Hills Industries Ltd v Skates - [2022] NSWPICMP 424

DETERMINATION OF APPEAL PANEL
CITATION:	Hills Industries Ltd v Skates [2022] NSWPICMP 424
APPELLANT:	Hills Industries Limited
RESPONDENT:	Anthony Earl Skates
Appeal Panel
MEMBER:	Paul Sweeney
MEDICAL ASSESSOR:	Dr Gregory McGroder
MEDICAL ASSESSOR:	Paul Sweeney
DATE OF DECISION:	26 October 2022
CATCHWORDS:	wORKERS cOMPENSATION - Medical dispute referred for assessment of “Left Upper Extremity (wrist, joint of ring finger)” and Scarring; Medical Assessor (MA) diagnosed Complex Regional Pain Syndrome (CRPS) which did not meet the criteria in Chapter 17 of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (4^th ed, 1 April 2016) (Guidelines) but accepted that the condition resulted from injury; he assessed each of the joints in the worker’s left upper extremity in accordance with Chapter 16 of the Guidelines and certified that he suffered 53% whole person impairment (WPI); employer argued that worker should have be assessed in accordance with the Referral; Skates v Hills Industries Ltd considered and applied; Held – MA required to assess WPI in accordance with the medical dispute referred for assessment; neither the Referral, the worker’s letter of claim, nor the medical evidence on which it was based permitted an assessment of all joints of the left upper extremity; Medical Assessment Certificate (MAC) revoked and new MAC issued assessing the body parts/systems referred for assessment.

BACKGROUND TO THE APPLICATION TO APPEAL

On 6 July 2022 Hills Industries Limited (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Todd Gothelf, a Medical Assessor (MA, formerly an Approved Medical Assessor), who issued a Medical Assessment Certificate (MAC) on 9 June 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,
· 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 grounds 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, 4^th ed 1 April 2016 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

RELEVANT FACTUAL BACKGROUND

Anthony Earl Skates (the respondent) suffered injury to his left hand and wrist in the course of his employment with the appellant on 7 June 2013. While installing a Foxtel dish on…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Hills Industries Ltd v Skates

Details

AGLC: Hills Industries Ltd v Skates [2022] NSWPICMP 424
Case: [2022] NSWPICMP 424
Decision Date: 26 October 2022

CaseChat Overview and Summary

Hills Industries Ltd was the respondent in a dispute brought by the worker, Skates, before the New South Wales Civil and Administrative Tribunal. The dispute centred around a medical assessment of Skates' left upper extremity, which was referred for evaluation of the wrist, joint of the ring finger, and scarring. The Medical Assessor diagnosed Complex Regional Pain Syndrome, a condition which, while accepted to be injury-related, did not meet the criteria for assessment in Chapter 17 of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment (4th ed, 1 April 2016). Instead, the Assessor assessed each of the joints in Skates' left upper extremity in accordance with Chapter 16 of the Guidelines and certified a 53% whole person impairment. The employer argued that Skates should have been assessed in accordance with the specific referral made.

The court needed to determine whether the Medical Assessor was required to confine the assessment to the specific body parts referred for assessment or whether he could assess other parts of the body. The court referred to Skates v Hills Industries Ltd to assist in its decision, finding that the Medical Assessor was indeed required to confine the assessment to the body parts referred for assessment. The court found that neither the Referral, Skates' letter of claim, nor the medical evidence on which it was based permitted an assessment of all joints of the left upper extremity.

Consequently, the Tribunal revoked the Medical Assessment Certificate and issued a new one assessing only the body parts and systems referred for assessment. This decision underscores the importance of adhering to the specific parameters of a medical dispute referral in workers' compensation cases. The Tribunal's ruling ensures that assessments remain focused on the referred conditions, thereby maintaining the integrity and specificity of the assessment process.

Orders