Rann v Saratoga Holdings Pty Ltd and ors t/as Victoria Park Plantations
[2006] NSWWCCPD 77
•8 May 2006
WORKERS COMPENSATION COMMISSION
DETERMINATION OF APPEAL AGAINST A DECISION OF THE COMMISSION CONSTITUTED BY AN ARBITRATOR
CITATION:Rann v Saratoga Holdings Pty Ltd and ors t/as Victoria Park Plantations [2006] NSWWCCPD 77
APPELLANT: Graeme Leslie Rann
RESPONDENT: Saratoga Holdings Pty Ltd and Uni-Fact Pty Ltd and New Line Building Supplies Pty Ltd (formerly New Line Investments Pty Ltd) trading jointly as Victoria Park Plantations
INSURER:QBE Workers Compensation (NSW) Limited
FILE NUMBER: WCC7021-05
DATE OF ARBITRATOR’S DECISION: 30 January 2006
DATE OF APPEAL DECISION: 8 May 2006
SUBJECT MATTER OF DECISION: Disease; deemed date of injury
PRESIDENTIAL MEMBER: Acting Deputy President Bill Roche
HEARING:On the papers
REPRESENTATION: Appellant: Lee Sames Egan
Respondent: Diana Benk, QBE In House Legal Department
ORDERS MADE ON APPEAL: Paragraph one of the Arbitrator’s decision dated 30 January 2006, is revoked and the following orders are made in its place:
1. That the Applicant suffered injury to his right shoulder in 1 September 1997 and as a result of that injury has suffered and continues to suffer pain and discomfort in his left shoulder which first developed in 1998.
2. That the Medical Assessment Certificate be referred to the Approved Medical Specialist with the request that the Approved Medical Specialist assess the loss of use of the Applicant’s left arm at or above the elbow pursuant to the Table of Disabilities for injuries received before 1 January 2002.
Paragraph two of the Arbitrator’s decision dated 30 January 2006 is confirmed.
The Respondent Employer is to pay the Appellant Worker’s cost of the appeal.
BACKGROUND TO THE APPEAL
On 15 February 2006 Graeme Leslie Rann (‘the Appellant Worker’) sought leave to bring an ‘Appeal Against Decision of Arbitrator’ in the Workers Compensation Commission (‘the Commission’) against a decision, dated 30 January 2006.
The Respondent to the Appeal is Saratoga Holdings Pty Ltd and Uni-Fact Ltd and New Line Building Supplies Pty Ltd (formerly New Line Investments Pty Ltd) trading jointly as Victoria Park Plantations (‘the Respondent Employer’).
The Appellant Worker suffered a serious injury to his right shoulder while working with the Respondent Employer on or about 1 September 1997. The injury required surgery and an extensive time away from work.
He brought a claim for lump sum compensation in the Compensation Court of NSW on 7 July 1999 which was settled by way of a consent award on 28 March 2000 in the sum of $13,500.00 representing 18% permanent loss of use of the Appellant Worker's right arm at or above the elbow under section 66 of the Workers Compensation Act 1987 (‘the 1987 Act’) and $7,750.00 compensation under section 67 of that Act.
Some time after his return to work he developed pain in his left shoulder and on 11 May 2005 filed an Application to Resolve a Dispute (‘the Application’) in the Commission seeking $7,500.00 in respect of a 10% loss of use of the left arm at or above the elbow, an additional $14,400.00 in respect of a further 18% loss of use of the right arm at or above the elbow, or in the alternative, $3,750.00 in respect of a 3% whole person impairment. The Application also sought additional compensation for pain and suffering and for impairment to the Appellant Worker's neck.
The only issue on appeal is the Appellant Worker's entitlement to compensation for his left shoulder symptoms.
The Application was made on the basis that the injury on 1 September1997 to the right shoulder caused the Appellant Worker to place extra stress and strain on his left shoulder resulting in injury to that shoulder. In the alternative it was argued that the nature and conditions of employment with the Respondent Employer between September 1997 and 4 May 2004 caused an injury to the left shoulder.
The matter came before an Arbitrator and was referred to an Approved Medical Specialist (‘the AMS’) to assess whether:
“Any of the injury or impairment of the applicant is the result of the nature and conditions of his employment between 1 September 1997 and May 2004 or is it the result of the frank injury on 1 September 1997.
