Insurance Australia Limited t/as NRMA Insurance v Spadijer

DETERMINATION OF REVIEW PANEL
CITATION:	Insurance Australia Limited t/as NRMA Insurance v Spadijer [2025] NSWPICMP 110
CLAIMANT:	Vasilije Spadijer
INSURER:	Insurance Australia Limited t/as NRMA Insurance
REVIEW PANEL
MEMBER:	Alexander Bolton
MEDICAL ASSESSOR:	Ian Cameron
MEDICAL ASSESSOR:	Leslie Barnsley
DATE OF DECISION:	21 February 2025
CATCHWORDS:	MOTOR ACCIDENTS – Review of certificate and reasons of Medical Assessor dated 22 April 2024 who assessed the claimant as having 20% whole person impairment (WPI); claimant injured in a motor vehicle accident on 19 January 2020 when the insured vehicle travelled across the path of the claimant bringing him to an immediate stop; injuries for review comprised the claimant’s cervical spine being an aggravation of an underlying degenerative change, right shoulder soft tissue injury, lumbar spine soft tissue injury, and left shoulder soft tissue injury; causation considered in light of subsequent fall by the claimant affecting his right shoulder; claimant had also been involved in an earlier accident and suffering similar injuries to the subject accident; significant time lapse between some complaints made by claimant from the time of the accident to time of complaint; Held – Review Panel satisfied that despite delay of complaints of injury to certain areas by the claimant he did suffer injuries to those areas as a direct result of the accident; Review Panel assessed total WPI at 12%; Medical Assessment Certificate revoked.
DETERMINATIONS MADE:	CERTIFICATE OF DETERMINATION 1. The Panel revokes the certificate of Medical Assessor Home dated 22 April 2024. 2. The Panel finds that as a result of the accident on 19 January 2020, the claimant has suffered injuries to his cervical spine, lumbar spine and right shoulder. 3. The Panel is not satisfied that the claimant injured his left shoulder in the accident. 4. The Panel assesses the claimant as having a total of 12% whole person impairment.

STATEMENT OF REASONS

INTRODUCTION

The claimant was assessed by Medical Assessor Home (the Medical Assessor) on
18 April 2024. In a Certificate dated 22 April 2024, the Medical Assessor diagnosed the claimant with soft tissue injuries to the right shoulder, left shoulder and lumbar spine and an aggravation of underlying degenerative changes in the cervical spine.
The Medical Assessor assessed a combined whole person impairment (WPI) of 20%. The insurer has applied for a review pursuant to s 7.26 of the Motor Accident Injuries Act 2017 (the MAI Act)
The following injuries were referred by the Personal Injury Commission (Commission) for assessment:
(a)    cervical spine -musculoligamentous strain and aggravation of underlying degenerative change;
(b)    lumbar spine - musculoligamentous strain and aggravation of underlying degenerative change;
(c)    right shoulder -rotator cuff pathology, and
(d)    left shoulder- rotator cuff pathology.
The Medical Assessor found the following injuries caused by the accident gave rise to a permanent impairment of 20%:
(a)    cervical spine-aggravation of underlying degenerative changes;
(b)    right shoulder-soft tissue injury;
(c)    lumbar spine-soft tissue injury, and
(d)    left shoulder-soft tissue injury.

Bundles of documents

The parties have each presented their respective bundles of documents upon which they rely. The Panel have read all the documentation. If a particular document is not referred to by the Panel, this does not mean that the Panel or a Panel Member has not read it, in much the same manner as parties not referring to or not specifically relying on a document in their own bundle and submissions.
The fact that evidence is not referred to in these reasons does not mean it has been overlooked and nor is it required that each piece of evidence be mentioned – see WAEE v Minister for Immigration and Citizenship (2003) 75 ALO 630 at [46].The Panel is not required to “analyse every piece of information from every opinion contained in a document with which he [it] was provided” – see Farr v Insurance Australia Limited t/as NRMA Insurance Ltd [2014] NSWSC 1435 at [46]. The Panel has come to its own conclusion and has taken its own history.

The accident

The claimant was involved in an accident on 19 January 2020. He was the driver of a Hyundai car and was wearing a seatbelt. The weather was fine and the road was dry. He was travelling in the gutter lane. There was heavy traffic in the lane adjacent to him and there were two lanes in each direction.
Another vehicle, travelling in the opposite direction, made a right hand turn across his path and towards a driveway on the claimant’s left-hand side. That other vehicle came through a gap in the stationary traffic in the lane beside him.
The claimant’s vehicle came to a sudden stop. It is understood that the airbags were deployed and that his car was written off for insurance purposes. An ambulance attended and he was taken to St George Hospital, which was close to where the accident occurred, with complaints of neck, shoulder and lower back pain. He was admitted overnight and discharged the following day.

Insurer’s submissions

The insurer has applied for a review pursuant to s 7.26 of the MAI Act on the following grounds:
(a)     the Medical Assessor failed to respond to the insurer's clearly articulated arguments relating to causation, namely the effect of the claimant's subsequent fall in August 2021 on his ongoing right shoulder symptoms;
(b)     the Medical Assessor failed to provide a clear path of reasoning in the conclusion relating to subsequent impairment, and
(c)     the Medical Assessor failed to review and evaluate the totality of the evidence before him in his assessment of causation.

Ground one - Failure to deal with the insurer's clearly articulated arguments

The insurer submits that, in paragraph 6(g) of its original submissions dated
14 November 2023, it made the following argument which is relevant to the issue of causation and to the assessment of WPI:
“6(g) The consultation entry by Dr Tomka, GP, dated 30 August 2021, refers to pain in the right shoulder following a fall at home. The insurer submits the claimant's ongoing right shoulder symptoms do not relate to the subject accident.”
The insurer says that whilst the Medical Assessor noted the parties' respective submissions, the Medical Assessor made no attempt to engage with the substance of the insurer's submission. Further, the insurer submits that the above argument raised by it appears to have been overlooked or disregarded entirely by the Medical Assessor. The insurer says that this is despite the issue of causation being brought to the Medical Assessor's attention, through the insurer's submissions, prior to the assessment of the claimant.
The insurer says that on pages 4 and 5 of his Certificate, the Medical Assessor took a history of the claimant. However, the insurer says that this history did not include any discussion of the above fall and the right shoulder symptoms reported by the claimant arising from this fall. The insurer submits the Medical Assessor did not discuss the right shoulder symptoms arising from the subsequent fall in August 2021 with the claimant during the examination and did not engage with the insurer's submissions on causation despite referring, on page 3 of his Certificate, to objective evidence that supports the insurer's position.
The insurer submits the argument raised in its original submissions was a matter which related substantially to the issue of causation. The insurer submits that as a matter of procedural fairness, the Medical Assessor ought to have raised with the claimant the right shoulder symptoms he complained of following his fall in August 2021 and referred to in the contemporaneous evidence which documents those symptoms, and engaged with the insurer's submissions with the claimant during the course of the assessment. The insurer submits that it is readily apparent that this did not occur.

