Secretary, Department of Education v Bisschop
[2024] NSWPICMP 382
•17 June 2024
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Secretary, Department of Education v Bisschop [2024] NSWPICMP 382 |
| APPELLANT: | Secretary, Department of Education |
| RESPONDENT: | Jessica Bisschop |
| APPEAL PANEL | |
| MEMBER: | John Wynyard |
| MEDICAL ASSESSOR: | Gregory McGroder |
| MEDICAL ASSESSOR: | John Brian Stephenson |
| DATE OF DECISION: | 17 June 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Personal Injury Commission Act 2020; appeal against award of 17% for injury to the right foot and ankle; whether Medical Assessor (MA) obliged to explain his interpretation of medically complex guidelines; whether unsupported speculation by MA as to opinion in an unread expert report a demonstrable error; whether confusing reference to guidelines a demonstrable error; Held – MA mistakenly thought an expert report was not before him, and wrongly presumed its opinion; clear error, which did not affect the assessment in that issue as to maximum medical improvement; the details describing the manner in which the MA is required to address the imaging studies before him is presumed to have been complied with; Campbelltown City Council v Vegan, Lancaster v Foxtel Management Pty Ltd, Jones v The Registrar WCC, and section 32 considered and applied; Panel determined that MA miscalculated the lower extremity impairment regarding Table 17-31 and corrected findings; MA not clear as to guideline he applied for another impairment; MA measurements not challenged; findings on examination confirmed correct assessment; Medical Assessment Certificate revoked. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 8 December 2023 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 Drew Dixon, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 10 November 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, 4th ed
1 March 2021 (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 24 October 2023 this matter was referred to a Medical Assessor for assessment of WPI arising from injury to the right lower extremity on 23 June 2022.
Ms Bisschop was employed by the appellant employer at Cromhurst School as a School Learning Support Officer.
On 23 June 2022 Ms Bisschop rolled her ankle whilst retrieving a soccer ball during a PE class. She thought she had suffered a bad sprain but on investigation it was discovered that she had sustained a fracture of the 5th metatarsal bone. She was put into a plaster cast and given crutches.
On 9 August 2022 the plaster was removed but Ms Bisschop continued to experience a lot of swelling and an MRI was performed which demonstrated a Chopart fracture dislocation of the right foot and right ankle. She was referred to Dr Andrew Wines who recommended a moon boot and to Dr Les Grujic who recommended a diabetic boot to reduce pressure on her skin as she is an insulin dependent diabetic. She now wears a Hoka jogger.
She returned to work on 14 November 2022, one day per week which at the time of the assessment had increased to two and a half days per week.
The Medical Assessor assessed 17% WPI.
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.
As a result of that preliminary review, the Appeal Panel determined that it was not necessary for the worker to undergo a further medical examination because although a minor error was corrected, there was no need to revoke the MAC.
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.
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 MAC
The Medical Assessor took a consistent history of the injury and its sequelae. The findings on physical examination were relevantly:[1]
“There was stiffness of her right ankle joint with dorsi-flexion 10 degrees, plantar flexion 25 degrees and stiffness of the subtalar joint with eversion 10 degrees and inversion 15 degrees.”
[1] Appeal papers page 32.
In his summary of injuries, the Medical Assessor said:[2]
“This claimant sustained fractures to her right foot as a result of the inversion stress injury to her foot while retrieving a soccer ball and ultimately sustained a Chopart fracture dislocation of the foot with multiple mid foot fractures and fracture of the base of the fifth metatarsal. This has been associated with post traumatic stiffness of her right ankle, right hind foot and mid foot and toe extension and she has developed a significant pes planus (flat foot) with only a modest arch on supported toe standing.”
[2] Appeal papers page 33.
At paragraph [8] of the MAC the following appeared:
“b. Have all body parts/systems stabilised/reached maximum medical improvement? Yes
c. If not, please list those injuries not yet stable/at maximum medical improvement: Not applicable.
d. If stabilisation/maximum medical improvement, of any or all injuries has not been reached, when, in your opinion, will this occur? Not applicable.”
