT: | David Wayne Dubois |
| RESPONDENT: | R & V Bergin Pty Ltd |
| Appeal Panel | |
| MEMBER: | Marshal Douglas |
| MEDICAL ASSESSOR: | Neil Berry |
| MEDICAL ASSESSOR: | Tommasino Mastroianni |
| DATE OF DECISION: | 27 October 2022 |
| CATCHWORDS: | wORKERS cOMPENSATION - Appellant suffered severe injuries in 2004 in work related motor vehicle accident; injury to right knee and perforation of his small bowel; suffered further severe injuries in 2007 in motor vehicle accident unrelated to his employment; included injury to his right knee; whether Medical Assessor (MA) provided adequate reasons for assigning half of appellant’s permanent impairment of his right lower extremity to 2004 work injury and half to 2007 injury; whether MA applied correct criteria to assess appellant’s permanent impairment of his digestive system; Held – MA provided adequate reasons for right lower extremity assessment and correctly assessed the appellant’s permanent impairment resulting from work injury to appellant’s right knee; MA made assessment of impairment of the appellant’s digestive system based on incorrect criteria; Medical Assessment Certificate revoked. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 5 September 2022 David Wayne Dubois, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Tim Anderson, a Medical Assessor.
The medical dispute that a delegate of the President of the Personal Injury Commission (Commission) referred to Medical Assessor Anderson to assess related to the degree of permanent impairment of the appellant resulting from an injury he suffered on 21 April 2004 whilst employed by R & V Bergin Pty Ltd, the respondent. It was described in the referral in these terms:
“MEDICAL DISPUTE REFERRED FOR ASSESSMENT (s319 WIM Act)
the degree of permanent impairment of the worker as a result of an injury (s319(c))
whether any proportion of permanent impairment is due to any previous injury or pre-existing condition or abnormality, and the extent of that proportion (s319(d))
whether impairment is permanent (s319(f))
whether the degree of permanent impairment of the injured worker is fully ascertainable (s319(g))
Date of Injury: 21 April 2004
Body part/s referred: Right Upper Extremity, Right Lower Extremity, Lumbar
Spine, Digestive System, Scarring (TEMSKI)
Method of assessment: Whole Person Impairment”
Medical Assessor Anderson issued a Medical Assessment Certificate (MAC) in response to that referral on 8 August 2022. In that, he certified he assessed the appellant had 19% whole person impairment (WPI) from his injury. In a table appended to the MAC, he set out the separate components comprising the appellant’s WPI and how those components combined to comprise the appellant’s WPI from his injury. That table was in the following form:
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)
Right upper extremity
21/04/04
Chap 2 P18
P 476 F 16-40
P 477 F 16-43
P 479 F 16-46
P 439 T 16-03
7
0
7
Right lower extremity
Chap 3 P13
P 537 T 17-10
4
½
2
Lumbar spine
Chap 4 P24
P 384 T15-03
7
2/5th
4
Digestive system
Chap 16 P79
P128 T6-4
5
0
5
Scarring
P74 T14.1
1
0
1
Total % WPI (the Combined Table values of all sub-totals)
19
The appellant’s appeal relates to the medical assessment of his impairment of his right lower extremity and digestive system.
The appellant relies on the following grounds for 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, 4th ed 1 April 2016 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).
RELEVANT FACTUAL BACKGROUND
The appellant worked for the respondent as a truck driver. He was driving a truck on 21 April 2004. The steering failed causing the truck to veer off the road and collide with trees. He suffered multiple lacerations, a dislocation of his right shoulder, dislocation of his right patella, a cruciate ligament injury, a compound fracture of his right fibula, a penetrating injury to the posterior-medial lower left thigh, a closed head injury with no related fracture, intestinal perforation and a lower back injury. He was transported to Canberra Hospital where he was admitted and remained until discharged approximately three weeks later.
Whilst admitted at Canberra Hospital, he had abdominal surgery where approximately 30 centimetres of his bowel was removed. The compound fracture he suffered to his right leg was also treated by open reduction. He also had surgical repair done on his right knee lateral collateral ligament.
