Vranic v Workers Compensation Nominal Insurer (iCare)

DETERMINATION OF APPEAL PANEL
CITATION:	Vranic v Workers Compensation Nominal Insurer (iCare) & Anor [2025] NSWPICMP 208
APPELLANT:	Tihomir Vranic
RESPONDENT:	Workers Compensation Nominal Insurer (iCare)
APPEAL PANEL
MEMBER:	Deborah Moore
MEDICAL ASSESSOR:	Graham Blom
MEDICAL ASSESSOR:	Professor Nicholas Glozier
DATE OF DECISION:	26 March 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); whether the Medical Assessor erred in whole person impairment (WPI) assessment of three of the psychiatric impairment rating scale (PIRS) categories, namely self-care and personal hygiene, social and recreational activities, travel, and concentration, persistence and pace; Held – fresh evidence rejected; Appeal Panel found error in two categories appealed; MAC revoked; new certificate issued.

BACKGROUND TO THE APPLICATION TO APPEAL

On 17 December 2024 Tihomir Vranic (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Ankur Gupta, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on
21 November 2024.
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;
·        the MAC contains a demonstrable error; and
·         the availability of additional relevant information (section 327(3)(b) of the 1998 Act.

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, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 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.
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 one was requested, we consider that we have sufficient evidence before us to enable us to determine this appeal, for reasons which will become apparent below.

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.

Fresh evidence

Section 328(3) of the 1998 Act provides that evidence that is fresh evidence or evidence in addition to or in substitution for the evidence received in relation to a medical assessment appealed against may not be given on an appeal by a party unless the evidence was not available to the party before the medical assessment and could not reasonably have been obtained by the party before that medical assessment.
The appellant seeks to admit the following evidence:
(a) a further statement from the appellant dated 17 December 2024; and
(b) a statement from the appellant’s wife, Susan Vranic dated 17 December 2024.
The appellant makes no submissions regarding the requirements of s 328(3).
The appellant relies upon the following “Grounds of appeal:”
(a)    the Medical Assessor was actually or ostensibly biased;
(b)    the Medical Assessor failed to afford procedural fairness;
(c)    the Medical Assessor failed to give adequate reasons, and
(d)    the Medical Assessor did not correctly apply the Psychiatric Injury Rating Scale (PIRS).
An appeal under s 327 is not an opportunity for an application on the basis of fresh evidence tendered without any constraint and/or on the basis of no more than a panel being invited to decide an application afresh.
We refer to the decision of Justice Hoeben in Petrovic v BC ServNo 14Pty Limited and Ors [2007] NSWSC 1156 where he considered what constitutes “additional relevant information” for the purposes of s 327(3)(b) of the 1998 Act: “…‘additional relevant information’ for the purposes of s 327(3)(b) is information of a medical kind or which is directly related to the decision required to be made by the AMS. It does not include matters going to the process whereby the AMS makes his or her assessment.”
For these reasons, the Panel has determined that the “fresh evidence” sought to be admitted by the appellant is not “additional relevant evidence” pursuant to s 327 (3)(b) and is rejected.
The submissions regarding bias and procedural fairness are not relevant to our task as an Appeal Panel. It is true that Chapter 1.46 requires that a report by a Medical Assessor should be “accurate, comprehensive and fair” but we are required to determine if the Medical Assessor erred in his assessments in accordance with Chapter 1.6 of the Guidelines
As regards the submissions regarding the adequacy of reasons and the various PIRS assessments, we will address these below.

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.
In summary, the appellant submits that the Medical Assessor erred in in his whole person impairment (WPI) assessment of three of the PIRS categories, namely Self-care and personal hygiene, Social and recreational activities, Travel, and Concentration, persistence and pace..
In reply, the respondent submits that no errors were made.

