Gulliver v In-Store Merchandising Services Pty Ltd
[2024] NSWPICMP 207
•9 April 2024
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Gulliver v In-Store Merchandising Services Pty Ltd [2024] NSWPICMP 207 |
| APPELLANT: | Jane Melissa Gulliver |
| RESPONDENT: | Workers Compensation Nominal Insurer (In-Store Merchandising Services Pty Ltd – deregistered) |
| APPEAL PANEL | |
| MEMBER: | Jane Peacock |
| MEDICAL ASSESSOR: | John Brian Stephenson |
| MEDICAL ASSESSOR: | James Bodel |
| DATE OF DECISION: | 9 April 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; left lower extremity injury; total knee replacement after injury; appeal by worker concerned the section 323 deduction of 2/5ths made by the Medical Assessor (MA); account must be taken of the contribution of the pre-existing condition and abnormality of the left knee to the overall level of permanent impairment assessed however deduction was excessive and at odds with the available evidence; a deduction of one-tenth was applied by the Appeal Panel; Held – Medical Assessment Certificate revoked. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 27 November 2023 Jane Melissa Gulliver (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Robert Kuru, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on
30 October 2023.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 in 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).
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.
The appellant requested that she be re-examined. As a result of the Appeal Panel’s preliminary review, the Appeal Panel determined that the worker need not undergo a further medical examination because although the Appeal Panel found error, for the reasons set out below, there was sufficient material before the Appeal Panel for it to make a determination.
EVIDENCE
Documentary evidence
The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment and has taken them into account in making this determination.
Medical Assessment Certificate
The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision.
SUBMISSIONS
Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
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 matter was referred to the Medical Assessor as follows:
| • | Date of injury: | 17 October 2001 |
| • | Body parts / systems referred: | Left leg at or above the knee Right leg at or above the knee Left arm at or above the elbow Right arm at or above the elbow |
| • | Method of assessment: | Table of Maims |
“The following matters have been referred for assessment (s 319 of the 1998 Act):
| • | Date of injury: | 17 October 2001 |
| • | Body parts / systems referred: | Left upper extremity (shoulder) Right upper extremity (shoulder) Left lower extremity (knee) Right lower extremity (knee) |
| • | Method of assessment: | Whole Person Impairment” |
The Medical Assessor issued a MAC in respect of his assessment under the Table of Disabilities as follows:
| Body Part (describe the body part as per Table of Disabilities) e.g. right leg at or above the knee | Date of injury | Total amount of permanent % loss of efficient use or impairment | Proportion of permanent impairment due to pre-existing injury, abnormality or condition | Total permanent % loss of efficient use or impairment attributable to this injury (after deduction of any pre-existing impairment in column 4.) |
| Left leg at or above the knee | 17/10/2001 | 35% | 2/5ths | 21% |
| Right leg at or above the knee | 17/10/2001 | 15% | 2/3rd | 5% |
| Left arm at or above the elbow | 17/10/2001 | 15% | 1/10 | 13.5% |
| Right arm at or above the elbow | 17/10/2001 | 15% | 1/10 | 13.5% |
The Medical Assessor issued a MAC as follows in respect of his assessment of whole person impairment (WPI) as follows:
| Body Part or system | Date of Injury | Chapter, page and paragraph number in SIRA 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) |
| Left lower extremity (knee) | 17/10/2001 | P 17 T 17.35 | P 547 17.33 | 20% | 2/5ths | 12% |
| Right lower extremity (knee) | 17/10/2001 | P 17 P 3.23 | P 536 17.10 | 4% | 2/3rds | 1% |
| Right upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 4% | 1/10th | 4% | |
| Left upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 2% | 1/10th | 2% | |
| Total % WPI (the Combined Table values of all sub-totals) | 19% | |||||
The worker appealed.
There is no complaint on appeal about the assessments under the Table of Disabilities for any of the body parts.
There is no complaint on appeal about the assessments of WPI for the right upper extremity and left upper extremity.
In respect of the left lower extremity (left knee) there is no complaint on appeal about the assessment of the overall permanent impairment at 20% WPI based upon a fair result of the left total knee replacement.
The complaint on appeal for the left lower extremity is in respect of the deduction made by the Medical Assessor under s 323 of the 1998 Act in respect of a pre-existing injury, condition or abnormality of 2/5ths.
In respect of the right lower extremity, there is complaint on appeal about method of assessment used to assess the overall impairment of 4% WPI. There is no complaint on appeal about the deduction made by the Medical Assessor under s 323 of 2/3rds.