The appellant was involved in a further motor vehicle accident on 17 August 2007 unrelated to his employment with the respondent, when a vehicle lost control in rain and collided with the appellant’s vehicle head on. The appellant suffered significant forehead and facial lacerations in that collision which required more than 70 sutures. He also suffered a fractured skull involving the right eye socket that resulted in 90% loss of vision in his right eye. He suffered chip fractures of his upper frontal incisor teeth and fractured ribs. He suffered a comminuted fracture of his right patella and a flare-up of his low back pain. The fracture of his right patella was repaired with a cerclage and K-wire fixation.
The appellant’s solicitors arranged for the appellant to be examined by surgeon Dr Sikander Kahn by video conference on 21 May 2021. In a report of that date to the appellant’s solicitors, Dr Kahn advised that he had assessed the appellant had 29% WPI from his injury on 21 April 2004. Relevantly, in terms of the appellant’s appeal against the MAC, Dr Kahn assessed the appellant to have 4% WPI relating to the injury to his right knee which he assessed by reference to the criteria of Table 17-10 of AMA 5, advising that the appellant had a restricted flexion of his right knee of less than 110 degrees. Dr Kahn said that in addition to that impairment the appellant also had an impairment “arising from patellectomy carried out for another unrelated motor vehicle accident that occurred in 2007 which attracts 9% WPI according to Table 17-33 on page 546 of AMA 5 Guides”. Dr Kahn also advised that he had assessed the appellant had 12% WPI relating to the appellant’s digestive system. Dr Khan advised that he assessed that by reference to Table 6-3 of AMA 5, noting that the appellant had a history of resection of his small bowel following the injury to his abdomen which had led to chronic diarrhoea, urgency and frequency with episodic incontinence and weight loss of less than 10%.
On 11 August 2021 the appellant’s solicitors wrote to the respondent’s insurer enclosing with their letter a copy of Dr Kahn’s report of 21 May 2021. They advised that based on “the findings of Dr Sikander Kahn” the appellant claimed compensation of $50,000 from the respondent under s 66 of the Workers Compensation Act 1987 (the 1987 Act) for 29% WPI.
The respondent’s solicitor then arranged for the appellant to be examined by general and vascular surgeon Associate Professor Paul Myers on 13 October 2021 and by orthopaedic surgeon Dr John Bosanquet on 18 October 2021.
In a report of 15 October 2021 to the respondent’s solicitors, Associate Professor Myers advised that he had conducted a telehealth assessment of the appellant by Zoom. It is apparent from Associate Professor Myers’ report that his examination of the appellant was limited to the appellant’s digestive system. Associate Professor Myers noted that the appellant reported defecating 6-8 times daily and experienced urgency and loose bowel actions. Associate Professor Myers noted that the appellant had a small bowel resection of 30 centimetres but had maintained a desirable weight and that there was no evidence of nutritional impairment. Associate Professor Myers correlated the appellant’s impairment of his digestive system with the criteria for Table 6.3 of AMA5 on the basis that the appellant had some symptoms related to the small bowel and has had anatomical loss. Associate Professor Myers said that he assessed the appellant to have 5% WPI relating to his digestive system.
Dr Bosanquet provided a report to the respondent’s solicitors on 9 November 2021. It is obvious from his report that his examination of the appellant related to the appellant’s right shoulder, right knee and lumbar spine and did not relate to the appellant’s injury to the appellant’s digestive tract. Dr Bosanquet advised that the appellant had 2% WPI relating to his right shoulder. He advised the appellant had 7% WPI relating to his lumbar spine, of which he considered half related to an earlier injury the appellant suffered in 2001 with the result that Dr Bosanquet considered the appellant had 4% WPI for his lumbar spine from the injury on 21 April 2004. Dr Bosanquet advised that the appellant had a total of 4% WPI relating to his right knee. Dr Bosanquet also said that without having specific details of what injuries the appellant suffered to his right knee in the incidents of 2004 and 2007 “it is reasonable to allocate 50% to the injury in 2004 and 50% to the injury in 2007”.
