Park v AAI Ltd t/as AAMI
[2025] NSWPICMP 464
•30 June 2025
| DETERMINATION OF REVIEW PANEL | |
CITATION: | Park v AAI Ltd t/as AAMI [2025] NSWPICMP 464 |
CLAIMANT: | Park |
INSURER: | AAI Limited t/as AAMI |
REVIEW PANEL | |
MEMBER: | Elizabeth Medland |
MEDICAL ASSESSOR: | Dr David Gorman |
MEDICAL ASSESSOR: | Dr Margaret Gibson |
DATE OF DECISION: | 30 June 2025 |
CATCHWORDS: | MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); Panel Review of medical assessment as to whether injuries caused by the accident give rise to a permanent impairment of greater than 10%; radiology demonstrates widespread degenerative changes in the cervical and lumbar spines; originally found that accident did not cause disc degeneration of the spine; left shoulder has cuff tear and originally found as not related; Held – accident did not cause disc pathology to the cervical and lumbar spine; accident caused aggravation to pre-existing changes; accident did not cause cuff tear as no acute pain in the left shoulder at the time of the accident; whole person impairment (WPI) assessed at 7%; MAC confirmed. |
DETERMINATIONS MADE: | 1. The Review Panel confirms the certificate of Medical Assessor Robert Kuru dated |
STATEMENT OF REASONS
INTRODUCTION
Ms Young Joon Park, (the claimant) is a 40-year-old man who suffered injury on
25 February 2022. The claimant was driving a truck when another vehicle failed to give way at an intersection causing a T-bone collision.
A claim was lodged upon AAI Limited t/as AAMI (the insurer) who is the compulsory third party insurer of the vehicle considered at fault. The insurer has a liability to pay statutory benefits and/or damages under the Motor Accident Injuries Act2017 (MAI Act).
The subject issue in dispute is whether the “degree of permanent impairment as a result of the injury caused by the motor accident is greater than 10%”.
This is a review of a medical assessment pursuant to s 7.26 of the MAI Act. The medical assessment the subject of this review was conducted by Medical Assessor Robert Kuru. He issued a certificate dated 4 October 2024. The Medical Assessor certified that the injuries caused by the accident give rise to a permanent impairment of 7% and is not greater than 10%.
THE REVIEW
The application for referral of a medical assessment to a Review Panel (the Panel) was made by the claimant, and the President’s delegate referred the medical assessment to the Panel as they were satisfied that there was reasonable cause to suspect that the medical assessment was incorrect in a material respect having regard to the particulars set out in the application.[1]
[1] Section 7.26(5) of the MAI Act.
Pursuant to s 7.26(5A) of the MAI Act and Schedule 1, cl 14F(2) of the Personal Injury Commission Act2020 (the PIC Act), the Panel consists of two Medical Assessors and a Member of the Motor Accidents Division of the Personal Injury Commission (Commission).
Part 5 of the PIC Act enables the Commission to make rules with respect to the practice and procedure before the Commission including proceedings before a panel reviewing a decision of a Merit Reviewer or a Medical Assessor.[2]
[2] Section 41(2) of the PIC Act.
Rules 127 to 130 of the Personal Injury Commission Rules 2021 (PIC Rules) are made pursuant to Part 5 of the PIC Act. A Review Panel determines how it conducts and determines the proceedings and may determine the proceedings solely based on the written application.[3]
[3] Rule 128 of the PIC Rules.
The review is by way of new assessment of all matters with which the medical assessment is concerned.[4]
[4] Section 7.26(6) of the MAI Act.
Interim directions were issued by the Panel requiring the parties to lodge bundles of all documents relied upon. Those bundles were received in compliance with the direction.
The Panel convened a teleconference and determined that a re-examination of the claimant was required. This occurred on 21 March 2025 with Medical Assessor Gorman in the Commission medical suites in Darlinghurst.
The Panel reconvened via teleconference on 10 April 2025.