If impairment is the result of the frank injury and nature and conditions then the Approved Medical Specialist requested to advise the degree of impairment due to each”
The AMS provided a “Combined Medical Assessment Certificate” (‘the MAC’) on 1 September 2005. The matter was then the subject of Arbitration on 23 January 2006 at which extensive argument was heard on the issue of the date of injury to the Appellant Worker's left shoulder (see transcript page two line 33).
The Arbitrator delivered a written decision on that issue and the Appellant Worker now appeals from that decision.
THE DECISION UNDER REVIEW
The ‘Certificate of Determination’, dated 30 January 2006 records the Arbitrator’s orders as follows:
“1 That the date of injury to the left upper extremity is 25 November 2004.
2That the Medical Assessment Certificate be referred to the Approved Medical Specialist with the request that he:
a. Clarify whether the Certification as to impairment should refer to the right arm at or above the elbow rather than as it presently states ‘below the elbow’.
b. Clarify whether the finding of 10% incapacity of the right arm is in addition to the previous impairment of 18% on which the settlement in 2000 was based. The details of the previous settlement are set out in the referral to the AMS.
c. Comment on the difference between Dr Searle’s opinion of loss of use of the right arm (36%) and the AMS opinion.”
ISSUES IN DISPUTE
The issues in dispute in the appeal are whether:
(a)the Appellant Worker's condition in his left shoulder has resulted from the extra strain placed on it as a result of the injury to the right shoulder and therefore the date of injury is 1 September 1997, or
(b)the Appellant Worker's condition in his left shoulder is a ‘disease’ in which event the date of injury is determined by under section 15 or section 16 of the 1987 Act, and
(c)the Arbitrator erred in finding the relevant date injury to the left shoulder was 25 November 2004 instead of 1 September 1997;
LEAVE
Before proceeding to deal with an appeal the Commission must determine whether the application meets the requirements of section 352 of the Workplace Injury Management and Workers Compensation Act 1998 (‘the 1998 Act’).
The quantum in issue on the appeal is in excess of $5,000.00 and therefore the threshold in section 352(2)(a) of the 1998 Act is satisfied. No award of compensation has been made in this case but the Arbitrator’s finding would result in the Appellant Worker receiving no compensation and therefore the second limb of section 352(2) does not apply (see Mawson v Fletchers International Exports Pty Ltd [2002] NSWWCCC PD 5).
The appeal was lodged within 28 days of the Arbitrator’s decision in compliance with section 352(4) of the 1998 Act.
I grant leave to appeal.
PRELIMINARY MATTERS
Section 354(6) of the 1998 Act provides:
“(6)If the Commission is satisfied that sufficient information has been supplied to it in connection with proceedings, the Commission may exercise functions under this Act without holding any conference or formal hearing.”
Having regard to Practice Directions Numbers 1 and 6, the documents that are before me, and the submission by the Appellant Worker's solicitor that the appeal can proceed to be determined on the basis of these documents, I am satisfied that I have sufficient information to proceed ‘on the papers’, without holding any conference or formal hearing, and that this is the appropriate course in the circumstances.
The Appellant Worker's solicitor has filed within time a Certificate of Service attesting to service on QBE Workers Compensation (NSW) Limited In House Legal (the Respondent Employer's legal representative) on 20 February 2006. I am satisfied that the appeal documents were properly served on the Respondent Employer's representative within the time set out in the Registrar’s direction of 15 February 2006.
Included in the appeal documents was a direction from the Registrar that the Respondent Employer file with the Commission by 9 March 2006 a Notice of Opposition and supporting documentation. The Respondent Employer has not filed a Notice of Opposition.
FRESH EVIDENCE
No party seeks to adduce fresh evidence on appeal.
EVIDENCE
Lay Evidence
The only relevant lay evidence is from the Appellant Worker in his statement (‘statement’) dated 8 December 2004. Mr Rann started work with the Respondent Employer in or shortly after 1992 as a casual farm hand. After about six months he was made permanent with the job of assisting the main mechanic rebuild parts of the processing shed. Since then he was employed as a farm hand. He describes the job as “not constantly heavy, but there are sometimes heavy tasks involved in it”.
His statement gives a detailed account of his right shoulder injury and its immediate consequences. He returned to work on his usual duties in April 1998 though he still had restrictions in his right shoulder, particularly with use above shoulder height or attempting to use any strength with his right arm across his body (see statement page six).
