Manzoupo v Arrow ECS Australia Pty Ltd
[2024] NSWPICMP 641
•11 September 2024
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Manzoupo v Arrow ECS Australia Pty Ltd [2024] NSWPICMP 641 |
| APPELLANT: | Jairo Manzoupo |
| RESPONDENT: | Arrow ECS Australia Pty Ltd |
| APPEAL PANEL | |
| MEMBER: | John Wynyard |
| MEDICAL ASSESSOR: | Doug Andrews |
| MEDICAL ASSESSOR: | Michael Hong |
| DATE OF DECISION: | 11 September 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; psychological injury; appeal by injured worker against maximum medical improvement (MMI) assessment; whether Medical Assessor (MA) gave any reasons; whether MA’s function is compromised by considering causation; Held – Medical Assessment Certificate revoked; no reasons given for MMI finding; suggested reasons advanced by respondent were speculative; MA’s consideration of causation demonstrated lack of understanding of a MA’s function and may have diverted attention from the relevant issues; claimant re-examined and assessed at 7% whole person impairment. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 21 December 2023 Jairo Manzoupo, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Surabhi Verma, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on
28 November 2023.The appellant relies on the following ground of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· 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 Guides) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5). “WPI” is reference to whole person impairment.
RELEVANT FACTUAL BACKGROUND
On 23 August 2023 Member Michael Wright gave an oral decision after a defended hearing remitting this matter to the President on 4 September 2023. A delegate of the President referred this matter for an assessment of WPI caused by psychological/psychiatric disorder on a deemed date of 1 October 2020.
Mr Manzoupo was employed as a Business Development Manager for the respondent.
Mr Manzoupo was invited to become involved in some unethical activities and was given an ultimatum that if he did not cooperate, his manager would find someone who would. This made Mr Manzoupo’s life difficult. He was bullied and micromanaged at the same time.There was a meeting in January 2021 in which Mr Manzoupo was put on a coaching program. Mr Manzoupo has not worked since 9 February 2021.
PRELIMINARY REVIEW
The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
The appellant stated that he did not seek a re-examination, but that he did seek that the matter be remitted to the President for referral for a further assessment with an alternate Medical Assessor. We were not referred to any statutory or other authority that gives us that power. Once the matter is before a Medical Appeal Panel it has two alternatives pursuant to s 328(5) of the 1998 Act, namely, to confirm or revoke the MAC. It does, however, have power to re-examine pursuant to s 324(1)(c) and (3), and (4), and s 328(2A) and (4) of the 1998 Act. Accordingly, the Panel determined that Mr Manzoupo should be re-examined, as it also determined that the Medical Assessor had fallen into error, as explained below.
EVIDENCE
Documentary evidence
The Appeal 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.
Further medical examination
Medical Assessor Michael Hong of the Appeal Panel conducted an examination of the worker on 15 August 2024 and reported to the Appeal Panel.
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 which have been considered by the Appeal Panel.
FINDINGS AND REASONS
The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made.
In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
The MAC
In her summary at [7] of the MAC, the Medical Assessor considered whether the workplace bullying had been causative of the injury. She said:
“…On one hand, Mr Manzoupo reported that his psychological injury was related to the alleged bullying and harassment at the workplace. It seems that he had been enjoying a reasonably stable and successful career track prior to joining Arrow ECS even though there had been periods of anxiety and depression in the past and a history of illicit substance use, but he never developed the clinical symptoms of severe and debilitating depression. The bullying and harassment that he suffered at work, it exacerbated his drug use, especially alcohol and cocaine use. He also started using methamphetamines which he said he had only done this time. His drug use further worsened his mental health and probably precipitated the depressive symptoms that Mr Manzoupo has been experiencing.
On the other hand, I have also noticed that Mr Manzoupo was being performance managed for his deteriorating performance at work along with the fact that he had misused the before the workplace incidents and it is clear that the workplace incidents exacerbated the alcohol and stimulant use. He also admitted to using methamphetamines which he had not used previously.
…
In light of the above information, it is quite difficult for me to comment whether the injuries are workplace-based or related to performance issues….”
The Medical Assessor, when discussing the opinion of Dr Graham George, at [10c] of the MAC the psychiatrist retained by the employer, that no psychological injury had been incurred, said:[1]
“On the balance of probabilities, I believe that if it can be proven that Mr Manzoupo was forced to engage in unethical activities, then it can be deduced that this injury was a work-related injury. However, if it is proven that because of being performance managed and being called out for misusing the company credit card, then it would be safe to deduce that his employment was not a substantial contributing factor to the condition.”
