Stuckey v Secretary, Department of Education
[2023] NSWPICMP 156
•26 April 2023
| DETERMINATION OF APPEAL PANEL | |
| CITATION: | Stuckey v Secretary, Department of Education [2023] NSWPICMP 156 |
| APPELLANT: | Carmel Stuckey |
| RESPONDENT: | Secretary, Department of Education |
| Appeal Panel | |
| MEMBER: | John Wynyard |
| MEDICAL ASSESSOR: | David Crocker |
| MEDICAL ASSESSOR: | Greg McGroder |
| DATE OF DECISION: | 26 April 2023 |
CATCHWORDS: | wORKERS cOMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; appeal from Medical Assessor (MA) finding that assessment of right knee replacement of 20% should be reduced by ¾ pursuant to section 323, and the assessment of the left knee of 30% should be so reduced by 100%; whether finding that left knee condition entirely due to constitutional features within MA’s remit; whether MA considered the whole of the evidence; Held – Medical Assessment Certificate revoked; MA made mistake of fact in identifying referred injury and considered an earlier event; Skates v Hills Industries considered and applied; MA failed to consider other relevant evidence; Elcheikh v Diamond Formwork considered and applied. |
BACKGROUND TO THE APPLICATION TO APPEAL
On 9 September 2022 Carmel Stuckey, the appellant lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Tim Anderson, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 15 August 2022.
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 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 the PIC Rules.
The assessment of permanent impairment is conducted in accordance with the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed, reissued 1 March 2021 (the Guidelines) 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 13 May 2022 the delegate of the President referred this matter for an assessment of WPI caused by injury to the right lower extremity (knee), left lower extremity (knee) and scarring (TEMSKI) caused by injury on 19 December 2018.
The appellant was employed as a school Principal by the Department of Education.
The Medical Assessor recorded that on 19 December 2018 Ms Stuckey was stepping down from a raised box at the radiology department where she had been having X-rays on her left ankle complex. She jarred her knee in the process. Symptoms persisted and she was referred to Dr Andrew Clout, specialist orthopaedic surgeon.
She was found to have extensive degenerative changes in the right knee and a degenerative medial meniscus tear. She was managed by a knee joint replacement on 31 January 2020.
Over the next eight months or so the left knee gradually deteriorated, and Dr Clout performed a left sided knee joint replacement on 17 September 2020.
The Medical Assessor found 20% WPI in relation to the right knee and 30% WPI in relation to the left knee. He found no WPI regarding the scarring.
However, in relation to the assessment of the right knee the Medical Assessor deducted ¾ pursuant to s 323 of the 1998 Act leaving an entitlement of 5%.
In relation to the left knee, the Medical Assessor deducted the entire assessment leaving a combined table value of 5%.
PRELIMINARY REVIEW
The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
The appellant requested to be re-examined by a member of the Appeal Panel. For reasons given below a re-examination was not indicated.
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.
The MAC
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
The appellant challenged the assessments pursuant to s 323.
The MAC
The Medical Assessor described the injury at [4]. He said:
“On 19/12/18, Mrs Stuckey was stepping down from a raised box in a radiology department where she had been having x-rays of her left ankle complex. As she came down, she jarred her right knee.
She thought the condition would go away but it didn’t, and she saw her doctor. She was referred to Specialist Orthopaedic Surgeon, Dr Andrew Clout. After further radiological investigation it was identified that she had extensive degenerative changes in the right knee. There was also a degenerate medial meniscus tear….”
At [7] the Medical Assessor summarised the matter, describing the injury as a “minor jarring event to the left knee.” He noted:
“Although it may not have been fully appreciated at the time, she had extensive pre-existing degenerative changes affecting mostly the medial compartment of each knee.”
The Medical Assessor described the surgical management of the right knee injury and said that the knee joint replacement gave Ms Stuckey “a fairly reasonable result.”