Though the Appellant Worker is left hand dominant he uses his right hand for a number of things. He was able to perform most of his duties at work after April 1998 but made his own “modifications” to avoid some duties. It is not clear which duties he avoided but it seems a reasonable inference that he avoided duties that placed an undue strain on his arms and shoulders.
Through 1999 he “basically did [his] normal job” but with “personal adjustments” to the way he did his duties as he “protected [his] right shoulder” (see statement page seven). He states that he used his left arm more and more to do the heavy tasks in his job. These duties included linking equipment, carrying lugs of nuts, carrying equipment, using chainsaws to trim trees, and working in and around machinery.
He noticed his left shoulder and neck getting worse from late 1998 (see statement page eight). This is a very vague and general statement of little assistance. He does not say exactly when or why the left shoulder pain started and he does not identify any particular task or tasks that caused him pain in his left shoulder. Nor does he suggest that at the end of a days work his left shoulder was painful because of his activities at work.
His employment with the Respondent Employer stopped in May 2004 when he resigned because of a disagreement with the farm manager. Since leaving the Respondent Employer he has continued to suffer symptoms in his left and right shoulders and in his neck but those symptoms appear to have plateaued (see statement page nine). He has returned to work with another employer doing work he describes as lighter.
Medical Evidence
The Appellant Worker saw Dr Alan Searle on 25 September 2004 and a report was prepared on 5 October 2004. That report records that “suppressing the right arm and over using the left has caused some pain in the left shoulder”. He also notes that the symptoms have “gradually increased this year”. It is not clear what has caused this increase given that the Appellant Worker left the Respondent Employer in May 2004 and took up an easier job. Dr Searle is quite specific that the Appellant Worker's “symptoms are still worsening” notwithstanding the easier job.
Under ‘examination’ the doctor records the results of a detailed examination of the Appellant Worker's right shoulder and neck but there is no note of an examination of the left shoulder. Under ‘opinion’ the doctor talks about the ongoing symptoms in the right shoulder and neck having now “been complicated by some capsulitis in the left shoulder as a result of the overuse when activities involving the right shoulder were very limited”. He adds that the current symptoms are directly a result of the September 1997 injury and “indirectly due to the nature and conditions of his employment”. The latter having caused “aggravation and exacerbation and deterioration” of the condition of both shoulders.
For the Respondent Employer the Appellant Worker was examined by Dr Parkington on 18 February 2005. Dr Parkington did examine the Appellant Worker's left shoulder and noted the complaint of that shoulder becoming “sore and stiff”.
Under ‘opinion’ he states that “there is no basis for the argument that Mr Rann’s left shoulder symptoms have developed as a result of him not using the right shoulder”. The doctor bases that opinion on his assessment that the Appellant Worker had been able to use his right shoulder very well. This ignores the Appellant Worker's evidence of significant restrictions in his right shoulder.
Dr Parkington found no evidence of any capsulitis in the left shoulder.
The last relevant medical evidence is from Dr Isbister, the Approved Medical Specialist (‘the AMS’), who prepared the MAC on 1 September 2005. In his history he records that when the Appellant Worker returned to work after treatment for his right shoulder he “had difficulty pushing and pulling”. He also records that the Appellant Worker left his ‘easier’ job in 2004 because of “ongoing shoulder problems”.
In respect of the left shoulder he recorded that “some three years ago, because of the disability to his right shoulder, his left shoulder became painful with pain in his shoulder girdle, elbow and neck and associated soreness and weakness”.
Under ‘present symptoms’ the AMS noted the right shoulder problems and added “his left shoulder is also becoming painful with pain radiating to the neck”.
The AMS makes a further comment about the onset of the left shoulder symptoms under ‘summary’ where he adds “due to the limitations of his right shoulder, it has been necessary for him to use his left shoulder in a more energetic manner and for the last three years he has suffered from symptoms in that shoulder”.
The AMS’s diagnosis is of a fracture dislocation of the right shoulder “with subsequent overuse syndrome affecting his left shoulder”. At part eight (g) of the MAC Dr Isbister states that the Appellant Worker has “developed pain in his left shoulder as a result of his activities at work”.
