Skillen v Aldi Stores (A Limited Partnership)
[2024] NSWPICMP 630
•5 September 2024
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Skillen v Aldi Stores (A Limited Partnership) [2024] NSWPICMP 630 |
| APPELLANT: | Brea Skillen |
| RESPONDENT: | Aldi Stores (A Limited Partnership) |
| APPEAL PANEL | |
| MEMBER: | John Wynyard |
| MEDICAL ASSESSOR: | Douglas Andrews |
| MEDICAL ASSESSOR: | Michael Hong |
| DATE OF DECISION: | 5 September 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; appeal against psychological assessment of 14% whole person impairment (WPI) including one-quarter deduction pursuant to section 323; whether Medical Assessor (MA) failed to place sufficient weight on opinions of medical specialists; whether section 323(2) assumption should have been applied; whether MA’s reasons adequate; Held – MA to apply his own medical experience and expertise; path of reasoning clearly expressed; Medical Assessment Certificate confirmed. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 1 May 2024 Brea Skillen, the appellant, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Patrick Morris, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 2 April 2024.
The appellant relies on the following ground of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act):
· 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 21 March 2024 this matter was referred for an assessment of permanent impairment regarding a psychiatric/psychological disorder that occurred on a deemed date of injury of
13 January 2022.Ms Skillen had been employed as a Retail Assistant for the respondent and began working at its Albion Park store in May of 2018.
On 13 January 2022 she was injured whilst trying to apprehend a female shoplifter who rammed Ms Skillen with a trolley full of goods. She was then assaulted by the female and was threatened with further violence. Ms Skillen had been taking Sertraline, 150 mg a day and seeing a psychiatrist once a month prior to this incident.
After the incident her psychological state deteriorated, and she tried to commit suicide whilst driving.
In March 2022 she was admitted for 2-3 weeks in the South Coast Private Hospital under a psychiatrist Dr Fernando. Her Sertraline dosage was increased.
She and her husband subsequently moved to Albury in December 2023.
The Medical Assessor found 19% WPI for the impairment caused by her injury, but deducted ¼ pursuant to s 323 of the 1998 Act, resulting in a MAC for 14%.
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 no error was established in 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 appeal concerned the s 323 deduction.
The MAC
The Medical Assessor discussed Ms Skillen’s pre-existing history in a number of places in his MAC. He detailed her prior history:[1]
“Details of any previous or subsequent accidents, injuries or condition:
Ms Skillen reported having a difficult childhood. She said her mother was diagnosed with Bipolar Disorder. She said her father was in gaol all her life. She said her mother had six children to five different fathers. She said her mother was an alcoholic and drug addict as were her partners. She said her mother was physically and emotionally abusive to her. There was no sexual abuse as a child. Ms Skillen said she saw a school counsellor but still did well at school. She said she had a period of self-harm, including cutting, when she was about 15 or 16 years old.
In her 20s, she became involved with a partner who was emotionally abusive towards her and who was a drug addict. She was addicted to heroin for four years at that time and then went on a Buprenorphine program for two years before coming off it. Over this period of time, she had four children to this partner. She was homeless for some time over this period.
In 2013, Ms Skillen said her brother who was an ‘ice’ drug addict and in and out of prison choked he to the point where she ‘passed out’ and ‘woke up on the ground'. After this incident, she received counselling from a women’s centre and attended a group therapy program at the centre for about six months.
She met her current husband in 2014 and her psychological symptoms improved.
Ms Skillen said she was diagnosed with post-natal depression after the birth of her youngest child in January 2017. She said she saw a counsellor named Andrea on a fortnightly then monthly then two monthly basis. At that time, her GP put her on Sertraline medication at a dose of 100mg daily. She said she was referred to a psychiatrist, Dr McKensey, in 2018. She said she saw him for four or five times. There was no change in her medications. She said he had diagnosed her with Complex Posttraumatic Stress Disorder.
Ms Skillen said that in mid-2020 there were difficulties regarding COVID rules at her work in the Aldi store as there were shoppers being very threatening about the lack of food in the store and fighting over food. She said she felt very scared and frightened and not being able to care for her children. She said she felt very unsafe and angry. She said her GP and Dr McKensey had arranged for her admission to South Pacific Private Hospital in Sydney where she spent four weeks as an inpatient. There was no change to her medications there. After discharge, she continued to take Sertraline at the dose of 150mg daily and continued to see her treating psychologist, Ms Sue Leicester, initially fortnightly then three weekly then monthly. She returned to work.