The Medical Assessor then noted that the left knee then deteriorated and investigations showed extensive generative changes. The Medical Assessor said:
“There has been no particular injury to the left knee.”
He said:[1]
“The left knee was at such a state that again, the only realistic option in her circumstances was a knee joint replacement ….”
[1] Appeal papers page 22.
The Medical Assessor noted on several occasions during his assessment that Ms Stuckey had always had difficulty with her weight control and that her body mass index was over 44. He said that throughout the clinical file, there was consistent evidence of a body mass index of well over 40 for many years. He said:
“This would significantly have contributed to the degenerative changes in both knees.”
At [8] the MA said:
“There have been extensive pre-existing degenerative changes in each knee. Her very gross excess body mass index would have contributed extensively to this development.”
He found, applying Table 17-33 of AMA 5 as modified by the Guides,[2] that there was a fair result on the right knee and a poor result on the left knee, which resulted in an entitlement of 20% and 30% WPI respectively.
[2] AMA 5 page 547, modified by Chapter 3 of the Guides page 21.
In considering the other medical opinions before him the Medical Assessor acknowledged that the baseline WPI was the same as Ms Stuckey’s medico-legal expert, Dr Leon Le Leu, in his report of 22 July 2021. He also referred to the opinion of Dr Ron Haig, the medico-legal specialist retained by the respondent, who applied 100% deduction for each knee due to the pre-existing degenerative changes. The MA said:[3]
“….Whilst there is extensive contribution from the pre-existing degenerative changes, I still believe that it is fair and reasonable for a modest contribution to be attributed to the event when she was stepping down from the radiography box. Dr Leon Le Leu applies a one-quarter deduction for each knee for pre-existing degenerative changes. With the greatest of respect, I believe that this should be substantially more.”
[3] Appeal papers page 24.
At [11] the Medical Assessor considered the application of s 323 of the 1998 Act. He said:[4]
“The only knee which was hurt which could reasonably be associated with her occupation was the right knee. This occurred when she was having her left ankle x-rayed, which had been injured in a work-related phenomenon some eight years beforehand.”
[4] Appeal papers pages 24-25.
He said:
“The radiological investigations very clearly demonstrate that with each knee there has been substantial degenerative changes which have obviously been in existence for many years before this particular event. The surgical reports confirm the extensive degenerative changes as well.”
The Medical Assessor continued:
“There has been no particular event associated with the development of the left knee necessitating the left knee joint replacement which was conducted in December 2020. Therefore, all of the condition of the left knee is due to constitutional features. It is likely that her very gross excess weight over many years is substantially responsible for this.”
He said:
“On the right side, this would largely be the same argument although there was the one event when she was stepping down from the radiography box and jarred her right knee. It is therefore assessed that three-quarters of the condition of the right knee and all of the condition of the left knee would be deducted for pre-existing features. The final whole person impairments therefore would be 0% on the left and 5% on the right.”
SUBMISSIONS
The appellant submitted that the evidence established that prior to her incident on 19 December 2018 she was asymptomatic and that “as a result of the accident” she had undergone bilateral knee replacements.
The appellant submitted that the respondent was estopped from denying that the operations were reasonable and necessary and that the need for the operations was caused by the accident. The Medical Assessor had not referred to Ms Stuckey’s statement and the appellant alleged that the Medical Assessor had made no reference to the incident on 19 December 2018.
The appellant submitted that the Medical Assessor’s statement that “the only knee that could reasonably be associated with her occupation” was inconsistent with the terms of his eventual assessment of both knees.
We were referred to s 323 of the 1998 Act. The appellant emphasised the terms of s 323(2).
The appellant submitted that the impairment was to be determined by reference to the surgery that was undertaken and that if there was an “absence of evidence what would assist” the Medical Assessor was obliged to apply “an entry point deduction of 10%.”
It was submitted that even if the Medical Assessor had available evidence with which to exercise his discretion pursuant to s 323(2) the absence of any medical complaint prior to the accident should result in a modest deduction.