Under ‘Reasons for Assessment’ the AMS notes the Appellant Worker has only suffered from symptoms in his left shoulder for the past three years and “he has no other [sic] restricted range of motion, wasting or neurological abnormality”.
Dealing with Dr Searle’s opinion the AMS states that in his opinion the capsulitis referred to by Dr Searle is “not significant and cannot be assessed as a permanent impairment or loss”.
The AMS’s comment on Dr Parkington’s report is that he is inclined to agree that the left shoulder problem does not result from the right shoulder problem as the symptoms in the left shoulder have only been present for “some three years”.
The AMS answered the questions set out at paragraph eight above as follows:
“In my opinion the symptoms in his left shoulder are not the result of the frank injury nor are they the result of the nature and conditions of his work.
Impairment of the right shoulder is the result of the frank injury and not the nature and conditions of Mr Rann’s work”
The above passage seems to me to be inconsistent with the AMS’s earlier statements about the Appellant Worker using his left shoulder in a more energetic manner due to the limitations in his right shoulder. It is submitted for the Appellant Worker that the AMS was really saying that there was no direct injury to the left shoulder in the incident on 1 September 1997 and none as a result of the nature and conditions of employment. That may or may not be correct. The AMS may have felt that there was no relevant loss of use or impairment resulting from the left shoulder symptoms in any circumstances. I note that there has never been a formal finding on that issue. Such an opinion from the AMS would be consistent with his view that the Appellant Worker “has no other [sic] restricted range of motion, wasting or neurological abnormality” in the left shoulder and his view about the capsulitis not being significant.
Nevertheless the AMS does have an incorrect history that the left shoulder symptoms started in 2002, that is, three years before his examination. That incorrect history may have lead him to conclude that the left shoulder had to be assessed under the American Medical Association’s Guides to the Evaluation of Permanent Impairment 5th edition (‘AMA 5’).
SUBMISSIONS AND FINDINGS
The submissions filed on behalf of the Appellant Worker suggest that the appropriate analysis of the evidence is as follows:
· the Appellant Worker injured his right shoulder in a fall at work with the Respondent Employer on 1 September 1997;
· the Appellant Worker did not injure his left shoulder in the fall on 1 September 1997;
· the Appellant Worker was thereafter required to overuse his left shoulder in all activities, including work;
· the resultant right shoulder disability has caused an overuse condition of the left shoulder generally, and
· there was no contribution at all from work activities after May 2004.
Accordingly it is submitted that the Arbitrator's finding of injury on 25 November 2004 is in error because there is no evidence to support injury on that date.
The argument is developed further with a submission that if the ‘nature and conditions of work’ are the basis for the finding of injury on 25 November 2004 then there must be specific findings as to:
· the specific contribution from work to any such condition;
· the specific work practices;
· the reasons those practices contributed to the condition;
· the actual period of work of the nature to which the injury is due, and
· if the injury is determined to be a disease, a specific finding to that effect.
In my opinion this appeal can be resolved in a much simpler way. The finding of injury on 25 November 2004 was on the basis that that was the date on which the claim for lump sum compensation was made. That can only be the case if the disease provisions in section 15 or 16 of the 1987 Act are being applied. Those provisions can only apply if there is first a finding of an injury under section 4(b)(i) or (ii) of the 1987 Act.
Section 4(b)(i) could only apply if the Appellant Worker suffered any injury that was a disease which he “contracted” “in the course of” his employment with the Respondent Employer. There is no evidence to support such a finding in this case.
Section 4(b)(ii) could apply if the Appellant Worker suffered from a disease which was aggravated, accelerated, exacerbated or deteriorated (‘aggravated’) as a result of his employment and his employment was a substantial contributing factor to that aggravation, acceleration, exacerbation or deterioration.
All we have in the present case is an allegation of injury due to ‘nature and conditions’ of employment. The mere incantation of the phrase ‘nature and conditions’ does not automatically invoke the disease provisions and permit a finding of disease. The expression is not one that is recognised in the workers compensation legislation. Judge Neilson discussed the expression and its incorrect use in Mirkovic v Davids Holdings Pty Ltd (1995) 11 NSWCCR 656 where at 667 he said:
“The phrase ‘nature and conditions of employment’ is not a term of art, although many who practise in this jurisdiction seem to think so. One Judge of Appeal recently referred to it as ‘quaint’. My colleague Burke J has repeatedly referred to it as a ‘meaningless concept’. It is used in this place as a shorthand way of alleging that, although no frank incident is relied upon, there was some aspect of the work carried out by a worker over a period of time, e.g. repeated lifting or bending, which caused some pathological condition or acted upon some underlying pathological condition to cause incapacity. Some classify such a period of work as a series of traumata or microtraumata, others classify it as causing a disease of gradual process within section 15 of the Act (where the pathology was caused by such work) or as the aggravation, acceleration, exacerbation or a deterioration of a disease within section 16. The ‘microtraumata’ contention was that advanced by the worker on review.”
