Insurance Australia Limited t/as NRMA Insurance v Schuettpelz
[2025] NSWPICMP 45
•22 January 2025
| DETERMINATION OF REVIEW PANEL | |
CITATION: | Insurance Australia Limited t/as NRMA Insurance v Schuettpelz [2025] NSWPICMP 45 |
CLAIMANT: | Michael Schuettpelz |
INSURER: | Insurance Australia Limited, ABN 11 000 016 722, trading as NRMA Insurance |
REVIEW PANEL | |
MEMBER: | Terence Stern OAM |
MEDICAL ASSESSOR: | David McGrath |
MEDICAL ASSESSOR: | David Gorman |
DATE OF DECISION: | 22 January 2025 |
CATCHWORDS: | MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; Motor Accident Compensation Regulation 2020 (the Regulation); medical assessment of whole person impairment (WPI) by Medical Assessor and review under section 7.23; claimant injured in motor vehicle accident of April 2019; issue of degree of WPI; review of Medical Assessment; Held – Panel revoked certificate of Medical Assessor; substituted determination of 10% WPI. |
DETERMINATIONS MADE: | CERTIFICATE OF DETERMINATION
|
STATEMENT OF REASONS
INTRODUCTION
Michael Schuettpelz (Mr Schuettpelz), the claimant, was born in April 1959.
On 29 April 2010, Mr Schuettpelz was injured in a motor vehicle accident (the accident).
Mr Schuettpelz has brought a claim for common law damages for the injuries he sustained under the Motor Accident Injuries Act 2017 (the MAI Act).
Insurance Australia Limited, ABN 11 000 016 722, trading as NRMA Insurance (NRMA) is the relevant insurer.
A medical dispute about the degree of Mr Schuettpelz’s whole person impairment (WPI) has arisen. This constitutes a medical assessment matter under Schedule 2, cl 2(a) of the MAI Act.
A medical assessment matter is determined in accordance with Division 7.5 of the MAI Act by a Medical Assessor: s 7.20 of the MAI Act.
The dispute was referred to the Personal Injury Commission (Commission) and assigned to Medical Assessor Geoffrey Miller for assessment.
On 17 March 2024, Medical Assessor Miller issued a certificate under s 7.23(1) of the MAI Act.
REVIEW PROCEDURE
NRMA sought a review of the Medical Assessment under s 7.26 of the MAI Act (the Review).
A delegate of the President of the Commission determined there was reasonable cause to suspect that the medical assessment was incorrect in a material respect and referred the matter to the Review Panel (the Panel).
The review provisions provide that a review panel consists of two Medical Assessors and a Member assigned to the Motor Accidents Division of the Commission: s 7.26(5A) of the MAI Act. The President’s delegate has convened this Panel to conduct the review of the medical assessment.
The Review of the medical assessment is not limited to a review of only that aspect of the assessment that is alleged to be incorrect. The Review is by way of a new assessment of all matters with which the medical assessment is concerned: s 7.26(6) of the MAI Act. Section 7.25 of the MAI Act provides that the review of a medical assessment can be made on the basis of any agreement by the parties as to the degree of permanent impairment from a particular injury and whether a particular injury was caused by the accident, without those matters having to be the subject of assessment.
Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the Personal Injury Commission Act 2020 (PIC Act). A review panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application: Rule 128 of the PIC Rules.
LEGISLATIVE FRAMEWORK
General provisions
14.Sections 5D and 5E of the Civil Liability Act 2002 (the CLA) apply to the MAI Act: s 3B(2) of the CLA.
Mr Schuettpelz’s claim and entitlements to compensation are governed by the provisions of the MAI Act. An injured person can make a claim for both economic losses and non-economic loss damages.
However, s 4.11 of the MAI Act provides that no damages for non-economic loss may be awarded in respect of injury unless the degree of permanent impairment of the injured person as a result of the injury caused by the motor accident is greater than 10%.
Permanent impairment assessment
Section 7.21 of the MAI Act provides that the degree of permanent impairment of an injured person is to be assessed in accordance with the Motor Accident Guidelines (the Guidelines).
The Guidelines were issued pursuant to Division 10.2 of the MAI Act and adopt the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA 4 Guides). The Guidelines are definitive in respect of the matters they address but where they are silent on an issue, the AMA 4 Guides should be followed: cl 6.2 of the Guidelines.
Permanent impairment is assessed in accordance with Chapter 6 of the Guidelines.