Dr Bosanquet provided a further report to the respondent’s solicitor dated 26 November 2021 in which he repeated those assessments.
On 7 December 2021 the respondent’s solicitor wrote to the appellant’s solicitors providing them with copies of Dr Bosanquet’s reports of 9 November 2021 and 26 November 2021 and the report of Associate Professor Myers of 15 October 2021. The respondent’s solicitor advised that the combined assessments of Dr Bosanquet and Associate Professor Myers of the appellant’s impairment from his injury on 21 April 2004 amounted to 13% WPI and, based on that, the respondent’s solicitors advised that they were instructed to make an offer to the appellant to pay $17,000 as compensation under s 66 for 13% WPI resulting from his injury.
That offer was not accepted and the appellant commenced proceedings in the Commission seeking determination of his claim for compensation for permanent impairment from his injury on 21 April 2004. As mentioned, it was referred to the Medical Assessor who issued a MAC on 8 August 2022 in which he certified the appellant had 19% WPI from his injury.
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. This is because the material before the Appeal Panel is sufficient for it to determine the appeal.
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.
The MAC
As mentioned, the appellant’s appeal relates to the Medical Assessor’s assessment of his permanent impairment of his right knee and digestive system from the injury on 21 April 2004.
With respect to the appellant’s right knee, the Medical Assessor noted that the appellant’s injury consisted of a tear to the lateral collateral ligament and a comminuted fracture to the upper fibula. The Medical Assessor recorded in the MAC that he found from his examination of the appellant’s knees that the appellant’s movement ranged from full extension of 00 through to 1300 on the left but only to 900 on the right. The Medical Assessor noted that there was no particular joint line or retro-patellar tenderness in either of the appellant’s knees and that there was no swelling.
The Medical Assessor recorded a history of the appellant suffering a fracture to his right patella in 2007 which the Medical Assessor noted was managed by surgical reconstruction.
The Medical Assessor observed that the only feature of significance with respect to the appellant’s right knee was the restricted flexion to 900 which, in accordance with the criteria set out in Table 17-10 of AMA 5, attracted a rating of 4% WPI. The Medical Assessor apportioned half of the appellant’s WPI related to his right knee to the injury the appellant suffered on 21 April 2004 and half to the subsequent injury the appellant suffered in 2007 providing the following reasons for doing so:
“The right knee was injured in the injury of 2004. There was a comminuted fracture of the proximal fibula, together with a tear of the lateral collateral ligament. In the 2007 injury there was a fracture of the right patella necessitating surgical reconstruction and the associated longitudinal surgical scar, which remains quite obvious. With his current condition, it is therefore assessed that each of these events would reasonably result in half of the current whole person impairment, therefore from today’s findings there is a deduction of one-half.”
With respect to the appellant’s digestive system, the Medical Assessor noted that in the incident on 21 April 2004 the appellant suffered intestinal trauma that necessitated abdominal surgery in which a short length of a devitalised portion of the appellant’s terminal ileum was excised but with the ileo-caecal valve being preserved. The Medical Assessor noted that the appellant had persistent diarrhoea and used “gastro-stop”.
The Medical Assessor’s examination of the appellant relating to the appellant’s digestive system revealed that the appellant was of a height of 1.64 metres with a weight of 80 kilograms which meant that the appellant had a body mass index of over 29. The Medical Assessor observed that “this is considerably overweight”. The Medical Assessor did not find any masses, guarding or tenderness in the appellant’s abdomen.
As mentioned, the Medical Assessor assessed the appellant had 5% WPI relating to his digestive system. He provided the following reasons in the MAC for that assessment:
“This is addressed in AMA 5, Page 128, Table 6-4. He continues to have associated symptoms, although no specific clinical findings. The major issue is continuing diarrhoea necessitating the need to be reasonably close to WC facilities. Midrange of Class I is assessed as appropriate with 5% WPI.”