Ground two - Failure to provide a clear path of reasoning

The insurer submits that the Medical Assessor does not provide any path of reasoning to demonstrate how he reached the conclusion regarding 'nil' subsequent impairment, in circumstances where:
(a) the Medical Assessor was plainly aware, from the insurer's submissions, of objective evidence relating to possible subsequent impairment, and
(b) the Medical Assessor failed to specifically discuss the subsequent fall in August 2021 which resulted in right shoulder symptoms, as raised by the insurer in its submissions, with the claimant.
The insurer says that as the Medical Assessor did not provide any reasoning, the Medical Assessor cannot be assumed to have properly calculated WPI as the basis for this conclusion is left wholly unexplained.

Ground three- Failure to review and consider the totality of the medical evidence in the assessment of causation

The insurer says that the Medical Assessor writes “there is no medical record that the claimant made any significant recovery from the injury sustained on 19 January 2020 to date.”
The insurer says that the Medical Assessor's above reasoning is inconsistent with the records by Dr Tomka, general practitioner (GP), as raised by the insurer in its original submissions dated 14 November 2023.
The insurer says that through the submissions made by it, the Medical Assessor was aware of medical evidence, that is, the clinical records of Dr Tomka, which suggests the claimant recovered from his accident-related injuries due to a lack of reporting of any symptoms. The insurer submits as the Medical Assessor's reasoning is inconsistent with the medical evidence, it remains unclear how the Medical Assessor reached his conclusion on causation.
The insurer submits the Medical Assessor failed to consider and properly evaluate the records by Dr Tomka in accepting causation of the claimant's injuries. The insurer says that the Medical Assessor did not refer to the clinical records by Dr Tomka at all. The insurer submits the above entries by Dr Tomka constitutes as evidence that would affect causation. The insurer says that the Medical Assessor was required under cls 6.17 and 6.18 of Motor Accident Guidelines (the Guidelines) to review and evaluate all the available evidence, including Dr Tomka's clinical records, in deciding whether the claimant's impairment, arising from an injury, was caused by the accident. The insurer says that it is apparent that the Medical Assessor did not do so.
The insurer submits, due to the inconsistent reasoning and the failure by the Medical Assessor to properly review and evaluate all the available evidence in reaching his conclusion regarding causation, a material error exists.

Insurer’s WPI submissions
Cervical spine

The insurer submits the injury to the claimant's cervical spine does not exceed the WPI threshold, for the following reasons:
(a)    The clinical records by Bathurst Street Medical Practice provide a history of neck pain, a whiplash injury and limited range of movement in the neck dating back to at least September 2017. The insurer submits the claimant suffers from pre-existing neck pain and reduced range of movement that was symptomatic at the time of the accident.
(b)    The CT cervical spine report dated 20 January 2020 did not identify any fracture or dislocation to the cervical spine. The insurer submits the radiological scan taken one day after the accident did not identify any abnormality or injury to the cervical spine.
(c)    At the initial post-accident consultation with Dr Tomka, GP, on 21 January 2020, the claimant reported the presence of neck pain. The insurer submits pain is not an assessable injury under cl 6.38 of the Guidelines.
(d)    The X-ray cervical spine report dated 2 March 2020 and CT cervical spine reports dated 2 May 2022 and 23 November 2022 all conclude the presence of degenerative discopathy, arthropathy and spondylosis in the claimant's cervical spine. The insurer submits the claimant suffers from multiple degenerative conditions in his cervical spine that are unrelated to the subject accident.
(e)    Between 6 April 2021 and 24 February 2022, the claimant did not report any symptoms in his cervical spine to Dr Tomka. The insurer submits based on the claimant's lack of reporting for almost one year, any accident-related cervical spine injury had resolved in the initial stages following the accident.
(f)    The insurer relies on the reports by Professor Shatwell dated 23 February 2021 and 15 September 2023. Professor Shatwell diagnosed the claimant with a soft tissue injury to the cervical spine and assesses WPI at 0%.
(g)    Based on Professor Shatwell's reports, the insurer submits the claimant's cervical spine injury should be assessed at 0% WPI.

Lumbar spine

The insurer submits the injury to the claimant's lumbar spine will not exceed the WPI threshold, for the following reasons:
(a)    The clinical records by Bathurst Street Medical Practice provide a history of pain and limited range of movement in the lumbar spine dating back to at least September 2017. The insurer submits the claimant suffers from pre-existing lumbar spine pain and reduced range of movement that was symptomatic at the time of the accident.
(b)    At the initial post-accident consultation with Dr Tomka, on 21 January 2020, the claimant reported the presence of pain in his upper and lower back. The insurer submits again that pain is not an assessable injury under cl 6.38 of the Guidelines.
(c)    Between 6 April 2021 and 24 February 2022, the claimant did not report any symptoms in his lumbar spine to Dr Tomka. The insurer submits based on the claimant's lack of reporting for almost one year, any accident-related lumbar spine injury had resolved in the initial stages following the accident.
(d)    The CT lumbar spine report dated 17 February 2020, X-ray lumbar spine report dated 2 March 2020, MRI lumbar spine report dated 10 March 2020 and CT lumbar spine report dated 2 May 2022 all concluded the presence of degenerative stenosis, spondylolisthesis, arthropathy and disc desiccation. The insurer submits the claimant suffers from multiple degenerative conditions in his lumbar spine which are unrelated to the subject accident.
(e)    The insurer relies on the reports by Professor Shatwell dated 23 February 2021 and 15 September 2023. Professor Shatwell diagnosed the claimant with a soft tissue injury to the lumbar spine and assessed WPI at 0%.
(f)    Based on Professor Shatwell's reports, the insurer submits the claimant's lumbar spine injury should be assessed at 0% WPI.