In summary, the respondent employer Workers Compensation nominal Insurer (In-Store Merchandising Services Pty Ltd – deregistered) (the respondent) submitted that the Medical Assessor did not make assessments on the basis of incorrect criteria and nor did he make demonstrable errors and accordingly the MAC should be confirmed.
The Medical Assessor took a history of injury and its sequalae including details of present symptoms as well as pre-existing conditions as follows:
“On 17 October 2001, Ms Gulliver was at Bi-Lo at Kurri Kurri, merchandising. She had placed materials in a shopping trolley. Whilst she was pushing it, a wheel became stuck on an irregularity in the concrete floor. The trolley struck her knees and she sustained a lateral dislocation of the left patella. She went to Kurri Kurri Hospital, where her knee was strapped and she was given crutches. She presented to her General Practitioner, who referred her for physiotherapy. She was subsequently referred to an Orthopaedic Surgeon, Dr Berton. In his clinical letter dated 26 November 2001, he notes patellofemoral crepitus and pain but otherwise, an intact knee at review on 4 December 2001. At that time he notes an MRI suggesting patellofemoral degenerative disease and injury to the anterior cruciate ligament (an unusual combination of injuries). On 4 February 2002 she underwent arthroscopy, chondral biopsy and a Fulkerson’s osteotomy. The state of the anterior cruciate ligament is not commented on.
A clinical letter dated 6 May 2002 notes persistent stiffness and pain subsequent to the surgical procedure. In that letter, Dr Berton notes the MRI “showed extensive wear of the patella without other lesions”. A manipulation under anaesthetic and arthroscopy was undertaken on 10 May 2002. Again, no mention is made of the integrity of the cruciate ligament.
On 21 March 2003, she underwent removal of screw fixation of the osteotomy and then a tenolysis. She also underwent chondral grafting. Unfortunately, Ms Gulliver continued to have pain and stiffness in her knee.
A further arthroscopy on the left knee was undertaken on 6 September 2007. At this time it was noted that the tibiofemoral joint and the cruciate ligaments and menisci were intact.
She underwent a further arthroscopy on 5 February 2010. At that time several cartilaginous loose bodies were removed, which had originated from the lateral femoral condyle.
Ultimately, Ms Gulliver went on to have a total knee replacement in May 2013. Initial follow up suggested she had significant pain improvement and had a reasonable range of movement in the joint (0° to 110° recorded on 23 April 2015).
Late in 2017, Ms Gulliver underwent a spinal fusion.
In January 2018 as she was getting up out of a chair and started walking, she had a turn and fell, landing heavily on both of her knees. She reports persistent pain in both knees since.
Around 18 months prior to undergoing knee replacement, she started developing pain in her shoulders. The pain was in the front of her shoulder, radiating up towards her neck and the front of her chest. She has gone on to have surgery on both shoulders with a reasonable result. If she elevates her arms beyond horizontal, she will get pain in the front of her shoulders.
· Present treatment:
Left Knee: She has pain on the outer aspect of the left knee. The left knee swells. She is able to walk for 20 minutes a day. She uses PEA, Naproxen and Endep and previously has been on Fentanyl.
Right Knee: She describes as having similar symptoms with pain in the back of the knee that radiates through to the front. She walks, undertakes hydrotherapy and intermittently has dry needling and massage.
For the shoulders, she has physiotherapy consistent of massage and dry needling. She does a limited exercise program.
Present symptoms:
The present symptoms are detailed above.
Details of any previous or subsequent accidents, injuries or conditions:
Ms Gulliver denies any previous injuries to her knees but imaging suggests a lateral subluxation of her patellae with established patellofemoral degenerative disease.
Ms Gulliver reports she had an injury to her shoulder in 1992, which was diagnosed as a rotator cuff tear.
· General health:
Her past history includes atrial fibrillation and angina. Medications include Cartia and Cordilox. She has multiple drug reactions, including to morphine, penicillin, Lyrica and tramadol.
· Work history including previous work history if relevant:
Nil relevant.
Social activities/ADL:
Ms Gulliver reports she previously enjoyed ice skating and skiing, which she is no longer able to do. Her knees inhibit her socialising regularly.”
The Medical Assessor recorded findings on examination in respect of the bilateral knees as follows:
“On examination, Ms Gulliver walked with a minor limp. Her range of motion was assessed as follows:
MOVEMENT
RIGHT
LEFT
Flexion
100°
120°
Extension
0°
0°
Her knees were coronally and sagittally stable. Both knees were in 8° of valgus. There was a 33cm scar over the front of the left leg, consistent with knee replacement surgery and tibial tubercle transfer. Quadriceps circumference was 66cm and gastrocnemius circumference 47cm.”
