Secretary, Department of Education v Alisha
[2021] NSWPICMP 148
•13 August 2021
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Secretary, Department of Education v Alisha [2021] NSWPICMP 148 |
| APPELLANT: | Secretary, Department of Education |
| RESPONDENT: | Jenny Alisha |
| APPEAL PANEL: | Member John Wynyard Dr Michael Davies Dr Ross Mellick |
| DATE OF DECISION: | 13 August 2021 |
| CATCHWORDS: | WORKERS COMPENSATION- Employer appeal against assessment of 65% WPI for upper extremity Complex Regional Pain Syndrome (CRPS); referral limited to the shoulders; whether Medical Assessor had discretion to ignore referral terms; Held- terms of referral discussed and agreed at teleconference; original claim based on range of motion methodology; Skates v Hills Industries Ltd discussed; respondent worker re-examined; MAC revoked and new MAC for 14% WPI on range of motion issued; CRPS found not to be present on re-examination. |
STATEMENT OF REASONS FOR DECISION OF THE APPEAL PANEL IN RELATION TO A MEDICAL DISPUTE
BACKGROUND TO THE APPLICATION TO APPEAL
On 13 January 2021 Secretary, Department of Education, the appellant employer, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Tim Anderson, a Medical Assessor (MA), who issued a Medical Assessment Certificate (MAC) on 16 December 2020.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act):
· the assessment was made on the basis of incorrect criteria,
· 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.
The WorkCover Medical Assessment Guidelines 2006 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 the WorkCover Medical Assessment Guidelines 2006.
The assessment of permanent impairment is conducted in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed 1 April 2016 (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 14 October 2020 a referral issued to the MA seeing an assessment of WPI caused to the right upper extremity (shoulder), and left upper extremity (shoulder) (consequential) which occurred on 31 March 2016.
The respondent worker, Ms Alisha, was employed as a teacher and was injured by two school boys chasing each other. She collided against the metal handrail of the stairs mostly with her right shoulder. Symptoms developed after that and she sought treatment as the condition of her right shoulder deteriorated.
She returned to work in 2017 but the extensive use of her left arm over a year and a half caused it to start deteriorating as well.
The MA concluded that the respondent worker suffered from complex regional pain syndrome. He certified a WPI of 65%.
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 WorkCover Medical Assessment Guidelines 2006.
The appellant employer requested that the respondent worker be re-examined by a member of the Panel, and a re-examination was conducted by Dr Ross Mellick on 27 May 2021.
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 Ross Mellick of the Appeal Panel conducted an examination of the worker on 27 May 2021 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 ground of appeal was that the MA had applied incorrect criteria and thus caused a demonstrable error by failing to make an assessment in accordance with the terms of the referral.
The MAC
Having carried out on examination, the MA summarised Ms Alisha’s condition:[1]
“Mrs Alisha gives a history of experiencing a relatively minor injury to her right forequarter in late March 2016. Very soon after this, however, the right forequarter started deteriorating markedly with swelling, bruising and since then, extreme dysfunction. This condition has prevailed since that occasion, which is now well over four and a half years ago. It has been identified clinically that she suffers from complex regional pain syndrome of the right hand. She has done her best to soldier on with her teaching and has predominantly used her left forequarter. At this assessment there was also dysfunction of the left forequarter, although no evidence of complex regional pain syndrome.
At this assessment, it was concluded that Mrs Alisha does qualify for the diagnosis of complex regional pain syndrome with the right forequarter. This is having an extraordinarily severe effect on her.”
[1] Appeal papers page 25.
The MA explained his calculations regarding the right upper extremity:[2]
“Complex Regional Pain Syndrome
Mrs Alisha qualifies historically for the four major features. Historically, there has been hyper-aesthesia of the right hand. Similarly, there are major motor changes with skin alteration. Sudomotor changes are also demonstrated by swelling. The motor and trophic changes are amply demonstrated by gross restriction of movement and also a tremor which was very obvious at this assessment. All patients are requested to fill in a Patient Identification and Authority Form. Mrs Alisha could only complete part of this with extremely shaky writing.During the assessment she again had evidence of these four features with hyper-algesia of the right hand from the wrist distally. Vasomotor features were demonstrated with the quality and deep hue of the skin. Sudomotor alteration featured with swelling of the fingers (and thumb). Again, there was ample evidence of motor dysfunction with very gross restriction of movement, especially with the digits of the right hand.