Causation of injury is addressed in cls 6.5, 6.6 and 6.7 of the Guidelines.
Clause 6.6 of the Guidelines notes:
“6.6 Causation is defined in the Glossary at page 316 of the AMA4 Guides as follows:
‘Causation means that a physical, chemical or biologic factor contributed to the occurrence of a medical condition. To decide that a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has, in fact, done so, it is necessary to verify both of the following:
(a)The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination. (emphasis added)
(b)The alleged factor did cause or contribute to worsening of the impairment, which is a non-medical determination.' (emphasis added)
This, therefore, involves a medical decision and a non-medical informed judgement.”
Clause 6.7 of the Guidelines states:
“There is no simple common test of causation that is applicable to all cases, but the accepted approach involves determining whether the injury (and the associated impairment) was caused or materially contributed to by the motor accident. The motor accident does not have to be a sole cause as long as it is a contributing cause, which is more than negligible. Considering the question 'Would this injury (or impairment) have occurred if not for the accident?' may be useful in some cases, although this is not a definitive test and may be inapplicable in circumstances where there are multiple contributing causes.”
Pre-existing impairment is addressed in cls 6.31, 6.32 and 6.33 of the Guidelines.
The evaluation of the permanent impairment may be complicated by the presence of an impairment in the same region that existed before the relevant motor accident. If there is objective evidence of a pre-existing symptomatic permanent impairment in the same region at the time of the accident, then its value must be calculated and subtracted from the current WPI value. If there is no objective evidence of the pre-existing symptomatic permanent impairment, then its possible presence should be ignored: cl 6.31 of the Guidelines.
Clause 6.32 of the Guidelines states:
“The capacity of a medical assessor to determine a change in physical impairment will depend upon the reliability of clinical information on the pre-existing condition. To quote the AMA 4 Guides (page 10): 'For example, in apportioning a spine impairment, first the current spine impairment would be estimated, and then impairment from any pre-existing spine problem would be estimated. The estimate for the pre-existing impairment would be subtracted from that for the present impairment to account for the effects of the former. Using this approach to apportionment would require accurate information and data on both impairments.”
Pre-existing impairments should not be assessed if they are unrelated or not relevant to the impairment arising from the motor accident: cl 6.33 of the Guidelines.
ASSESSMENT UNDER REVIEW
Medical Assessor Geoffrey Miller examined Mr Schuettpelz on 5 March 2024 and issued a certificate under s 7.23 of the MAI Act.
The following injuries were referred by the Commission for assessment:
(a) cervical spine;
(b) lumbar spine – injury to right sacroiliac joint;
(c) left upper extremity – left rotator cuff tendonitis possible frozen shoulder;
(d) right upper extremity;
(e) right lower extremity – right hip – right gluteus medius and minimus tendinopathy with a partial tear of gluteus medius;
(f) left lower extremity – left knee – significant chrondomalaciae patellae and possible meniscal cartilage tear, and
(g) skin – scarring .
Medical Assessor Miller took a detailed psychosocial history and pre-accident history at [8].
He took a history of the accident at [9]:
“On 29 April 2010 this gentleman was a pedestrian on a footpath. Two cars collided. One car mounted the curb and he was struck from behind. He claims that he went over the bonnet of the vehicle onto the roadway. He is unsure of whether he lost consciousness. He stated that the impact with the motor vehicle occurred on his right buttock.”
Medical Assessor Miller completed a clinical examination, the findings being set out at [12] to [18] in his certificate.
He reviewed the submitted documents provided by the claimant and placed particular emphasis on the imaging listed in [20].
At “Diagnosis and reasons”, Medical Assessor Miller found:
“Cervical spine:
Aggravation of degenerative disease in the cervical spine. Non verifiable radicular complaint.
Lumbar spine:
Aggravation of degenerative change.
Left upper extremity:
Restricted range of motion due to supraspinatus tendinopathy subacromial bursitis.
Right upper extremity:
No abnormality detected.
Right lower extremity:
Right trochanteric bursitis gluteal tendinopathy with decreased external rotation due to shortening of the gluteal musculature.
Left lower extremity – left knee:
No significant abnormality detected on today’s examination.
Scarring:
He has scarring in the left medial epicondyle and left shoulder which are well healed and the result of elective surgery.”
He continued at “Causation and reasons”:
“The causation for Mr Schuettpelz’s injuries to the above listed regions are as a direct result of his motor accident on 20 April 2020.