Ms Skillen reports having no significant psychological symptoms in the 18 month period prior to the subject work injury in January 2022.”
[1] Appeal Papers page 25.
The Medical Assessor noted Mr Skillen’s current situation. Under the templated social activities/ADL paragraph he noted:[2]
“Ms Skillen said she moved to the Illawarra from Sydney in 2015 to be with her husband who is a Police Officer. They married in 2019. She said she moved to Albury as her husband was transferred there in December 2023 for his work.
Ms Skillen lives in her own home on a 10 acre property just outside Albury with her husband and her 15, 13 and 7 year old children….”
[2] Appeal papers pages 25 - 26.
In his summary the Medical Assessor described Ms Skillen as presenting with a “complex diagnostic feature”. He found that she presented with post-traumatic stress disorder as a result of the subject incident on 13 January 2022.
He said:[3]
“…This occurred against the background of a significant psychiatric history including being diagnosed with Complex Posttraumatic Stress Disorder and having an admission to a psychiatric hospital for four weeks in 2020. She appears to have had a history of some Borderline Personality traits and has been diagnosed with Complex Posttraumatic Stress Disorder which I think is an accurate diagnosis. I note that this is an ICD-11 diagnosis which is not included as a diagnosis under DSM-5. This diagnosis would take into consideration the significant impact of Ms Skillen’s very abusive and neglected childhood on her development of psychological symptoms and distress over her life. Ms Skillen’s likely pre--existing Borderline Personality traits have been exacerbated by the subject work injury.”
[3] Appeal papers pages 27.
The Medical Assessor further elaborated at paragraph [8e]:[4]
“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?
Yes. Ms Skillen reports a long history of psychiatric and psychological treatment. She gives a history of a childhood where she was the victim of neglect and abuse. She reports symptoms of emotional dysregulation in her teenage years where she was cutting herself and also a period in her 20s when she was addicted to heroin and then on a Buprenorphine program. She has been diagnosed by other psychiatrists and psychologists with Complex Posttraumatic Stress Disorder and Borderline Personality Disorder. She developed depression after the birth of her youngest child in 2017 and was treated with Sertraline at a dose of 100-150mg daily. She started seeing a psychologist on a very regular basis at that time. Prior to her work injury, she was admitted as an in-patient to a private hospital in 2020 for four weeks for treatment of psychological symptoms.
Therefore, I believe that this pre-existing psychiatric condition needs to be taken into consideration in assessing Ms Skillen’s current level of permanent impairment. There is a significant overlay of symptoms between Complex Posttraumatic Stress Disorder and the Post Traumatic Stress Disorder that Ms Skillen suffers as a result of the work injury on 13 January 2022. Some of the symptoms that she is experiencing now I believe are more related to her earlier life trauma including her suicidal ideation on a daily basis, self-harm behaviour such as biting herself on her wrists and feelings of emptiness.”
[4] Appeal papers pages 28.
At [10] of the MAC the Medical Assessor said he made a 25% deduction for the pre-existing condition of “what was likely to be treated a asymptomatic Complex Posttraumatic Stress Disorder or Borderline Personality Disorder/Traits prior to the subject work injury”.
In response to the invitation in the templated question [10c] regarding the other medical opinions, the Medical Assessor discussed the opinions that were before him relevantly. In discussing Dr Khan’s report, the Medical Assessor said:
“…Dr Khan only gave Ms Skillen a one-tenth deduction for the pre-existing condition, whereas I have given her a 25% deduction for the reasons I have outlined in this Certificate. I believe a one-tenth deduction would not adequately evaluate the contribution of Ms Skillen’s significant previous, including recent, psychiatric history to her current level of impairment.”
The Medical Assessor noted that Dr Parmegiani did not make any comment regarding any deduction. The Medical Assessor did note that Dr Parmegiani had said:
“[Ms Skillen] stated that she was clinically well when the subject incident occurred.”
The Medical Assessor further noted the opinion by Dr Lee Ingram. He noted that Dr Ingram did not make any deduction but the Medical Assessor stated that he had done so for the reasons he had outlined. In any event Dr Ingram did not think that Ms Skillen had reached maximum medical improvement.
He noted the report of Ms Skillen’s previous psychologist Dr Sue Leicester who had written that Ms Skillen was self-referred to her for treatment of trauma in May 2020 and that “Brea reportedly has a significant and lengthy history of sexual, physical, emotion and psychological abuse for ‘as long as I can remember’”.[5]
[5] Appeal papers 31.