[1] Appeal papers page 26.
The Medical Assessor answered the templated questions (emphasised in bold) at paragraph [8] of the MAC as follows, relevantly:
“b. Have all body parts/systems stabilised/reached maximum medical improvement? No.
c. If not, please list those injuries not yet stable/at maximum medical improvement:
Psychological/Psychiatric.
d. If stabilisation/maximum medical improvement, of any or all injuries has not been reached, when, in your opinion, will this occur? Once he receives evidence-based treatment and management.”
The treatment being given was described by the Medical Assessor:[2]
“Present treatment: He sees Dr Vladimir Sazhin, Psychiatrist. He is currently on Sertraline 50 mg and Diazepam 10 mg which he takes a couple of days a week. He also sees Benjamin, Psychologist. Mr Manzoupo used to see him weekly initially and sees him fortnightly now. He has completed cognitive behavioural therapy and is exploring other options with him.”
[2] Appeal papers page 22.
The formal certificate issued pursuant to Table 11.8 of the Guides contained the following question (emphasised in bold) and answer:
“Is impairment permanent? No. Mr Manzoupo has not achieved maximum medical improvement.”
SUBMISSIONS
The appellant
Mr Manzoupo submitted firstly that the Medical Assessor had erred by traversing the reasons given by Member Wright and proffering alternate potential causes for Mr Manzoupo’s injury.
Secondly, Mr Manzoupo submitted that the Medical Assessor did not give adequate reasons for her finding that maximum medical improvement (MMI) had not been reached. Her statement that it would occur when Mr Manzoupo received evidence-based treatment and management was not explained, nor did she engage with her description of the treatment presently being given.
Mr Manzoupo noted that the deemed injury date occurred on 1 October 2020, over three years earlier, and that his medico-legal expert, Dr Oldtree Clark had indeed found that
Mr Manzoupo had reached maximum medical improvement in November 2021.
The respondent
The respondent submitted that it was open for the Medical Assessor to make any comment she wished regarding the circumstances of the injury and indeed she said as much in the MAC itself. Those comments had no impact on her assessment and did not amount to a demonstrable error.
As to whether the finding of no maximum medical improvement was an error or not, the respondent referred to Chapter 1.6 of the Guides which set out the basis upon which such a finding could be made.
We were also referred to Chapter 1.15 of the Guides which is the one which specifically relates to MMI.
We were referred to the Medical Assessor’s comments as to the medical treatment being received. The respondent noted that the Medical Assessor was aware that further options of treatment were being explored with a psychologist and that Mr Manzoupo’s condition had worsened as a result of his recent behavioural conduct which involved imbibing alcohol and taking cocaine and methamphetamines. The respondent noted the finding that Mr Manzoupo had suffered an exacerbation of his psychological symptoms because of that behaviour and was exploring further treatment options.
It was accordingly submitted that it was open for the Medical Assessor to find that MMI had not been reached.
The respondent submitted it was not the role of a Medical Assessor to prescribe treatment for an appellant which role fell to an appellant’s treating practitioners.
The respondent submitted that the appellant’s situation on 17 November 2021, when
Dr Oldtree Clark reported, appeared to be significantly different to his condition when he was assessed by the Medical Assessor.We were referred to Stramit Corporation Pty Ltd t/as Stramit Building Products v Holl.[3]
[3] [2009] NSWWCCMA 32.
The respondent observed under the heading “Other issues” that the Medical Assessment Certificate has revealed that Mr Manzoupo engaged in subsequent employment in June 2023 to September 2023 which, according to the history taken by the Medical Assessor, resulted in the drug and alcohol use worsening. We were advised that the subsequent employment had not been disclosed by the appellant.
The respondent advised that it had sought particulars about that alleged employment, but had only received a partial response. It noted that the information might be relevant to the present claim and reserved the right to rely on the same once the information was received. We note that there is no ground before us based on this issue.
DISCUSSION
Whilst it is correct, as submitted by the respondent, that the comments by the Medical Assessor as to the injury itself did not of themselves constitute a demonstrable error, they did indicate that the Medical Assessor was not fully aware of her function – and particularly not aware that when she was appointed to assess WPI, the question of injury had already been decided. By contemplating the various issues relating to causation, the Medical Assessor appeared to be somewhat diverted from her function.
We note the various theories advanced by the respondent as to why the Medical Assessor decided that maximum medical improvement had not been reached, but its submissions were necessarily speculative, and suffered from the singular disadvantage that the Medical Assessor did not give any reasons at all. The Medical Assessor was bound, following the High Court authority of Wingfoot Australia Pty Ltd v Kocak,[4] to set out in a statement of reasons the actual path of reasoning by which the she arrived at her opinion, and she did not, with respect.