In respect of the special investigations the Medical Assessor noted as follows:
“I was able to review the following modalities of imaging:
DATE
INVESTIGATION
RESULTS
23/10/2002
X-ray left knee
Postoperative x-ray Fulkerson’s osteotomy.
04/02/2003
CT right knee
Lateral patellar subluxation, patellofemoral degenerative disease.
11/06/2003
MRI left knee
Patellofemoral degenerative disease.
13/11/2004
MRI right knee
Patellofemoral degenerative disease.
24/04/2013
X-ray left knee
Postoperative total knee replacement without complication.
08/04/2014
X-ray right knee
Lateral subluxation, patellofemoral arthritis.
X-ray left knee
Total knee replacement, united tibial tubercle osteotomy.
30/01/2017
X-ray both knees
Left total knee replacement, right patellofemoral subluxation and osteoarthritis.
The Medical Assessor summarised the injuries and diagnosis as follows:
(a) Summary of injuries and diagnoses:
Ms Gulliver struck her knee and aggravated pre-existing lateral patellar subluxation in the left knee. She has gone on to have a left sided knee replacement. She has a similar pre-existing condition in the right knee, which has become symptomatic over time. She has developed pain in her shoulders from impingement which she attributes to use of crutches.
(b) Consistency of presentation:
Ms Gulliver was cooperative throughout the assessment.
The Medical Assessor explained his assessment of the overall level of impairment of the bilateral knees as follows showing his calculations:
“The range of motion of the knees was assessed as follows:
MOVEMENT
RIGHT
LEFT
Flexion
100°
120°
Extension
0°
0°
Both knees were stable in a coronal and sagittal plane. Both knees were in 8° of valgus. There was patellofemoral crepitus of the right knee. Skyline x-ray demonstrated reduction of patellofemoral articular cartilage to 2mm.
The left total knee replacement is assessed according to the SIRA Guidelines page 17, Table 17.35 as follows:
Pain
20 points
Range of motion
20 points
Stability
Anteroposterior
10 points
Mediolateral
15 points
Deductions
Flexion contracture
0
Extension lag
0
Tibiofemoral alignment
0
Giving a total of 65 points. According to AMA 5 page 547, Table 17.33, this is assessed as a ‘fair’ result (20% whole person impairment).
The right knee is assessed according to AMA 5 page 536, Table 17.10. 4% whole person impairment is assessable for restricted flexion. AMA 5 page 544, Table 17.31 allows an alternative assessment for arthritis based on the patellofemoral joint space. 2mm joint space is also assessed at 4% whole person impairment. Given that the reference scale of measurement is not included in the x-ray, it is elected to assess impairment according to AMA 5 page 536, Table 17.10.”
The Medical Assessor had regard to the opinions of the other experts whose reports were in evidence explaining briefly were his opinion differed relevantly as follows in respect of the WPI assessments for the bilateral knees:
“With respect to the report by Dr Randhawa dated 10 June 2021…
With respect to the knee arthroplasty, I have assessed a “fair” rather than “good” result and assessed a higher impairment.
…
Dr Randhawa has not addressed pre-existing conditions in his report and this will be dealt with subsequently.
With respect to the report by Dr Machart dated 27 March 2023, I have assessed a similar impairment for the right knee but greater impairment for the left knee.
Dr Machart has made a two-third deduction for the right knee and a two-fifths deduction for the left knee for pre-existing conditions. I note this is consistent with deductions made in the MAC by Dr Higgs on 24 October 2005.”The Medical Assessor then addressed the question of the deductions made under s 323 as follows:
“DEDUCTION (IF ANY) FOR THE PROPORTION OF THE IMPAIRMENT THAT IS DUE TO PREVIOUS INJURY OR PRE-EXISTING CONDITION OR ABNORMALITY
a. In my opinion the worker suffers from the following relevant previous injuries, pre-existing conditions or abnormalities:
(i)Lateral patellar subluxation and patellofemoral osteoarthritis left knee.
(ii)Lateral patellar subluxation and patellofemoral osteoarthritis right knee.
(iii)Rotator cuff disease right shoulder.
(iv)Rotator cuff disease left shoulder.
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)Each of the injuries represents aggravation of a pre-existing condition.
c. Left Knee: 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 two-fifths for the following reasons:
(i)The lateral patellar subluxation and patellofemoral osteoarthritis is a pre-existing condition. In the absence of this pre-existing condition, it is unlikely the injury would have led to any impairment of the left knee.
