Hesketh v Sunnyfield
[2022] NSWPICMP 419
•24 October 2022
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Hesketh v Sunnyfield [2022] NSWPICMP 419 |
| APPELLANT: | Martin Hesketh |
| RESPONDENT: | Sunnyfield |
| Appeal Panel | |
| MEMBER: | John Wynyard |
| MEDICAL ASSESSOR: | Patrick Morris |
| MEDICAL ASSESSOR: | Douglas Andrews |
| DATE OF DECISION: | 24 October 2022 |
| CATCHWORDS: | wORKERS cOMPENSATION - Appeal by worker against Medical Assessor’s (MA) finding of no Maximum Medical Improvement (MMI); whether application of chapter 1.15 of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (4th ed, reissued 1 March 2021) demonstrated that MMI had occurred when consideration given to relevant facts; whether MA diverted by confusion about causation; Held – contemporaneous medical reports showed the worker’s condition to have been well stabilised for almost 2 years and that the medical treatment referred to by the MA had already been given; it was accordingly unlikely that the condition would change in the next 12 months; MA failed to adequately explain his reasons; MA may also have been diverted from his task by irrelevant concerns as to causation; Bindah v Carter Holt Harvey Woodproducts Australia Pty Ltd, Jaffarie v Quality Castings Pty Ltd and Skates v Hills Industries Ltd considered; error established and worker re-examined by Panel member; Medical Assessment Certificate revoked and award for 24% substituted. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 28 March 2022 Martin Hesketh, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Andrew McClure, a Medical Assessor (MA), who issued a Medical Assessment Certificate (MAC) on
7 March 2022.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, and
· 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 Personal Injury Commission Rules 2021 (the PIC Rules), and Procedural Direction PIC7 – Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes 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 PIC Rules.
The assessment of permanent impairment is conducted in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed, reissued
1 March 2021 (the Guides) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5). “WPI” is reference to whole person impairment.
RELEVANT FACTUAL BACKGROUND
On 22 November 2021 the delegate of the President referred this matter for a WPI assessment arising from psychological/psychiatric disorder which occurred on
16 November 2016.The appellant was employed as a support worker when he was assaulted by a very large and strong young man whom he was looking after.
He had further injury to his knee on 16 May 2018 when he jumped from a company van he was driving in the carpark after four intellectually disabled clients had got out of the van before he had parked it. The appellant was afraid one or more of the clients could be injured by passing traffic.
He sought psychological help after the subject injury and become psychiatrically affected.
He had regular psychiatric consultations with the late Dr Selwyn Smith and regular general practitioner (GP) attendance.
He saw a psychologist once a month and was on medication.
For reasons we will come to, the MA was unable to provide an assessment.
PRELIMINARY REVIEW
The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties.
As a result of that preliminary review, the Appeal Panel determined that the worker should undergo a further medical examination as we found that a demonstrable error had been made. Such examination was necessary as no assessment had been done by the MA.
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.
Further medical examination
Medical Assessor Patrick Morris of the Appeal Panel conducted an examination of the worker on 28 July 2022 and reported to the Appeal Panel.
Medical Assessment Certificate
The parts of the medical certificate given by the MA that are relevant to the appeal are set out, where relevant, in the body of this decision.
SUBMISSIONS
Both parties made written submissions which 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 appeal was based firstly on a challenge to the decision by the MA that maximum medical improvement had not been achieved, and secondly that the MA had made a demonstrable error in entering into the field of causation.
The MAC
Maximum medical improvement
In his findings on mental examination the MA said:[1]
“I saw the applicant by teleconference (as arranged) using the Zoom platform. He was sat at home at the time in a rather untidy-looking room in his downstairs 'granny flat.'
He stood regularly. He was highly anxious and indeed, at times, he was tremulous. His hair was long, matted, filthy and unbrushed. His beard was long, tangled and untrimmed. He wore casual clothing and it was notable that his T-shirt adhered to his torso (particularly at the back) as a result of a significant amount of sweat.”
[1] Appeal papers p 29.
The MA noted that the assessment lasted 80 minutes during which time Mr Hesketh would have consumed about 1.5 l of water.
The MA thought that the appellant’s cognitive difficulty was difficult to assess. He said:
“If his presentation is genuine, he has both a short term and long term memory deficit. The latter is most uncommon in depression and anxiety disorders….”