[4] Wingfoot Australia Pty Ltd v Kocak [2013] HCA 43; (2013) 252 CLR 480, at [49].
In El Masri v Woolworths Ltd[5] Campbell J at [50] said:
“[The] statement of reasons must explain that actual path of reasoning in sufficient detail to enable a court to see whether the opinion does or does not involve any error of law’.”
[5] [2014] NSWSC 1344.
Thus the Medical Assessor fell into error, and it was determined that Mr Manzoupo should be re-examined by Medical Assessor Michael Hong of the Panel. Medical Assessor Hong’s report follows:
“1. HISTORY RELATING TO THE INJURY
· Brief history of the incident/onset of symptoms and of subsequent related events, including treatment:
Briefly, Mr Manzoupo confirmed the history that he worked at Arrow as a business development manager from 2019, and worked there for about 17 months. Due to the bullying and harassment, he suffered depression and anxiety and started abusing substances. He recalled his employer wanted him to engage in illegal activities.
He had two psychiatric admissions. With treatment, he said he improved and then in the mid or later part of 2023, he went to Melbourne to work for Innovative Security and Data, performing a full-time sales role, which was very similar to what he did at Arrow. He said he has done similar work all of his life and has been doing corporate sales since his 20s. He reported he only lasted 4-5 weeks and said that the work environment reminded him of what happened at Arrow. He ‘went off the rails’ and the doctor certified him unfit for work. He reported he started abusing drugs and alcohol and self-harming because he felt overwhelmed. He said the only method of self-harm has been using drugs.
Mr Manzoupo is now off all psychiatric medication and said that when his psychiatrist saw him the last time, 4 months ago, he told him what he suffered from is PTSD and not depression and he does not need psychiatric medication for it. He has been seeing his psychologist regularly and doing psychotherapy to manage his psychiatric condition. There has been some improvement over time.
He said now, he has periods of anxiety and depression and they come and go. Some days he feels entirely normal and can enjoy life and get up and do things, but the next day, he might be triggered and started wanting to use drugs. He said he might disappear for a day or even a week, and go through a spell where he abused drugs. The frequency of substance use has definitely reduced over time and he said that he only used drugs once in the last four weeks. He does not abuse alcohol and has never wanted to use other substances. He said that his treating team have never referred him to a drug and alcohol centre but they have been doing things to help him identify triggers and prevent relapses in substance use.
· Present treatment:
Mr Manzoupo has been consulting Benjamin Petrovic, psychologist for around 3 years, recently every 2 weeks and has been having Cognitive behavioural therapy and possibly exploratory psychotherapy. He consulted Dr Vladimir Sazhin, 4 months ago and all psychotropic medications were ceased then. His last psychiatric admission was in 2021.
· Present symptoms:
Mr Manzoupo reported that his symptoms can be triggered by being in a similar situation as when he was at work and being mistreated, reading emails regarding this claim or being spoken to in a certain way. He has intermittent depressive symptoms and anxiety.
His weight is reasonably stable since he ceased psychotropic medications. He said he is pretty healthy overall, and is 82kg now, which he said is good for him. He eats regularly and tries to eat a healthy diet. He said self-care and personal hygiene is only a problem if he takes drugs.
His concentration and memory vary and he said some day he is a fully functioning genius, then next day his concentration is not good and he cannot answer simple questions.
His sleep is variable and he can have good sleep for 4 days, then bad sleep for a few days.
He said he does not have anger or irritability problems now, and in fact, he is the other way, he goes inwards and if upset, he recluses and does not act out.
· Details of any previous or subsequent accidents, injuries or condition:
In terms of past history, Mr Manzoupo reported he was born in Portugal and came to Australia in 1995. He confirmed he had some depression during migration but didn’t have any treatment. He confirmed that his father was aggressive. He said that in 1998 his brother attempted suicide by hanging, he was resuscitated and now is in full-time care. He said it was difficult growing up with an aggressive father in a single-parent household with a disabled brother.
Mr Manzoupo doesn’t believe he has any previous psychiatric diagnosis but he recalled that a year before he started working at Arrow, he asked for an antidepressant. He thought he might have been given Agomelatine and took it for six to eight months. He recalled at the time he had no energy, he had no drive and had low moods. He didn’t feel great and recalled lots of people told him he should get help. He found the antidepressant really helped.