It was submitted that the Medical Assessor failed to reconcile his finding that Ms Stuckey did not suffer injury to her left knee at work and his agreement with Dr Le Leu that the impairment was caused by the accident.
The appellant repeated her submission that the Medical Assessor had failed to consider the injury itself, or her statement.
The Medical Assessor did not adequately deal with the pre-existing impairment, it was submitted, because he did not have regard to the “entry point” and failed to explain his deduction by reference to the evidence.
Respondent
The respondent submitted that the appellant’s interpretation of the application of s 323 was much narrower than was either provided by the section or indeed by relevant authority. The statutory presumption was only applicable if the extent of the deduction was difficult or costly to determine.
The respondent submitted that the Medical Assessor gave a detailed explanation for the extent of the deductions he made. The right knee had not been asymptomatic as the appellant submitted, as Ms Stuckey herself recounted at [16]-[18] of her statement that she had suffered right knee pain when she stepped off a box some months before the subject accident.
In any event, the respondent submitted that even if Ms Stuckey’s condition had been asymptomatic, it could still attract a deduction. We were referred to Vitaz v Westform NSW Pty Ltd[5] in that regard. We were also referred to the well-known authority of Cole v Wenaline Pty Ltd[6] and the respondent kindly set out the relevant dicta on which it relied.
[5] [2011] NSWCA 254.
[6] [2010] NSWSC 78.
The Medical Assessor had correctly applied the relevant test, it was submitted. He identified the fact that the appellant was already grossly overweight and it was likely substantially responsible for the constitutional features in her knees. There was further surgical and radiological confirmation of that condition.
The respondent submitted that the Medical Assessor had exercised his skill and clinical judgment in making the deductions he did.
As to the estoppel point raised by the appellant, the respondent submitted that it did not arise as no such dispute had been raised by the respondent or noted by the Medical Assessor.
As to the alleged failure by the Medical Assessor to provide adequate reasons, we were referred to Vegan which we have referred to above. It was submitted that sufficient reasons were given by the Medical Assessor and that his path of reasoning was clear.
DISCUSSION
There is a fundamental problem with the assessment by the Medical Assessor, namely, that the history he based his assessment on was incorrect. The Application to Resolve a Dispute and the referral referred to an injury of 19 December 2019. In her statement Ms Stuckey said:[7]
“4. I sustained significant injuries when I was walking down a flight of stairs during the course of my employment with the NSW Department of Education on 19 December 2018.
5. When I was walking down the flight of stairs, I jarred my right knee. When this occurred, I felt my right knee hyperextend.”
[7] Appeal papers page 37.
Ms Stuckey later in her statement described an earlier accident of 2010 wherein she injured her left ankle, which eventually required fusion. She said:
“15. In approximately 2018, several months before the subject accident, I was required to obtain an x-ray of my left ankle at i-Med due to the ongoing symptoms I continued to experience from my 2010 accident. I recall standing on a box to have the x-ray image taken. When I went to step down from the box, I felt like I jolted my right knee. However, I did not feel any immediate pain in that region following this event.
16. The pain I experienced following the incident at i-Med was not as significant as the injuries I sustained in the subject accident.”
It is apparent that the Medical Assessor has assessed the wrong injury, as he recounted the relevant facts pertaining to when Ms Stuckey stepped down off the box some months prior to the subject injury (the earlier event). The terms of the referral stipulated that the injury was personal, and the date of injury was 19 December 2018.
We have some sympathy for the Medical Assessor. What he was required to assess was a factual mystery, in the final analysis. The history recorded by Dr Le Leu included an acknowledgement of treating surgeon Dr Clout’s advice of 6 November 2019 that the earlier event was the cause of Ms Stuckey’s injuries. Dr Clout had also noted that there had been contemporaneous imaging done of the right knee. (We note these X-rays were not before the Medical Assessor). Dr Clout did not mention the subject accident at all.