Finally, there is no other diagnosis that better explains this condition.”
[2] Appeal papers page 26.
In his Table 2 Certificate, the MA indicated that he was applying Chapter 2 and Table 17.1 of the Guides. He assessed 55% WPI with regard to the right upper extremity, and 22% for the left upper extremity. The MA did not explain his reasons for his assessment of the left upper extremity, but we infer that it was on the basis of the range of motion measurements.
It is not necessary to consider the MAC in any further detail, as Ms Alisha’s condition has been more fully considered in the report of Dr Mellick, which follows shortly.
SUBMISSIONS
The appellant employer
The appellant employer submitted that the assessment had not been conducted in accordance with Chapter 2 of the Guides. The appellant employer stated that the scope of the referral was confirmed at teleconference by Arbitrator (as he then was) Harris with the respondent worker’s solicitor. Contrary to the terms of the referral, the appellant employer submitted, the MA proceeded to conduct an assessment of the entirety of both upper extremities.
Moreover, the MA had erred further by assessing the respondent worker using the wrong criteria, namely chapter 17 of the Guides, which contained the criteria for assessing Complex Regional Pain Syndrome.
In the alternative the appellant employer argued that the respondent worker was unable to bring herself within those criteria in any event, and the MA had erred in finding a diagnosis of Complex Regional Pain Syndrome.
The respondent worker
The respondent worker referred to chapter 1.9 of the Guides. Chapter 1.9 of the Guides states:
“1.9 The Guidelines may specify more than one method that assessors can use to establish the degree of a claimant’s permanent impairment. In that case, assessors should use the method that yields the highest degree of permanent impairment…”
The respondent worker referred to the summary by the MA which we have reproduced above. This, it was argued, was the justification for the CRPS diagnosis. The diagnosis had also been recorded in treating certificates.
We were also referred to Chapter 1.6 of the Guides which, the respondent worker submitted emphasised the importance of the exercise of clinical judgement by an MA in determining the assessment. The respondent worker was kind enough to reproduce portions of Chapter 1.6.
Accordingly, it was argued, the diagnosis found by the MA was consistent with his obligation pursuant to Chapter 1.6, as the MA was entitled to rely on his clinical judgement. In this case, that judgement led to the application of the criteria in Chapter 17 being applied, as we understood the submission, because it was the method that yielded the highest degree of permanent impairment.
The respondent worker disputed that the provisions of Chapter 17 had not been properly applied by the MA. We were referred to the opinions of Ms Alisha’s medical experts who also were of the view that CRPS was the appropriate diagnosis.
The respondent worker helpfully analysed the findings of the MA and their application to the provisions of, particularly, Table 17.1 of the Guides which sets out the criteria for a diagnosis of CRPS.
Discussion
The importance of the referral in the statutory scheme regarding medical disputes has recently been considered in the Court of Appeal in Skatesv Hills Industries Ltd.[3]
[3] [2021] NSWCA 142 (Skates).
Skates had a similar factual background as pertains in the present case. The AMS (as MAs were then called) assessed a WPI of 61% for a condition of CRPS. The referral however restricted the matters for referral to an assessment of the “Left Upper Extremity (joint ring finger), scarring (TEMSKI).” The Appeal Panel accordingly revoked the MAC on the basis that the AMS had not restricted his assessment to the matters within the referral, but had assessed the whole of the left upper extremity.
In the Court below, Adamson J found at [71]:[4]
“71. In my view, the plain meaning of the referral was that the only part of the left upper extremity which was to be assessed was the joint ring finger and scarring. … . the AMS was not entitled to assess the whole of the left upper extremity and went beyond the jurisdiction conferred on him by the referral. …. The Appeal Panel was correct to recognise this error. It, too, was bound by the terms of the referral…. l.”
[4] Skates v Hill Industries Ltd [2020] NSWSC 837.