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 appellant was referred to the Medical Assessor for assessment of WPI in respect of a primary psychological/psychiatric injury occurring on
12 January 2020.
2 May 2018. The Medical Assessor obtained a history of the circumstances of the injury as follows:
“Mr Vranic was injured in the course of his work as an Uber driver. He reported to an address and saw that there were three lads, two men and a woman. They were all drunk. He tried not to take them on, the woman then vomited outside. He says that one of them wanted him to drive to a McDonalds in the other area. He says that there were a lot of other things that he did not want to talk about. He says that one of them then started threatening to kill him. He says that he asked them to get out. They got out, as did he. He jumped back into the car, and they jumped back in. He remembered that there was a police station four kilometres behind. He turned around and started driving towards the police station. One of them started punching him and his ear started bleeding. His head hit the mirror. He stopped the car and got out to get away, but they got out and started hitting him. He saw an opportunity to get back into the car and got in. He says he started driving slowly, but one of them jumped into the car in the back seat where the woman was already in. The woman was pulling at his mouth while the man kept punching him on the back of his head. He says that the two of them then got out of the car and he drove to the police station. He was then taken to the hospital, where he spent a few hours before being discharged. He suffered soft tissue injuries to his neck, head, nose, mouth and ear. He had pre-existing tinnitus, which was worsened. The three assailants were charged and found guilty. He provided evidence in court, but he could not handle it well. He says he was advised not to return to the court after his first appearance.”
Present treatment was noted as follows:
“Mr Vranic [is on] Ibuprofen and CBD oil. He says that he does not want to take any psychotropic medication. He has received cognitive behavioural therapy but has not had a session for several months because he was ‘cut off from the insurance company.’”
Present symptoms were described as:
““Mr Vranic says that his mental state is not good. He says that he does not want to live. He has not made any plans or attempted it, but he thinks about this. He says that he is easy to anger. He says that he went to attend a family function in February, where he grabbed his brother around the neck and choked him. He does not like being e does not like the people behind him. He describes hypervigilance and hyperacusis. He has an increased startle response as well.
He says that he is unable to sleep because of the pain. He says that his brain does not stop, either. He says that he finds it difficult to get to sleep because of that. He says that he has nightmares and describes flashbacks. He gets irritated if anyone parks in front of their house. He said that his appetite is reduced, and he has ‘lost a lot of weight.’ He estimates that he has lost over 20 kilos in body weight.
He says that he spends his time watching TV, fishing programs and sports. He has suffered dissociative episodes. He denies any substance misuse.
He says that he is okay when he is on his own but gets anxious if anyone comes near him. He is uncertain about his future ‘but wants to be left alone.’”
When asked to provide “Details of any previous or subsequent accidents, injuries or conditions” the Medical Assessor said:
“Mr Vranic says that he was in a motor vehicle accident in 2009 but denies suffering from any psychological injury from that. He says that he has never suffered from any mental illness. He says that a psychiatrist once mentioned possible bipolar but says that he has never been formally diagnosed or taken any medication for that. He denies any subsequent trauma. However, according to documentation, he has suffered from severe reflux and erectile dysfunction over 2023/24. Furthermore, a letter dated 12 October 2009 from treating general practitioner (GP) Dr Howard Nguyen states that he suffered depression and anxiety in the aftermath of the motor vehicle accident which occurred on 14 January 2007. Short-term memory issues were noted as well. Dr Howard had provided a letter dated 29 June 07 when he had described the condition as PTSD and had also noted the presence of white matter hyperintensities on an MRI brain scan. Furthermore, Dr Nguyen had completed a disability support pension medical report dated 13 February 12, where he had described the most significant medical condition as depression and had described symptoms including anger issues, reduced concentration and extreme highs. He was on Venlafaxine 75mg and was receiving treatment under the care of a psychiatrist and psychologist. Mr Vranic completed an application for disability support pension dated 15 February 12, where he described depression, anxiety and bipolar as his main concerns.”
The Medical Assessor then turned to consider the impact of the injury on his social activities and activities of daily living (ADL’s) and said:
“Mr Vranic lives with his wife. His son lives with them part-time. He says that his son tries to get him out of the house. His son tries to involve him in business. His middle daughter has not spoken with him and her mother for the last three years. He says that he argues a lot with his wife and his son. He says he cannot travel far because he gets ‘road rage’. He said that his wife drives him most of the time. Mr Vranic says he goes to the gym as much as possible. He goes five days per week. He says that he usually goes there around 0100 AM and drives himself there. He says that he is able to do that since there is no traffic on the road and the gym is empty. He says that he is not very good with people and keeps his headphones on his ears. He was on a train once but found handling all the people around him difficult. He also sometimes goes to the gym in the morning with his wife. He says that he is unable to go to his local shopping centre. He stays in his room, watching TV. He says that his wife has become his carer. She has to prompt him to eat and shower. He does not shower regularly and does not change his underwear. He says that his breath stinks. He has developed a rash because of not showering. He has also developed a fungal infection because of uncleanliness. He walks his dog to the park once a week. He says that he could go to the shops, but not recently, as he feels that his mental state is getting worse. He says that his concentration is reduced and he sometimes puts salt in his coffee instead of sugar. He says that he is unable to read because of reduced concentration and his wife reads legal and medical correspondence to him. He says that he takes his CBD oil three times per week and his reflux medication daily.”
The Medical Assessor did not set out his findings on examination.
The Medical Assessor diagnosed “Post Traumatic Stress Disorder.”
He added:
“No inconsistencies were observed during the assessment. However, it appeared that Mr Vranic and his wife were familiar with the Psychiatric Impairment Rating Scale (PIRS), as they provided specific responses pre-emptively, without direct questioning. For instance, Mr Vranic exhibited a reaction of surprise and seemed to emphasise a sense of embarrassment when his wife spontaneously reported issues with his personal hygiene, such as failing to change his underwear regularly. Furthermore, his complaints of weight loss are inconsistent with the clinical documentation, as is his assertion that he did not have any psychiatric history. While no outright inconsistencies were observed, there was evidence of symptom exaggeration and a tendency to minimise pre-existing conditions.”
The Medical Assessor assessed 8% WPI from which he deducted one-tenth pursuant to
s 323 for the pre-existing condition, leaving a total of 7% WPI.
He then set out in considerable detail a summary of all the medical and other evidence he had before him. We do not intend to repeat that here, but will refer to it, where relevant, in our determination below.
Many of the appellant’s submissions are predicated upon his supplementary statement and that of his wife which, for reasons referred to above, we have rejected.
The submissions are as follows:
(a)    the Medical Assessor appears to have inferred from a presumption on his part that the worker had knowledge of the PIRS and that this was somehow nefarious if it be so;
(b)    of comparatively less significance, but not to be overlooked, is the conclusion for Self- Care and Personal Hygiene that the history given and the clinical notes differ on the question of weight loss;
(c)    the implied credit finding which the Medical Assessor made is not tenable. See Cheers v MidCoast Council [2024] NSWSC 1553;
(d)    whilst it certainly is a matter of clinical judgment to apply the PIRS, it is a process which must correspond with the facts or it will be infected by jurisdictional error;
(e)    as noted above, the question of weight loss has been approach [sic] without procedural fairness. The findings are not maintainable. It should be Class 3’
(f)    as to social and recreational activities, Class 3 is appropriate because the Medical Assessor has impermissibly found (without procedural fairness) that the pre-injury state was downplayed;
(g)    as to travel, it is noted that the Medical Assessor appears to have invented the idea that the worker uses taxis with no evidentiary foundation (see worker’s statement filed with this appeal). A finding without evidence is not legally supportable, nor within the discretion of the Medical Assessor. If one removes the (wrong) reliance on using taxis, then it would follow that the Class as found (Class 2) would probably be best increased to Class 3, and
(h)    as to concentration etc, there is moderate impairment and this should be Class 3. The worker cannot even follow television programs, for example.
These submissions do not address any particular evidence in support of the submissions. Mere assertions that a particular Class “should be” allocated without explanation do not assist us.