Right shoulder

The insurer submits the injury to the claimant's right shoulder will not exceed the WPI threshold, for the following reasons:
(a)    The clinical records by Bathurst Street Medical Practice provide a history of pain and limited range of movement in the right shoulder dating back to at least September 2017. The insurer submits the claimant suffers from pre-existing right shoulder pain and reduced range of movement that was symptomatic at tthe time of the accident.
(b)    The St George Hospital discharge referral dated 20 January 2020 refers to “ongoing right shoulder pain with nil injuries identified on CT scan”. The insurer submits the radiological scan taken one day after the accident did not identify any abnormality or injury to the right shoulder.
(c)    At the initial post-accident consultation with Dr Tomka, on 21 January 2020, the claimant reported the presence of pain in his right shoulder. The insurer again submits pain is not an assessable injury under cl 6.38 of the Guidelines.
(d)    The X-ray of bilateral shoulders report dated 2 March 2020, X-ray of both shoulders report dated 5 March 2020 and the MRI of both shoulders report dated 5 March 2020 all conclude the presence of degenerative changes. The insurer submits the claimant suffers from degenerative changes in his right shoulder which are unrelated to the subject accident.
(e)    Between 5 February 2020 and 24 February 2022, the claimant did not report any symptoms in his right shoulder to Dr Tomka. The insurer submits based on the claimant's lack of reporting for more than two years, any accident-related right shoulder injury had resolved by 5 February 2020.
(f)    A right shoulder ultrasound report dated 14 February 2020 concluded the presence of subacromial bursitis only with no evidence of a rotator cuff tear. The insurer submitted a subacromial bursitis meets the definition of a soft tissue injury and this injury would have resolved shortly after the accident.
(g)    The consultation entry by Dr Tomka, dated 30 August 2021 refers to pain in the right shoulder following a fall at home. The insurer submits the claimant's ongoing right shoulder symptoms do not relate to the subject accident.
(h)    The insurer relies on the reports by Professor Shatwell dated 23 February 2021 and 15 September 2023. Professor Shatwell diagnosed the claimant with a soft tissue injury to the right shoulder and assessed WPI at 0%.
(i)    Based on Professor Shatwell's reports, the insurer submits the claimant's right shoulder injury should be assessed at 0% WPI.

Left shoulder

The insurer submits the claimant did not sustain an injury to his left shoulder, for the following reasons:
(a)    The clinical records by Bathurst Street Medical Practice provide a history of pain and limited range of movement in the left shoulder dating back to at least May 2017. The insurer submits the claimant suffers from pre-existing left shoulder pain and reduced range of movement that was symptomatic at the time of the accident.
(b)    At the initial post-accident consultation with Dr Tomka, on 21 January 2020, the claimant reported the presence of pain in his left shoulder. The insurer submits pain is not an assessable injury under cl 6.38 of the Guidelines.
Between 5 February 2020 and 24 February 2022, the claimant did not report any symptoms in his left shoulder to Dr Tomka. The insurer submits based on the claimant's lack of reporting for over two years, any accident-related left shoulder injury has resolved.
(c)    The X-ray of bilateral shoulders report dated 2 March 2020 and MRI of both shoulders report dated 5 March 2020 conclude the presence of degenerative changes in the left acromioclavicular (AC) joint with no significant cuff tear or labral/biceps pathology. The insurer submits the claimant suffers from degenerative changes in his left shoulder which are unrelated to the accident.
(d)    The insurer relies on the reports by Professor Shatwell dated 23 February 2021 and 15 September 2023. The insurer says that Professor Shatwell did not diagnose the claimant with any left shoulder injury arising from the accident.
(e)    Based on Professor Shatwell's reports, the insurer submits the claimant did not sustain an injury to his left shoulder as a result of the subject accident and his ongoing symptoms are due solely to his degenerative conditions, which are unrelated to the accident.
The insurer submits the claimant's injuries do not exceed the WPI threshold.

Claimant’s submissions

For the purposes of responding in detail, the claimant referred to the insurer’s submissions of 22 May 2024, where the insurer submitted that the Medical Assessor erred in the following respects:
(a)    Ground one: failed to deal with the submissions.
(b)    Ground two: failed to provide a clear path of reasoning.
(c)    Ground three: failed to review and consider all available medical documentation.

Ground one

The claimant submits that the Medical Assessor comprehensively set out the reasons for his diagnosis and causal connection of the injuries with the subject accident. The claimant submits he has considered all radiological investigations in depth together with the claimant’s medical history including the prior motor vehicle accident of 2016.
The claimant says the Medical Assessor clearly read the report of Medical Assessor Perla for the medical assessment in August 2017, records of Dr Tomka, reports of Dr Herald and as to the expert report of Associate Professor Shatwell, the Medical Assessor said:
“I have carefully reviewed the reports of Associate Professor Michael Shatwell addressed to McCabes/Curwood Lawyers…”

Ground two

The claimant says the Medical Assessor, as indicated in response to ground one of the review application, comprehensively considered all documentation before him, provided a summary of the submissions of each party, set out a summary of the radiological investigations and subsequently in fine detail provided a clear path of reasoning with respect to his determination.

Ground three

The claimant referred to the final complaint of the insurer, under ground three, which was that the Medical Assessor failed to consider all documents with respect to causation.
The claimant submits that it is not the task of the Medical Assessor to determine if the GP was wrong or right but rather it is the task of the Medical Assessor to consider the documents before him which he has done. The Medical Assessor clearly set out that he accepted certain injuries based on his clinical findings and the available documentation.
The claimant submits that the Medical Assessor has applied the correct test of causation, provided an adequate path of reasoning and found the correct impairment as to each injury supported by the medical evidence and his clinical findings

Claimant’s submissions for WPI assessment

The claimant submits that he consulted his GP, Dr Tomka, on a minimal basis following the motor accident of 2016, as evidenced by the lack of radiological investigation in the years prior to the subject motor accident.
The claimant submits that the subject accident occurred with significant force as both the insured and the claimant were travelling at approximately 50kmph.
The claimant refers to his medical examination by the Medical Assessor on
28 February 2023. The claimant acknowledges that the Medical Assessor issued a certificate dated 3 March 2023 determining the posterior cervical foraminotomy with decompression at both the right C5 and C6 nerve roots did not relate to the injury caused by the accident and was not reasonable and necessary in the circumstances. This determination is not for review by this Panel.