In the Court of Appeal the majority upheld the determination that the Appeal Panel was correct to have found that the AMS went beyond the terms of the referral.
At [35] Basten JA said:
“…It is apparent that the referral by the Registrar was in a standard form, as was the application to resolve a dispute. There was no suggestion that these forms were not in appropriate terms. It follows that the primary judge was correct in finding that the Appeal Panel….. was correct in concluding that [the AMS’s] assessment contained demonstrable error in failing to be limited to the terms of the claim.”
The finding of the MAP was however revoked, as the respondent agreed that it had been intended that the wrist be included for assessment, but that neither party had raised the error in the referral with the Registrar – an error that Basten JA described as "inexplicable" at [36].
The Appeal Panel, although aware of the error, simply revoked the MAC, taking the view that its function gave it no option. His Honour stated that it was not necessary to rule on the correctness of that view, as the decision in the lower Court by Adamson J revoking the MAP had not been appealed. Adamson J had said at [73]:
“While the Appeal Panel was correct to determine that the AMS had gone beyond the terms of the referral in considering the shoulder, elbow and other fingers and thumb, the Appeal Panel itself was in error in not giving effect to the Employer’s concession that the left wrist ought also to have been referred. When it became aware of the parties’ concession, the Appeal Panel should have reverted to the Registrar to obtain a referral which reflected the parties’ agreement as to the correction required. It was not entitled to ignore the Employer’s concession that the wrist should have been included.”
In her dissenting judgement in the Court of Appeal, McCallum JA did not accept that an AMS was bound by the terms of the referral. The Appeal Panel had stated that it was “settled law” that an AMS was confined by the terms of the referral, and Her Honour disagreed.
Leeming JA, having noted the different approach taken by McCallum JA, agreed with Basten JA.
In the present case we note that whilst the injuries were described in the ARD form as “Left upper extremity and Right upper extremity,” the terms of the referral had additional descriptions of the anatomical regions to be assessed, as each upper extremity had the word “shoulder” added to it in parenthesis.
The circumstances under which this amendment was made to the initial claim were referred to by the appellant employer in its submissions, as we have indicated above – namely that the scope of the referral was “confirmed with the applicant’s solicitor by Arbitrator Harris at the teleconference on 12 October 2020.”
No challenge was made to that statement by the respondent worker, and we accept therefore that the form of the referral was agreed between the parties.
That being the case we find that the MA has made a demonstrable error by including the whole of each extremity in his assessment.
The respondent worker’s reliance on the provisions of Chapter 1.6 and 1.9 of the Guides is misconceived, with respect. The discretion given to an MA either to choose the highest assessment, or to rely on his clinical judgement, relates only to the matters that have been referred to him as set out in the referral form. In the present case the MA was limited to an assessment of Ms Alisha’s shoulders. Whether his findings were consistent with a diagnosis of CRPS or not was irrelevant, as was the question of whether other specialists had made or hinted at that diagnosis.
The respondent worker in her letter of claim relied on the assessment of Dr Paul Darveniza of 14% and claimed the amount of $31,300.[5] It included in its letter the reports that it relied on in its submissions that a CRPS diagnosis was appropriate, but limited its claim to that defined by Dr Darveniza. Ms Alisha’s consent to the amendment on the terms confirmed by Arbitrator Harris at teleconference is consistent with an informed decision to rely on the opinion of Dr Darveniza.
[5] Appeal papers page 64.