Permanent impairment assessment
Section 7.21 of the MAI Act provides that the degree of permanent impairment of an injured person is to be assessed in accordance with the Motor Accident Guidelines (the Guidelines).
The Guidelines are issued pursuant to s 10.2 of the MAI Act. The Guidelines adopt the fourth edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA 4). Where there is any difference between AMA 4 and the Guidelines, the Guidelines are definitive.[5]
[5] Clause 6.2 of the Guidelines.
Guidelines
Causation of injury is addressed from cl 1.5 of the Guidelines. Whilst the clauses are set out in respect of permanent impairment they are relevant to a dispute as to threshold injury.[6] Clauses 1.6 and 1.7 provides:
“1.6 Causation is defined in the Glossary at page 316 of the AMA4 Guides as follows:
Causation means that a physical, chemical or biologic factor contributed to the occurrence of a medical condition. To decide that a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has, in fact, done so, it is necessary to verify both of the following:
1. The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination.
2. The alleged factor did cause or contribute to worsening of the impairment, which is a non-medical determination.'
This, therefore, involves a medical decision and a non-medical informed judgement.
1.7 There is no simple common test of causation that is applicable to all cases, but the accepted approach involves determining whether the injury (and the associated impairment) was caused or materially contributed to by the motor accident. The motor accident does not have to be a sole cause as long as it is a contributing cause, which is more than negligible. Considering the question 'Would this injury (or impairment) have occurred if not for the accident?' may be useful in some cases, although this is not a definitive test and may be inapplicable in circumstances where there are multiple contributing causes.”
[6] See Briggs v IAG Limited t/as NRMA Insurance [2022] NSWSC 372 at [35].
In determining the issue of causation, the Panel is to also have regard to s 5D of the Civil Liability Act 2002 (CL Act):[7]
[7] See s 3B(2) of the CL Act.
“5D General principles
(1) A determination that negligence caused particular harm comprises the following elements—
(a) that the negligence was a necessary condition of the occurrence of the harm (factual causation), and
(b) that it is appropriate for the scope of the negligent person’s liability to extend to the harm so caused (scope of liability).
(2) In determining in an exceptional case, in accordance with established principles, whether negligence that cannot be established as a necessary condition of the occurrence of harm should be accepted as establishing factual causation, the court is to consider (amongst other relevant things) whether or not and why responsibility for the harm should be imposed on the negligent party.
(3) If it is relevant to the determination of factual causation to determine what the person who suffered harm would have done if the negligent person had not been negligent—
(a) the matter is to be determined subjectively in the light of all relevant circumstances, subject to paragraph (b), and
(b) any statement made by the person after suffering the harm about what he or she would have done is inadmissible except to the extent (if any) that the statement is against his or her interest.
(4) For the purpose of determining the scope of liability, the court is to consider (amongst other relevant things) whether or not and why responsibility for the harm should be imposed on the negligent party.”
ASSESSMENT SUBJECT TO REVIEW
Medical Assessor Kuru examined the claimant on 23 August 2024 and provided a certificate dated 4 October 2024. He determined that the following injuries gave rise to a permanent impairment of 7% (5% lumbar spine, 1% left knee, 1% right knee):
· left knee – horizontal cleavage tear of the medial meniscus, bony oedema of medial femoral condyle, soft tissue injury;
· aggravation to degenerative change in L3/4, L4/5, L4/5 and L5/S1, soft tissue injury;
· right knee – horizontal cleavage tear of the medial meniscus, surgery, soft tissue injury, and
· skin – TEMSKI scarring.
He certified that the following injuries were caused by the accident and had resolved, giving rise to no permanent impairment:
· right shoulder – soft tissue injury;
· left shoulder – soft tissue injury, and
· cervical spine – soft tissue injury.