SUBMISSIONS
Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submitted that the Medical Assessor did not provide adequate reasons for attributing half of the appellant’s WPI relating to his knee to the injury on 21 April 2004 and half to the injury on 17 August 2007. The appellant referred to an opinion of Dr William Bye, as expressed in reports Dr Bye provided the appellant’s then solicitor on 22 September 2009 and 28 September 2009, that the appellant’s fracture of the right patella that occurred in the injury the appellant suffered in 2007 had caused early arthritis in his lateral patellofemoral compartment. The appellant also referred to Dr Bye’s opinion that the appellant’s injury on 21 April 2004 had resulted in a compound fracture of the appellant’s right leg and a cruciate deficient right knee. The appellant observed that Dr Bye assessed he had 10% WPI for the cruciate deficiency of his right knee.
The appellant also referred to Dr Bosanquet’s assessment that he had 4% WPI relating to his right knee and that half of that was due to the injury the appellant suffered in 2007. The appellant submitted that Dr Bosanquet was not clear as to what injury occurred to the right knee in 2004 or in 2007.
The appellant referred to the opinion of Dr Kahn who assessed he had 4% WPI due to restriction of flexion of his right knee from the 2004 injury and 9% WPI for “the patellectomy” that Dr Kahn considered followed the 2007 injury.
The appellant submitted that the Medical Assessor failed to give proper consideration to the opinion of the assessment of Dr Kahn or to the findings of Dr Bye who considered that the 2004 injury resulted in a cruciate deficiency. The appellant submitted that Dr Kahn’s assessment was “more appropriate because he took account of the correct history and noted the patellectomy impairment was covered by a different assessment”. The appellant submitted that “there is no evidence that the patellectomy has resulted in restricted flexion whereas there is evidence of cruciate deficiency as a result of the 2004 work incident”.
With respect to the Medical Assessor’s assessment of the appellant’s permanent impairment relating to his digestive system, the appellant submitted that the Medical Assessor incorrectly used the criteria of Table 6-4 of AMA 5 to assess his impairment. The appellant noted that that table relates to the colon, rectum and anus. The appellant noted that Dr Kahn had assessed his impairment based on the criteria of Table 6-3 of AMA 5, as did Associate Professor Myers.
The appellant submitted that the evidence is that he has diarrhoea following the resection of 30 centimetres of his small intestine. The appellant submitted that the Medical Assessor did not give any or any adequate reasons to explain why a 5% WPI was selected.
In reply, the respondent submits that the Medical Assessor provided adequate reasons for the assessment he made of the appellant’s permanent impairment relating to his right knee. The respondent submitted that Dr Kahn’s assessment of the appellant’s right knee impairment based on an incorrect history because Dr Kahn considered the appellant required reconstruction of his right knee after the 2004 injury whereas there is no evidence that this occurred. The respondent referred to findings that occupational physician Dr Haynes made and set out in a report of 20 June 2006, that the appellant then had a normal range of motion of his right knee. The respondent submitted that the appellant suffered a significant injury to his right knee in the accident on 17 August 2007. The respondent submitted that “the deduction of 50% of the right knee impairment was appropriate on the evidence”.
The respondent submitted with respect to the Medical Assessor’s assessment of the appellant’s impairment of his digestive system, that the Medical Assessor’s assessment “was consistent with the assessment of Associate Professor Myers’”. The respondent submitted that an assessment of 5% WPI was appropriate on the evidence. The respondent submitted that even if the Medical Assessor made the assessment under an incorrect table, if the appellant’s impairment was assessed under the correct table, that is Table 6-3, the assessment would still be 5% WPI in line with the assessment of Associate Professor Myers. The respondent referred to example 6-3 of AMA 5, which involved a 30 centimetre resection of the terminal ileum with the worker having two to three soft stools a day. The impairment rating in that example was 0% WPI.
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.
Right knee
The Medical Assessor assessed the appellant’s impairment relating to his right knee by reference to the restriction of flexion the appellant exhibited in his right knee. The Medical Assessor was correct to do so because that method of assessment, that is the criteria of Table 17-10 of AMA 5, specifically addressed the only assessable feature that the appellant exhibited at the time of assessment. In accordance with [3.2] of the Guidelines, the Medical Assessor applied the correct criteria to assess the appellant’s impairment of his right knee.