Medical evidence

There is a pre-accident Certificate provided by Medical Assessor Perla dated
17 August 2017 which refers to a motor vehicle accident on 7 March 2016. This documented the following injuries cervical spine, soft tissue injury, right shoulder, soft tissue injury and left shoulder, soft tissue injury.
The claimant referred the following injury back to the Medical Service:
Cervical spine- post-traumatic cervical dystonic tremor. This was not assessed by Medical Assessor Perla.
At the time of that assessment, Medical Assessor Perla documented ongoing current symptoms of chronic neck pain with bilateral shoulder pain and restricted range of neck motion, worse on the right than the left. There was pain and numbness down the entire right upper limb, in particular, extending into the right fourth and fifth fingers. There was a complaint of chronic lower back pain with radiation into the lateral aspect of the right leg and to the lateral aspect of the right foot, in particular, fourth and fifth toes. There was cramping in the right lower limb. There was uniform loss of cervical spine motion without dysmetria. There were no abnormal neurological findings. However, altered sensation was recorded over the entire right upper limb and the entire right hand in a non-anatomical non-dermatomal fashion. There was no muscle atrophy or wasting. Power was normal. There was restricted straight leg raise on the right at 60 degrees but with altered sensibility in the right lower limb in a non anatomical non-dermatomal fashion.
Regarding the earlier accident in 2016, the Medical Assessor noted that the claimant had symptoms of persisting chronic neck pain, bilateral shoulder pain and persisting lower back pain radiating to the right leg.
The clinical findings set out by Medical Assessor Perla were very similar to the clinical findings after the accident the subject of this claim where there was restricted neck motion and restricted back spinal motion and non-dermatomal right-sided upper and lower limb sensory disturbances.
Medical Assessor Perla assessed 9% WPI.
Medical Assessor Home provided a certificate dated 3 March 2023 going to treatment and care. He noted that the claimant recalled that he had made a recovery from his previous symptoms of chronic neck and back pain by 2018. There was no record of presentations to his GP between 2018 and 2020 in the medical records.
The Medical Assessor concluded that the medical records were consistent with the claimant’s history that his symptoms had improved well before the subject accident.
The Medical Assessor said that the mechanism of the accident could well cause injury to the cervical and lumbar spine and to the right shoulder, which was protected by the claimant’s seat belt. He reported that there was early documentation of complaints of right shoulder pain in the GP's records.
There was also record of bilateral shoulder pain documented by Dr Tomka on a certificate issued on 21 January 2020, only two days post-accident.
In this regard Medical Assessor Home was satisfied the claimant suffered the following injuries in the motor vehicle accident;
(a)    cervical spine- aggravation of underlying degenerative changes at CS/6 with less prominent changes at C4/5 and C6/7;
(b)    right shoulder- soft tissue injury to the right shoulder;
(c)    lumbar spine- soft tissue injury to the lumbar spine, and
(d)    left shoulder- soft tissue injury.
He specifically reported a review of the reports of Associate Professor Shatwell including his most recent report dated 15 September 2023.
Associate Professor Shatwell concluded that the claimant had sustained soft tissue injuries caused by the restraint of the seatbelt during deceleration without contact with the inside of the cabin.
The Medical Assessor noted that Associate Professor Shatwell said that the subsequent investigations had not demonstrated any significant pathology, however the Medical Assessor reported that MRI scans of the spine had demonstrated significant underlying degenerative changes.
He said that an initial ultrasound of the right shoulder performed on 14 February 2020 demonstrated subacromial bursitis with impingement. MRI scans performed on
5 March 2020 demonstrated a tendinopathy of the supraspinatus tendon without a tear and AC joint degenerative changes. The more recent ultrasound of September 2023 showed a partial intrasubstance tear within the supraspinatus tendon. The Medical Assessor said that this was not present in the post-accident imaging including the MRI scans performed on 5 March 2020.
The Medical Assessor concluded that the subsequent development of an intra-substance tear reflected progressive degeneration in the shoulder rather than a traumatic tear, noting the initial imaging did not show such a tear.
Whilst Associate Professor Shatwell documented several clinical findings which he regarded to be reflective of illness behaviour, the Medical Assessor said that he did not find evidence of illness behaviour at the assessment.
The claimant's condition was reported to be internally consistent.
The Medical Assessor noted that Associate Professor Shatwell had said that any soft tissue injuries to the cervical spine and lumbar spine, right shoulder and left knee and soft tissue injuries sustained on 19 January 2020 would have settled within 2-3 weeks of the accident in question.
However, the Medical Assessor said that there was no medical record that the claimant made any significant recovery from the injury sustained on 19 January 2020 to date. The Medical Assessor said that his clinical findings detected at the current assessment were very similar to those set out by Dr Bodel, for the claimant.
The Medical Assessor assessed WPI comprising 5% for his cervical spine, 5% for the lumbar spine, 8% for the right shoulder and 4% for the left shoulder giving a combined value of 20%.
Certificates of Capacity commencing 21 January 2020 noted injuries to the neck, upper and lower back and both shoulders, left and right knees.
A report of Dr Herald dated 21 February 2020 noted that there was restricted motion of the right shoulder, grossly neurologically intact with a positive Spurling's test in the left upper limb. There was marked stiffness, positive leg raise on the left but a grossly neurologically intact. There was aggravation of underlying tricompartmental osteoarthritis of both knees. There was subsequent referral for imaging. There is also indication of bilateral shoulder pain, right worse than left. Dr Herald made a diagnosis of a right shoulder rotator cuff tear and a left shoulder impingement syndrome.
A further report of Dr Herald dated 17 March 2020 records meniscal tears and chondral loose bodies in the knees and impingement syndrome in both shoulders with subacromial bursitis. There was degenerative spondylosis in the neck and back.