The Medical Assessor noted Dr Leicester’s further comment that “[Ms Skillen] has a trifecta of risk factors – significant developmental trauma, many episodes of historical trauma (in adulthood) and now, fresh trauma which is added to her ‘trauma bank’.”
The Medical Assessor noted Dr Leicester’s opinion “it is my clinical view that what occurred in Aldi on 14 January 2022 was the sole contributor to a decompression in Brae’s mental health”.
The Medical Assessor further referred to the opinion of Dr Andrew McKensey, Ms Skillen’s treating psychiatrist. The Medical Assessor noted the history recorded by Dr McKensey of a long history of difficulties that are most likely a result of complex relational-based trauma. He attributed the observation that “the surprise is not so much her symptoms however but the resilience and instability she has found” to Dr McKensey, but we note it was actually made by Dr Leicester.[6]
[6] Appeal papers page 137.
The Medical Assessor also noted a discharge summary from the Wollongong clinic by psychiatrist Dr Sunera Fernando regarding an admission from 9 to 30 March 2022.
The Medical Assessor noted Dr Fernando’s diagnosis has being “depressive episode in someone with a background of personality vulnerabilities (effective dysregulation and poor distress tolerance skills)”.
The Medical Assessor concluded his survey of the evidence before him by saying:
“After reviewing the documentation, including the previous psychiatrist and psychological report, I believe that a 25% deduction from Ms Skillen’s whole person impairment rating as a result of her pre-existing psychiatric condition, is appropriate.”
Paragraph [11] is the templated question regarding whether a deduction should be made. The following appears:
“a. In my opinion the worker suffers from the following relevant previous injuries, preexisting conditions or abnormalities:
(i) I believe the best diagnostic conceptualisation for Ms Skillen -existing psychiatric condition is Complex Posttraumatic Stress Disorder, although I note this is an ICD-11 diagnosis, not a DSM-5 diagnosis. In DSM-5 terms, I believe that she suffered with Borderline Personality traits which may have fulfilled diagnostic criteria for Borderline Personality Disorder at times.
b. The previous injury, pre-existing condition or abnormality directly contributes to the
following matters that were taken into account when assessing the whole person
impairment that results from the injury, being the matters taken into account in 10a,
and in the following ways:
(i) I note that Ms Skillen was diagnosed with post-natal depression in 2017 and had been seeing a psychologist regularly since that time and had been on Sertraline medication at a dose of 100-150mg. She also had a four week in-patient admission to a psychiatric hospital in mid-2020 because of psychological symptoms related to the stress of the COVID pandemic impacting upon her work and family life. Therefore, I believe there is a significant contribution from Ms Skillen pre-existing condition to her current level of impairment.
c. Whilst the extent of the deduction is difficult or costly to determine, the available evidence is that the deductible proportion is large and a deduction of one tenth is at odds with the available evidence. In my opinion the deductible proportion is 25% for the following reasons:
(ii) I believe that this takes into consideration the significant but not overwhelming impact of Ms Skillen pre-existing condition to her current level of impairment. I do not believe that it is higher than 25% as I note that despite being on antidepressant medication and having psychological therapy, Ms Skillen reported having no symptoms and functioning well both at work and at home in the 18 months prior to the subject work injury on 13 January 2022.”
SUBMISSIONS
Ms Skillen’s submissions were prepared by Mr James McEnaney of counsel. The gravamen of his submission was that the Medical Assessor had erred in his application of the provisions of s 323 of the 1998 Act.
We were referred to the provisions of Chapter 11.10 of the Guides, but we note that they have been found to be inconsistent with the provisions of s 323.[7]
[7] Department of Communities and Justice v Lewandowski [2023] NSWSC 334 at [54-55]; Camden Council v Harle [2022] NSWPICMP 339 at [115-133].
Ms Skillen conceded that a deduction was appropriate in the circumstances, but noted that the qualified medical experts had limited the deduction to 1/10th. There was, it was submitted “comity” between the other assessors. Whilst the fact of the disagreement between assessors was not of itself an error, it was submitted that in this case, it “was instructive of an error in reasoning”.
It was submitted that at the time of the workplace injury, Ms Skillen had been fully functional for a period of some years. We were referred to the opinion of psychologist Sue Leicester in that regard, which the Medical Assessor had referred to.
Mr McEnaney also referred to the opinion of Dr Andrew McKensey, who was Ms Skillen's “therapeutic” psychiatrist. Dr McKensey noted that:
“despite the chaos of her life, [Ms Skillen] managed the formative years without maladaptation. She got [through] school, parented her younger siblings and avoided behavioural, emotional and substance use troubles that would commonly be seen associated with this untreated condition.”[8]
[8] Report of Dr McKensey 16 8.2018, appeal papers page 138.