Having determined that the MA had made a demonstrable error, Ms Alisha was re-examined by Dr Ross Mellick of the Panel on 27 May 2021. His report follows:
“PERSONAL INJURY COMMISSION
MEDICAL ASSESSMENT CERTIFICATE
ASSESSMENT OF DEGREE OF PERMANENT IMPAIRMENT
Matter Number: M1-5253/20 Applicant worker: Jenny ALISHA Date of MAC: 27 May 2021 Medical Assessor: Dr Ross Mellick Specialty: Neurology
1. DETAILS OF MATTERS REFERRED FOR ASSESSMENT
The following matters have been referred for assessment (s 319 of the 1998 Act):
·Date of injury: 31 March 2016
·Body parts/systems referred: Right Upper Extremity (shoulder)
Left Upper Extremity (shoulder) (consequential)
·Method of assessment: Whole Person Impairment
2. EVIDENCE
Documentary Evidence
The following documents were referred by the Commission for this assessment:
· As listed in the referral from the Registrar
Additional Information
The following information was obtained in accordance with Section 324(1) of the 1998 Act:
· List any imaging studies provided by the worker which were not listed in the documentation provided:
3. WORKER’S DETAILS INCLUDING
· Date of examination: 27 May 2021
· Date of birth and age at examination: 13 September 1954 – aged 66
· Hand dominance: Right
· Details of who attended the examination: Alone
· Date of injury: 31 March 2016
· Employer and occupation: Dept of Education - Teacher
4. HISTORY RELATING TO THE INJURY
· Brief history of the incident/onset of symptoms and of subsequent related events, including treatment: Ms Alisha was walking up stairs with her class when two boys ran up the stairs from behind. One made contact with her lower back, pushing her to the right as he ran past. She lost her balance and fell towards the right. The right shoulder made contact with a metal railing. Members of her class grabbed her and she did not fall to the stairs. This incident happened at about 1.55pm. She continued with her planned teaching session despite nausea and feeling very upset and shaken by the incident. She was not able to teach normally because she felt emotionally disturbed. The next lesson was a singing lesson which she was able to manage. She spoke to the Principal after that lesson and reported the incident, and went home early.
She saw her general practitioner on the following day and an arthroscopic rotator cuff repair was performed on the right shoulder by Dr Sher on 27 June 2016 because of shoulder pain. Following the operation, the right arm was put in a sling for approximately a month. During that time her hand became swollen.
She was away from work for approximately 12 months, resuming work in or near to 2 March 2017. When she returned to teaching, she reported that she was obliged to use the left upper extremity more than usual because of the symptoms in the right shoulder and because of that, she developed pain in the left shoulder during 2017 and 2018. I understand that she continued her normal teaching duties for all of 2017 and stopped work in the final term of 2018 because of the symptoms in the right upper extremity.
· Present treatment: Analgesic medication and medication for depression of mood, nortriptyline, which has developed since the surgical operation in 2016.
· Present symptoms: At the time of Ms Alisha’s visit, there is continuing pain in the right shoulder associated with a decreased range of movement of the shoulder because of the pain. She also makes reference to impaired movement of the fingers of the right hand associated with cramping feelings in the fingers, which cause impairment of the right upper extremity. She said that the symptoms are now of sufficient severity that she has stopped all housework, cooking and shopping because of dominant right arm pain and impairment of function.
Pain is also described to involve the right side of the neck in particular, with extension over the vertex. She describes cranial headache which is not associated with nausea, vomiting or photophobia.
The symptoms in the neck and right shoulder are not associated with referred pain or other sensory symptoms into the right or left upper extremity.
She also experiences considerable depression of mood. Her marriage has unravelled since the injury and she is deeply saddened by that.
· Details of any previous or subsequent accidents, injuries or condition: There have been no previous relevant accidents.
· General health: Good without a history of hypertension or diabetes.
· Work history including previous work history if relevant: Ms Alisha has a Bachelor’s Degree in Education obtained after she migrated from Fiji. She was teaching for more than 20 years prior to ceasing in 2018.
· Social activities/ADL: Ms Alisha is separated from her husband and is in the process of a divorce. She does not smoke, takes alcohol occasionally and takes no recreational drugs.
Although Ms Alisha is able to care for her personal needs and activities of daily living, she has help from family members for activities that require bimanual function, as in heavy household activities. Her mother lives nearby and visits her frequently to help. Her daughter also lives nearby and is available to assist with household tasks and shopping.
5. FINDINGS ON PHYSICAL EXAMINATION
On examination, Ms Alisha gave a clear history and exhibited no abnormality of cognition. There was psychomotor retardation and evidence of mood disorder. She was briefly tearful when describing the unravelling of her marriage.
There was no abnormality of the normal rhythm of gait and no disorder on examining the cranial nerves.
Cervical movements were performed symmetrically in all directions without restriction or muscle guarding.