In explaining his calculations at [10b] the Medical Assessor said:[3]
“That for the measured arthritic change between the talo-navicular joint of 1mm is 15% lower extremity impairment, that for the calcaneocuboid joint of 1mm is 15% lower extremity, that for the 2mm narrowing of the subtalar joint is 10% lower extremity impairment.
This gives a total from the Combined Values Chart of 35% lower extremity impairment for post traumatic arthritis.
That for the stiffness of dorsi-flexion of her right ankle is 7% lower extremity impairment.
That for the loss of extension at the 4th and 5th toes is 2 + 2 = 4% lower extremity Impairment, giving a total of 11% lower extremity impairment for her foot and ankle. This gives a total from the Combined Values Chart of 42% lower extremity impairment, which equates to 17% whole person impairment.”
[3] Appeal papers page 34.
When discussing other medical pinions at [10c] the Medical Assessor indicated the following:
“This [the 17%] is line with the percentage found by Dr Eugene Gehr in his IME report of May 3, 2023 where he preferred to use the loss of range of motion as well as the moderate rocker bottom foot, Para 3.2 to 3.6 Page 18, and Table 17-33, for mid foot deformity.
I do not have the IME report of Dr Kim Slater but I understand it was less than 10% WPI.”
The Medical Assessor referred to “Table 17 – 33” as one of the AMA 5 tables in his formal Table 2 certificate.[4]
SUBMISSIONS
[4] Appeal papers page 37.
The appellant employer
The appellant employer relied on three grounds.
Dr Slater
Firstly, the appellant employer submitted that in failing to review and consider the medico-legal report of Dr Kim Slater, orthopaedic surgeon, dated 5 July 2023, the Medical Assessor had made a demonstrable error. Although he assumed Dr Slater had assessed less than 10% WPI, in fact Dr Slater did not consider that the worker had reached maximum medical improvement.
The appellant employer submitted that whilst it was open for the Medical Assessor to reach an opinion different to that of the expert witnesses, he was nonetheless required to consider and engage with Dr Slater’s report.
The appellant employer submitted that the Medical Assessor failed to disclose his path of reasoning as to why his opinion on the issue of maximum medical improvement differed from that of Dr Slater.
Post-traumatic arthritis
Secondly, the appellant employer also challenged the calculations made by the Medical Assessor for including in the lower extremity impairment calculation an adjustment for post-traumatic arthritis.
We were referred to Chapters 3.19, 3.20, 3.21 and 3.23 of the Guides, and it was submitted that the Medical Assessor fell into error because he did not comment on whether he had the radiological evidence on which it was necessary to make his assessment of 35% lower extremity impairment (LEI).
It was submitted that Chapter 3.23 had not been complied with, as it was not evident from the investigations of the right foot whether the subtalar joint was assessed from the coronal plane. It was submitted that the Medical Assessor had failed to disclose sufficient reasons to identify his actual path of reasoning, in that he failed to explain why:
· an assessment of WPI due to arthritic change was warranted, or
· that he had the necessary radiological evidence as required by the Guides to make that assessment.
We were referred to the well-known dicta of the High Court in Wingfoot Australia Partners Pty Ltd v Kocak.[5]
[5] [2013] HCA 43.
Alternatively, it was submitted that if the assessment based on arthritic change was open to the Medical Assessor, he had nonetheless miscalculated and should have assessed the LEI at 23% and not 35%.
Dorsiflexion
Thirdly, the appellant employer submitted that the Medical Assessor had made an error in allowing 7% LEI for the stiffness of the dorsi-flexion of the right ankle.
The appellant employer submitted that it was “not clear from the MAC” that the Medical Assessor had used Table 17-33 of AMA 5 for this purpose, as it appeared as one of the tables referred to in the Table 2 MAC itself.