A report of Dr Ho dated 1 June 2020 noted complaints of chronic nociplastic neck pain which was secondary to TS-6 discogenic pain with a component of facet joint pain, chronic neuropathic pain, left upper limb to left CS radiculopathy, chronic nociplastic lower back, which was secondary to C4/S discogenic pain, central sensitisation with potentiation and secondary hyperalgesia, maladaptive pain, coping with adjustment disorder.
The upper and lower limb neurological examination was relatively normal but from neurotension in the left upper limb. The claimant presented with pain extending to the left upper limb and for which Dr Ho recommended injections at the CS/6 level.
Dr Nair submitted a report dated 27 January 2021. This noted complaints of axial and right C6 radicular symptoms. He said that MRI scans showed foraminal stenosis at C5/6. The claimant was keen to progress toward anterior cervical surgery. Dr Nair suggested a second opinion. There was a subsequent referral to Associate Professor Steel. Dr Nair stated that there was debilitating axial and right C6 radicular symptoms, however, when examined by the Medical Assessor, the claimant did not recall any symptoms conforming to a right C6 radicular symptom. The claimant had reported to the Medical Assessor that any upper limb sensory symptoms had been on the left side, and not on the right.
Associate Professor Shatwell provided a report for the insurer dated 23 February 2021. The airbags were noted not to have deployed however this is contrary to what the claimant had reported to Dr Bodel. Associate Professor Shatwell said that there was unlikely to be serious injuries sustained if the airbags in the vehicle did not deploy and the claimant was restrained by a seat belt. On examination he found no abnormal neurological findings in the upper or lower extremities.
The claimant relies on a report of Associate Professor Steel dated 4 May 2021. The claimant complained of subsequent neck, right arm and lower back pain, which he estimated at 8 out of 10. Pain was said to radiate from the shoulder down to the elbow. There was some sensory disturbance at C6 distribution, thumb and index finger of the right hand. Symptoms were brought on by lateral rotation and extension. On examination there was mild to moderate weakness of shoulder abduction and bicep function. Associate Professor Steel recommended cervical foraminotomy and decompression of both right C5 and C6 nerve roots with an estimated 80% likelihood of alleviation of pain.
Associate Professor Steel stated there were sensory disturbances in the C6 distribution of the thumb and index finger of the right hand. The claimant denied any symptoms in this territory in the past or presently.
In a supplementary report dated 5 May 2021, Associate Professor Steel indicated that after discussion with the neuroradiologist, Dr Bou-Haidar at St Vincent's Clinic, there was an agreement about the MRI findings of high-grade foraminal stenosis on the right at C4/5 and C5/6 with severe nerve root compression.
A report of Dr Bodel dated 26 August 2021 sets out the claimant had received corticosteroid injections to the shoulder provided by Dr Herald and various injections to the neck performed by Dr Ho which were of no assistance. Dr Bodel detailed symptoms of neck and bilateral shoulder pain, worse on the right.
Dr Bodel noted that although there was pre-existing pathology, this was likely to be asymptomatic at the time of the accident and should not be taken into consideration in the overall assessment of impairment. He said that the surgery proposed by Associate Professor Steel appeared to be reasonable and necessary. This assessment was undertaken by video and a detailed neurological assessment was not possible.
A further report of Dr Bodel dated 6 April 2023 followed a face-to-face examination. There were complaints of widespread pain in the neck and lower back. Shoulder girdle pain was worse on the right than the left. Restricted shoulder motion is documented. Restricted neck motion was noted with guarding and restricted rotation of the neck to the left. He found that there was reduced range of lateral bending to the left of the lumbar spine.
Dr Bodel found a diagnosis related estimate (DRE) Category II impairment for the cervicothoracic spine, the lumbosacral spine and restricted motion of the right shoulder with 7% WPI rating for the right and 6% WPI rating for the left shoulder. He also found there was restricted knee motion attracting 4% WPI for both knees.
A further report from Associate Professor Shatwell dated 15 December 2023 noted complaints of pain in the neck, mid-line back pain, right and left shoulder pain and left knee pain. It is documented symmetrically reduced neck motion, restricted back motion, restricted motion of both shoulders without crepitation. Associate Professor Shatwell said that the claimant had suffered soft tissue injuries caused by the restraint of seat belt during deceleration without contact of the inside of the cabin. The claimant had said that he struck his left knee on the dashboard.
Associate Professor Shatwell said that the claimant presented with illness behaviour with the examination not revealing radiculopathy or radiculitis. There was no disuse wasting of the right upper limb as a result of shoulder or neck pain. He found that reduced grip strength was consistent with non-maximal effort. He diagnosed soft tissue injuries to the cervical spine, lumbar spine, right shoulder and left knee.
Associate Professor Shatwell also noted a past history of chronic symptoms relating to the neck and back following the 2016 motor vehicle accident, and also chronic pain at the right shoulder and left knee which had persisted since the motor vehicle accident of 2016.
Associate Professor Shatwell concluded that the majority of the disability suffered by the claimant was related to chronic degenerative disease and facet joint disease and chronic medial compartment patellofemoral arthritis in the knees which was constitutional. There had been a previous fall and arthroscopic surgery to the left knee. He said that the soft tissue injuries sustained on 19 January 2020 would have settled within 2-3 weeks of the accident in question. Associate Professor Shatwell said that any limitation of motion of the shoulders was not caused by a soft tissue injury sustained in January 2020. He found no permanent impairment arising from the soft tissue injuries sustained.
Attached to the bundle of documents of the insurer is a report from Dr Bisht, psychiatrist, dated 26 April 2021. As this report relates to the claimant’s psychiatric diagnosis, it does not take the assessment of his physical disabilities any further for the assistance of the Panel. There is also a report on the claimant’s bundle from Dr Teoh, psychiatrist, dated
5 September 2023.
Clinical notes of Greenfield physiotherapy, Dr Tomka and Dr Kulijic have been reviewed by the Panel.