There was no wasting of the shoulder girdle, upper arm or forearm muscles and no wasting of the intrinsic muscles of the hands.
There was no disorder of contour, tone, coordination or sensation in the left upper extremity. Fine finger movement and power were intact. There was a normal range of elbow and wrist movement. There was also normal power of grip and finger dexterity in the left upper extremity, some impairment of left shoulder movement was noted.
There was pain in the region of the right shoulder during movement and marked restriction of right shoulder movement.
SHOULDER
RIGHT UEI% LEFT UEI% Flexion 110° 5% 120° 4% Extension 20° 2% 40° 1% Abduction 80° 5% 160° 1% Adduction 40° 0% 40° 0% Internal rotation 40° 3% 80° 0% External rotation 30° 1% 60° 0%
Upper extremity impairment on the right equals 16% and left equals 6%.
With reference to Table 16-3, this converts to a WPI of 10% and 4% respectively and using the Combined Tables, this equals 14% WPI with no deductions.
There was no abnormality in the range of elbow or wrist movement on the right side. However, there was highly variable impairment of fine finger movement on the right side with slowness of movement and variable impairment of finger/thumb opposition and the power of grip. There was impairment of finger extension on the right side, however passive movements were normal. The contour of the interphalangeal and metacarpophalangeal joints was normal. There was no wasting of the intrinsic muscles of the hand on the right side.
There was no abnormality of skin colour, temperature or texture and fingernail growth was normal. There were no vasomotor changes noted in the right upper extremity, in particular in the right hand. There was no nerve pain induced by pressure contact or light contact of the skin of the hand. Proprioception was intact.
The deep tendon reflexes were symmetrical and normally brisk in the upper extremities.
6. DETAILS AND DATES OF SPECIAL INVESTIGATIONS
An ultrasound of the right shoulder was performed on 1 April 2016 and reported to reveal a supraspinatus tear.
An MRI scan of the right shoulder was performed on 27 April 2016 and reported to reveal a tear of the supraspinatus and infraspinatus, as well as a subscapular tendinopathy.
An ultrasound of the left shoulder performed on 10 August 2018 was reported to reveal subacromial bursitis with impingement and supraspinatus partial thickness tear.
7. SUMMARY
· summary of injuries and diagnoses:
There is clear history of a injury involving trauma to the right shoulder with symptoms persisting such that surgery was performed on the shoulder and persisting impairment of function with pain exists. Additionally, because of the extra use of the left upper extremity, pain was identified there involving the left shoulder as well. There continues to be evidence of impairment of left shoulder function of minor degree associated with the consequences of the injury in question.
There is no evidence in documents seen justifying a diagnosis of Complex Regional Pain Syndrome and at the time of my examination no diagnostic evidence of that disorder.
There is impairment of movement of the fingers of the right hand and “functional” abnormality that is not determined by an underlying organic process, nor valid WPI assessment.
· consistency of presentation
There is consistency of presentation in keeping with details of the history and the documentary evidence.
8. EVALUATION OF PERMANENT IMPAIRMENT
My answers to the following questions regarding the assessment of impairment and or whole person impairment in accordance with the NSW workers compensation guidelines for the evaluation of permanent impairment with respect to the injury suffered in the accident are:
a. Is the worker claiming for any body part/system outside your field of expertise? If so, please indicate the body part/system: No
b. Have all body parts/systems stabilized/reached maximum medical improvement? Yes
c. If not, please list those injuries not yet stable/at maximum medical improvement: N/A
d. If stabilisation/maximum medical improvement, of any or all injuries has not been reached, when, in your opinion, will this occur? N/A
e. Is any proportion of loss of efficient use or impairment or whole person impairment, due to a previous injury, pre-existing condition or abnormality? N/A
f. If so, please indicate which body part/system is affected by the previous injury, pre-existing condition or abnormality. N/A
g. Indicate whether there has been any further injury subsequent to the subject work injury. If this injury has caused any additional impairment this should not be included with the assessment of impairment due to the subject work injury. N/A
9. THE FACTS ON WHICH THE ASSESSMENT IS BASED
The facts on which I have based my assessment of whole person impairment are:
The history obtained by me, my findings on physical examination and a consideration of the results of investigations and other documentary evidence.