There is no doubt that he experienced considerable force to the regions listed and that the injury matches the definition in the Motor Accident’s Guidelines Version 7 1st March 2021 as listed on Page 94 6.6 – Causation means that a physical, chemical or biological factor contributed to the occurrence of a medical condition.
I believe Mr Schuettpelz’s injuries comply with this definition.”
Medical Assessor Miller concluded that the cervical spine, lumbar spine, left shoulder, and right lower extremity – right hip injuries were caused by the motor accident, but the right upper extremity, left lower extremity – left knee, and skin/scarring had resolved after being caused by the accident.
He concluded that the injuries referred to him and caused by the accident, gave rise to a WPI of 16%.
SUBMISSIONS
Claimant’s submissions, dated 4 June 2024
The claimant submits that the Medical Assessor’s certificate was dated 17 March 2024 but was emailed to the parties by the Commission on 18 April 2024, meaning any medical appeal or review application should have been filed at the Commission by 16 May 2024 and thus the application to admit late documents filed 22 May 2024 was filed outside time limits and should be dismissed.
The claimant submits that the insurer’s explanation as to the filing the review application outside the 28-day time limit was inadequate within the requirements of the Commission part 14 rule 133A.
The claimant submits that the test under the Part 14 rule 133A(5) is not satisfied and that the insurer’s solicitors have not made out exceptional circumstances through the brevity of description and in any event the substance of the explanation does not form exceptional circumstances.
The claimant submits that the insurer’s submissions regarding the permanent impairment guidelines indicate that the WPI should have been 17%, in which case no review of the medical assessment certificate is required because the percentage would actually increase rather than decrease from the existing assessment of 10% WPI.
The claimant submits that the insurer failed to engage a reasoning as to why the claimant’s continuous reporting in cervical spine pain was not related to the motor vehicle accident and failed to indicate a cause for that pathology from the motor vehicle accident. The claimant thus submits that this ground of review is without merit and should be dismissed.
The claimant submits that the left shoulder impairment was properly assessed by Dr Miller and would not cause the decision-maker to suspect that the medical assessment was incorrect in a material respect and thus the application for review should be dismissed.
NRMA’s submissions, dated 22 May 2024
The insurer submits that Medical Assessor Miller did not comply with clause 1.31-1.32 of the Motor Accident Permanent Impairment Guidelines because he failed to show how the pre-existing impairment was calculated based on objective evidence regarding the cervical spine, left shoulder, and right hip, thus constituting a material error.
The insurer submits that Medical Assessor Miller has not provided sufficient reasons that the claimant’s present impairment was caused or contributed by the subject accident and that he merely accepted that because the impairment was present 14 years after the subject accident, then it must have been caused or contributed by a more than negligible effect, by that accident.
The insurer submits that because it was not evident from the assessment how Medical Assessor Miller found it appropriate to deduct one tenth from the impairment assessment, this was an impermissible approach to apportionment regarding evidence of cervical spine disease.
The insurer submits that the Medical Assessor has failed to give sufficient, if any reasons, for the application of s 3.1(m) of the Guidelines with respect to an acromioplasty.
The insurer submits Medical Assessor Miller failed to address the claimant’s recovery from his shoulder surgery 11 years ago and explain how there is now deterioration of the shoulder such that the claimant’s impairment is now 8% upper extremity impairment (UEI).
THE PANEL’S EXAMINATION
At the first Panel meeting on 11 November 2024, it was agreed that a re-examination would be necessary in order to address the Parties’ submissions.
Background
NRMA is seeking a review of the certificate of determination of Medical Assessor Geoffrey Miller dated 17 March 2024 asserting that he had erred in his determination of WPI.
History before the accident
Mr Schuettpelz is 65 years of age and is right-handed. He was born in Seymour Victoria. He currently lives in a house in Murwillumbah with his wife, 34-year-old daughter and 11-year-old grandson.
He has two daughters who live in Brisbane.
He smokes 20 cigarettes per day.
He has two to three beers every couple of days.
In regard to previous employment, he obtained a qualification as a chef over a four-year course in the TAFE. He also obtained a Certificate in Hotel Management over three months in the TAFE. He worked for Four Seasons Motor Hotels in Tasmania. He completed his apprenticeship as a chef and then worked as a chef. He then became the hotel Duty Manager and worked in this capacity for 10 years.