Medical Assessor Kuru further certified that the following injuries were referred for assessment but found to have been not caused by the accident:
· cervical spine – C5/C6 disc bulge, annular tears at C4/C5, C7/T1, foraminal stenosis at C5/C6, C4/C5 and C3/C4;
· lumbar spine – disc degeneration at L4/L5 and L5/S1, and
· left shoulder – bursitis, cuff tear.
SUBMISSIONS
Claimant’s submissions dated 2 February 2024
The submissions rely on the opinion of Dr Bodel who provided a report with an assessment of whole person impairment of 17%.
Claimant’s review submissions dated 25 November 2021
The submissions state that the claimant seeks a review only in respect of the cervical spine. Whilst this is stated in the submissions, at the request of the Panel the claimant’s representatives later clarified in a message on the Commission’s portal dated 18 March 2025 that the claimant requests that all referred body parts form part of the Panel’s Review.
The submissions assert that the Medical Assessor failed to give sufficient reasons as to why the cervical spine injury was not caused by the accident. It is alleged that there is “no doubt” that such injury was suffered as a result of the accident. The claimant refers to radiology of the cervical spine that occurred after the accident that records pathology.
The submissions allege that apart from two blanket statements of the Medical Assessor that the pathology found on radiology were pre-existing degenerative changes. It is also submitted that the findings are inconsistent in that the Medical Assessor does find that the claimant suffered a musculoligamentous injury caused by the accident. The claimant notes that there is no evidence of any pre accident symptomatology of the cervical spine.
Insurer’s review submissions dated 18 November 2024
The insurer notes that Medical Assessor Kuru on examination found a normal range of unrestricted cervical flexion, extension, rotation and lateral flexion. The insurer submits that the claimant misconstrued the findings of the Medical Assessor who provided a clear path of reasoning.
It is also noted that both Dr Wallace and Dr Bodel diagnosed soft tissue injuries to the neck, with Dr Bodel also noting degenerative changes of the cervical spine.
DOCUMENTATION
The Panel has considered all documents provided by the parties in the bundles lodged in compliance with the Panel’s interim directions. Whilst not every piece of evidence is mentioned within these reasons, all evidence has been considered. Some specific evidence is referred to when directly relevant to a finding.
Application for personal injury benefits and 29 March 2022
The claimant has left the injuries description blank in this document.
Medico-legal opinions
The claimant relies on a report of Dr Bodel dated 3 October 2023. The doctor found a 17% whole person impairment due to injuries sustained in the accident. This comprises of a 5% impairment to the cervical spine on the basis of a DRE Category II impairment. He noted asymmetry of movement and guarding but no clinical sign of radiculopathy.
In respect of the lumbar spine he found a 5% whole person impairment based on a DRE category II noting an asymmetry of movement and guarding but no clinical sign of radiculopathy.
He found a 6% whole person impairment of the right shoulder on the basis of restriction of movement.
In addition, a 1% whole person impairment was found in respect of each knee.
Dr Wallace has provided a report to the insurer dated 30 May 2023. He found a 7% whole person impairment arising from 5% to the lumbar spine (DRE II) and 1% in respect of each knee.
RE-EXAMINATION
Who attended the assessment?
Mr Park attended the examination alone. He gave a clear account of his history.
HISTORY
Pre-accident medical history and relevant personal details
Mr Park is a 41-year-old right handed man.
He was born in Korea and came to Australia in 2001.
He lives with his partner and her two sons.
He is a non-smoker and non-drinker of alcohol.
He had worked as a Bar Attendant. He then worked as a Furniture Removalist.
He has not worked since the subject accident.
Mr Park told me that he was well.
He told me he took no regular medications and that he had no allergies.
Prior to the accident, he enjoyed playing and refereeing soccer, playing tennis and badminton.
He told me he had been unable to do these subsequent to this accident.
History of the motor accident
Mr Park was driving a truck at approximately 50kmph. A car came through an intersection from his right hand side. He was unable to brake in time and struck the car from the left hand side. He was unable to get out of the truck after the accident.