Dr Le Leu dealt with the earlier event in some detail. He said that Ms Stuckey’s right knee was symptomatic from shortly after that event, and that she developed sharp pain around her knee which resulted in “a bit of a limp.” She found that she needed to grasp the railings when descending and ascending the staircases at school. Dr Le Leu described the subject injury in these terms:
“The school incident on 19 December 2018 occurred when she was coming down a flight of stairs. Again, she did not fall, but she jarred her right knee. It was a more severe jarring than the one at i-Med. It almost felt like the knee had hyperextended too much.”
Dr Haig advised that there was no earlier history to Ms Stuckey’s knee at the time of the subject injury. Ms Stuckey told him that she “jarred her right knee descending stairs in December 2018.”
Although the Medical Assessor did not allude to these inconsistencies, it is apparent that he tried to untangle the factual confusion and in doing so fell into error.
The referral
An MA is bound by the terms of the referral, unless the terms do not reflect the agreement of the parties.[8] There has been no suggestion in this case that the terms of the referral on 13 May 2022 did not reflect the parties’ agreement, and accordingly the Medical Assessor was bound to accept that both knees had been injured. As we noted, the terms were that the Medical Assessor was to assess the WPI caused by the personal injuries of 19 December 2018.
[8] Skates v Hills Industries Ltd [2021] NSWCA 142 per Basten JA at [35], Leeming JA at [48] and McCallum JA at [82].
It is possible, although we do not have to decide, that the subject injury constitutes the aggravation, exacerbation, acceleration, or deterioration of Ms Stucker’s degenerative disease, to which different considerations arise when applying the provisions of s 323.[9]
[9] See Craigie v Faircloth & Reynolds Pty Ltd [2021] NSWSC 1211.
However, the terms of the referral were unambiguous, and from the perspective of a personal injury, a pre-existing condition and/or previous injury clearly existed. We find Dr Le Leu’s history to be persuasive. His description of Ms Stuckey’s disabilities following the earlier event were indicative of significant impairment. The implication from Dr Clout’s failure to mention the subject injury is that he either did not think it important, or that he was not aware of it.
In any event, this evidence shows that there was at least a relevant pre-existing condition (and perhaps a previous injury) that became symptomatic when Ms Stuckey stepped off the box some months prior to the subject injury. Dr Le Leu’s description of Ms Stuckey’s consequent difficulties confirms the significance of that event.
It follows that the MAC must be revoked. The Medical Assessor has not assessed the injury that was referred to him. We did not require a re-examination however, as there was no appeal from the baseline percentages found by the Medical Assessor.
Section 323
The mechanism of injury, however, becomes relevant when considering the application of s 323 of the 1998 Act.
Section 323 of the 1998 Act provides relevantly:
“(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 “injury” therein referred to is a reference to a subject injury, clearly enough. It follows that the Medical Assessor has also considered the wrong injury in determining the appropriate deductions, and they need to be reassessed.
The reasoning of the Medical Assessor
Before doing so, however, it is necessary to consider the reasons given by the Medical Assessor in that respect, notwithstanding that he applied them to the wrong injury.
It is logically difficult to reconcile a finding that a pre-existing degenerative condition has caused, in the case of the left knee, 100% WPI, with the terms of the referral. The finding of 75% for the right knee is equally problematic.
At [11] of his MAC, the Medical Assessor advised that the right knee was the only knee that was hurt. Further, he said that, as there had been “no particular event” associated with the onset of the left knee symptoms, the whole of the left knee condition was “due to constitutional features.”
The rationale for the deductions regarding both knees was that the radiology (which post-dated the subject injury) demonstrated the presence of degenerative changes. The Medical Assessor described them as “substantial,” and concluded that they had “obviously been in existence for many years.” He advised that Ms Stuckey’s “very gross excess weight over many years” had been “substantially responsible.”