The MA, after discussing the question of causation, stated that Mr Hesketh’s “current condition is not yet stabilised and he needs further treatment”.
In the templated paragraph 8d, the MA stated:[2]
“If stabilisation/maximum medical improvement, of any or all injuries has not been reached, when, in your opinion, will this occur? With further treatment - including psychiatric and psychological consultations, medication trials, EMDR and possibly hospital admission - and resolution of his marital situation, Mr Hesketh's condition, I would expect, will improve and stabilise in 12 months' time.”
[2] Appeal papers p 31.
The MA said further: [3]
“If,…….the applicant’s current WPI is to be assessed; …the applicant’s current condition has not yet stabilised and he needs further treatment…”
[3] Appeal papers p 31.
The MA also said at [8]:[4]
“(c) …. [P]lease list those injuries not yet stable/at maximum medical improvement: Posttraumatic Stress Disorder and a chronic Major Depressive Episode.”
[4] Appeal papers p 31.
Causation
When discussing Mr Hesketh’s social activities and activities of daily living, the MA described a person who was clearly suffering from a psychiatric condition. However the MA said[5]:
“I emphasis that the above represents the applicant’s self-reported current ADLs, social activities and general functioning. It is unclear to me, however, whether his whole person impairment should be assessed from his current functioning or on his level of functioning immediately before the subsequent injury in the shopping mall carpark in May 2018. In this I need a direction from the Registrar to proceed.” (Emphases as written).
[5] Appeal papers p 29.
The MA said of Mr Hesketh’s presentation:[6]
“The applicant has provided me with a 'slanted' history today. His condition had in fact improved and largely gone into remission by around mid-2018 and his doctor had declared him fit to return to pre-injury duties. These additional difficulties coincided with, and followed, the injury to his right knee which was allegedly work related (though there is a past history of knee injury).”
[6] Appeal papers p 30.
In his summary the MA said:[7]
“Retrospectively Mr Hesketh became increasingly anxious after the incident of 16 November 2017. He felt that his life had been threatened. His doctor referred him to a psychologist, Ms Lucchese, who after 10 sessions terminated treatment as there had been significant improvement and Mr Hesketh's condition was virtually in remission.
It seems however that the applicant's knee injury sustained on 16 May 2018 created ongoing problems for him. In pain and limping, he was once again on work restrictions. He was working a short week. As a result he was increasingly anxious about his future in the job, and indeed whether he would recover from his injury. His anxiety accelerated after he was told that there were no suitable duties available. He was by now (according to the file) only working casually; hence he no longer had an income.
Anxious and depressed, he saw Dr Smith at the 'St John of God' Hospital Burwood and the psychiatrist diagnosed Posttraumatic Stress Disorder. This is likely to have been a recurrence of the applicant's original condition which was caused by the assault on 16 November 2017. However the precipitant was a new - and unrelated - injury, namely the right knee injury.
…
Mr Hesketh's current symptoms are entirely consistent with Posttraumatic Stress Disorder and Major Depression. These are recurrences of the original condition and have been precipitated by the subsequent injury.”
[7] Appeal papers p 30.
The MA stated:[8]
“To clarify, I cannot proceed with an assessment of permanent Whole Person Impairment (WPI) at this stage. The question of causation of the worker's current condition is one for the Commission. If the Commission determines that Mr Hesketh sustained a new psychiatric injury when he injured his knee, breaking the 'chain of causation' (I believe this is termed a novus actus interveniens, but I am not a lawyer), then I will assess this gentleman's WPI based on his condition immediately before the subsequent injury.”
SUBMISSIONS
The appellant
[8] Appeal papers p 31.
Maximum medical improvement
We were referred to the relevant explanations given by the MA recounted above. The appellant submitted that his domestic situation, whereby he lives in a granny flat, had been extant since 2020 as reported by Dr Stephen Allnutt, the worker’s medico-legal expert. Moreover, Mr Hesketh’s complaints to the MA were similar to those given to Dr Allnutt in October 2020. (Dr Allnut’s report was in fact dated 14 December 2020, but related to an assessment on 20 October 2020). A perusal of Guideline 1.15 of the Guides established that maximal medical improvement had occurred, the appellant argued.
