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Monda v G & E Monda Pty Ltd

Monda v G & E Monda Pty Ltd

Case [2025] NSWPICMP 568 4 August 2025

Review of Medical Assessment Certificate

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DETERMINATION OF APPEAL PANEL
CITATION:	Monda v G & E Monda Pty Ltd [2025] NSWPICMP 568
APPELLANT:	Giosino Monda
RESPONDENT:	G & E MONDA PTY LTD
APPEAL PANEL
MEMBER:	Mitchell Strachan
MEDICAL ASSESSOR:	Drew Dixon
MEDICAL ASSESSOR:	John O’Neill
DATE OF DECISION:	4 August 2025
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); appeal from assessment of Medical Assessor (MA); incorrect criteria; demonstrable error; application to rely on fresh evidence; Ross v Zurich Workers Compensation Insurance, and Lukacevic v Coates Hire Operation Pty Ltd applied; nature of dispute referred for assessment; Skates v Hills Industries Ltd, and Klement v Bull ‘N’ Bush Nurseries Pty Limited applied; Held – MA fell into error in making finding as to causation beyond scope of referral; MAC revoked; new MAC issued.

BACKGROUND TO THE APPLICATION TO APPEAL

On 14 April 2025, the appellant, Giosino Monda, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ross Mellick, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 13 March 2025.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· the assessment was made on the basis of incorrect criteria, and
· the MAC contains a demonstrable error.
The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the grounds 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, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

RELEVANT FACTUAL BACKGROUND

The appellant sustained an injury on 1 February 2016 in the course of his employment with the respondent. The injury occurred as a result of reaching over to pick up a box.
Solicitors acting for the appellant initially wrote to the insurer for the respondent making a claim for lump sum compensation under s 66 of the Workers Compensation Act 1987 (the 1987 Act). The claim was with respect to 24% whole person impairment (WPI) and relied upon reports of Dr Berry dated 2 September 2020 and 30 November 2021.
The claim was responded to by solicitors acting from the respondent’s insurer…

Grounds of appeal

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

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

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

Consideration

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

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

Continue reading Monda v G & E Monda Pty Ltd

Details

AGLC: Monda v G & E Monda Pty Ltd [2025] NSWPICMP 568
Case: [2025] NSWPICMP 568
Decision Date: 4 August 2025

CaseChat Overview and Summary

The case of Monda v G & E Monda Pty Ltd involves an appeal against the assessment of a Medical Assessor in a workers' compensation matter. The dispute centres on the validity and correctness of a Medical Assessment Certificate (MAC) issued following a referral for a medical assessment under the Workers Compensation Act 1987 and the Workplace Injury Management and Workers Compensation Act 1998. The applicant, Monda, sought to challenge the MAC, arguing that the Medical Assessor had applied incorrect criteria and made a demonstrable error in their assessment, particularly concerning the causation of the injury. The court was required to determine whether the MA's findings were within the scope of the referral and whether the errors were of such a nature as to warrant a revocation of the MAC and the issuance of a new one.

The legal issues that the court had to resolve included whether the Medical Assessor had applied the correct legal criteria in making their assessment, whether there was a demonstrable error that went beyond the scope of the referral, and whether the application to rely on fresh evidence was permissible under the circumstances. The court considered relevant authorities such as Ross v Zurich Workers Compensation Insurance and Lukacevic v Coates Hire Operation Pty Ltd to assess the nature of the error and the potential for reliance on fresh evidence. Additionally, the court examined Skates v Hills Industries Ltd and Klement v Bull ‘N’ Bush Nurseries Pty Limited to understand the nature of the dispute and the scope of the referral for assessment.

In its reasoning, the court found that the Medical Assessor had indeed fallen into error by making a finding as to causation that was beyond the scope of the referral. This error was deemed significant enough to warrant the revocation of the MAC. Consequently, the court ordered that the MAC be revoked and a new one issued, reflecting a correct assessment in line with the legal criteria and the scope of the referral. This decision underscores the importance of precise adherence to the referral criteria and the consequences of exceeding those boundaries. The court's decision ensures that the MAC accurately reflects the medical assessment required for the workers' compensation claim.

Orders