He had pain in his back and pain in his knees.
An ambulance attended the scene and helped him get out of the truck. He went home following the accident.
History of symptoms and treatment following the motor accident
Following the accident, Mr Park presented to his general practitioner. He was referred for scans on his knees, back and neck.
He was subsequently referred to an orthopaedic surgeon (Dr Chien) for his knees.
On 27 July 2022 Dr Chien details injury to the right knee and notes an MRI demonstrating some retro-patellar chondral change as well as evidence of a medial meniscal tear. He recommended proceeding with arthroscopy and medial meniscal repair. This was undertaken on the right knee in August 2022.
In September 2022, Dr Chien reviewed the left knee. He described pain in the inner aspect of the knee is noted with an MRI demonstrating evidence of meniscal tear. He recommended arthroscopic meniscectomy on the left knee. This was undertaken in March 2023.
Mr Park has subsequently seen another orthopaedic surgeon, Dr Popoff. On 24 June 2024 he noted a month of sudden onset pain in the left knee with lesser pain in the right knee. He organised some updated imaging.
On 27 June 2024, Dr Popoff noted changes in the inner aspect of the left knee joint consistent with progressive osteoarthritis. He noted a minor tear of the medial meniscus of the right knee. He considers that ultimately Mr Park may benefit from a high tibial osteotomy.
Subsequent to having meniscectomies, Mr Park reports improvement in his knees although he does still have pain in the fronts of his knees. He has some minor numbness in the front of his shin more so on the right than on the left. He has occasional swelling in the knee. He reports no locking and no instability.
He had an MRI on his neck and lumbar spine and he was referred to Dr Pope, neurosurgeon. On 15 November 2022, Dr Pope noted the injury and assesses the back and right leg pain. He records no neck pain. He noted an MRI of the cervical spine demonstrating ‘C5/6 central disc bulge with minimal annular tearing, no neural exit foraminal stenosis, no cord compression’. He also notes MRI of the lumbar spine demonstrating ‘multiple levels of disc bulging with some modic type 2 changes at L5/S1 and L4/5 with no annular tearing. There was a perineural cyst at the level of the S2 sacral level and then epidural lipomatosis from L4 down to S1 which is congenital’.
Dr Pope concludes ‘My opinion is that Mr Park has bilateral knee injury. There is also mechanical lower back pain which could be due to the disc bulges at the epidural lipomatosis, this is not due to the accident nor is the perineural cyst’.
On 16 May 2023, Dr Pope notes ongoing low back pain and right lower limb numbness which he attributes to L4/5 disc pathology on the basis of discogenic back pain. He subsequently refers Mr Park to Dr Nazha, a pain management specialist.
Dr Nazha undertook radiofrequency injections on Mr Park. Mr Park says these were not helpful. Subsequent review on 15 September 2023 details ongoing back and leg symptoms as well as neck pain and bilateral upper limb symptoms.
Mr Park reported that he has no problem with either the right or left shoulder. He did not recall having any significant problems with either shoulder after the accident.
Details of any relevant injuries or conditions sustained since the motor accident
Nil.
Current symptoms
Mr Park has pain in both knees. There is some numbness down the front of the shins. He has occasional swelling of the knees but no locking or feeling of instability in the knees.
He wakes with knee pain. If he sits for more than 10-20 minutes the knees feel stiff – he needs to get up and walk.
He has used crutches as there was more pain in the last few weeks.
He has pain as well in the lateral right calf and lateral side of the right foot – there is some numbness and tingling there.
He has neck pain. The pain with rotation more so to the right than to the left and when the neck extends. If he lifts his left arm it feels stiff. The right arm is painful and there can be radiation of pain over the lateral right arm.
Mr Park has pain in his lower back if he stands for anything more than 20-30 minutes. He is uncomfortable sitting for prolonged periods of time or leaning forward to wash the dishes.
He feels depressed and has trouble sleeping. He is tired in the morning.