The Medical Assessor provided a summary of radiological investigations as follows

CT cervical spine dated 20 January 2020: No fractures of the cervical spine.
CT brain dated 20 January 2020: No acute intracranial pathology.
CT chest, abdomen and pelvis dated 20 January 2020: No acute intra-thoracic or intra abdominal pathology.
Ultrasound right shoulder dated 14 February 2020: Subacromial bursitis. No evidence of a rotator cuff tear.
CT scan cervical spine dated 18 February 2020: Paraforaminal disc bulges at C4/5 and C5/6 with potential root impingement.
CT lumbar spine dated 18 February 2020: Degenerative spondylolisthesis at L3/4 with moderate canal stenosis and further canal stenosis at L4/5. Facet joint arthropathy in the lower three lumbar levels.
X-rays cervical spine dated 2 March 2020: Normal alignment of the cervical spine. Vertebral body heights preserved. There is mild degenerative discopathy and spondylosis of the cervical spine, predominantly at C5/6 and C6/7 with anterior osteophyte bridging. Mild degenerative facet arthropathy at these levels is noted. No suspicious osseous lesion.
X-rays lumbar spine dated 2 March 2020: lntervertebral disc spaces are preserved. There is mild hypertrophic degenerative change at L4/5 and L5/S1 facet joints. No suspicious osseous lesion.
X-rays both shoulders dated 5 March 2020: The glenohumeral and AC joints are normal. No significant degenerative changes in the shoulder joints. Minimal degeneration is noted at the AC joints bilaterally.
MRI left shoulder dated 5 March 2020: No significant cuff tear or labral or biceps pathology. Mild AC joint degenerative change.
MRI right shoulder dated 5 March 2020: Evidence of mild to moderate tendinopathy affecting the supraspinatus. No evidence of significant full or partial thickness cuff tear. Associated mild to moderate subdeltoid subacromial bursitis. Mild tendinopathy in the infraspinatus. Moderate AC joint degenerative change and reactive oedema.
MRI cervical spine dated 10 March 2020: At C5/6, mild broad-based dorsal disc bulge with mild narrowing of the bilateral exit foramina. No significant central canal narrowing.
MRI lumbar spine dated 10 March 2020: There is mild disc bulge at L4/5 with a tiny dorsal annular tear. No significant central canal narrowing or foraminal narrowing. There is moderate disc desiccation at L2/3 and L4/5.
MRI cervical spine dated 19 December 2020: C2/3 minimal disc bulge and facet arthropathy, no neural impingement, C3/4, no significant disc lesion. Mild facet joint arthropathy. C4/5 minimal disc bulge. No neural impingement. C5/6 low grade disc bulge and mild facet joint arthropathy with some foraminal osteophytes. There is a right para-foraminal component to the disc impinging on the right C6 nerve root. This may account for clinical symptoms. No cord compression. At C6/7 minimal disc bulge, no neural impingement. At C7-T1 no disc lesion, no neural compromise, no cervical ribs, no intrinsic cord signal, no cord oedema or myelomalacia and no syrinx formation.
The claimant was examined on behalf of the Panel by Medical Assessor Barnsley and Medical Assessor Cameron on 15 November 2024. Their report follows;
Mr Spadijer was reassessed at Hornsby by Dr Barnsley and Dr Cameron on
15 November 2024. He was unaccompanied.
The reasons for the re-examination were explained.
Past history
Mr Spadijer is now 73 years of age and said that he was self-employed and was “95% to 100%” fit prior to the subject accident. There was a previous motor vehicle crash when his vehicle was hit from behind. That was in 2016 and there was a compensation claim with reference to the neck and lower back. He said that he had recovered from this previous accident.
Mr Spadijer was self-employed in handyman work and painting at the time of the motor accident.
Mr Spadijer said that he did not have problems immediately before the accident, specifically he did not have any neck, shoulder or low back pain.
History of injury
On 19 January 2020, Mr Spadijer was the driver of a vehicle on Stoney Creek Road in the inside lane. Another vehicle which had been travelling in the opposite direction turned across him and he hit the side of that vehicle.
His wife was in car and was injured. His attention was focused on her.
Mr Spadijer said that he had immediately had pain in the right shoulder anteriorly. He also hit his left knee. There was also subsequent bruising from the seatbelt over his right anterior shoulder. He was also aware of neck and low back pain. He had complaints of dizziness and some left trapezial pain.
An ambulance attended and he was taken to St George Hospital. He was assessed and discharged the next day.
After a few days Mr Spadijer attended the general practitioner, Dr Tomka. He provided an assessment and confirmed that there were no fractures.
Subsequently he was referred to Dr Herald, orthopaedic surgeon, and Dr Ho, a pain management specialist. He has also seen Dr Tim Steel, neurosurgeon. He received two cervical spine injections which did not help.
Mr Spadijer has been troubled by persisting problems from the neck, back, right shoulder and abdomen.
He had an upper gastrointestinal endoscopy for symptoms which fall outside the scope of this review. He reported having three steroid injections to the right biceps.
Current status
There are continuing symptoms with disability. Mr Spadijer said that low back pain continues to be present. There are pins and needles in the lateral aspect of the left foot. There are cramps in the left lower leg.
There is neck pain felt posteriorly more on the right than the left. There is numbness in the ulnar fingers in both hands.
There is right biceps pain with restriction in shoulder movement. Furthermore, there is dizziness.
Current medications include Panadeine Forte, Panadol, Somac, vitamin D, magnesium, Zoloft, nizatidine, Carafate and Mylanta.
Mr Spadijer is in receipt of the Age Pension. He reports only being able to drive short distances around Casula.
Mr Spadijer denied that there had been a fall at the airport in April 2021, which was mentioned in the insurer’s submissions. He said that he had not had any falls since the subject motor accident.
Examination
Mr Spadijer is right handed, 182cm in height and weighs 108kg. He was wearing a cervical collar.
At the lumbar spine there was no guarding or spasm, and tenderness was reported.
Lumbar spine movements revealed flexion of 50%, extension was 30%, lateral bending was asymmetric with finger translation down the legs of 4cm on right and 2cm on left.
Straight leg raising was to 40 degrees on the right, on left to 40 degrees with negative sciatic nerve stretch test on right and positive on the left.
There was normal muscle power in legs with give way weakness on the right due to back pain.
Knee jerks were present but ankle jerks were symmetrically absent. The medical assessors considered that this was consistent with age. Global, subjective sensory change was reported in the right foot.
Circumferences of the lower extremities measured 10cm above and below the superior and inferior poles of the patella respectively were: above knee left 53cm and right 53cm; below knee left 41cm and right 40cm.
At the thoracic spine there were symmetrical movement to 50% normal.
Cervical spine movement was rotation to 40 degrees to the right and 60 degrees to the left, flexion full, extension 50%, and lateral flexion 25 degrees and symmetrical.
At the left shoulder range of movement (with repetitions listed) was flexion 130 / 110 / 120 degrees, extension 60 / 50 / 50 degrees, abduction 100 /110 / 110 degrees, adduction 50 / 20 / 40 degrees, external rotation 80 / 80 / 70 degrees, internal rotation 80 / 90 / 70 degrees. Movements were associated with trapezial pain.
At the right shoulder range of movement (with repetitions listed) was flexion 80 / 80 degrees, extension 50 / 40 degrees, abduction 80 / 90 degrees, adduction 30 / 20 degrees, external rotation 70 / 70 degrees, internal rotation 70 / 70 degrees. These movements were limited by pain.
Mr Spadijer said that pain limited movement at both shoulders.
There was tenderness over the cervical spine posteriorly. Spurling’s test was negative.
There was no shoulder muscle wasting. There was mild right glenohumeral joint tenderness.
Biceps, triceps and brachioradialis reflexes as well as finger jerks were present and symmetrical in the upper limbs. Widespread subjective sensory change was reported in the right upper extremity. There was no dermatomal sensory loss.
Circumferences of the upper extremities were above elbow left 34cm and right 35cm; below elbow left 30cm and right 30cm.
The panel notes that there is significant variation in the ranges of movement obtained by different examiners in the right shoulder. These are summarised in the table below. There was some inconsistency within the measurements taken at re-examination. The assessors put this to Mr Spadijer, who indicated that his symptoms varied according to how much pain he was in.
Right Shoulder

