Hulme v QBE Management Services Pty Limited
[2023] NSWPICMP 166
•28 April 2023
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Hulme v QBE Management Services Pty Limited [2023] NSWPICMP 166 |
| APPELLANT: | Liane Catherine Hulme |
| RESPONDENT: | QBE Management Services Pty Limited |
| Appeal Panel | |
| MEMBER: | Brett Batchelor |
| MEDICAL ASSESSOR: | Doug Andrews |
| MEDICAL ASSESSOR: | Graham Blom |
| DATE OF DECISION: | 28 April 2023 |
CATCHWORDS: | wORKERS cOMPENSATION - Appeal by worker against findings in Medical Assessment Certificate (MAC) in respect of the psychiatric impairment rating scale (PIRS) categories of: self-care and personal hygiene, social and recreational activity, social functioning, concentration, persistence and pace, and employability; review of evidence and comprehensive summary thereof in the MAC; Held – decision of the Appeal Panel that the findings of the Medical Assessor in respect of concentration, persistence and pace and employability should be overturned; MAC revoked and fresh MAC issued. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 6 January 2023 Liane Catherine Hulme (the appellant/Ms Hulme) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Yu-Tang Shen, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 14 December 2022.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 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.
Rule 128 of 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 r 128(1) of the PIC Rules.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).
RELEVANT FACTUAL BACKGROUND
The appellant commenced work for QBE Management Services Pty Limited (the respondent) as a full-time credit control officer in 2008. Her duties primarily involved managing the respondent’s key clients, both government and non-government organisations, and their payments of greenslip and compulsory third party (CTP) policies. These duties included follow-up with clients in cases where there were issues with late payments.
The appellant experienced problems with completing the end of month work loads and approached her team leader for help. The need for assistance was acknowledged by the team leader but, such as it was, help offered did not assist Ms Hulme. Similarly, a high staff turnover contributed to the problem.
In about April 2019 claimed negative treatment from co-workers, and a number of other small incidents, resulted in the appellant becoming very mentally unwell. She started to experience panic attacks, both in the workplace and at home from where she worked on Mondays prior to the onset of her workplace injury. She was nauseous and physically unwell before going to work, and experienced continuous anxiety before and at work.
In May 2019 the appellant had a family situation with two of her sons who refused to attend a baby shower being held for her third son. This devastated Ms Hulme, as a result of which she ended up in a catatonic on the bathroom floor, and took four days off work.
On or about 7 May 2019 the appellant informed her team leader that she was having problems with mental health. Human Resources (HR) became involved in September 2019, and Ms Hulme was assigned an occupational therapist to work with her in an attempt to identify the causes of her anxiety.
The appellant’s problems with work continued throughout the rest of 2019, and by December 2019 her anxiety increased to the extent that she was finding it difficult to function. Her first certificate of capacity was issued in January 2020. On 11 February 2020 Ms Hulme attended work, but became very upset when a colleague enquired after her welfare. She had to leave work, but returned later in the day, and again became very upset in front of her team who were asked to observe how unwell she was. Ms Hulme left work and has not worked since that date.
As at August 2021 Ms Hulme was being treated by her general practitioner, Dr Nina Robertson, Ms Samantha Simmons, psychologist, and Dr Tim Mac Donald, psychiatrist. She had in the past experienced upheaval with treating practitioners who moved away or took maternity leave.
The appellant was independently medically examined by Dr Phillip Brown, psychiatrist, on behalf of the respondent’s insurer, icare Workers Insurance (icare), on 28 May 2020 and 16 August 2021. Dr Brown produced reports dated 10 November 2020[1] and 6 October 2021,[2] and a supplementary report darted 22 October 2021.[3]
[1] Appeal Papers (AP) p 765.
[2] AP p 812.
[3] AP p 863
The appellant was independently medically examined by Dr Frank Chow, psychiatrist, at the request of her solicitors on 1 September 2021. Dr Chow produced a report dated 16 September 2021.[4]
[4] AP p 118.