His partner does the cooking and shopping.
Current and proposed treatment
Mr Park is on a number of medications:
· Celebrex 200mg alternating with Voltaren 50mg;
· Efexor 150mg;
· Quetiapine 25mg;
· Duloxetine 60mg, and
· Panadol and Nurofen as required.
He sees a psychiatrist. He was seeing a psychologist but this has ceased.
The physiotherapy ceased two years ago. He still sees the physiotherapy with the help of his BUPA Health Insurance.
He goes to the pool two days per week and the Gym two days per week.
CLINICAL EXAMINATION
General presentation
He presented using bilateral crutches. He said that he had resumed using these when he goes out over the two weeks before the assessment because of increased knee pain.
His height was 176cm and his weight 92.9kg.
He walked without the crutches with a slow, bilaterally antalgic gait. There were pain behaviours.
Cervical spine
In the cervical spine rotation to the left was normal but rotation to the right was one half normal.
Extension was 2/3 normal but flexion was normal. He had dysmetria.
Neurological examination of the upper limbs demonstrates symmetrical reflexes with a negative Hoffman test. Peripheral power is intact. Sensation is normal.
It was pointed out that Medical Assessor Kuru and other examiners had not found abnormal movements in the cervical spine. Mr Park did not know why the previous reports were different but could only say that at present he has difficulty turning to the right.
Upper extremities
There is a good range of movement of both shoulders as outlined below but with mild restriction in the right compared with the left upper extremity. Impingement tests for the shoulders were negative.
| SHOULDER MOVEMENT | Right (degrees) | Left (degrees) |
| Flexion | 180 | 180 |
| Extension | 50 | 50 |
| Abduction | 170 | 180 |
| Adduction | 50 | 50 |
| Internal rotation | 80 | 80 |
| External rotation | 80 | 90 |
Lumbar spine
Flexion of the lumbar spine is to 2/3 normal with extension to ½ normal only. Lateral flexion is to 10cm above the knees bilaterally (1/2 normal).
Lower limb power is intact. Straight leg raise was to 90° in the sitting position without tension signs.
Reflexes were normal as was objective sensation – he indicated intermittent numbness over the lateral right foot. He indicated pain running down the right leg laterally to the foot.
Lower extremities
Examination of the knees demonstrates symmetrical quadriceps and gastrocnemius bulk. Range of motion in the knees was from 0°-120°.
There was no swelling or ligamentous instability.
There are well-healed arthroscopic portals over both knees.
Comments on consistency
Mr Park was co-operative throughout the assessment and but there was evidence of inconsistency with previous examiners who found no dysmetria in the cervical spine and on other occasions no pain in the cervical spine. He did demonstrate pain behaviours including presenting with two crutches without definite medical indication for them. The inconsistency in respect of the cervical spine was put to the claimant by Medical Assessor Gorman. The claimant replied that the changes were due to the way he turned his head.
Summary of relevant radiological and medical imaging and other investigations
I was able to review the following imaging reports:
· 7 June 2022: MRI cervical spine: C4/5, C5/6 degenerative disc disease with foraminal stenosis.
· 1 July 2022: MRI cervical spine: C4/5, C5/6 degenerative disc disease with foraminal stenosis.
· 1 July 2022: MRI lumbar spine: L1/2, L4/5, L5/S1 degenerative disc disease.
· 1 July 2022: MRI right knee: Medial compartment osteoarthritis with meniscal tear.
· 12 September 2022: MRI left knee: Medial compartment osteoarthritis with meniscal tear.
· 3 July 2023: MRI both knees: Medial compartment osteoarthritis of the left knee.
· 28 August 2023: MRI lumbar spine: L1/2, L4/5, L5/S1 degenerative disc disease.
· 12 September 2023: MRI cervical spine: C4/5, C5/6 degenerative disc disease with minor foraminal stenosis.