The injury the appellant suffered to his right knee in the incident of 21 April 2004 was a compound fracture of his upper fibula, a dislocation of his patella, and a tear to the lateral collateral ligament. His injury was treated by reduction of the compound fracture and repair of the lateral collateral ligament. The appellant, when examined by occupational physician Dr Haynes on 20 June 2006, that is before his subsequent injury, exhibited normal range of movement and stability of his right knee. Dr Haynes noted that the appellant did not report tenderness to palpation around the right knee. In other words, at that time the appellant exhibited no impairment of his right knee, and certainly no restriction in flexion of his right knee.
Notwithstanding that, the Appeal Panel considers that it is likely that the trauma to the appellant’s right knee from the injury he suffered to it on 21 April 2004, and the treatment the appellant received for that injury, would in all likelihood have initiated a degenerative process in his right knee that would have likely caused some restriction in flexion of the appellant’s right knee.
The injury the appellant suffered to his right knee on 17 August 2007 was a comminuted fracture of his patella, which was repaired using a cerclage and K-wire. The Appeal Panel notes that Dr Kahn said that the appellant underwent a patellectomy. There is no evidence to support that was the case. Dr Kahn noted in his report of 21 May 2021 that he had reviewed clinical notes of Dr Maher and clinical notes from the Batlow Medical Practice. The clinical notes of Dr Maher that are in evidence before the Appeal Panel relate to a David A Dubois born on 22 February 1937, and not to the appellant. The Appeal Panel assumes that those notes relate to the appellant’s father. There is nothing within those notes in any event that indicate that the appellant had a patellectomy done following the injury he suffered on 17 August 2007. Similarly, the notes of the Batlow Medical Practice do not reveal that the appellant had a patellectomy following the injury he suffered on 17 August 2007. Moreover, the Medical Assessor noted from his clinical examination of the appellant that there was no clinical evidence of the appellant having had a patellectomy.
The Appeal Panel considers that it is unlikely that the appellant had a patellectomy and that Dr Kahn was simply mistaken.
The opinion of the Medical Assessors on the Appeal Panel is that the injury the appellant suffered to his knee on 17 August 2007, that is a communited fracture to his patella, and the treatment he received for that, was likely to have caused osteoarthritis in the patellafemoral compartment of his right knee, which has resulted in a further restriction of flexion of the appellant’s right knee. That further restriction of movement in the appellant’s right knee is in addition to the restriction of movement the appellant had from his injury on 21 April 2004. In other words, the appellant had an increment in the restriction of the movement of his right knee that was solely the consequence of the injury the appellant suffered on 17 August 2007. Saying that slightly differently, if the appellant had not suffered injury to his right knee on 21 April 2004, the injury he suffered on 17 August 2007 would have caused damage to the patellafemoral compartment and restriction in the appellant’s flexion of his right knee. To repeat, the injury the appellant suffered on 17 August 2007 independently caused an increment in the restricted range of flexion he has in his right knee.
As to what restriction of movement related to the injury the appellant suffered on 21 April 2004 and the damage consequent upon that and what related to the subsequent injury he suffered on 21 August 2017 is really a matter of clinical opinion. The Medical Assessors of the Appeal Panel consider that most of the restriction of movement of the appellant’s flexion of his right knee would be likely due to the latter injury, rather than the earlier injury, given that when Dr Haynes assessed the appellant in 2006 the appellant was then exhibiting no restriction in the range of movement of his right knee. The fact that the Appeal Panel has a different opinion from the Medical Assessor on that does not however demonstrate that the Medical Assessor’s clinical judgement on it is wrong.
The Medical Assessor has had regard to the opinions of other clinicians and this is apparent because the Medical Assessor said in the MAC that all the documents the Commission forwarded him were “studied in detail”. The Medical Assessor has relied upon his examination of the appellant and his clinical judgment to assess that the appellant has 2% WPI relating to his knee from the injury on 21 April 2014. The Appeal Panel discerns no error in his assessment. The Appeal Panel considers he has applied correct criteria to assess the appellant’s impairment relating to his right knee.