PRELIMINARY REVIEW
The Appeal Panel (the Panel) conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
As a result of that preliminary review, the Panel determined that it was not necessary for the worker to undergo a further medical examination. Although the appellant requested that she be examined by a Medical Assessor who is a member of the Panel, it considers that there is sufficient information in the AP on which to base its decision.
EVIDENCE
Documentary evidence
The 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.
Appellant
In summary, the appellant submits that the Medical Assessor has fallen into error in respect of the following:
(a) failure to properly refer to and consider [11.12] of the Guidelines and the classes for each of the following rating psychiatric impairment rating scales (PIRS):
(i)Self care and personal hygiene (Table 11.1);
(ii)Social and recreational activities (Table 11.2);
(iii)Social functioning (Table 11.4);
(iv)Concentration, persistence and pace (Table 11.5), and
(v)Employability (Table 11.6).
(b) the Medical Assessor does not refer to the requirements of [11.12] of the Guidelines, or the differences in classes which are set out in Tables 11.1, 11.2, 11.4, 11.5 and 11.6;
(c) the reasoning process by which the Medical Assessor arrived at his determination for each class for each of the scales is inadequate;
(d) the Medical Assessor has failed to consider activities that are usual for the appellant’s age, sex and cultural norms when assessing the appellant as required by [11.12] of the guidelines, and
(e) the Medical assessor has not set out the relevant descriptors of the competing classes for each category under the PIRS, and/or he has not considered those alternatives when making his assessment. The failure to do so is a demonstrable error and a failure to apply the correct criteria.
The appellant submits that in respect of self care and personal hygiene, the focus of the descriptors in this scale is on injured workers’ ability to adequately care for themselves and maintain their own personal hygiene. After referring to the Reasons for Decision given by the Medical Assessor, the appellant submits that the facts cited are at least more consistent with Class 3.
In the alternative, the appellant submits that based on the Medical Assessor’s factual findings set out in the MAC there was more than one conclusion open to assess between Classes 2 and 3 for this category, and that it was incumbent on him to provide adequate reasons as to why he preferred Class 2 over Class 3. His failure to do so is an error of law.
The appellant submits that in respect of social and recreational activity the Medical Assessor erred when characterising the appellant:
(a) enjoying crocheting or knitting as being relevant to the PIRS scale for social and recreational activity, citing Ballas v Department of Education & Communities.[5] This evidence falls into the separate category of concentration, persistence and pace, and
(b) maintaining contact with and/or seeing 3-4 close friends as being relevant to the PIRS scale for social and recreational activity. This evidence falls into the separate category of social functioning.
[5] [2020] NSWCA 86 (Ballas).
The appellant submits that the assessment of Class 2 by the Medical Assessor is not consistent with his factual findings recorded in Table 11.8 of the MAC.
The appellant submits that the meaning of social or recreational activities involves some degree of interaction with others, whether assessed as Class 1 or Class 5. The appellant submits that, having regard to the description recorded by the Medical Assessor in his Reason for Decision, the findings are more consistent with Class 3.
In the alternative, the appellant makes the same submission in respect of social and recreational activities as she makes in respect of self care and personal hygiene recorded at [22] above.
The appellant submits that in respect of social functioning, the assessment in Class 2 is not consistent with the Medical Assessor’s factual findings recorded in Table 11.8 of the MAC.
The appellant submits that since the injury, her previously established relationships with friends have become strained. She does not see her friends as much as previously, has lost some friendships, and while she continues to see her children has experienced multiple issues with her children and family. These facts are more consistent with Class 3.
In the alternative, the appellant makes the same submission in respect of social functioning as she makes in respect of self care and personal hygiene recorded at [22] above.
The appellant submits that in respect of concentration, persistence and pace, the assessment in Class 2 is not consistent with the Medical Assessor’s factual findings recorded in Table 11.8 of the MAC.