· 10 July 2024: X-ray both knees: Reduction in the medial joint space left greater than right consistent with osteoarthritis. Lateral subluxation of the patella on the left.
DETERMINATIONS
Diagnosis and reasons
Cervical spine
C5/C6 disc bulge, annular tears at C4/C5 C7/T1, foraminal Stenosis at C5/C6, C4/C5 and C3/C4, soft tissue injury. The diagnosis for the cervical spine is soft tissue injury with aggravation of degenerative disease.
Lumbar spine
Disc degeneration at L4/L5 and L5/S1, aggravation to degenerative change in L3/L4, L4/L5 and L5/S1, soft tissue injury. The diagnosis for the lumbar spine is soft tissue injury with aggravation of degenerative disease.
Left knee
Horizontal cleavage tear of the medial meniscus, bony oedema of medial femoral condyle, soft tissue injury. The diagnosis for the left knee is aggravation of pre-existing medial compartment osteoarthritis with horizontal cleavage tear of the medial meniscus.
Right knee
Horizontal cleavage tear of the medial meniscus, surgery, soft tissue injury. The diagnosis for the right knee is medial meniscal tear.
Right shoulder
Soft tissue injury. The diagnosis for the right shoulder is that of soft tissue injury.
Left shoulder
Bursitis, cuff tear, soft tissue injury. The diagnosis for the left shoulder is that of soft tissue injury.
Skin
TEMSKI scarring.
Causation and reasons
Cervical spine
C5/C6 disc bulge, annular tears at C4/C5 C7/T1; foraminal stenosis at C5/C6, C4/C5 and C3/C4 – these changes were not caused by the motor vehicle accident. They are widespread and not consistent with an acute annular tear. The widespread nature of the changes makes it overwhelmingly likely that they are degenerative in nature and not caused by an acute trauma. There was also no acute cervical spinal pain. Degenerative changes are often asymptomatic and the absence of complaint prior to the accident does not negate the likelihood that the pathology existed prior to the accident.
The soft tissue cervical musculoligamentous injury with aggravation of degenerative disease was caused by the motor vehicle accident.
Lumbar spine
Disc degeneration at L4/L5 and L5/S1 aggravation to degenerative change in L3/L4, L4/L5 and L5/S1 - disc degeneration at L4/5 and L5/S1. The changes are widespread and not consistent with an acute injury. The changes in the lumbar spine are pre-existing degenerative change and not caused by the motor vehicle accident.
The soft tissue injury subsequent to the accident represents aggravation to degenerative change at L4/5 and L5/S1 and a soft tissue musculoligamentous injury caused by the accident.
Left knee
Horizontal cleavage tear of the medial meniscus, bony oedema of medial femoral condyle, soft tissue injury – these injuries were caused by the motor vehicle accident.
Right knee
Horizontal cleavage tear of the medial meniscus, surgery, soft tissue injury – these injuries were caused by the motor vehicle accident.
Right shoulder
Soft tissue injury - was caused by the motor vehicle accident as evidenced by the contemporaneous treating evidence. The injury has now resolved.
Left shoulder
Soft tissue injury – was caused by the motor vehicle accident but has resolved. The Panel finds that the bursitis and cuff tear were not caused by motor vehicle accident, on the balance of probabilities, as there was no acute pain in the left shoulder at the time of the accident which would have been the finding if the accident was responsible for the tear.
Summary of injuries referred by the parties
The following injuries WERE caused by the motor accident:
· cervical spine – aggravation of degenerative change; soft tissue injury;
· lumbar spine – aggravation degenerative change, soft tissue injury;
· left knee – horizontal cleavage tear of the medial meniscus, bony oedema, soft tissue injury;
· right knee – horizontal cleavage tear of the medial meniscus, surgery, soft tissue injury;
· right shoulder – soft tissue injury, and
· left shoulder – soft tissue injury.