Right Knee: 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 two-thirds for the following reasons:
Imaging taken of the right knee shortly after injury demonstrates significant lateral patellar subluxation and patellofemoral osteoarthritis. On the balance of probabilities, Ms Gulliver would have become symptomatic from the pathology seen in the right knee in around the same time in the absence of injury to the left knee.”
The deduction that is complained about on appeal is the deduction made by the Medical Assessor in respect of the WPI assessment for the left lower extremity (left knee) of 2/5ths from the 20% WPI assessed on the basis of a fair result for the knee replacement. There is no complaint on appeal about the deduction of 2/3rds from the overall WPI assessed for the right knee.
A s 323 deduction can only be made if the pre-existing injury, condition or abnormality has contributed to the level of permanent impairment assessed. The Medical Assessor deducted 2/5ths in respect of the left lower extremity for the reasons he gave above.
The appellant submitted that no deduction can be made once the appellant has had a knee replacement because the knee no longer exists, it has been replaced by an artificial joint or prothesis and so any pre-existing condition of the knee no longer exists and cannot sound therefore in a deduction. In the alternative, it was submitted the deductionwas excessive and that any deduction if to be applied should be limited to one-tenth.
A deduction can only be made if the pre-existing condition or abnormality has contributed to the level of permanent impairment assessed. Here the level of permanent impairment is assessed in accordance with the correct criteria in the guidelines on the basis of the total knee replacement having had a “fair result” which results in a 20% WPI.
The appellant has come to a total knee replacement as a result of both the injury and the underlying condition/abnormality of the left knee.
The appellant had a pre-existing degenerative condition of the left knee. She doesn’t dispute that because she doesn’t complain about the deduction made under the table of disabilities or the deduction made for the same pre-existing condition in the right knee.
The Medical Assessor diagnosed as follows:
“Ms Gulliver struck her knee and aggravated pre-existing lateral patellar subluxation in the left knee. She has gone on to have a left sided knee replacement. She has a similar pre-existing condition in the right knee, which has become symptomatic over time.”
The injury represented an aggravation of a pre-existing condition and she has gone onto have a knee replacement. The knee replacement surgery has occurred as a result of both the pre-existing condition and the aggravation of it by the injury. The impairment of the knee is assessed on the basis of the knee replacement which has resulted from both the underlying condition and the injury. The contribution of the pre-existing condition of the left knee to the level of permanent impairment assessed as a result of the surgery to the left knee must be taken into account. The Medical Assessor has made a deduction of 2/5ths saying the evidence reasoned 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 two-fifths for the following reasons:
(i)The lateral patellar subluxation and patellofemoral osteoarthritis is a pre-existing condition. In the absence of this pre-existing condition, it is unlikely the injury would have led to any impairment of the left knee.”
The Appeal Panel considers the extent of the deduction at 2/5ths is not adequately explained noting that all of the radiological evidence post dates the injury and the worker says she was asymptomatic prior to injury and there is no evidence to the contrary. The Appeal Panel agrees that the deductible proportion is too difficult or costly to determine as found by the Medical Assessor. Where the Appeal Panel considers that the Medical Assessor erred is that he then said a deduction of one-tenth was at odds with the available evidence which it is not. The appropriate deduction is accordingly one-tenth. As the overall level of impairment was assessed at 20% a deduction of one-tenth leaves 18% WPI for the left lower extremity. Accordingly’ the Appeal Panel will revoke the 12% WPI assessed for the left lower extremity and issue a new certificate assessing 18% WPI.
In respect of the right lower extremity, the Medical Assessor assessed 4% WPI based upon ROM and then deducted 2/3rds under s 323.
The appellant submitted that there was a failure by the Medical Assessor to adopt an appropriate method of assessment as well as a failure to adequately explain why this method was adopted.
The Medical Assessor conducted a physical examination which he recorded as above.
He then explained his method of assessment which in respect of the left knee was required to be based on the knee replacement. There is no complaint about this method for the left knee.
The right knee could not be assessed in this way since it has not been replaced.
The Medical Assessor very clearly explained why he adopted the assessment because of the restriction on range of motion as follows:
“The right knee is assessed according to AMA 5 page 536, Table 17.10. 4% whole person impairment is assessable for restricted flexion. AMA 5 page 544, Table 17.31 allows an alternative assessment for arthritis based on the patellofemoral joint space. 2mm joint space is also assessed at 4% whole person impairment. Given that the reference scale of measurement is not included in the x-ray, it is elected to assess impairment according to AMA 5 page 536, Table 17.10.”