The appellant employer said that the particular part of table 17-33 had not been identified and that indeed there was no criteria in table 17-33 which accounted for dorsi-flexion stiffness.
The appellant employer submitted that the Medical Assessor did not provide sufficient reasons to identify his actual path of reasoning in this respect.
The respondent
Dr Slater
With regard to the alleged error regarding Dr Slater, Ms Bisschop submitted that Dr Slater’s report was the only document attached to the Reply and constituted the basis of the dispute, which was whether maximum medical improvement had occurred. Dr Slater’s advice was that it had not, and could be not expected to occur until the end of 2023.
It followed, Ms Bisschop argued, that there had been no failure by the Medical Assessor to engage with Dr Slater’s opinion. The date of the medical assessment was 6 November 2023 which was consistent with Dr Slater’s view that maximum medical improvement would occur towards the end of 2023.
There was therefore, it was argued, no competing view for the Medical Assessor to engage with. We were referred to Bojko v ICM Property Service Pty Ltd [6] in that regard.
[6] [2009] NSWCA 175.
Similarly, Ms Bisschop argued that the submission that Wingfoot applied was also not made out. The Medical Assessor had sufficiently articulated his path of reasons to the ultimate conclusion reached by him. We were also referred to Lancaster v Foxtel Management Pty Ltd[7] and to McGinn v Ashfield Council.[8]
[7] [2022] NSWSC 929 at [45].
[8] [2012] NSWCA 238 at [17].
Post-traumatic arthritis
As to the appellant employer’s complaint that the assessment due to arthritic change was not warranted or that the Medical Assessor had the necessary radiological evidence as required by the Guides, Ms Bisschop said that this approach was “precisely the type of legally incorrect method” which had been demonstrated in Wu Shan Liang.[9]
[9] (1996) 185 CLR 259 [1996] HCA 6
It was submitted that the Medical Assessor was appointed on the basis of his particular specialist medical knowledge. He was not required to confirm that the radiological findings he was relying on were those required by the Guides. Ms Bisschop submitted that “the Medical Assessor’s review and adoption of that radiology makes the point plain”.
We were referred again to Lancaster, at [45].
As to the submission that the tables in Table 2 of the MAC should be individually explained by reference to each guideline, Ms Bisschop submitted that the Medical Assessor had clearly set out his reasons by relating his findings on examination, reasons for assessment and the Table 2 Medical Assessment Certificate itself, which itemised the tables and references on which it was based.
Ms Bisschop submitted that “the adoption of those guides to the assessment of permanent impairment is a complex medical task of which the writer, and neither the Appellant writer, are qualified or equipped to grapple with [sic].”
Ms Bisschop conceded that the reasons of the Medical Assessor appear to have misstated the measurements by reference to the table at table 17-31. The assessment had been made at a 1mm and 0mm cartilage intervals respectively, which should have resulted in assessments of 10%, 15% and 15%.
Dorsiflexion
Ms Bisschop submitted that the appellant employer’s argument regarding dorsi-flexion ignored the wording of table 17-33 of the AMA 5. The table encompassed a situation that where there was an extraarticular angulation following a fracture then a 6% impairment resulted for an angulation of between 10° and 14° and a further 1% was applicable for an angulation of 20° +. The examination findings were consistent with those findings, it was submitted, and no error had been demonstrated.
DISCUSSION
Dr Slater
The appellant employer conceded that the Medical Assessor did consider the question of maximum medical improvement of the MAC. His attention to the issue is required by the templated question [8b] of the MAC, which we have copied above. However, in view of
Dr Slater’s report it was argued that the Medical Assessor was required to consider and engage with that opinion, and to disclose his path of reasoning for differing. In the circumstances the simple answer “yes” was insufficient, as we understood the appellant employer’s argument, in the light of Dr Slater’s report.In Dr Slater’s report of 5 July 2023, the following appears:[10]
“6. Has Jessica reached maximum medical improvement in relation to the right foot and ankle? If not, can you please provide time frames for MMI to be achieved.