I asked Mr Manzoupo about Dr Clarke’s recorded history that when he assessed him for his work injury, he wrote he had been ‘addicted to cocaine for ten years’. He said that this is not a correct history because he wasn’t addicted; he has only used cocaine recreationally before his work injury, he functions well and has been using cocaine since his 20s and had been a model employee all of his life. Cocaine only became a problem after working at Arrow.
I asked Mr Manzoupo about a history of suicide attempts and discussed the reports saying he attempted suicide a few times. He said, again that is incorrect. He has only attempted suicide once and this was when he was 13 or 14 by hanging due to the pressure at home.
I asked Mr Manzoupo about chronic suicidal thoughts as noted in the hospital file, in March 2021. He said that suicidal thoughts have always been in the back of his mind since childhood, like most people would have. When things are particularly bad and when he has very low moods, or when he is overwhelmed by stress, the suicidal thoughts become more severe. He said this can be highly variable. The severe suicidal thoughts can be five minutes or can last for a couple of weeks when he has low moods.
In terms of previous counselling, Mr Manzoupo said he did it a few times when he was 11 or maybe between the ages of 10 and 15, but it wasn’t for long because long-term counselling wasn’t available.
There is no subsequent psychological injury identified.
He does not have a family history of psychiatric illness.
· Social activities/ADL:
Mr Manzoupo is 38 and about six weeks ago, he moved to Brisbane and is living with a housemate. He reported that his ex-partner restricted his access to his seven-year-old son and recently she has allowed him to start having contact, so he moved to Brisbane because they are living in Brisbane now.
Mr Manzoupo showers daily, although there are periods when he does not shower for a week when he feels overwhelmed. He does not need prompting to shower and said he showers if he goes out. He occasionally goes shopping, but mostly buys groceries online and said it is easier and more convenient.
He stated that he spends most of his time learning new things, from watching YouTube videos on self-development. He spends a few hours online or watching videos. He has never been one to read books, but he listens to audiobooks, such as business books, learning new things and listening for about an hour.
He said he has been taking good care of himself. On good days, he takes walks, although there are days when he does not.
Mr Manzoupo said that by design, he does not have many friends now. He has four to five close friends and he said they are on the same journey, with an interest in self-betterment and a couple of those friends have had substance issues. He said all of his friends are in Sydney. In Sydney, he had lived with some friends and tries to catch up with his friends regularly.
When he was working at Arrow, he had a girlfriend, but that relationship ended, he said due to his changed behaviour, which made him unbearable to be around. They still talk now. Subsequently, he said he went partying and met another girl, but that relationship was not healthy. He said he has had no other relationships and is not interested in ‘distractions.’
In November 2023, he mentioned that he had a "stupid" relationship and decided to run away from her because she lied a lot, was abusive towards him, and had relationships with other men.
He has not spoken to his father for about five years and they have never been close. He has a reasonable relationship with his brother, whom he saw recently, and he is very close to his mother, who is currently visiting Australia.
Mr Manzoupo avoids social events and restaurants, and explained that when he goes to social events, he cannot stop using alcohol, which can lead to substance abuse, so he avoids social events now.
He is rebuilding his relationship with his son and now has a reasonable relationship with his ex-partner. He talks to his son every five days recently, since his ex-partner allowed him access.
In terms of trips, Mr Manzoupo went to Indonesia on his own and stayed with a long-term friend, visited some other friends, and stayed for three months, going to the beach every day. This was in early 2024 before moving to Brisbane. He said he took walks on the beach and enjoyed the silence.
He went to Portugal and lived with his mother and stepfather, and returned in February 2023. He recalled he visited some family, went exploring, sightseeing, and to the beach, and travelled around Europe and was in Morocco for his birthday, and went out a couple of times with some friends.
In October 2023, he went to Thailand on a “boys' trip” with a friend. He explored on his own as his friend did not want to go and that friend stayed and drank alcohol. He recalled he met locals, took walks on the beach. He thinks he only had two trips in 2023, including the trip to Indonesia.
He regained his driving licence 12 months ago, after losing it due to driving while disqualified. He mentioned that his driving is good now and that he is a law-abiding citizen.
2.FINDINGS ON PHYSICAL EXAMINATION
Mr Manzoupo was assessed by video. He was at home during the assessment. I assessed him from my Sydney office. I have completed a full psychiatric assessment with consent. I have taken handwritten notes, and there was no audio-visual recording of the assessment.
Mr Manzoupo wore glasses and had short greying hair, and was clean-shaven. He engaged well with the assessment process. There was no psychomotor slowing or abnormal movements. He was not restricted in his affect range and was generally bright and appropriately reactive and laughed regularly. He spoke spontaneously and fluently. He was attentive and gave a clear history and provided clarification when asked. He remained focused throughout the assessment. He maintained a steady pace.