The medico- legal report prepared for the insurer by Dr Lee Ingram of 30 October 2023, it was submitted, gave a “very careful analysis” of Ms Skillen’s pre-existing conditions and similarly noted that she was functioning well when she was working for the respondent.
Dr Ingram found that no deduction should be made.We were referred also to the appellant's statement that expressed her subjective view in similar terms to those expressed by the above experts.
Ms Skillen submitted that for the last five years there was nothing in her employment record that would indicate that she came under notice for any performance or discipline issues other than the subject injury.
The medico-legal report of Dr Abdal Khan was referred to and Ms Skillen again agreed with his opinion that a deduction of 1/10th was appropriate.
A more substantial deduction than that however, Ms Skillen submitted, was not supported by the evidence. The medical evidence showed that Ms Skillen was a resilient woman who had managed to cope remarkably well. The mere existence of earlier trauma and brief episodes of incapacity, it was submitted, was not sufficient to justify the deduction made by the Medical Assessor.
Ms Skillen, it was submitted, was functioning capably, maintaining full time employment, managing her personal and social life without interference and was not otherwise symptomatic.
We referred to “Marks” (no citation was given for this case, but we assume that the appellant was referring to Marks v Secretary, Department of Communities and Justice (No 2)[9]) in furtherance of a submission that the ultimate conclusion reached by the Medical Assessor was that one quarter of the total of the present impairment should be deducted for a pre-existing condition which was of an unknown precise diagnosis, when (apart from a brief interlude in 2020), Ms Skillen showed no impairment. This, it was said, “did not sit easily with the evidence”.
[9] [2021] NSWSC 306 and [2021] NSWSC 616.
Ms Skillen noted that Dr Kahn “at least in part” attributed the brief interlude in 2020 to anxiety associated with food supply issues.
It was further submitted that the deduction stood well outside the views of Dr Ingram and
Dr Khan and by implication that of Dr Parmegiani. The deduction was an instance of “impermissible speculation” as to the extent and severity of a mild pre-existing condition.It was submitted that the totality of the medical evidence was difficult to reconcile with the assessment by the Medical Assessor where a pre-existing condition was evidently causative of no persistent symptoms, dysfunction or deficiencies. The appellant submitted that the error made by the Medical Assessor was that his assessment was at odds with all of the available medical experts, and had been made on the basis of speculation without considering the consensus of the opposing medical experts and indeed Ms Skillen's own evidence.
The respondent
The respondent submitted that a mere difference of opinion is not sufficient to establish statutory error. The respondent noted the concession made by the appellant that a deduction ought to apply in these circumstances and submitted that in essence the question was whether the statutory deduction of 10% should have been found, rather than the ¼ assessed by the Medical Assessor.
The respondent argued that the Medical Assessor had provided detailed reasons for his decision. We referred to the Medical Assessor's findings in that regard.
The respondent reproduced some paragraphs from submissions attached to the reply. These submissions again underlined the detail of Ms Skillen’s pre-existing condition.
In the light of that detail, it was submitted that the statutory 10% deduction pursuant to s 323(2) would have been at odds with the available evidence and the Medical Assessor had given detailed reasons as to why this was so.
The appellant’s submissions ultimately comprised no more than a difference of opinion, the respondent repeated.
DISCUSSION
Section 323 of the 1998 Act provides:
“(1) In assessing the degree of permanent impairment resulting from an injury, there is to be a deduction for any proportion of the impairment that is due to any previous injury (whether or not it is an injury for which compensation has been paid or is payable under Division 4 of Part 3 of the 1987 Act) or that is due to any pre-existing condition or abnormality.
(2) If the extent of a deduction under this section (or a part of it) will be difficult or costly to determine (because, for example, of the absence of medical evidence), it is to be assumed (for the purpose of avoiding disputation) that the deduction (or the relevant part of it) is 10% of the impairment, unless this assumption is at odds with the available evidence.”
The authorities are clear and consistent with respect to what s 323(1) of the 1998 Act requires. Firstly, the level of a worker’s post-injury impairment at the time of assessment must be determined, sometimes called the “baseline” impairment. Secondly, a prior injury or pre-existing condition or abnormality must be identified. Thirdly, it must be determined whether a proportion of the worker’s baseline impairment is due to that prior injury or pre-existing condition. If so, then the extent to which the worker’s baseline impairment is due to the prior injury or pre-existing condition or abnormality must be determined.[10]
[10] See for example Cole v Wenaline Pty Ltd [2010] NSWSC78, Ryder v Sundance Bakehouse [2015] NSWSC526 and Pereira v Siemens Ltd [2015] NSWSC 1133.