When he relocated to the Gold Coast he worked as a chef at Twin Town Services Club for two years. He then worked as a chef at the Tweed District Hospital for 25 years. He then worked at the Tweed District Hospital for 10 years as Grade 2 Assistant in charge of food orders and delivery of meals.
He stated that after his accident he took long service leave and has not worked since January 2024. He is using up his long service leave before retirement.
He stated he had no medical problems prior to his accident.
He stated that he played golf, attended the gym and was a keen bass fisherman prior to his accident.
History of the accident
On 29 April 2010, Mr Schuettpelz was a pedestrian on a footpath. Two cars collided. One car mounted the curb, and he was struck from behind. He claimed that he went over the bonnet of the vehicle onto the roadway. He is unsure of whether he lost consciousness. He stated that the impact with the motor vehicle occurred on his right buttock.
History of symptoms and treatment
At the Murwillumbah Hospital, Mr Schuettpelz complained of cervical, thoracic and lumbar spine pain, also pain in his left knee. Plain X-rays were taken. No fractures were detected, and he was discharged the same day to be followed up by his local medical officer and the physiotherapist at the Murwillumbah District Hospital.
He was off work for one week.
He attended his general practitioner (GP) Dr Biles.
He had physiotherapy at Tweed District Hospital over a six month (12 treatments).
He continued to have pain in his lumbar spine and left shoulder. His GP Dr Biles arranged for him to have a CT of his lumbar spine on 17 May 2010 and X-ray ultrasound of his hip on 6 August 2010. The X-ray of the lumbar spine demonstrated degenerative change. The MRI of his right hip demonstrated a right gluteus medius and minimus tendinopathy with partial tear of the gluteus medius.
He was referred to a chiropractor Jason Henderson.
He stated that his left shoulder pain increased in mid-2011 and he was referred for left shoulder X-ray and ultrasound on 3 February 2011. This demonstrated subacromial bursitis with impingement. He was referred to Dr Michael Tong, a shoulder surgeon at the John Flynn Hospital in Tugun,
In regard to his left shoulder, Dr Tong saw him in July 2012 and diagnosed a left frozen shoulder impingement. Dr Tong noted that his shoulder problems had commenced within a few weeks of his accident. Dr Tong referred him for hydro dilatation of the shoulder which did not give any benefit.
On 8 April 2013 he proceeded to an arthroscopic capsulectomy and arthroscopic acromioplasty. Dr Tong noted that he made a full recovery following this surgery and he noted normal range of movement on 28 June 2013. His left shoulder however remained symptomatic.
Dr Tong also diagnosed a left the cubital tunnel syndrome – he had numbness of the 4th and 5th fingers on the left. An ulnar nerve transposition was performed in 2017.
Dr Tong also assessed his gluteal tendinopathy. He initially sent him for a steroid injection around the gluteal tendon insertion but recommended that he continue with conservative care in the form of physiotherapy and hydrotherapy.
He saw Dr Tong regarding his left knee pain. Dr Tong felt his symptoms were “patellofemoral in nature”.
Over the next six years he continued to have neck and lower back pain. He was referred to Dr Laurence McEntee spinal surgeon. Dr McEntee investigated his cervical and lumbar spine with an MRI performed on 30 June 2019. The cervical spine showed moderate to severe narrowing of the left C5/6 and left C6/7 intervertebral foramina. The lumbar spine showed mild degenerative disease. Dr McEntee also arranged for him to have a nerve conduction study. This demonstrated neurophysiological evidence of chronic left C6 and C7 nerve root dysfunction. There were also clinical symptoms suggestive of musculoskeletal pathology in the left shoulder.
He was reviewed by Dr McEntee on 2 August 2019. He discussed options for Mr Schuettpelz which included CT guided C6 C7 nerve blocks, or ultimately two-level cervical disc replacement.
His right hip pain continued, and he was referred to the Brisbane Hip Clinic and saw Dr Michael Ottley on 22 August 2022. Dr Ottley noted he had an acetabular tear of the right hip joint, mild chondropathy of the right hip joint and gluteal tendinopathy of the right hip. Dr Ottley recommended Mr Schuettpelz have a trial of a hyaluronic acid injection of the right hip to assess response, and if his condition did not prove a diagnostic/therapeutic arthroscopy or viscous supplementation trial. Mr Schuettpelz stated he underwent a hyaluronic acid injection which did improve your symptoms and range of motion in his right hip.