The following injuries WERE NOT caused by the motor accident:
· cervical spine – C5/6 disc bulge, annular tears at C4/5 C7/T1, foraminal stenosis at C5/6, C4/5 and C3/4;
· lumbar spine – disc degeneration at L4/5 and L5/S1, and
· left shoulder – bursitis and cuff tear.
The following injuries caused by the motor accident have resolved:
• right shoulder – soft tissue injury, and
• left shoulder – soft tissue injury.
PERMANENCY OF IMPAIRMENT
Statement about permanent impairment Permanent impairment is defined in the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fourth Edition (AMA4 Guides) (p.315) as follows:
“Permanent impairment is impairment that has become static or well stabilised with or without medical treatment and is not likely to remit despite medical treatment. A permanent impairment is considered to be unlikely to change substantially and by more than 3% in the next year with or without medical treatment.”
I consider the impairment to be permanent and it is unlikely the impairment will change substantially and by more than 3% in the next year with or without medical treatment.
DETERMINATIONS – PERMANENT IMPAIRMENT
The determination as to permanent impairment is made in accordance with the AMA4 Guides and Part 6 of the Motor Accident Guidelines.
Cervical spine
Aggravation of degenerative change; soft tissue injury – he has dysmetria observed on examination. Medical Assessor Kuru noted pain on turning to the right was also a symptom but did not find dysmetria. Dr Wallace in his report to the insurer found that the cervical spinal pain had resolved. Dr Pope did not consider the cervical spine of significance in his assessment. Dr Bodel in his report found that there was tightness turning to the left (not the right as was seen by Medical Assessor Gorman on re-examination). Radiculopathy as defined by the Guidelines is not present. He has intermittent right arm symptoms, but they are not radicular in distribution. The Panel felt with this level of inconsistency that the cervical spine did not have a significant permanent impairment. He has a DRE category I impairment giving him 0% WPI based on Table 73 on page 110 of AMA4 Guides.
Lumbar spine
Aggravation degenerative change, soft tissue injury – he has dysmetria. He has no radiculopathy. He has non-verifiable symptoms running down the right leg to his foot with numbness over the lateral foot. He has a DRE category II impairment giving him a WPI of 5% based on Table 72 on page 110 of the AMA4 Guides.
Left knee
Horizontal cleavage tear of the medial meniscus, bony oedema, soft tissue injury he has had a partial meniscectomy and therefore has 1% WPI based on Table 64 on page 85 of AMA4 Guides.
Right knee
Horizontal cleavage tear of the medial meniscus, surgery, soft tissue injury – he has had a partial meniscectomy and therefore has 1% WPI based on Table 64 on page 85 of the
AMA4 Guides.
Skin - scarring
The claimant has well healed arthroscopy scars – 0% WPI based on TEMSKI.
Permanent Impairment Table
| Body Part or System | AMA Guides/ Guidelines References (chapter/ page/table) | Permanent (YES/NO) | Current %WPI* | %WPI* from pre-existing OR subsequent causes | %WPI* due to motor accident |
| Cervical spine | Table 73 on page 110 of AMA 4th Edition | Yes | 0% | 0% | 0% |
| Lumbar spine | Table 72 on page 110 of AMA 4th Edition | Yes | 5% | 0% | 5% |
| Left knee | Table 64 on page 85 AMA 4th Edition | Yes | 1% | 0% | 1% |
| Right knee | Table 64 on page 85 of AMA 4th Edition | Yes | 1% | 0% | 1% |
| Scarring - TEMSKI | TEMSKI scale | Yes | 0% | 0% | 0% |
* %WPI = percentage whole person impairment
Pre-existing/subsequent impairment
No adjustment is required for pre-existing or subsequent impairment.
Apportionment
No apportionment is required.
Effects of treatment
No adjustment for the effects of treatment is required.
CONCLUSION – PERMANENT IMPAIRMENT
Degree of permanent impairment caused by the motor accident is 7%. The certificate of Medical Assessor Kuru is confirmed.
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