The appellant complained that the Medical Assessor did not provide a table for the right knee like he did for the left knee but the criteria in the table for the left knee is the correct criteria for assessment of the result from the knee replacement to enable an assessment of whether it is poor, fair or good.
The criteria set out in the table for the left knee are not relevant for the right knee which has not been replaced. Rather the Medical Assessor has used the correct criteria for assessing the right knee, namely ROM.
The Appeal Panel considers that the appropriate method of assessment for the right knee was adopted by the Medical Assessor and that it was assessed on the basis of correct criteria and adequately explained. The Appeal Panel can discern no error in the assessment of 4% WPI for the right knee as the overall impairment.
The Medical Assessor then deducted 2/3rds under s 323 leaving a 1% WPI. There is no complaint on appeal about the deduction of 2/3rds. Accordingly the 1% WPI assessed for the right lower extremity is confirmed by the Appeal Panel.
This means that the assessment for the left lower extremity is to be corrected to 20% WPI less 1/10th leaving 18% WPI, the right lower extremity is confirmed at 1%WPI and the right upper extremity and left upper extremity which were not complained about on appeal remain at 4% and 2% WPI respectively. Under the combined values table this gives a total of 24% WPI as a result of injury on 17 October 2001.
The effect of these findings is that the MAC will need to be revoked and a new MAC issued as follows:
| Body Part or system | Date of Injury | Chapter, page and paragraph number in SIRA 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) |
| Left lower extremity (knee) | 17/10/2001 | P 17 T 17.35 | P 547 17.33 | 20% | 1/10th | 18% |
| Right lower extremity (knee) | 17/10/2001 | P 17 P 3.23 | P 536 17.10 | 4% | 2/3rds | 1% |
| Right upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 4% | 1/10th | 4% | |
| Left upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 2% | 1/10th | 2% | |
| Total % WPI (the Combined Table values of all sub-totals) | 24% | |||||
As the table of disability assessments were not complained about on appeal the Appeal Panel will simply re-issue the Medical Assessor’s certificate in this regard so that both Tables are in the attached document for the parties’ ease of reference.
For these reasons, the Appeal Panel has determined that the MAC issued on
30 October 2023 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: | W4700/23 |
Applicant: | Jane Melissa Gulliver |
Respondent: | Workers Compensation Nominal Insurer (In-Store Merchandising Services Pty Ltd – deregistered) |
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 Medical Assessor Robert Kuru and issues this new Medical Assessment Certificate as to the matters set out in the Table below:
| Body Part or system | Date of Injury | Chapter, page and paragraph number in SIRA 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) |
| Left lower extremity (knee) | 17/10/2001 | P 17 T 17.35 | P 547 17.33 | 20% | 1/10th | 18% |
| Right lower extremity (knee) | 17/10/2001 | P 17 P 3.23 | P 536 17.10 | 4% | 2/3rds | 1% |
| Right upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 4% | 1/10th | 4% | |
| Left upper extremity (shoulder) | 17/10/2001 | P 476 16.40 P 477 16.43 P 479 16.46 P 439 16.03 | 2% | 1/10th | 2% | |
| Total % WPI (the Combined Table values of all sub-totals) | 24% | |||||
PERSONAL INJURY COMMISSION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received before 1 January 2002
Matter Number: | W4700/23 |
Applicant: | Jane Melissa Gulliver |
Respondent: | Workers Compensation Nominal Insurer (In-Store Merchandising Services Pty Ltd – deregistered) |
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 Medical Assessor Robert Kuru and issues this new Medical Assessment Certificate as to the matters set out in the Table below:
Assessment in accordance with the Table of Disabilities for injuries received before
1 January 2002
| Body Part (describe the body part as per Table of Disabilities) e.g. right leg at or above the knee | Date of injury | Total amount of permanent % loss of efficient use or impairment | Proportion of permanent impairment due to pre-existing injury, abnormality or condition | Total permanent % loss of efficient use or impairment attributable to this injury (after deduction of any pre-existing impairment in column 4.) |
| Left leg at or above the knee | 17/10/2001 | 35% | 2/5ths | 21% |
| Right leg at or above the knee | 17/10/2001 | 15% | 2/3rd | 5% |
| Left arm at or above the elbow | 17/10/2001 | 15% | 1/10 | 13.5% |
| Right arm at or above the elbow | 17/10/2001 | 15% | 1/10 | 13.5% |
0