Earlier in 2024, he had some “mental issues” he reported. He was thinking about suicide. He was upset that he could not do things such as use his left shoulder above horizontal.
Subsequent injury
Nil identified.
Current treatment
Nil identified.
Current symptoms
In the cervical spine, he stated he has intermittent pain in the left paravertebral region principally in the C5 C6 C7 region. It is worse when looking up to the left. There is no radiation of the pain into his arms. He stated his pain is worse when he looks to the left or looks up. He stated that bending, stooping and lifting aggravates his problem.
In the lumbar spine, he stated he has intermittent pain in the lumbar region. There is no radiation into his legs. He stated his pain is worse if he sits for periods of about one hour. He also stated he is unable to stand for periods of greater than 60 minutes without changing position. He stated that bending, stooping and lifting also aggravates his back pain.
In the left shoulder he continues to have symptoms. He stated he has constant pain in the posterior aspect of his left shoulder in the supraspinatus and scapular region. He stated the pain in his left arm is worse if he uses it repetitively. He finds it particularly difficult to perform activities above the horizontal. He stated that his left upper extremity is weaker.
He stated that he has only occasional problems with his right arm.
He stated he has pain in the lateral aspect of his right hip in the gluteal region although it is better since he has stopped work. He stated the pain is worse when he twists to the left – the hip can cramp. He finds it difficult to squat and he stated that his pain is made worse by walking.
In the left knee he stated that he has tenderness in the lateral and superior aspects of his knee. He stated that his knee occasionally swells. He stated it does not give way. He stated it is difficult to kneel on. He stated his pain is worse when he walks up slopes or stairs.
His wife does many of the household tasks. He can look after his personal care. He finds it difficult to vacuum, sweep, mop, clean the bathroom or hang out washing. He finds it difficult to perform handyman work and wash his car. Mr Schuettpelz attends to the lawn with a ride on mower but does not tend to the garden.
He stated he can drive for periods of about two hours.
He has given up golf and bass fishing. He no longer goes to the gym. He leads a sedentary lifestyle.
Clinical examination
Mr Schuettpelz presented as a well-looking man. He was 180cm in height and weighed 74kg. His body mass index (BMI) is 23 (normal). He walked slowly. He could walk on his toes and heels. He found it difficult to squat.
Cervical spine
Mr Schuettpelz was tender to palpation over the left paravertebral region in the C5/6 region. There was no muscle guarding.
In regard to range of movement, flexion and extension was normal. Rotation to the right was normal and rotation to the left was decreased to 2/3 normal.
There was no muscle wasting in his upper extremities. Biceps circumference was 26cm on the right and left sides.
Reflexes, sensation and power were normal in the upper limbs.
Thoracic spine
There was no tenderness. There was normal flexion and extension and normal rotation to the left and right. There were no radiating chest symptoms.
Lumbar spine
Mr Schuettpelz had decreased lumbar lordosis. There was no tenderness to palpation. He had a full range of movement. Reflexes, sensation and power was normal in the lower limbs. There was no muscle wasting. Straight leg raising was normal.
Upper extremities
Shoulder movements were mildly restricted on the left as outlined below.
Shoulder Movements
Active ROM Measured
RIGHT
Active ROM Measured
LEFT
Flexion
180°
150°
Extension
50°
40°
Adduction
50°
50°
Abduction
180°
150°
Internal Rotation
80°
70°
External Rotation
90°
90°
Elbow, wrist and hand movements were normal.
There were no signs of any ulnar neuropathy remaining on the left. There was a 9cm scar from the ulnar transposition.
Lower extremities
Mr Schuettpelz’s gait was normal.
In the right hip there was groin discomfort mainly on external rotation.
Hip Movements
Active ROM Measured
RIGHT
Active ROM Measured
LEFT
Flexion
110°
120°
Extension
20°
20°
Adduction
30°
30°
Abduction
30°
40°
Internal Rotation
45°
45°
External Rotation
30° (with groin discomfort)
45°
There was no knee swelling.
There was no ligamentous instability.
There was no crepitus on palpation of either knee.
Knee Movements
Active ROM Measured
RIGHT
Active ROM Measured
LEFT
Flexion
130°
130°
Extension
0°
0°
Scarring
He had a 9cm scar over his left lateral epicondyle consistent with his ulnar nerve transposition. He had three arthroscopic scars over his left shoulder, one anteriorly, one laterally and one posteriorly measuring about 1cm. These were well healed.