It was submitted that a comparison of the complaints made by Mr Hesketh to the MA were consistent with those made to Dr Allnutt almost two years before. Whilst Dr Graham Vickery’s comments were brief and lacking in insight, the appellant said, his notes were not inconsistent with the complaints recorded by both Dr Allnutt and the MA. (Dr Vickery was the employer’s qualified expert). The appellant contended that a comparison of the psychiatric impairment rating scale (PIRS) findings of both experts with the comments made by the MA during his assessment showed no change to the level of impairment, notwithstanding that the base level was lower in Dr Vickery’s case. Using that methodology, the appellant kindly drew up a comparison table for our reference.
Causation
As to the question of causation, the appellant submitted there was no causation dispute that the Commission had to determine. The respondent had admitted liability.
The appellant submitted that neither Dr Vickery nor Dr Allnutt were concerned about the incident of 16 May 2018.
It was further submitted that in any event, if the 2018 injury had exacerbated the appellant’s psychiatric condition, then the MA should have assessed the whole of the impairment. Resulting from the same pathology should have been assessed together pursuant, it was claimed, to s 322(2) of the 1998 Act.
The respondent
Maximum medical improvement
The respondent noted that the appeal regarding maximum medical improvement was based on an allegation that the appellant’s familial and marital dysfunction would not change, and his treatment had been adequate. However, the MA had expressed “an unequivocal view” as expressed in [8d] of the MAC.
This view, we understood the employer to submit, was based on the MA’s clinical judgement about which the appellant had failed to identify any error in history taking or the evidence relied upon. We were referred to Mahenthirarasa v State Rail Authority of New South Wales & Ors[9] and The UGL Rail Services Pty Ltd (formerly United Group Rail Service Pty Ltd) v Attard[10] in support of a submission that no demonstrable error had been established.
[9] [2007] NSWSC 22.
[10] [2016] NSWSC 911.
The respondent said because prior medical reports identified the same issues as were mentioned by the MA, that was no basis upon which to conclude that circumstances will not change with further treatment, as the appellant submitted. The MA had identified “multiple treatment modalities” which he thought would improve the degree of impairment. The respondent argued.
The employer conceded that the relevant guideline indicated a stabilisation period of 12 months, and submitted that there was “a timeframe of 12 months for substantial change”. The employer submitted that the MA was able to consider the stabilisation of the condition with reference to further medical treatment.
Causation
With regard to causation, the respondent submitted that the appellant had not identified a proper ground of appeal as the MA’s comments regarding causation were not matters that would be “conclusive presumed to be correct in proceedings before a court or the Commission as prescribed by s 327(2) of the 1998 Act”.
DISCUSSION
Maximum medical improvement
Chapter 1.15 of the Guides provides:
“Assessments are only to be conducted when the medical assessor considers that the degree of permanent impairment of the claimant is unlikely to improve further and has attained maximum medical improvement.
This is considered to occur when the worker’s condition is well stabilised and is unlikely to change substantially in the next year with or without medical treatment.”
It can be seen that the employer’s submission regarding the application of Chapter 1.15 somewhat mistakes its provisions. Firstly, there is no “timeframe of 12 months for substantial change”. The MA is required to consider whether any further improvement is unlikely, and this is informed by:
i.establishing whether the condition is well stabilised, and
ii.establishing whether the condition is unlikely to change substantially in the next year, with or without medical treatment.
The employer’s assumption that there was a timetable of 12 months available was not supportable if the evidence demonstrated that the psychiatric condition was, firstly, well established. The evidence of both experts demonstrated that such was the case. Indeed
Dr Vickery on 1 February 2021 was specifically asked whether maximum medical improvement had been achieved, and advised:[11]“Mr Hesketh has reached Maximum Medical Improvement.”
[11] Appeal papers p 343.
Further, the treatment recommended by the MA was for “further treatment – including psychiatric and psychological consultations...”. The MA noted that Mr Hesketh was already undergoing such treatment, although he gave no indication of when such treatment began. However the clinical notes recorded by Dr Allnutt showed that Mr Hesketh had been attending Ms Marcia Lucchese, for psychological treatment from 26 March 2018 to 7 May 2018;
Dr Gerull on 11 November 2019 noted panic attacks and post-traumatic stress disorder(PTSD); and Mr Hesketh consulted the late Dr Selwyn Smith from 18 March 2020.[12][12] Appeal papers pp 68-69.