At [31] of her submissions[6] the appellant summarises the Reason for Decision given by the Medical Assessor in Table 11.8 of the MAC, then submits that she is often unable to complete a crochet project due to numerous mistakes, despite having crocheted since she was very young. The appellant also asserts at [32] of her submissions that the Medical Assessor cut her off whilst she was speaking on multiple occasions throughout the assessment and did not allow her to complete stating information relevant to the assessment, even when responding to a question from him, including when answering questions regarding her crochet. (Comment: there does not appear to be evidence of the inability of the appellant to complete a crochet project, of being cut off by the Medical Assessor on multiple occasions whilst speaking, or failing to allow her to complete stating information relevant to the assessment.)
[6] AP p 15.
The appellant submits that the facts referred to are at least more consistent with Class 3.
In the alternative, the appellant makes the same submission in respect of concentration, persistence and pace as she makes in respect of self care and personal hygiene recorded at [22] above.
The appellant submits that the assessment of Class 3 for employability by the Medical Assessor is not consistent with his factual findings recorded in Table 11.8 of the MAC.
The appellant submits the facts recorded in his Reason for Decision in Table 11.8 of the MAC, are more consistent with Class 5, or at least Class 4 for employability.
In the alternative, the appellant submits that based on the Medical Assessor’s factual findings set out in the MAC there was more than one conclusion open to assess between Classes 3 and 5 for this category, and that it was incumbent on him to provide adequate reasons as to why he preferred Class 3 over Class 4 or Class 5. His failure to do so is an error of law.
The appellant submits that the Medical Assessor failed to have regard to or consider the reports of Dr Stirling Carlsen dated 22 August 2022[7] and 21 September 2022.[8] The appellant notes that these reports are the most recent medical evidence in the proceedings and provide a history of her physical manifestations of anxiety and panic attacks resulting in trips to hospital. The applicant submits that this evidence is relevant in the context of an assessment of whole person impairment (WPI) being carried out less than three months later. The appellant submits that it was incumbent on the Medical Assessor to consider the content of these reports and to specifically outline them as he has done with other evidence at the commencement of the MAC. His failure to do so is an error of law.
[7] AP p 964.
[8] AP p 966.
The appellant asserts that a further medical examination is required by a Medical Assessor.
Respondent
In reply, the respondent submits that it was open to the Medical Assessor to assess the appellant as falling within the Classes specified in the PIRS rating form in the MAC. The Medical Assessor has given reasons to account for the basis upon which he has assessed the appellant in respect of each category.
The respondent summarises Class 2 of the PIRS category for self-care and personal hygiene, and submits that Class 2 was a finding that was open to him using his clinical judgement on the day of the examination, and ought not to be disturbed.
The respondent summarises Class 2 of the PIRS category for social and recreational activity and notes that the Medical Assessor reports that the appellant attends a crocheting group most weeks. She now has three to four close friends, whom she maintains contact with every couple of weeks, and she sees once a month. Medical Assessor Shen notes that although she does not engage as much, and attends these social gatherings less frequently, on six occasions in the past year the appellant stayed for the whole time.
The respondent submits that the crochet group that the appellant attends most weeks involves some degree of interaction with others, and is hence a relevant consideration in this Category. Class 2 assessed by the Medical Assessor was appropriate.
The respondent refers to the example provided in the PIRS category for social functioning and notes the Medical Assessor’s recording that the appellant is living alone but regularly sees her four children. She has lost some friendships but has three to four close friends with whom she maintains contact every couple of weeks and sees once a month.
The respondent submits that having regard to the facts recorded by the Medical Assessor, the Class 2 categorisation was appropriate.
The respondent notes the history recorded by the Medical Assessor in respect of concentration, persistence and pace, but also notes his observation that the appellant was able to sustain her attention for the duration of his assessment. In this circumstance, the respondent submits that Class 2 for concentration, persistence and pace was open to him and appropriate on the history he recorded. Class 2 ought to be confirmed.
The respondent notes the history recorded by the Medical Assessor for employability, and his recording of the appellant’s desire to return to work, even in a different role. The Medical Assessor highlights that the appellant’s level of symptoms and functioning would allow her to work to some degree without total incapacity, but would require significant support and a gradual return to work at a reduced pace and complexity.
The respondent submits that Class 3 for employability was appropriate.