10. REASONS FOR ASSESSMENT
a. My opinion and assessment of whole person impairment
In making that assessment I have taken account of the following matters:-
The history obtained by me, my findings on physical examination and a consideration of the results of investigations and other documentary evidence.
b. An explanation of my calculations (if applicable)
No explanation is necessary.
c. My brief comments regarding the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs
A report from Dr Sher dated 19 July 2019 made brief reference to a physical examination that was reported to demonstrate “a painful arc with some loss of forward elevation with weakness of external rotation and positive impingement signs”. He also referred to Ms Alisha describing a return to work and overuse of the left arm, which became “sore and swollen and a repeat of the pain she had previously experienced on her right side”. He also referred to “new complaints such as tremors in her hands and feels anxious and depressed”. The doctor suggested that the features he observed indicated “a flare-up of her Complex Regional Pain Syndrome”.
However, Dr Sher’s report does not contain any diagnostic evidence of a Complex Regional Pain Syndrome.
My assessment differs considerably from that of the MA. There are essentially two diagnostic issues which need to be resolved prior to making a determination regarding whole person impairment. The first is whether a diagnosis of Complex Regional Pain Syndrome can reasonably be applied to explain impairment of function of the body parts reported above, right upper extremity and left upper extremity. Clearly that diagnosis requires specific abnormalities to be present. There are no diagnostic features of a complex regional pain syndrome.
Secondly, there is impairment of right hand function, however the impairment is highly variable and not amenable to a range of movement impairment assessment because of that variability. There is also no objective evidence supporting an organically based disorder involving the right upper extremity distally, explaining the abnormalities observed. Those abnormalities are variable and represent a functional disorder not an organically determined abnormality.
There is persistent impairment of the range of right shoulder movement and left shoulder movement, as explained above, allowing a WPI assessment to be made.
The findings, therefore, are comfortably in accord with the neurological findings reported by Dr Paul Darveniza, Neurologist, in his report of 30 September 2019. Although there is some variation with regard to the figures we each recorded for the impairments of right and left shoulder, the findings are consistent and produce similar WPI findings.
There is a relevant remark that Dr Darveniza also does not identify a Complex Regional Pain Syndrome.d. I certify that the impairment is permanent and that the degree of permanent impairment is fully ascertainable.
11. DEDUCTION (IF ANY) FOR THE PROPORTION OF THE IMPAIRMENT THAT IS DUE TO PREVIOUS INJURY OR PRE-EXISTING CONDITION OR ABNORMALITY
There is no deductible proportion
12. ANSWERS TO SPECIFIC QUESTIONS
Your answers to the specific questions raised by the Member. (I have included the questions as well as the answers)
No specific questions.
I CERTIFY THAT THIS IS A TRUE AND ACCURATE RECORD OF THE MEDICAL ASSESSMENT CERTIFICATE ISSUED BY ROSS MELLICK, MEDICAL ASSESSOR, PERSONAL INJURY COMMISSION.”
We adopt the contents of Dr Mellick’s comprehensive report.
For these reasons, the Appeal Panel has determined that the MAC issued on16 December 2020 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
PERSONAL INJURY COMMISSION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
| Matter Number: | 5253/20 |
| Applicant: | Secretary, Department of Education |
| Respondent: | Jenny Alisha (known as Ali) |
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 Dr Anderson 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) |
| Right upper extremity | 31.3.16 | Chapter 2 Pages 10-12 Par 2.5 Par 2.14 Par 2.20 | Chapter 16 Pages 443-518 Shoulder: 1640, 16-43,16-46 | 10% | 0 | 10% |
| Left upper extremity | 31.3.16 | Chapter 2 Pages 10-12 Par 2.5 Par 2.14 Par 2.20 | Chapter 16 Pages 443-518 Shoulder: 1640, 16-43,16-46 | 4% | 0 | 4% |
| Total % WPI (the Combined Table values of all sub-totals) | 14% | |||||
John Wynyard
Member
Dr Michael Davies
Medical Assessor
Dr Ross Mellick
Medical Assessor
0
3
0