We note the comment by the MA that Ms Lucchese’s treatment showed significant improvement and that the appellant was “in virtual remission” when he suffered his injury of
16 May 2018. However the subsequent worsening of Mr Hesketh’s condition was nonetheless, as the MA himself noted, a recurrence of the subject injury.The MA also stated that “medication trials” were needed. Dr Allnutt’s research showed that Mr Hesketh had been prescribed antidepressant medication as at 11 November 2019; he had been prescribed Zoloft on 6 November 2019, Lexapro and “new medication” as at
18 March 2020, Temaze as at 29 April 2020, and Effexor as at 19 May 2020. The MA failed to discuss that and other earlier medication, and he gave no reasons as to why further trials were necessary.The MA also suggested that EMDR (eye movement desensitization and reprocessing) and “possibly” hospital admission should be considered. No reasons were given as to why EMDR would improve Mr Hesketh’s condition. Further, Mr Hesketh had been attending St John of God Hospital one day a week for 12 weeks from April 2020, and the MA did not give any adequate reasons as to why a “possible” hospital admission might have any further benefit.
The MA also suggested that the resolution of Mr Hesketh’s marital situation, which had been ongoing since at least October 2020, as reported by Dr Allnutt, would be one of the factors that would improve and stabilise Mr Hesketh’s condition. The MA gave no reasons for making that assumption which, in the light of the history of the marital situation, appeared to be unlikely to occur within 12 months.
Accordingly, we find that the MA has fallen into error in his finding that maximum medical improvement had not been achieved. His reasons were peremptory, and he gave no adequate explanation for his determination.
Causation
Both Dr Vickery and Dr Allnutt took histories of the incident of 16 May 2018 that were consistent with that taken by the MA.[13] Dr Allnutt was of the view that the subject injury:
“…has made a substantial contribution to his current mental state likely aggravated by his knee injury.”
[13] Dr Vickery at Appeal papers p 340: Dr Allnutt at p 65.
Dr Vickery noted a history that about nine months after the subject injury:
“…‘several of the clients had got out of the van and I saw another vehicle was reversing into the car park next to the van and I jumped out of the van to be with the clients’….”
Both experts however made their assessments on the basis that the psychiatric injury had been caused by the subject injury.
We note further the applicant’s statement of 1 July 2021[14] which did not mention the injury of 16 May 2018. However in the s 78 notice dated 17 February 2021 the insurer noted the
16 May 2018 injury and that it “resulted in a flare up of his psychological symptoms and has led to the current PTSD diagnosis”[15]. It accordingly cannot be said that the respondent had agreed to the referral without being fully aware of the 2018 injury.[14] Appeal papers p 46.
[15] Appeal papers p 58.
Matters of causation are sometimes difficult to establish, and since Bindah[16] there has been no doubt that an MA or a medical appeal panel has power to make determinations regarding causation in the medical field. However, following Bindah the decision of Jaffarie[17] has confirmed that the determination of whether a worker has received an injury as defined by s 4 of the 1987 Act or whether there are any disentitling provisions, is within the exclusive jurisdiction of the Commission.
[16] Bindah v Carter Holt Harvey Woodproducts Australia Pty Ltd [2014] NSWCA 264.
[17] Jaffarie v Quality Castings Pty Ltd [2018] NSWCA 88 at [80].
Further, it is now settled that the terms of the referral are binding on an MA, unless they do not reflect the intention of the parties.[18]
[18] See Skates v Hills Industries Ltd [2021] NSWCA 142.
We appreciate the concern shown by the MA, but the above principles demonstrate he was incorrect in his appreciation of his remit. Contrary to the submission by the respondent, the hesitation shown by the MA in the appreciation of his task betrayed a misapprehension, and we are not confident that it did not distract him from conducting an assessment on proper grounds. We reject the submission by the respondent that s 327(2) of the 1998 Act was of any relevance. The error made by the MA had wider implications.
In passing, we note with respect the submissions of the appellant as to the relevance of
s 322(2) of the 1998 Act, but in the absence of any explanatory submissions were unable to follow the appellant’s argument.We are accordingly satisfied that the MA has fallen into error in both finding that maximum medical improvement has not been achieved and also that there was a causation issue that may well have diverted the MA from his task.
Although the appellant did not seek a re-examination, in view of the matters we have discussed herein, a re-examination is essential to properly assess the appropriate level of impairment.