The Appeal Panel observes however that in the table to the MAC the Medical Assessor purported to make a deduction of half of the appellant’s impairment relating to his right knee on account of the appellant having a pre-existing injury condition or abnormality. That is not the case. That is a deduction was not required to be made under s 323 of the 1998 Act. Rather, what the Medical Assessor did was to assess what permanent impairment the appellant has resulting from the injury on 21 April 2004 and what impairment the appellant had from the latter injury. The Appeal Panel will correct the table such that the appellant’s WPI relating to his right lower extremity from the injury on 21 April 2004 is specified as 2% and such that there is no deduction made under s 323.
Digestive system
The appellant’s impairment relating to his digestive system was required to be assessed in accordance with the criteria of Table 6-3 of AMA 5, and not by reference to the criteria of Table 6-4. Table 6-3 is headed “criteria for rating permanent impairment due to upper digestive tract (oesophagus. Stomach and duodenum, small intestine and pancreas (disease))”. Table 16-4 is titled “criteria for rating permanent impairment due to colonic and rectal disorders”. The appellant’s injury to his digestive system involved his small intestine
The Medical Assessor consequently applied incorrect criteria to assess the appellant’s impairment relating to his digestive system and by doing so made an error. That in turn means the MAC contains a demonstrable error. Consequently, the Appeal Panel must reassess the medical dispute relating to the appellant’s impairment of his digestive system from the injury the appellant suffered on 21 April 2014, so as to correct the error the Medical Assessor made.
The appellant does not suffer any nutritional impairment as a result of his injury to his digestive system. His weight is above the desirable weight for men, as specified in Table 6-1 of AMA 5. The appellant’s impairment cannot therefore be assessed under class 2 of Table 6-3, because one of the criteria that must be met for a worker to be assessed within this class is that the worker has weight loss below desirable weight but does not exceed 10%. The appellant does not have weight loss.
The appellant has had anatomic destruction as a consequence of his injury in that he has had resection of part of his small bowel. In other words, he has an altered anatomy as a consequence of the injury he suffered to his digestive system.
The appellant has chronic and troublesome diarrhoea, that necessitates he be reasonably close to a toilet. This symptom is a sequelae from the appellant’s surgical procedure. It has a major impact on the appellant’s life. The appellant has taken Gastro-stop, but he does not require continuous treatment. As mentioned, he maintains his weight above a desirable level.
The Appeal Panel assesses the appellant as being 9% WPI in accordance with the criteria of Table 6-3 of AMA 5. The Appeal Panel notes example 6-3 of AMA5, as referred to by the respondent, but observes that this is just an example and does not determine how the Appeal Panel is to rate the appellant’s impairment. In any event, the circumstances of that example are far apart from the circumstances of the appellant, in that the appellant’s persistent and troublesome diarrhoea impacts his life, in that it requires him to be near a toilet, and has required treatment in the form of his taking Gastro-stop. The appellant however, does not require continuous treatment and, as indicated maintains his weight above a desirable level.
For these reasons, the Appeal Panel has determined that the MAC issued on 8 August 2022 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
Matter Number: | W6548/21 |
Applicant: | David Wayne Dubois |
Respondent: | R & V Bergin Pty Ltd |
This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act1998.
The Appeal Panel revokes the Medical Assessment Certificate of Dr Tim Anderson 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) |
| Right upper extremity | 21/04/04 | Chap 2 P18 | P 476 P 477 P 479 P 439 | 7 | 0 | 7 |
| Right lower extremity | Chap 3 P13 | P 537 | 2 | 0 | 2 | |
| Lumbar spine | Chap 4 P24 | P 384 | 7 | 2/5th | 4 | |
| Digestive system | Chap 16 P79 | P121 | 9 | 0 | 9 | |
| Scarring | P74 T14.1 | 1 | 0 | 1 | ||
| Total % WPI (the Combined Table values of all sub-totals) | 21 | |||||
0