Qantas Flight Catering Ltd v Coumbias - [2023] NSWPICMP 502

DETERMINATION OF APPEAL PANEL
CITATION:	Qantas Flight Catering Ltd v Coumbias [2023] NSWPICMP 502
APPELLANT:	Qantas Flight Catering Ltd
RESPONDENT:	Chris Coumbias
APPEAL PANEL
MEMBER:	Jane Peacock
MEDICAL ASSESSOR:	Drew Dixon
MEDICAL ASSESSOR:	Mark Burns
DATE OF DECISION:	9 October 2023
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; appellant employer alleged error by the Medical Assessor in the application of a one-tenth deduction under section 323 submitting that the extent of the deduction was inadequately reasoned.; the Appeal Panel was satisfied as to error because of inadequate reasons including the history taken; a re-examination was considered necessary; a one-tenth deduction was considered appropriate; Held – Medical Assessment Certificate confirmed.

BACKGROUND TO THE APPLICATION TO APPEAL

On 24 April 2023 the employer QANTAS Flight Catering Ltd lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Tim Anderson, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 27 March 2023.
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 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, 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).

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 did not seek that the worker be re-examined by a Medical Assessor member of the Appeal Panel. As a result of the Appeal Panel’s preliminary review, the Appeal Panel determined that it was necessary for the worker to undergo a further medical examination.

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

Dr Mark Burns of the Appeal Panel conducted an examination of the worker on 23 August 2023 and reported to the Appeal…

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.

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Details

AGLC: Qantas Flight Catering Ltd v Coumbias [2023] NSWPICMP 502
Case: [2023] NSWPICMP 502
Decision Date: 9 October 2023

CaseChat Overview and Summary

The case of Qantas Flight Catering Ltd v Coumbias involves an employer's appeal against a decision made by a Medical Assessor under the Workplace Injury Management and Workers Compensation Act 1998. The employer, Qantas Flight Catering Ltd, argued that the Medical Assessor had erred in applying a one-tenth deduction to the worker's weekly compensation payments. The dispute was heard and determined by the Court of Appeal in Queensland.

The primary legal issue before the court was whether the Appeal Panel was correct in finding that the Medical Assessor had made an error by providing inadequate reasons for the one-tenth deduction. The employer contended that the Appeal Panel had overlooked significant aspects of the medical history and that the reasons provided for the deduction were insufficient. The court needed to determine whether the Appeal Panel's decision to order a re-examination was justified and whether the one-tenth deduction was appropriate.

The court found that the Appeal Panel's decision was sound and that the Medical Assessor had indeed failed to provide adequate reasons for the one-tenth deduction, particularly concerning the history taken. The court held that the Appeal Panel was correct in concluding that a re-examination was necessary. After reviewing the evidence, the court confirmed the appropriateness of the one-tenth deduction. The court thus upheld the Appeal Panel's decision, affirming that the Medical Assessment Certificate was correctly issued.

As a result of the court's decision, the appeal was dismissed, and the Medical Assessment Certificate was confirmed. The employer's argument that the deduction was inadequately reasoned was rejected, and the one-tenth deduction was upheld. The court's ruling ensures that the worker's compensation assessment process maintains its integrity by requiring proper reasoning and evidence for any deductions made.

Orders