Accordingly, MA Patrick Morris examined Mr Hesketh on 28 July 2022. His opinion follows:
“PERSONAL INJURY COMMISSION
RE-ASSESSMENT FOR MEDICAL APPEAL PANEL
MatterNumber: | M1-W5373/21 |
| Applicant worker: Date of Birth: Date of Injury: | Martin Hesketh 15 January 1964 16 November 2017 |
DateofAssessment: | 28 July 2022 (via Microsoft Teams video link) |
I have focussed in this assessment upon the period since Mr Hesketh was assessed by Dr Andrew McClure for a Medical Assessment Certificate in February 2022.
Mr Hesketh said he has continued to take the same medications that he was taking at that time. He takes Venlafaxine-XR 150 mg daily. He has been able to reduce his Lorazepam dosage down to 1 mg a day and 1 mg when required for anxiety. He takes Temazepam 10 mg at night when needed to help his sleep.
Mr Hesketh has continued to see his treating psychologist, Ms Sally Blair, via video consultations on a monthly basis. He has been seeing her since March 2020.
Mr Hesketh said that his previous psychiatrist, Dr Selwyn Smith, deceased in January 2022. Mr Hesketh started seeing a new psychiatrist, Dr Scurrah, in February or March 2022 and he has been seeing him on a two-monthly basis. Dr Scurrah has not changed Mr Hesketh’s medication regime. Mr Hesketh also sees his GP, Dr Channo, on a monthly basis.Mr Hesketh reported that his symptoms have been stable for the past six months since he was assessed by Dr McClure. He still has frequent intrusive traumatic memories of the work incident that occurred on 16 November 2017. These memories are associated with strong emotions of fear and physical sensations of abdominal distress, tingling sensations in his wrists, sweating and dizziness. He said that some cooking smells and the noise of showers running would trigger these memories. He describes feeling detached and cut off from people. He said that he prefers to stay at home. He has very poor sleep and has nightmares relating to the work incident about once to twice per week. He tries to avoid thinking and talking about the traumatic work incident. He tries to avoid reminders of the incident and gave as an example that the family of the client who assaulted him lives nearby so he does not want to go shopping for fear of seeing the family, and this triggering intrusive traumatic memories for him. He describes now seeing the world as a dangerous place. He said he is “on edge” all the time. He is hypervigilant and on the lookout for danger frequently and is very jumpy at sudden noises. He describes very poor concentration and said that his mind “wanders”. He describes feeling “numb”. He finds it difficult to trust people now. He said that he has lost interest in watching football, rugby, going to the swimming club and reading.
Mr Hesketh reports feeling depressed and sad frequently, and said he is frequently close to tears. He reports having very little pleasure or enjoyment in life now. His appetite is variable and his weight fluctuates. He reports reduced energy and reduced motivation to do things. He often stays in bed. He feels a lot of guilt and self-blame about the work incident and also how it has affected his wife and son and his relationship with them. He has occasional feelings of hopelessness. He had felt his life was not worth living when his wife and son went to Japan but these feelings have improved now that they have returned to live in the same house as him.
Mr Hesketh lives in his own home in Collaroy Plateau with his wife and 10-year-old son. He is currently not working. His wife works as a travel agent from home. He has been living separately from his wife and son in a granny flat on a lower floor of the family home for the past two and a half years. He and his wife have separate finances, do not eat or socialize together and there have been no intimate relations over this period of time.
Mr Hesketh said that he goes to a supermarket to shop early in the mornings when there are few people around. He has a microwave and he heats pre-cooked food or eats take-away food or cereal and milk. He said that his wife occasionally does his clothes washing for him. He said he does not keep his flat clean. He said he does not shower because it triggers memories of the traumatic work incident and uses wipes to clean himself. He does not change his clothes often as he does not leave the home to visit other people which would motivate him to do this. He takes his dog for a walk two to three times per week. He does not go to the swimming club which he used to enjoy. He does not read or watch TV or do any social or recreational activities outside with his son or estranged wife. He has some contact with his son who visits him in his flat. He reports having no contact with friends now.
On mental state examination, Mr Hesketh was a dishevelled-looking man, looking older than his stated age, with an unkempt beard and wearing glasses. He was wearing an ironed shirt. He was cooperative but tense in his manner. His speech was soft and of normal rate and flow. His mood was depressed and anxious. His affect was appropriate to his mood and unreactive. There was no formal thought disorder and no psychotic symptoms.