Bodel 2023	Herald 2020	Shatwell 2023	Home 2023	Home 2024
Flexion	120	100	90	100	90
Extension	40	-	30	50	50
Abduction	90	-	90	90	90
Adduction	“230”*	-	20	40	40
Int Rot	60	-	70	40	40
Ext Rot	60	20	40	70	80

*Obvious error
Left Shoulder

Bodel 2023	Herald 2020	Shatwell 2023	Home 2023	Home 2024
Flexion	140	Full	120	120	130
Extension	40	“	30	50	50
Abduction	120	“	160	110	130
Adduction	20	“	30	50	40
Int Rot	60	“	90	80	50
Ext Rot	60	“	40	90	90

Summary of injuries
Mr Spadijer was involved in a head on accident with significant damage to his vehicle. The assessors considered that this impact could have caused injuries to the cervical and lumbar spines and restrained right shoulder. The medical assessors consider he has sustained soft tissue injuries to the cervical and lumbar spines and the right shoulder. The reported left shoulder pain is pain in the left trapezius, which is referred from the neck. Mr Spadijer does not have complaints of left shoulder pain at present.
He has complaints of cervical spinal pain starting in close proximity to the motor vehicle accident. He does not have physical findings of radiculopathy but does have dysmetria, so meets criteria for DRE II impairment of the cervical spine. This attracts a 5% whole person impairment.
In the lumbar spine he has complaints of pain starting in close proximity to the subject accident. He does not have physical findings of radiculopathy, but has non verifiable radicular complaints and dysmetria, so meets criteria for DRE II impairment of the lumbar spine. This attracts a 5% whole person impairment
The medical assessors were concerned that there was some inconsistency within the re-examination findings and between assessors with regard to right shoulder movements, so did not consider that the reactive range of movement measured during re-examination was appropriate for calculation of WPI. In this regard the Motor Accident Guidelines, clause 6.40 are noted: “The medical assessor must utilise the entire gamut of clinical skill and judgment in assessing whether or not the results of measurements or tests are plausible and relate to the impairment being evaluated. If, in spite of an observation or test result, the medical evidence appears not to verify that an impairment of a certain magnitude exists, the Assessor should modify the impairment estimate accordingly, describing the modification and outline the reasons in the impairment evaluation report”.
It is, in the judgment of the Medical Assessors, not appropriate to rely on the measured range of motion in this case. The clinical information does not show that there are major significant pathological changes present in this shoulder. Therefore the assessment of permanent impairment is made by analogy and it is determined that the impairment would be equivalent to mild crepitation (Section 6.24 of the Motor Accident Guidelines) and see Table 19 page 59 AMA4 Guides) at the acromioclavicular joints (see Table 18, page 58 AMA4 Guides) and therefore would be 10% of 25% UEI, which rounds to 3% UEI and converts to 2% WPI.
Cervical spine – soft tissue injury – DRE II – dysmetria – 5% WPI
Lumbar spine – soft tissue injury – DRE II – dysmetria and non-verifiable radicular complaints – 5% WPI
Right shoulder – soft tissue injury – inconsistent movement – 2% WPI
Left shoulder – soft tissue injury – causation not established
Total – 12% WPI

The Panel adopts the findings of Medical Assessor Cameron and Medical Assessor Barnsley.

Causation/Reasons

The Panel is satisfied that on the balance of probabilities, the motor accident caused injury to the claimant which has given rise to the development of injury to his cervical spine, his lumbar spine, and his right shoulder. The Panel is not satisfied that there was an injury to the left shoulder.
The claimant has been involved in two motor vehicle accidents, both with similar injuries. The accident the subject of this claim occurred on 19 January 2020. The first accident before that occurred on 7 March 2016 the claimant said that he had recovered from the injuries arising from the first accident. It is clear from the medical records that there is no record of consultations with the claimant’s GP between 2018 and 2020. From this information, the Panel concludes that the claimant was asymptomatic at the time of the subject accident concerning any injuries arising from the accident of 7 March 2016.
Arguably, the CT scan taken at St George Hospital the day following the accident might not have identified any abnormality or injury to the right shoulder. However, the scan was taken because the claimant was complaining of pain in his right shoulder. Subsequently, the claimant however did not report any accident related injury to his right shoulder for more than two years. A right shoulder ultrasound on 14 February 2020 concluded the presence of subacromial bursitis but there was no evidence of a rotator cuff tear.
The claimant did report shoulder pain to his GP on 21 January 2020 but there were degenerative changes evidenced in scans taken shortly after the accident.
Between 5 February 2020 and 24 February 2022 the claimant did not report any symptoms in his right shoulder to his GP, Dr Tomka.
In August 2021 the claimant suffered a fall and following this, he complained of right shoulder symptoms. The insurer says that this fall is the cause of his right shoulder symptoms and not the accident.
Regarding the claimant’s cervical spine, a CT scan taken on 20 January 2020, this did not identify any abnormality. However, the claimant did report neck pain to his GP on
29 January 2020. Scans taken on 2 March 2020, 2 May 2022 and 23 November 2022 indicate the presence of degenerative discopathy, arthropathy and spondylosis.
With the claimant’s left shoulder, he did not report any symptoms to his GP between
5 February 2020 and 24 February 2022. The claimant did however make a complaint of pain in his left shoulder when consulting his GP on 21 January 2020 following the accident.
The Panel assumes that some complaint must have been made as scans were taken of both shoulders on 2 March 2020 and 5 March 2020. These showed the presence of degenerative changes in the left AC joint but no significant cuff tear or labral/biceps pathology.
The insurer has submitted that the claimant had left shoulder complaints before the accident and dating back to at least May 2017.
A consultation entry by Dr Tomka, GP, dated 30 August 2021, refers to pain in the right shoulder following a fall at home. The insurer submits the claimant's ongoing right shoulder symptoms do not relate to the subject accident.
The insurer submits that as a matter of procedural fairness, the Medical Assessor ought to have raised with the claimant the right shoulder symptoms he complained of following his fall in August 2021 and referred to in the contemporaneous evidence and engaged with the insurer's submissions with the claimant during the course of the assessment.