In my opinion the patient has not yet reached maximum medical improvement in relation to her right foot and ankle. I would anticipate this to occur at approximately 12-18 months after her injury which was sustained on 23 June 2022, in other words, towards the end of 2023, an assessment could be made in this regard.”
[10] Appeal papers page 470.
There is force in Ms Bisschop’s submission that there was therefore no necessity to consider Dr Slater’s opinion, as when she was assessed by the Medical Assessor it was indeed towards the end of 2023, namely, 10 November 2023.
Thus the Medical Assessor fell into error by failing to consider the report of Dr Slater and indeed speculating wrongly as to what the content of Dr Slater’s report was. It is however an error that can be corrected without a re-examination by the Medical Appeal Panel, notwithstanding the submissions by the appellant employer. There was no contradiction as to the nature of Ms Bisschop’s injury, which was described consistently by Dr Slater, and no contradiction as to when maximum medical improvement would be achieved. The Medical Assessor was required to turn his mind to the subject, and his affirmative answer demonstrates that he did so.
Post-traumatic arthritis
The Medical Assessor stated in his summary that the inversion stress injury had ultimately caused Ms Bisschop to sustain a Chopart fracture dislocation of the foot with multiple mid foot fractures and fracture of the base of the 5th metatarsal. As indicated, he said that these injuries were associated with post-traumatic stiffness and he made an assessment of 35% LEI for post-traumatic arthritis.
The challenge to that finding was based upon a recital of Chapters 3.19 – 3.23:
“3.19 Impairment due to arthritis (AMA5 Section 17.2n, pp 544–45) following a work-related injury is uncommon, but may occur in isolated cases. The presence of arthritis may indicate a pre-existing condition and this should be assessed and an appropriate deduction made (see Chapter 1).
3.20 The presence of osteoarthritis is defined as cartilage loss. Cartilage loss can be measured by properly aligned plain X-ray, or by direct vision (arthroscopy), but impairment can only be assessed according to the radiologically determined cartilage loss intervals shown in AMA5 Table 17-31 (p 544). When assessing impairment of the knee joint, which has three compartments, only the compartment with the major impairment is used in the assessment. That is, measured impairments in the different compartments cannot be added or combined.
3.21 Detecting the subtle changes of cartilage loss on plain radiography requires comparison with the normal side. All joints should be imaged directly through the joint space, with no overlapping of bones. If comparison views are not available, AMA5 Table 17-31 (p 544) is used as a guide to assess joint space narrowing.
3.22 One should be cautious in making a diagnosis of cartilage loss on plain radiography if secondary features of osteoarthritis, such as osteophytes, subarticular cysts or subchondral sclerosis are lacking, unless the other side is available for comparison. The presence of an intra-articular fracture with a step in the articular margin in the weight-bearing area implies cartilage loss.
3.23 The accurate radiographic assessment of joints always requires at least two views. In some cases, further supplementary views will optimise the detection of joint space narrowing or the secondary signs of osteoarthritis.
…..
Ankle: The ankle should be assessed in the mortice view (preferably weight-bearing), with comparison views of the other side, although this is not as necessary as with the hip and knee.
Subtalar: This joint is better assessed by CT (in the coronal plane) than by plain radiography. The complex nature of the joint does not lend itself to accurate and easy plain X-ray assessment of osteoarthritis.
Talonavicular and calcaneocuboid: Anteroposterior and lateral views are necessary. Osteophytes may assist in making the diagnosis.
…”
The appellant employer acknowledged that the Medical Assessor had reviewed the investigations of the right foot, but complained that the Medical Assessor did not comment on whether those investigations were sufficient for him to assess impairment caused by arthritis. It can be seen from the above recital of Chapters 3.19 - 3.23 of the Guides, that a Medical Assessor is required to utilise his medical expertise in the analysis of radiographic and cross-sectional imaging, and making such an assessment is dependent on the criteria he applied in reaching his conclusion.