Mr Hesketh was alert and orientated and able to concentrate and answer questions appropriately during the assessment.
I asked Mr Hesketh about whether he had any previous psychiatric history. He said that in 2015 just after he, his wife and son had migrated to Australia, he was treated by a GP for anxiety and sleeplessness. He is not sure if he took medications and if he did, it was only for a short period of time. He said that he remembers this anxiety being related to the stress of moving to Australia and having to look for a house and having a two-year-old son at the same time. He reported no on-going treatment or symptoms and did not see a psychologist at that time.
My diagnostic opinion is that Mr Hesketh suffers with the psychiatric conditions of Posttraumatic Stress Disorder and Major Depressive Disorder. I believe that his condition is well-stabilised and that he has reached maximum medical improvement.”
We adopt the report of MA, Morris. Although it is suggested that there was a prior injury in 2015, the records show that that was one episode of treatment for anxiety and insomnia and did not of itself constitute a psychiatric condition or cause any impairment that contributed to the present WPI.
For these reasons, the Appeal Panel has determined that the MAC issued on 7 March 2022 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
PERSONAL INJURY COMMISSION
Table 11.8: PIRS Rating Form
| Name | Martin Hesketh | Claim reference number | M1-W5373/21 |
| Date of Injury | 16/11/2017 | ||
| Date of Assessment | 28/07/2022 |
| Psychiatric diagnoses | 1.Posttraumatic Stress Disorder | |
| 2.Major Depressive Disorder | ||
| Is impairment permanent? | Yes | |
PIRS Category | Class | Reason for Decision |
| Self Care and personal hygiene | 2 | Mild impairment. Mr Hesketh is living independently. He does his own shopping and is able to cook simple pre- heated meals using a microwave. He does not shower regularly or change his clothes. His wife occasionally does his clothes washing. |
| Social and recreational activities | 3 | Moderate impairment. Mr Hesketh generally remains quiet and withdrawn in his home. His only outing is to take his dog for a walk by himself, two to three times per week. He said occasionally his son visits him in his granny flat. He has lost interest in watching sports, swimming and reading. |
Travel | 2 | Mild impairment. Mr Hesketh is only able to drive short distances by himself such as to the shops and to see his GP. He can go for a walk in his local area with his dog. He said that if he had to travel longer distances, he would need to be accompanied by another person because of his marked anxiety. |
Social functioning | 4 | Severe impairment.Mr Hesketh and his wife have been living separately for the past two and a half years because she could not cope with his psychological symptoms. They live in separate levels of the same house. They have had no intimate relations over this time, do not eat or socialize together and manage their own finances separately. He reports having a very distant relationship with his 10-year- old son. He said that he has lost all his friendships and has almost no contact now with his family who live in the United Kingdom. |
| Concentration, persistence and pace | 3 | Moderate impairment. Mr Hesketh complains of very poor concentration and memory. He said that he can only potter in the garden or feed his wife’s chickens for short periods. He is only able to drive for about five minutes’ duration because of reduced concentration. |
| Employability | 5 | Totally impaired. Mr Hesketh’s severe symptoms of Posttraumatic Stress Disorder and Major Depressive Disorder including his marked agitation, hypervigilance, reduced motivation, poor concentration, depressed mood and reduced energy levels would prevent him from working at all. |
Score Median class
| Aggregate Score Impairment | Total | ||||||||||
| +2 | +2 | +3 | +3 | +4 | +5 | = 19 | |||||
| Impairment Percentage WPI from table 11.8: | 24 % | ||||||||||
| Less pre-existing impairment if any: | Nil | ||||||||||
| Final Impairment % WPI: | 24 % | ||||||||||
PERSONAL INJURY COMMISSION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter Number: | W5373/21 |
Applicant: | Martin Hesketh |
Respondent: | Sunnyfield |
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 Andrew McClure and issues this new Medical Assessment Certificate as to the matters set out in the Table below:
Table - Whole Person Impairment (WPI)
| Body Part or system | Date of Injury | Chapter, page and paragraph number in NSW workers compensation guidelines | Chapter, page, paragraph, figure and table numbers in 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) |
| Psychological injury | 16/11/2017 | Chapter 11 | 24% | 24% | ||
| Total % WPI (the Combined Table values of all sub-totals) | 24% | |||||
0
6
0