REVIEW

The insurer submits that the clinical records of Dr Tomka, suggest the claimant recovered from his accident-related injuries due to a lack of reporting of any symptoms.
Dr Tomka’s records show:
“(a)    Between 6 April 2021 and 24 February 2022, (accident date 19 January 2020) the claimant did not report any symptoms in his cervical spine to Dr Tomka, GP. The insurer submits based on the claimant's lack of reporting for almost one year, any accident-related cervical spine injury had resolved in the initial stages following the accident.
(b)     Between 6 April 2021 and 24 February 2022, the claimant did not report any symptoms in his lumbar spine to Dr Tomka, GP. The insurer submits based on the claimant’s lack of reporting for almost one year, any accident-related lumbar spine injury had resolved in the initial stages following the accident.
(c)     Between 5 February 2020 and 24 February 2022, the claimant did not report any symptoms in his right shoulder to Dr Tomka, GP. The insurer submits based on the claimant's lack of reporting for more than two years, any accident related right shoulder injury had resolved by 5 February 2020.
(d)     Between 5 February 2020 and 24 February 2022, the claimant did not report any symptoms in his left shoulder to Dr Tomka, GP. The insurer submits based on the claimant's lack of reporting for over two years, any accident related left shoulder injury has resolved.”
The Panel is mindful that a lack of reported complaint should not preclude a conclusion that this condition arose from the accident.
The Panel must also ask itself in considering whether the accident contributed to the claimant’s physical injuries as referred to it by the Commission, whether the claimant’s condition arises because of contribution by the accident, and whether the accident materially contributed to that condition and need for treatment.
On the balance of probabilities, can it be said that the injuries said to have been suffered by the claimant but not complained of, following the initial immediate complaint, for some of the injuries between 10-20 months post-accident, were caused by the accident? The Panel is satisfied that this is the case for reasons which will follow.
The insurer referred to a fall at an airport. The Medical Assessors asked the claimant if he had any falls since the accident. He said no and did not know why this was recorded. If he had failed to recall the incident and it did occur the Panel notes that Dr Tomka’s findings at the time were of tenderness over the scapula, rather than the shoulder cowl and biceps where he has his current symptoms.
Regarding degenerative changes in the shoulders, the Medical Assessors note that there is a poor relationship between degenerative changes and symptoms. The presence of degenerative changes in shoulder structures does not mean there are symptomatic preceding shoulder complaints. The Panel notes that there is record of a previous motor vehicle accident in 2016 when he developed shoulder pains and had subsequent imaging. Pain in the right shoulder is noted in subsequent consultations up until October 2017. There is then no mention of shoulder pain in Dr Tomka’s notes until the subject accident in 2020. This accords with the claimant’s assertions at the re -examination that he had recovered from the 2016 crash and was able to do handyman and painting work at the time of the subject accident. There was no evidence before the Panel that he had shoulder pain immediately before the subject accident.
With respect to persistence of right shoulder symptoms, contrary to the insurer’s comments that right shoulder pain had resolved by 5 February 2020, Dr Herald, reporting on
21 February 2020 was sufficiently concerned over the right shoulder pain that he wanted bilateral shoulder X-rays and MRI’s. The MRI showed reactive oedema at the acromioclavicular joint, as well as tendinosis and bursitis. At follow up on 17 March 2020 Dr Herald again noted persisting shoulder pain and recommended physiotherapy. In his report of May 2020
Dr Herald said that the accident had aggravated underlying rotator cuff disease. The Panel therefore finds contemporaneous evidence for persisting shoulder pain and treatment recommendations for several months after the accident, in accord with the claimant’s report of persisting symptoms. Physiotherapy notes between 20 November 2020 until 2023 list “Injuries to Neck shld Lower back”. The Medical Assessors take “shld” to refer to shoulder pain. The Panel considered the issue of causation of the claimant’s right shoulder pain. A front on impact would have resulted in uncontrolled forward movement of the trunk, restrained by the seatbelt at the right shoulder. Noting the presence of degeneration in the acromioclavicular joint, the claimant would have been more susceptible to injury from direct impact. The Medical Assessors therefore considered that the accident could have caused a right shoulder injury, and that the persistent new symptoms detailed above show that it did, therefore meeting appropriate criteria for causation.
With the claimant’s left shoulder, although there is record of early left shoulder symptoms, the claimant did not complain of current shoulder symptoms.
As to the claimant’s cervical spine, the insurer says that he had a pre-existing condition and that scans in March 2020, May 2022 and November 2022 all show degenerative discopathy. The insurer alleges that what is now seen is unrelated to the accident. Prof Shatwell considered as much.
The Panel notes that there is degenerative change of the cervical spine. However, the
subject motor accident on 19 January 2020 caused this to become symptomatic.
The insurer says that between 6 April 2021 and 24 February 2022, the claimant did not report any symptoms in his cervical spine to his GP. The insurer says that by virtue of no complaints for at least one year then this is evidence that accident related cervical spine
issues had resolved shortly after the accident. The Panel responds by noting that the claimant said that he had ongoing neck symptoms. The fact that they are not recorded in the GP records over those nine months does not confirm that they were not present.
With the lumbar spine, the insurer says that between 6 April 2021 and 24 February 2022 the claimant did not report any symptoms to his GP. The insurer says that any injuries for the lumbar spine resolved early and complaints now are not related to the accident. In this regard the Panel makes the same comments relating to the cervical spine. The absence of symptoms being recorded by the GP does not establish that they were not present.
With the cervical and lumbar spine, the claimant had signs of dysmetria. The claimant is assessed as he presented on the day of the examination. The Panel has accepted causation. There was asymmetric loss of range of movement at the cervical and lumbar spinal regions as documented in the examination report. This constitutes dysmetria as defined in the Motor Accident Guidelines and AMA4 Guides.
The Panel is satisfied that on the balance of probabilities, the motor accident caused injury to the claimant which has given rise to the development pain in his right shoulder, cervical spine and lumbar spine. However, the Panel is not satisfied that the claimant has suffered assessable impairment to all of those areas.
The Panel is satisfied that the accident was a contributing cause to the development of disability to the aforementioned areas. However, the level of disability has not been significant, as evidenced by the examination results of Medical Assessor Cameron.

CONCLUSION

As a result of the accident on 19 January 2020 the claimant has suffered injuries to his cervical spine, lumbar spine and right shoulder.
The Panel is not satisfied that the claimant injured his left shoulder in the accident.
The Panel assesses the claimant as having a total of 12% WPI.

DETERMINATION

The Panel revokes the certificate of Medical Assessor Home dated 22 April 2024.
The Panel finds that as a result of the accident on 19 January 2020, the claimant has suffered injuries to his cervical spine, lumbar spine and right shoulder.
The Panel is not satisfied that the claimant injured his left shoulder in the accident.
The Panel assesses the claimant as having a total of 12% WPI.

[2025] NSWPICMP 110

21 February 2025