We have referred above to Vegan regarding the extent to which a Medical Assessor is required to give reasons. At [122] of the decision, Basten JA (Handley and McColl JJA agreeing) said:
“On the other hand, to fulfil a minimum legal standard, the reasons need not be extensive or provide detailed explanation of the criteria applied by medical specialists in reaching a professional judgment: see Soulemezis at 273-274 (Mahoney JA) and 281-282 (McHugh JA). At least, that will be so where the medical science is not controversial: if it is, a more expansive explanation may be required.”
The medical science involved in the interpretation of imaging is not controversial, and the appellant employer did not raise any issue concerned with such an interpretation, apart from a complaint that the Medical Assessor did not identify or disclose his path of reasoning in the use of such imaging in reaching his conclusion.
The phrase “path of reasoning” has been liberally used by the appellant employer. It comes from the High Court decision of Wingfoot:
“….What is to be set out in the statement of reasons is the actual path of reasoning by which the Medical Panel arrived at the opinion the Medical Panel actually formed for itself.”
In Lancaster, Basten AJ, sitting in the Supreme Court, said at [45]:
“Although Wingfoot was concerned with a statutory obligation to give reasons, it is appropriate to adopt a similar approach in relation to the implied obligation under the Workplace Injury Act, based on a similar purpose from which it is derived. That purpose is to ensure that, to the extent possible, any error of law in the reasoning of the Appeal Panel is revealed and may be the subject of an application for judicial review. However, as a practical matter, the Appeal Panel is likely to determine the question before it as a matter of expert medical opinion, the basis for which is peculiarly a matter of its special expertise and which will rarely give rise to any error of law, except on the basis that it is devoid of support in the material before the panel.”
This issue is such a matter. A Medical Assessor is under no obligation to explain the detail of how he interpreted the imaging that was before him. There is a presumption of regularity which attends administrative action, which a Medical Assessor performs.[11] That presumption is rebuttable, but a complaint on the basis that a Medical Assessor has not explain the minutiae of his application of the Guides is not sufficient to do so.
[11] Jones v The Registrar WCC [2010] NSWSC 481 at [37]: S 32 Personal Injury Act 2020.
Basten AJ’s referral to the practicality involved in the work of a Medical Panel however is illustrated in this matter, as the expert medical members of the Panel have indeed found that the Medical Assessor’s calculations are devoid of support, in that they have been miscalculated.
The Panel found that the Medical Assessor made an error when calculating the entitlement based on his measurements, as he has misapplied the guideline on which such calculations are required to be made. This is Table 17 – 31:[12]
[12] AMA 5 page 544.
Whole Person (Lower Extremity) [Foot] Impairment (%)
Cartilage Interval
Joint
3 mm
2 mm
1 mm
0 mm
Sacroiliac (3 mm)*
—
1 ( 2)
3 (7)
3 (7)
Hip (4 mm)
3 (7)
8 (20)
10 (25)
20 (50)
Knee (4 mm)
3 (7)
8 (20)
10 (25)
20 (50)
Patellofemoral
—
4 (10)
6 (15)
8 (20)
Ankle (4 mm)
2 (5) [7]
6 (15) [21]
8 (20) [28]
12 (30) [43]
Subtalar (3 mm)
—
2 (5) [ 7]
6 (15) [21]
10 (25) [35]
Talonavicular (2-3 mm)
—
—
4 (10) [14]
8 (20) [28]
Calcaneocuboid
—
—
4 (10) [14]
8 (20) [28]
First metatarsophalangeal
—
—
2 (5) [7]
5 (12) [17]
Other metatarsophalangeal
—
—
1 (2) [3]
3 (7) [10]
The Medical Assessor found there to be a 1 mm arthritic change in the talonavicular joint, and assessed 15% LEI therefor. A perusal of the above Table demonstrates that a 10% LEI should have been assessed. A similar error was made with respect to the calcaneocuboid joint for which a 10% LEI should also have been assessed. For the subtalar joint the Medical Assessor found there to be a 2 mm cartilage interval but again erred in his application of the above Table, allowing 10% LEI when he should have assessed 5%LEI.