In response to the appellant’s submission that the Medical Assessor failed to have regard to, or consider, the reports of Dr Stirling Carlsen, the respondent notes that the Medical Assessor has specifically outlined review of evidence “…as listed in the referral from the Commission”, under “Documentary Evidence” on the first page of the MAC. He has not referenced a multitude of documents outlined in the amended referral from the Personal Injury Commission dated 15 November 2022. The Medical Assessor nevertheless did acknowledge the appellant’s physical manifestations of anxiety and panic attacks on several occasions in the MAC.
The respondent submits that the view that one class in the PIRS categories is more appropriate than another reflects only a difference of opinion and is not a demonstrable error. The respondent submits that more than a mere difference of opinion on a subject about which reasonable minds may differ is required to establish an error when the assessment is to be made on the behavioural consequences of a psychiatric condition or disorder. In this regard, the respondent relies on what Campbell J said in Ferguson v State of New South Wales.[9]
[9] (2017) NSWSC 887.
The respondent submits that the Guidelines specify at [1.6] that a Medical Assessor is to exercise clinical judgment on the day of examination in assessment of the appellant in each of the PIRS categories. The pre-eminence of the clinical observations of the Medical Assessor in determining the relevant class within each PIRS category cannot be understated, citing NSW Police Force v Danial Wark.[10]
[10] [2012] NSWWCCMA 36.
The respondent submits that it was open to the Medical Assessor Shen to use his skill, judgment, and expertise to conclude as he did, and that the appellant worker was assessed appropriately.
The respondent submits that the MAC issued by the Medical Assessor containing an assessment of 7% WPI should be confirmed.
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. Once error is made out, the Panel may “review” the MAC. (see Siddik v Workcover Authority of NSW[11] and NSW Police Force v Registrar of the Workers Compensation Commission of New South Wales[12]).
[11] [2008] NSWCA 116.
[12] [2013] NSWCA 1792.
In Campbelltown City Council v Vegan[13] 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.
[13] [2006] NSWCA 284.
The appellant challenges the assessment of the Medical Assessor in respect of her classification in five of the six PIRS categories. The appellant does not challenge the classification in the Travel category, confirming to the Panel that the inclusion of this category in [10.(a)(ii)] of her submissions dated 6 January 2023 was a typographical error.
The Medical Assessment Certificate
The Medical Assessor has provided a comprehensive review of the documentary evidence he was sent, in particular Documentary Evidence at p 1 of the MAC[14] and the Relevant Medical Records at p 10 of the MAC.[15] The appellant notes however that reference is not made to the reports of Dr Stirling Carlsen, cardiologist, dated 22 August 2022 and 21 September 2022, and that it was incumbent on the Medical Assessor to consider the content of those reports and to specifically outline the same as he has done with other evidence at the commencement of the MAC.
[14] AP p 26.
[15] AP p 35.
The Panel does not accept this submission. It is not required of a Medical Assessor to refer to every piece of evidence before him, and as submitted by the respondent, the Medical Assessor does record the present symptoms experienced by Ms Hulme as being of predominantly anxious mood with ongoing panic attacks, less frequent, and only a couple of such attacks a week. Dr Carlsen saw the appellant on two occasions, in August and September 2022, and noted that she enjoyed crocheting, but that social activities had diminished with the worsening of the anxiety and depression. He was able to reassure the appellant after a CT coronary angiogram that she had no evidence of any coronary disease and did not require a cardiologist at that stage. The Medical Assessor saw the appellant on 5 December 2022. In his assessment of social and recreational activities he noted the less frequent attendance at social gatherings, noting six occasions in the past year and the maintenance of contact with three to four close friends every couple of weeks.
Self care and personal hygiene
The descriptor for Class 2 for self care and personal hygiene is:
“Mild impairment: Able to live independently; looks after self adequately, though may look unkempt occasionally; sometimes misses a meal or relies on take-away food.”
The descriptor for Class 3 is:
“Moderate impairment: Can't live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit) 2-3 times per week to ensure minimum level of hygiene and nutrition.”