The third and fourth stages of that process cannot be done based on assumption or hypothesis.[11] That is to say, it cannot be assumed from the fact that a worker has a pre-existing condition or has had a previous injury that a proportion of the baseline impairment is due to that pre-existing condition or prior injury.
[11] See for example Cole v Wenaline Pty Ltd [2010] NSWSC78, Ryder v Sundance Bakehouse [2015] NSWSC526 and Pereira v Siemens Ltd [2015] NSWSC 1133.
The difficulty with Ms Skillen’s challenge is that the Medical Assessor had addressed each of the specialist opinions that were before him. These included the medico-legal expert reports of Dr Khan and Dr Ingram, and those of the treating specialists including psychologist Dr Sue Leicester, psychiatrist Dr McKensey, and the advisory report of psychiatrist Dr Enrico Parmegiani. It was not suggested that the Medical Assessor had misquoted or misunderstood the purport of these reports, and we note that they all gave a consistent account of Ms Skillen’s past history. The Medical Assessor acknowledged those views, upon which Ms Skillen now relies. Ms Skillen stressed that those reports were so positive about the resilience and stability she had found in the face of such a challenging start in life - her dysfunctional relationships and exposure to drugs, violence, crime and fear at a young age.
The submission therefore that the assessment of one quarter of the baseline impairment pursuant to s 323 was at odds with the evidence amounts to an assertion that the Medical Assessor has failed to give adequate reasons.
We have already referred to Vegan at the outset of these reasons. At [122] the Court said:
“122 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 (citation omitted). At least, that will be so where the medical science is not controversial: if it is, a more expansive explanation may be required.”
We emphasise that the medical science regarding this case is not controversial. The exact nature of Ms Skillen’s condition has been the subject of some debate in the reports, but it has been admitted by the respondent that her condition constitutes a psychological injury. The issue concerns the estimate made by the Medical Assessor of the impairment caused by the pre-existing conditions. As was submitted by the respondent, the appellant’s submission was not that there should not have been any deduction at all, but that it should have been restricted to the statutory assumption in s 323(2) of 10%, as it was not at odds with the available evidence.
The Medical Assessor explained why he thought that such was not the case. We have reproduced his reasons above. His summary was, to repeat:
“c. Whilst the extent of the deduction is difficult or costly to determine, the available evidence is that the deductible proportion is large and a deduction of one tenth is at odds with the available evidence. In my opinion the deductible proportion is 25% for the following reasons:
(ii) I believe that this takes into consideration the significant but not overwhelming impact of Ms Skillen pre-existing condition to her current level of impairment. I do not believe that it is higher than 25% as I note that despite being on antidepressant medication and having psychological therapy, Ms Skillen reported having no symptoms and functioning well both at work and at home in the 18 months prior to the subject work injury on 13 January 2022.”
This summary followed the comprehensive history he took and the extensive survey he made of the medical material before him, which we have reproduced above, he concluded, again to repeat:
“After reviewing the documentation, including the previous psychiatrist and psychological report, I believe that a 25% deduction from Ms Skillen’s whole person impairment rating as a result of her pre-existing psychiatric condition, is appropriate.”
The function of a Medical Assessor was described in Wingfoot Australia Pty Ltd v Kocak.[12] The Court (French CJ, Crennan, Bell, Gageler and Keane JJ agreeing) held that –
“47….. The function of a Medical Panel is neither arbitral nor adjudicative: it is neither to choose between competing arguments, nor to opine on the correctness of other opinions on that medical question. The function is in every case to form and to give its own opinion on the medical question referred to it by applying its own medical experience and its own medical expertise.”
[12] [2013] HCA 43; (2013) 252 CLR 480.
At [48] the Court said:
“…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 [Assessor]l actually formed for [himself].”[13]
[13] The remarks were made regarding the functions of a Medical Panel, but the High Court’s remarks are accepted as applying to the functions of a Medical Assessor: See e.g. Western Sydney Local Health District v Chan [2015] NSWSC 1968 at [13].
Thus, the weight a Medical Assessor places on the evidence before him is subject to the application of his/her medical experience and medical expertise. This the Medical Assessor has done in his thorough consideration of the issues before him. His path of reasoning was also clearly explained.
For these reasons, the Appeal Panel has determined that the MAC issued on 2 April 2024 should be confirmed.
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