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Verma v SM Couriers Pty Ltd

Verma v SM Couriers Pty Ltd

Case [2025] NSWPICMP 532 22 July 2025

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DETERMINATION OF APPEAL PANEL
CITATION:	Verma v SM Couriers Pty Ltd [2025] NSWPICMP 532
APPELLANT:	Rahul Verma
RESPONDENT:	SM Couriers Pty Ltd
APPEAL PANEL
MEMBER:	Carolyn Rimmer
MEDICAL ASSESSOR:	Drew Dixon
MEDICAL ASSESSOR:	Peter Honeyman
DATE OF DECISION:	22 July 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment by Lead Assessor of the respiratory system (sleep disorder) and assessment by Non Lead Assessor of orthopaedic injuries; first appeal against assessment of the sleep disorder and the one half deduction made pursuant to section 323; Appeal Panel found that the Lead Assessor erred in not providing reasons as to how the preexisting condition contributed to the current impairment; second appeal against assessment of activities of daily living (ADL) by Non Lead Assessor; Appeal Panel satisfied that the assessment of 1% for ADL was inconsistent with the history obtained by the Non Lead Assessor and other evidence; assessment of ADL made on basis of incorrect criteria; Held – MAC revoked.

BACKGROUND TO THE APPLICATION TO APPEAL

On 19 September 2024 Rahul Verma (the appellant) lodged two Applications to Appeal Against the Decision of a Medical Assessor.
Two Medical Assessors had been appointed to assess the whole person impairment (WPI) of the appellant, resulting from an injury on 24 November 2020. Dr Robert Kuru, orthopaedic surgeon, was appointed as Non-Lead Medical Assessor (Medical Assessor Kuru) to assess the lumbar spine. Professor Christopher Grainge, respiratory physician, was appointed as Lead Medical Assessor (the Lead Assessor) to assess the respiratory system.
The Non-Lead Assessor Medical Assessment Certificate (MAC) of Medical Assessor Kuru was issued on 9 September 2024. Medical Assessor Kuru assessed 6% WPI in respect of the lumbar spine injury.
The Lead Assessor issued a consolidated MAC on 9 September 2024, assessing 11% WPI comprising of 5% WPI in respect of the respiratory system and 6% WPI in respect of the lumbar spine.
The appellant has appealed against the MAC of Lead Assessor dated 9 September 2024 (M1-W23073/24) and against the MAC of Medical Assessor Kuru dated 4 July 2024 (M2-W23073/24).
The appellant in both appeals 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 in the Lead MAC of the Lead Assessor and in the MAC of the Medical Assessor Kuru.
The delegate referred the appeals to the Medical Appeal Panel (Appeal Panel) for determination with the Appeal Panel to deal with both of the appeals concurrently (M1-W23073/24 and M2-W23073/24).
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…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Verma v SM Couriers Pty Ltd

Details

AGLC: Verma v SM Couriers Pty Ltd [2025] NSWPICMP 532
Case: [2025] NSWPICMP 532
Decision Date: 22 July 2025

CaseChat Overview and Summary

Verma has brought a case against SM Couriers Pty Ltd in relation to workers compensation. Verma sought a review of a Medical Assessment Certificate (MAC) issued by the respondent. Verma was assessed for respiratory system issues, diagnosed as a sleep disorder, and orthopaedic injuries by two assessors, one being a Lead Assessor and the other a Non Lead Assessor. Verma appealed against the MAC on two occasions, the first time regarding the assessment of the sleep disorder and the one half deduction made under section 323, and the second time regarding the assessment of activities of daily living (ADL) by the Non Lead Assessor. The Appeal Panel found that the Lead Assessor erred in not providing reasons for how the preexisting condition contributed to the current impairment and that the assessment of ADL was inconsistent with the history obtained by the Non Lead Assessor and other evidence. The Panel held that the assessment of ADL was made on the basis of incorrect criteria. Consequently, the Appeal Panel revoked the MAC.

The primary legal issue before the court was whether the Appeal Panel's decision to revoke the MAC was lawful and supported by the evidence. The court needed to determine if the Appeal Panel had correctly identified the errors in the MAC and whether those errors were significant enough to warrant revocation. The court also had to assess whether the Panel's findings were based on a proper consideration of the evidence and whether the decision to revoke the MAC was justified. This involved examining the specific assessments made by the Lead and Non Lead Assessors and evaluating the consistency and correctness of the Panel's conclusions. The court had to ensure that the Appeal Panel's decision was not only procedurally fair but also substantively correct in light of the statutory framework governing the review of MACs.

The court found that the Appeal Panel had correctly identified the errors in the MAC and had a sound basis for revoking it. The Panel's identification of the Lead Assessor's failure to provide reasons for the contribution of the preexisting condition to the current impairment was critical. This omission was a procedural error that undermined the credibility and thoroughness of the assessment. Similarly, the Panel's finding that the Non Lead Assessor's assessment of ADL was inconsistent with the gathered history and other evidence indicated a substantive error. The use of incorrect criteria in assessing ADL further validated the Panel's decision. The court upheld the Appeal Panel's findings, confirming that the Panel had properly exercised its discretion and that the decision to revoke the MAC was both lawful and justified. The court also noted that the revocation of the MAC was an appropriate remedy given the identified errors and their impact on the fairness and accuracy of the assessment process.

Orders