The Medical Assessor stated that this reasoning applied to both knees, but he acknowledged in the case of the right knee that there had been “one event” when Ms Stuckey “jarred her … knee,” and he therefore deducted 75%, rather than the hundred percent that he deducted for the left knee.
The Medical Assessor has erred in finding that the left knee was not injured, as he was bound by the referral to accept that it had.
Other evidence
As to the Medical Assessor’s explanation of his reasoning behind the extent of his deductions, there was other evidence that he did not address. In Elcheikh v Diamond Formwork (NSW) Pty Ltd (in liquidation)[10] Schmidt J said at [89]:
“89. As discussed in Cole v Wenaline Pty Limited at [30], [the s 323] assessment cannot be made on the basis of an assumption or hypothesis that a pre-existing condition contributed to the impairment flowing from the subsequent injury. It has to have regard to the evidence as to the actual consequences of the pre-existing condition.
…….
91. [The Appeal Panel] noted, correctly, that the fact that the pre-existing condition had been asymptomatic did not preclude it from contributing to the impairment being assessed. Nor, however, could it be assumed that an asymptomatic condition did contribute to the impairment. Whether or not there had been any contribution had to be determined on the evidence, which included the competing specialist opinions on that matter, as well as various other evidence.”
[10] [2013] NSWSC 365.
The “other evidence” showed amongst other things that Mr Elcheikh had, unbeknownst to him, a pre-existing condition since adolescence. He had worked in heavy work for many years without symptoms when his injury occurred. This latter evidence had not been considered, and the matter was accordingly remitted back to the Workers Compensation Commission.
In the present case, the Medical Assessor based his assessment on a hypothesis that the degree of degenerative change shown after the injury in the radiological investigations had caused the majority of the WPI. Whether or not the imaging showed “obviously” that the changes had been in place for many years, the Medical Assessor’s hypothesis failed to consider the other evidence that was before him.
Ms Stuckey had been born in 1962, and her injury occurred on 19 December 2018. Throughout her working life she had worked in education, and had been working as a Principal at the Franklin Public School in Tumut for the last 10 of the 16 years she had been there.
We note the Medical Assessor’s opinion that Ms Stuckey’s “very gross weight” was substantially responsible for the changes. Whilst there is some scientific basis for that assumption, the Medical Assessor again did not consider that despite Ms Stuckey’s weight problems, she had been able to fulfil her duties as Principal without any symptoms in her knees. Neither did he engage with the evidence from Dr Le Leu in his report of 22 July 2022. Dr Le Leu recorded:[11]
“She says she had had no prior symptoms in either knee. She had been working full-time without difficulty. She was not participating in any sporting activities, but she and her husband have a big block in Tumut where she was regularly outside gardening, performing home maintenance, ’all of that‘. She says she is a person who frequently arrives at school at 6:30 a.m. and works there until 6 p.m. On weekends she would actively be doing housework and gardening. She regarded herself as ’very independent.’”
[11] Appeal page 40.
We regard this evidence as being of some relevance. Had the Medical Assessor considered this aspect of it he may well have concluded, as we have, that the assessment of the proportion of the impairment caused by the asymptomatic pre-existing condition of Ms Stuckey’s knees should not be as large as he found.
The “entry point”
In Elcheikh at [126] Schmidt J said:
“126. As discussed in Cole v Wenaline Pty Limited at [30], in the case of a workplace injury caused by an exacerbation or acceleration of a pre-existing condition, what must be determined by a medical specialist under s 323 is:
·Firstly, what the extent of the resulting impairment is.
·Secondly, whether the pre-existing condition contributed to the impairment.
·Thirdly, if it did, what proportion of the impairment was due to the pre-existing condition.
127. The statutory scheme recognises that this may be a difficult exercise and so provides a mechanism for its resolution, in s 323(2). If a medical specialist considers that it to be either difficult or costly to determine the contribution to the impairment which the pre-existing condition has made, the assumption provided by s 323(2) has to be applied by the medical specialist. That is, the contribution has to be assessed to be 10%, unless that is considered to be at odds with the available evidence.”