To rely on the disease provisions in section 4(b)(ii) and section 16 of the 1987 Act the following must be established:
· that the worker is suffering from a disease;
· the disease has been aggravated by the work done, and
· the employment concerned is a substantial contributing factor to that aggravation.
In my view the disease argument fails at the first step in this case because there is no evidence the Appellant Worker is suffering from a disease in his left shoulder. The only diagnosis offered for the left shoulder is that of ‘capsulitis’ from Dr Searle. That opinion is given without the benefit of any radiological investigations of the left shoulder and without an examination of that shoulder.
Against that is the opinion of Dr Parkington (who did examine the Appellant Worker’s left shoulder) who felt there was no evidence of any capsulitis. In addition the AMS states that the capsulitis is “not significant”.
The need to identify whether the injury was a ‘frank injury’ or a ‘disease’ was noted in the submissions made on behalf of the Respondent Employer before the Arbitrator (see transcript at page seven line two). It was then submitted that the injury was “in the nature of a disease process”. The evidence in support of that submission is said to be the report of Dr Searle because he uses the words “aggravation, exacerbation, deterioration of the condition of both shoulders” (emphasis added). There is no evidence that “the condition” in the Appellant Worker's left shoulder is a disease.
The question of what constitutes a disease was considered by Judge Burke in Perry v Tanine Pty Ltd t/as Ermington Hotel & others (1998) 16 NSWCCR 253. In that case the worker suffered from carpal tunnel syndrome which the court concluded was a disease. In the course of his decision his Honour considered the general nature of a disease and after quoting from Blakiston's Gould Medical Dictionary said at [48]:
“This concept of failure of some element of the body to cope with repetitive stress seems typical of carpal tunnel syndrome, many forms of rotator cuff lesion, problems of epicondylitis affecting elbows, tenosynovitis and a whole range of other problems affecting various joints, tendons, nerves and muscles of the body not infrequently presented to this Court in the industrial context.” (emphasis added)
In the present case there is no evidence that the Appellant Worker has a rotator cuff lesion in his left shoulder. Further I do not believe that the weight of the evidence supports a conclusion that the Appellant Worker has capsulitis in his left shoulder or that that condition is a disease.
If I am wrong and the better view is that the Appellant Worker does have capsulitis and that such a condition is a disease, there can only be a finding of injury under section 4(b)(ii) if the Commission is satisfied that the relevant employment was a substantial contributing factor to the aggravation. There is no evidence to that effect in this case.
The Respondent Employer's submissions before the Arbitrator relied on paragraph eight of Dr Searle’s report to support the disease argument. Paragraph eight starts by referring to the appearances on ultrasound and x-ray which were “indicative of tendon degeneration”. The doctor then adds:
“The ongoing work he was doing has contributed to this degeneration. This degeneration is a pathological condition of gradual process with ongoing aggravation.”
The passage quoted above was read to the Arbitrator as supporting a finding of disease in respect of the claim for the left shoulder. With respect the radiological investigations the doctor was referring to were the investigations performed on the Appellant Worker's right shoulder. They do provide some support for a disease finding and are a good illustration of the kind of evidence that is needed before such a finding can be made but they provide no assistance in determining the present case where the dispute relates to the left shoulder.
The Respondent Employer’s solicitor referred the Arbitrator to Stone v Stannard Brothers Launch Services Pty Ltd [2004] NSWCA 277 in support of her submissions. In that case the worker was found to have contracted a skin disease with an earlier employer as a result of prolonged exposure to sun. It was also found that the condition had been aggravated by his later employment. The Court of Appeal held that the correct date of injury for the purposes of section 16 of the 1987 Act was the date on which the worker made his claim for compensation.