At the end of the assessment, he was invited to discuss what he thought might be relevant. He talked about how the past four years have been difficult and how he lost his dignity, his son, and went from being an award-winning employee who was loved by everyone to suddenly being pushed out because he refused to do unethical things. He said he should have done Dialectical Behavioural Therapy in 2023 before they pulled his funding.
11. DEDUCTION (IF ANY) FOR THE PROPORTION OF THE IMPAIRMENT THAT IS DUE TO PREVIOUS INJURY OR PRE-EXISTING CONDITION OR ABNORMALITY
a. In my opinion the worker suffers from the following relevant previous injuries, pre-existing conditions or abnormalities:
(i) There was a pre-existing condition, which was consistent with Major depressive disorder.
b. The previous injury, pre-existing condition or abnormality directly contributes to the following matters that were taken into account when assessing the whole person impairment that results from the injury, being the matters taken into account in 10a, and in the following ways:
(i) Mr Manzoupo's pre-existing condition contributed to his current impairment, because recurrent depressive episodes are generally more severe and more disabling, resulting in a greater overall impairment, even when the previous episode had remitted or had been asymptomatic.
c. The extent of the deduction is difficult and/or costly to determine, so in applying the provisions of s.323(2), I assess the deductible proportion as one-tenth for a pre-existing injury.
Summary
Mr Manzoupo described a long history of recreational drug use and having chronic suicidal ideation with intermittent exacerbation, associated with low moods and he reported being treated with antidepressants about a year before he worked at Arrow. His previous symptoms were consistent with a major depressive episode. He had counselling when he was younger, potentially after a suicide attempt when he was 14.”
DISCERNMENT
The Panel adopts the report of Medical Assessor Hong.
Mr Manzoupo’s current psychological presentation can be conceptualised in several ways and the Panel's view is that he suffered from recurrent major depressive disorder. He has a substance use disorder. He has had long-term treatment, which is effective, and his condition is stabilised for the purpose of a WPI assessment. The Panel noted his treating team had revised his diagnosis to post-traumatic stress disorder or complex post-traumatic stress disorder, which would also be a reasonable formulation in view of his prejudicial childhood and long-term trajectory.
The following PIRS Table is accordingly assessed.
PERSONAL INJURY COMMISSION
PIRS Category
Class
Reason for Decision
Self-care and personal hygiene
2
Mr Manzoupo's weight is stable now and he has good general self-care and personal hygiene, except during drug use, which causes mild impairment.
Social and recreational activities
1
He has regular social and recreational activities and does not need a support person or prompting. He avoids parties as he knows it is an at-risk situation that can lead to relapse in substance use.
There is no deficit or minor deficit, attributable to the normal variation in the general population.
Travel
1
Mr Manzoupo's driving is good since he regained his driver’s licence and he can go everywhere on his own, and went overseas several times, including on his own.
Social functioning
2
Mr Manzoupo's relationship with his partner ended as a result of his psychological injury and he has gained improvement since. He has had other partnerships since, but he ended them as they were not healthy relationships.
He lost some friends.
He chose to end some friendships as they were unhealthy relationships.
His relationship with his family, son and ex-partner is good.
Concentration, persistence and pace
2
Mr Manzoupo reported having reduced concentration when under the influence of substances.
Day-to-day, he can focus on intellectually demanding tasks for more than 30 minutes e.g. reading books and learning from watching videos.
Employability
3
He can manage lower-stress employment at around 20 hours per week, with a different employer in an environment that does not trigger his substance use.
Score
Median Class
1
1
2
2
2
3
= 2
Aggregate Score Impairment
Total
%
+
+
+
+
+
11
5
Pre-existing injury
One-tenth
Treatment effects
The Panel noted he has had long-term effective treatment and has assessed his functioning before and after treatment, and there was evidence of substantial but not total elimination of his impairment with treatment, and he is able to choose more healthy relationships and reduced his substance usage, and returned to many of his usual recreational activities. If treatment is withdrawn, he is likely to revert to a greater level of impairment.
2
Final WPI
7%
For these reasons, the Appeal Panel has determined that the MAC issued on
28 November 2023 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: | W3411/23 |
Appellant: | Jairo Manzoupo |
Respondent: | Arrow ECS Australia Pty Ltd |
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 Verma 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) |
| Psychological injury | 1.10.2020 | N/A | 11 | 7% | 1/10th | 6% |
| Total % WPI (the Combined Table values of all sub-totals) | 6% | |||||
0
4
0