The extent of the resulting impairment, as we have noted, is not challenged. But the extent of the contribution to the resulting impairment, it was argued, was incorrect, and the Medical Assessor ought to have applied the statutory 10% presumption in accordance with s 323(2).
The left knee
A matter that clearly perplexed the Medical Assessor, and has caused the Panel some consternation, is the claim regarding the left knee. The evidence for the left knee has been hard to find, and we have had difficulty in identifying the injurious event. The condition of the left knee was described by Dr Le Leu as “secondary…,”[12] but the parties have agreed that it was an injury. If the claim had been based on Dr Le Leu’s opinion, then it would have been pleaded as a consequential condition, and not as an injury. The contrast is of some significance.[13]
[12] Appeal papers 49.
[13] See e.g. Bouchmouni v Bakhos Matta T/as Western Red Services [2013] NSWWCCPD 124.
Be that as it may, and doing the best we can with the terms of the referral, we find that the left knee injury concerned the same injurious process as that experienced in the right knee, being the aggravation, exacerbation, acceleration or deterioration of her previously degenerative state.
Discernment
In considering the facts it is somewhat unrealistic to regard the earlier event as being as being of little moment, as the appellant seemed to suggest. To that extent we reject the appellant’s submission that Ms Stuckey was asymptomatic when she suffered the subject injury. It is apparent for the reasons we have given, that Ms Stuckey was asymptomatic until the earlier event, which occurred some months prior to the subject injury.
In assessing the appropriate deduction, it is convenient to firstly consider Ms Stuckey’s position when she became symptomatic.
It can be seen that, in Elcheikh at least, at [127] Schmidt J thought that the statutory 10% provided by s 323(2) was designed to address cases such as this. We apprehend that this too was the basis of the appellant’s reference to “the entry point deduction of 10%.”
Each case however depends on its facts, and in this case there was explicit detail given by Dr Le Leu as to the symptomatic effect the earlier event had caused. The extent of the deduction is not difficult or costly to determine.
The event of 19 December 2018 caused injury to Ms Stuckey’s right knee, which had by then been rendered symptomatic by the earlier event. We accept that the imaging demonstrated degenerative disease in Ms Stuckey’s knees which was in such an advanced state that some contribution from it to the resulting impairment was open to be found by the Medical Assessor. However he failed to explain why he had ignored the other evidence to which we have referred. From the earlier event, we find the appropriate contribution regarding Ms Stuckey’s right knee would then have been 1/5th.
With the left knee injury, doing the best we can, we find the appropriate contribution at the time of the earlier event to have been ¾.
We consider these assessments to be useful indicia when considering the relevant contributions applicable to the date of injury some months later, on 19 December 2018. Ms Stuckey’s pre-existing condition was then symptomatic, with the difficulties to which we have referred. It is appropriate therefore to increase the deductible proportion to ¼, as the additional symptoms described by Dr Le Leu showed an evolving deterioration of Ms Stuckey’s degenerative condition.
We propose, again doing the best we can, to increase the deductible proportion for the left knee to 7/8ths in view of the matters we have above referred to.
For these reasons, the Appeal Panel has determined that the MAC issued on 15 August 2022 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: | W2421/22 |
Applicant: | Carmel Stuckey |
Respondent: | Secretary, Department of Education |
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 NSW workers compensation guidelines | 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) |
| 1. Right lower extremity (knee) | 19/12/18 | Chapter 3 pages 13 and 21: Table 17-35 as modified | Page 547 Table 17-33 | 20% | ¼ | 15% |
| 2.Left lower extremity (knee) | 19/12/18 | 30% | 7/8ths | 4% (rounded) | ||
| 3. Scarring | 19/12/18 | Page 74 Table 14.1 | 0 | |||
| Total % WPI (the Combined Table values of all sub-totals) | 18% | |||||
0
6
0