Comments on consistency
Mr Schuettpelz presented appropriately and was cooperative. The examiner did not detect any inconsistencies in his history or physical examination.
Diagnosis and reasons
Cervical spine: aggravation of degenerative disease in the cervical spine.
Lumbar spine: aggravation of existing degenerative change.
Left upper extremity: restricted range of motion due to supraspinatus tendinopathy subacromial bursitis.
Right upper extremity: no abnormality detected on examination now – soft tissue injury.
Right lower extremity: right trochanteric bursitis gluteal tendinopathy with decreased external rotation due to shortening of the gluteal musculature.
Left lower extremity – left knee: no significant abnormality detected on today’s examination but does have symptoms intermittently.
Scarring: he has scarring in the left medial epicondyle and left shoulder which are well healed and the result of elective surgery.
Causation
The causation for Mr Schuettpelz’s injuries to the above listed regions are as a direct result of his motor accident on 29 April 2020.
The clinical record supports an initial neck injury, which was overshadowed by other injuries in the early phase. There are reports of continuous pains and symptoms since the MVA. There is no record of neck or back pains prior to the MVA. A slow deterioration is accepted as a late complication of the MVA. The panel do not accept a simple age-related deterioration.
Permanency of impairment
The impairment is permanent. Mr Schuettpelz’s symptoms have been stable for more than 12 months. There is no further specific treatment planned. He has reached maximal medical improvement.
Statement about permanent impairment
The determination as to permanent impairment is made in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment (Fourth Edition) (AMA 4th Edition) and the Motor Accident Permanent Impairment Guidelines.
In relation to his cervical spine, there is dysmetria. There is no radiculopathy. Mr Schuettpelz has a diagnosis-related estimate (DRE) II impairment giving him 5% WPI based on Table 73 on page 110.
In relation to his lumbar spine, Mr Schuettpelz has pain but does not have dysmetria, radiculopathy or non-verifiable radicular symptoms. He is DRE I giving him a WPI of 0% based on Table 72 on page 110.
In relation to his left shoulder, he has mild limitation in range of motion. Figures 38, 41 and 44 are used on pages 43, 44 and 45 of AMA 4th Edition. The limitation in flexion gives 2% UEI, limitation in extension 0% UEI, limitation in adduction 0% UEI, limitation in abduction 1% UEI and limitation in internal rotation 1% UEI. The total UEI is therefore 5% which equals 3% WPI (Table 3 on page 20). Note that there is no additional impairment for an acromioplasty.
The insurer [46] submitted that the Medical Assessor had failed to give sufficient reasons for applying section 3.1(m) of the guidelines, with respect to an acromioplasty.
At [116], the panel noted that there was no additional impairment for an acromioplasty.
An acromioplasty is a surgical procedure designed to smooth out the acromion bone to stop the Supraspinatus Tendon from rubbing against it. This provides relief from shoulder pain.
The period of recovery from an acromioplasty is short and normally full recovery and unrestricted activity is made.
Assessor Miller used 3.1m of AMA4 and in particular Table 27 p61, in order to use 10% UEI for distal clavicle arthroplasty. This is incorrect, when only an acromioplasty occurred surgically.
In addition, quoting AMA4 3.1m “The criteria described in this section should be used only when the other criteria have not adequately encompassed the extent of the impairments.”
In the Panel’s view, ROM is an adequate assessment of impairment (in line with Dr Home's assessment).
In relation to the right lower extremity – right hip, the limitation in right hip external rotation gives a mild impairment based on Table 40 on page 78. This equates to 2% WPI.
In relation to the left lower extremity – left knee, there is no assessable impairment.
In relation to skin/scarring, well-healed scars are not easily seen. This equates to 0% WPI based on the Table for the Evaluation of Minor Skin Impairment (TEMSKI) scale.
Pre-existing/subsequent impairment
Mr Schuettpelz had no pre-existing evidence of cervical spine disease and deduction is not appropriate. He had previous mild knee problems which he saw Dr Tong about prior to his accident but there was no assessable impairment able to be documented – therefore no deductions are appropriate. He had no previous right hip problems.
Determination
The Panel revokes the certificate of Medical Assessor Geoffrey Miller, dated 17 March 2024, and substitutes the determination to certify that the injuries referred to the Panel and caused by the accident, gave rise to a WPI of 10%.
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