The Reason for Decision given by the Medical Assessor in Table 11.8 is:
“She generally eats one or two meals a day, and she doesn’t prepare her meals, and she either eats biscuits or chips, or her daughter will cook, or she will get takeaway. She doesn’t shower every day and can dress herself. She finds showering a real trigger. She can still look after herself, though to the standard of her baseline, hence she has mild impairment.
She is currently living in Goonellabah, Lismore. She lives alone now, and her daughter was living with her in the past 12 months from January to September 2022, but she has moved out. She has four children, whom she sees regularly. She has a sister. She previously had a lot of friends and would socialise extensively.”
The Panel notes that the references to the appellant seeing her four children regularly and to her sister, and that she previously had a lot of friends and would socialise extensively, is not relevant to this category (see Ballas at [84] and [93]). The Medical assessor notes that the appellant eats a poor quality diet and does not attend to hygiene, but successfully lives independently.
Clause [1.6] of the Guidelines notes that assessing permanent impairment involves clinical assessment of the claimant as they present on the day of assessment taking account of the claimant’s relevant medical history and all available relevant medical information to make a determination. Clause [11.12] notes that the examples of activities are examples only. The assessing psychiatrist should take account of the person’s cultural background, and consider activities that are usual for the person’s age, sex and cultural norms.
The assessment of the appellant in Class 2 for self care and personal hygiene in this case is one where reasonable minds may differ. However, having regard to the evidence referred to by the Medical Assessor in the MAC and his Reason for Decision, the Panel is of the view that the assessment of the Medical Assessor of Class 2 this category is appropriate and should be confirmed.
Social and recreational activities
The descriptor for Class 2 for social and recreational activities is:
“Mild impairment; Occasionally goes to such events eg without needing a support person, but does not become actively involved (eg dancing, cheering favourite team).”
The descriptor for Class 3 is:
“Moderate impairment: Rarely goes out to such events, and mostly when prompted by family or close friend. Will not go out without a support person. Not actively involved, remains quiet and withdrawn.”
The Reason for Decision given by the Medical Assessor in Table 11.8 is:
“She now only enjoys crocheting and knitting. She has a crocheting group, and she attends most weeks. She now has 3-4 close friends, whom she maintains contact every couple of weeks, and she sees them once a month. They previously go out on weekly, and now she attends those social gatherings less frequently, on 6 occasions in the past year, and she would remain for the whole time, though she doesn’t engage as much.
Hence she has mild impairment.”
The Panel is of the view that the fact that the appellant enjoys crocheting and knitting is irrelevant to this category. However the remainder of the Medical Assessor’s Reason for Decision is consistent with a Class 2, and the appellant should be assessed as such.
Social functioning
The descriptor for Class 2 for social functioning is:
“Mild impairment: Existing relationships strained. Tension and arguments with partner or close family member, loss of some friendships.”
The descriptor for Class 3 is:
“Moderate impairment: Previously established relationships severely strained, evidenced by periods of separation or domestic violence. Spouse, relatives or community services looking after children.”
The Reason for Decision given by the Medical Assessor in Table 11.8 is:
“She is currently living in Goonellabah, Lismore. She lives alone now, and her daughter was living with her in the past 12 months from January to September 2022, but she has moved out. She has four children, whom she sees regularly. She has a sister. She previously had a lot of friends and would socialise extensively. She now has 3-4 close friends, whom she maintains contact every couple of weeks, and she sees them once a month. Given the loss of some friendships, she has mild impairment with her social functioning.”
The Panel is of the view that the Reason for Decision given by the Medical Assessor is consistent with Class 2, which was the Class assigned by both Dr Chow and Dr Brown. The Panel is of the view that Class 2 for social functioning is the correct classification.
Concentration, persistence and pace
The descriptor for Class 2 for concentration, persistence and pace is:
“Mild impairment: can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache.”
The descriptor for Class 3 is:
“Moderate impairment: Unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.”
The Reason for Decision given by the Medical Assessor in Table 11.8 is:
“Her concentration has been poor, and she struggles to concentrate and focus on movies, unless she enjoys the movies when she will re-watch it a few times. She cannot read much now, and she cannot recall what she has read recently. She was able to sustain her attention for the duration of the assessment. She has been able to undertake crocheting regularly. Hence she has mild impairment.”