Dorsi flexion
The appellant employer noted that Table 17-33 of AMA5 had been referred to by the Medical Assessor in his Table 2 Certificate. It made submissions that the Medical Assessor must therefore have applied Table 17-33, “although it was not clear”.
The appellant employer noted accurately that there was no criterion within Table 17-33 which accounted for dorsi flexion stiffness of the ankle, and accordingly it submitted that the Medical Assessor had not identified his path of reasoning in assessing 7% LEI for the stiffness in the right ankle.
Ms Bisschop submitted on the other hand that Table 17-33 did apply because there was stiffness of the ankle joint. This was incorrect. Ms Bisschop appears to have overlooked the requirement that the ankle itself be fractured, which was not the case in her injury.
The confusion exhibited by the parties was quite justified in view of the Medical Assessor’s statement at [10b] of the MAC that the 7% LEI was given for stiffness of dorsi flexion in the right ankle, and yet at [10c], when discussing Dr Gehr’s report, stated, as indicated above, that the 17% LEI the Medical Assessor had found was in line with the percentage found by
Dr Gehr “where he preferred to use the loss of range of motion as well as the moderate rock bottom foot, Para 3.2 to 3.6 Page 18, and Table 17-33, for midfoot deformity”.A perusal of Dr Gehr’s report of 3 May 2023 however did not confirm the Medical Assessor’s assumption, as Dr Gehr properly applied Table 17.11, allowing 7% LEI for a mild impairment of ankle motion.
In this category therefore, the Medical Assessor has again fallen into error. The confusion surrounding his two references to Table 17-33 is regrettable, but we do not consider that the MAC should be revoked on this ground. The parties have not challenged the LEI assessment of 7% regarding the ankle, but rather complained they could not comprehend on what basis it was made.
Table 17-11 provides:
Whole Person (Lower Extremity) [Foot] Impairment
Motion
Mild
3% (7%) [10%]
Moderate
6% (15%) [21%]
Severe
12% (30%)
Plantar flexion capability
11°-20°
1°-10°
None
Flexion contracture
—
10°
20°
Extension
71. 10°-0°
(neutral)
—
Relevantly, the Medical Assessor found stiffness in the right ankle joint with dorsi -flexion 10°.
It can be seen that Table 17-11 provides that the appropriate assessment is 7°LEI. We repeated that has been no criticism of the measurements taken by the Medical Assessor and accordingly, notwithstanding the confusion surrounding this assessment, it may be confirmed.
DECISION
Accordingly, the MAC will be revoked to reflect these findings.
Table 17- 2 provides that the lower extremity impairments found under Table 17-31 should be combined, which, on our above findings, gives an impairment of 23% LEI. This total is then combined with the LEI impairments for the right ankle and the fourth and fifth toes, giving a combined value under the Combined Value Charts of 31%.[13] Table 17-3 provides that 31% LEI converts to 12% WPI.
[13] From AMA5 page 604.
For these reasons, the Appeal Panel has determined that the MAC issued on
10 November 2023 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.
WORKERS COMPENSATION DIVISION
APPEAL PANEL
MEDICAL ASSESSMENT CERTIFICATE
Injuries received after 1 January 2002
Matter number: | W7202/23 |
Applicant: | Secretary, Department of Education |
Respondent: | Jessica Bisschop |
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 Medical Assessor Drew Dixon 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 lower extremity | 23.6.22 | Chapter 3.23 page 16, Chapter 3.17 page 15 | Table 71-11, 17-14, page 537, Table 17-31 page 544 | 12 | nil | 12 |
| Total % WPI (the Combined Table values of all sub-totals) | 12% | |||||
0
8
0