The case of Stone does not assist in the present matter as there has been no finding that the Appellant Worker suffered from a disease or that his employment was a substantial contributing factor to any aggravation or acceleration of a disease.
In the absence of evidence that the condition in the left shoulder is a disease the question remains: what has caused the symptoms in the left shoulder? The Appellant Worker’s solicitor submits that it results from the frank injury to the right shoulder. Before the Arbitrator the Respondent Employer’s solicitor submitted that the condition was a disease. There are two other alternatives:
· injury due to repeated micro traumata as a result of the work duties performed with the Respondent Employer, or
· no ‘injury’ at all to the left shoulder within the terms of the 1987 Act.
It is difficult to see how a finding of a repetitive injury due to micro traumata (not a disease) could be made in the absence of the following evidence:
· contemporaneous complaints that the Appellant Worker's duties with the Respondent Employer were causing him pain in his left shoulder;
· specific details of the work duties that are alleged to have caused the left shoulder injury;
· evidence of the nature and extent of the pathology in the left shoulder, and
· evidence of the nature of the injury caused by the Appellant Worker's duties with the Respondent Employer.
In addition such a finding is not open when there is no evidence that employment was a substantial contributing factor to such an injury.
In these circumstances I think the better view is that the Appellant Worker did not suffer any injury to his left shoulder caused by or arising out of his employment duties with the Respondent Employer but has experienced symptoms in his left shoulder as a result of more energetic use of his left arm over time as a result of the injury to his right shoulder on 1 September 1997. That ‘more energetic use’ has included use both at work and away from work.
The question of causation was considered in detail by the Court of Appeal in KooragangCement Pty Ltd v Bates (1994) 10 NSWCCR 796 the deceased suffered a back injury at work in 1981 and died of a heart attack in 1992. The trial judge found that the death resulted from the back injury. That finding was confirmed on appeal. The Court of Appeal held that in assessing the issue of causation what is required is a commonsense evaluation of the casual chain with due regard to the statutory formula by asking the question whether the loss has ‘resulted from’ the work event in question (see Kooragang at page 810).
In the present case the work event in question is the injury on 1 September 1997. Provided there is a direct chain of causation between the event and the subsequent pain and restriction in the left shoulder, the Appellant Worker is entitled to have that pain and restriction assessed under the Table of Disabilities for injuries before 1 January 2002. The fact that the Appellant Worker continued in employment after that event does not, in the circumstances of this case, diminish its significance in causing the problem with the left shoulder. The situation may well have been different had the worker suffered an identifiable injury to his left shoulder caused by an independent and separate event.
Evidence supporting this conclusion is found in the report of Dr Searle at page two where he states that “suppressing the right arm and overusing the left has caused some pain in the left shoulder” and at page five where he said the neck and shoulder problems have been complicated by some capsulitis in the left shoulder “as a result of the overuse when activities involving the right shoulder were very limited”.
In respect of section 9A of the 1987 Act it should be noted that the provision requires that employment be a substantial contributing factor to the injury (in this case the right shoulder injury of 1 September 1997), not the loss which results from the injury (see Rootsy v Tiger Nominees Pty Ltd (2002) 23 NSWCCR 725).
For the above reasons it is my opinion that the Arbitrator was in error in finding that the Appellant Worker sustained injury to his left shoulder on 25 November 2004.
DECISION
Paragraph one of the Arbitrator's decision dated 30 January 2006 is revoked and the following orders made:
“1.That the Applicant suffered injury to his right shoulder on 1 September 1997 and as a result of that injury has suffered and continues to suffer pain and discomfort in his left shoulder which first developed in 1998.
2.That the Medical Assessment Certificate be referred to the Approved Medical Specialist with the request that the AMS assess the loss of use the left arm at or above the elbow pursuant to the Table of Disabilities for injuries received before 1 January 2002.”
Paragraph two of the Arbitrator’s decision dated 30 January 2006 is confirmed.
COSTS
The Respondent Employer is to pay the Appellant Worker's costs of the appeal.
Bill Roche
Acting Deputy President
8 May 2006
I CERTIFY THAT THIS IS A TRUE AND ACCURATE RECORD OF THE REASONS FOR DECISION OF BILL ROCHE, ACTING DEPUTY PRESIDENT OF THE WORKERS COMPENSATION COMMISSION.
ASSOCIATE
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