The Panel does not accept the reasoning of the Medical Assessor for placing the appellant in Class 2 for concentration, persistence and pace. His description of Ms Hulme’s activities is consistent with Class 3 in this category. Both Dr Chow and Dr Brown classify her as moderately impaired. Dr Chow notes that Ms Hulme has poor concentration and poor focus, gets confused, and gets lost in her thoughts easily. Dr Brown records the appellant’s description of a subjective impairment concentrating, etcetera, but notes that she had no objective problem concentrating and attending to his assessment which lasted 100 minutes.
The Panel is of the view that Class 3 is the correct classification for concentration, persistence and pace.
Employability
The descriptor Class 3 for employability is:
“Moderate impairment: Cannot work at all in same position. Can perform less than 20 hours per week in a different position, which requires less skill or is qualitatively different (eg less stressful).”
The descriptor for Class 4 is:
“Severe impairment: Cannot work more than one or two days at a time, less than 20 hours per fortnight. Pace is reduced, attendance is erratic.”
The descriptor for Class 5 is:
“Totally impaired: Cannot work at all.”
The Reason for Decision given by the Medical Assessor in Table 11.8 is:
“She is not working at all now. Since leaving her work, she had engaged a rehabilitation provider, but she was not able to return to work, nor able to engage in volunteer work. She is currently on worker compensation.
She is wanting to return to work, and even a different role, though she is not sure how she will learn something new, given she has ongoing symptoms of anxiety and panic, and she finds her concentration poor and she loses track of her conversation and struggles to communicate well.
Overall, given the level of symptoms and functioning, she would still be able to do work to some degree, without total incapacity, but this would require significant support and graduated return, at a reduced pace and complexity.”
The Panel is of the view that the Medical Assessor has failed to give adequate reasons why he considered Class 3, moderate impairment, appropriate. He notes that Ms Hulme was not working at all. It appears from the evidence that she has not worked in three years since ceasing work for the respondent. She has been predominantly certified in WorkCover certificates of capacity in evidence to have no capacity for any employment, and also to be fit for four hours a week on a return-to-work programme,[16] but this has not been put into effect and remains untested.
[16] AP pp 946-962.
Dr Chow classifies the appellant as remaining totally unfit for work. Dr Brown places her in Class 4, severely impaired, saying that taking her presentation at face value she is totally unfit for employment. However, in his opinion this is exaggerated, and he discounts the classification from Class 5 to Class 4.
Having regard to the matters referred to in [81] above, and that the appellant is moderately impaired in respect of concentration, persistence and pace, the Panel is of the view that the Ms Hulme is totally impaired for employment, and cannot work at all.
On the evidence before the Panel, Class 5 for employability is the best fit, and Ms Hulme should be so classified.
Calculation of WPI
The Panel therefore finds that the appellant should be classed as follows in respect of the categories the subject of appeal:
(a) Self care and personal hygiene (Table 11.1) – Class 2;
(b) Social and recreational activities (Table 11.2) – Class 2;
(c) Social functioning (Table 11.4) – Class 2;
(d) Concentration, persistence and pace (Table 11.5) – Class 3, and
(e) Employability (Table 11.6) – Class 5.
Using the Conversion Table 11.7 in the Guidelines, the appellant’s WPI is calculated as follows:
Score
Median Class
2
2
2
2
3
5
=2
Aggregate Score Impairment
Total
%
+2
+2
+2
+2
+3
+5
16
9
For these reasons, the Appeal Panel has determined that the MAC issued on 14 December 2022 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
WORKERS COMPENSATION DIVISION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter number: | W4415/22 |
Applicant: | Liane Catherine Hulme |
Respondent: | QBE Management Services Pty Limited |
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 Yu-Tang Shen 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) |
| Psychiatric disorder | 28 January 2020 (deemed) | Chapter 11, Page 54 | 9 | 0 | 9 | |
| Total % WPI (the Combined Table values of all sub-totals) | 9 | |||||
0
3
4