Discussion

To begin with, we agree that there are certainly some inconsistencies in the appellant’s account of various matters but having said that, we agreed that notwithstanding those inconsistencies, we had sufficient evidence before us to enable us to determine this appeal.
Dealing firstly with the category of self-care and personal hygiene, we agree with the appellant that the Medical Assessor seems to have been overly focussed on the issue of the appellant’s weight.
In the body of the MAC, the Medical Assessor notes:
“He says that his wife has become his carer. She has to prompt him to eat and shower. He does not shower regularly and does not change his underwear. He says that his breath stinks. He has developed a rash because of not showering. He has also developed a fungal infection because of uncleanliness.”
It is also worth noting that when asked to provide “Details of who attended the examination” the Medical Assessor said: “The Claimant Mr Tihomir Vranic and his wife & carer Mrs Susin Vranic.” (our emphasis)
The concept of “self-care and personal hygiene” is not defined in the Guidelines. The reference is to examples or “descriptors” relevant to the assigning of a specific class.
The examples in Table 11.1 are examples only and are not exclusive.
The Medical Assessor assessed a Class 2 rating and said:
“He complains of significant weight loss and impairment in his ability to look after his hygiene. Lack of dental hygiene has been noted by his genal practitioner (GP). However, his report of weight loss owing to a lack of interest in food is not supported by documentation. He has been advised weight loss by his GP for dyslipidaemia. According to documentation, his weight has increased from 100 kg in July 24 to 103 kg in September 24 and has been in this range since the injury. It is documented that he has a history of recurrent groin dermatitis predating the current injury. He is considered to have mild impairment objectively.”
The descriptor for a Class 2 rating reads: “Mild impairment: able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food.”
For a Class 3 it reads:
“Moderate impairment: Can’t live independently without regular support. Needs prompting to shower daily and wear clean clothes. Does not prepare own meals, frequently misses meals. Family member or community nurse visits (or should visit)
2–3 times per week to ensure minimum level of hygiene and nutrition.”
The Medical Assessor’s own history was that:
“His wife has to prompt him to eat and shower. He does not shower regularly and does not change his underwear. He says that his breath stinks. He has developed a rash because of not showering. He has also developed a fungal infection because of uncleanliness.”

That level of poor self-care and hygiene is significant. It cannot be said that Mr Vranic looks after himself adequately.” Indeed, his GP referred to his dental hygiene problems.
As the Medical Assessor noted, documents from the Avoca Medical Centre disclose:
(a) “On 07 August 23, he was advised to eat healthily and undergo a weight loss program because of his impaired lipid profile.
(b) He presented on 09 November 23 regarding dental hygiene. He had suffered a dental infection.
(c) He was advised dental hygiene again on 02 April 24.”
Although not bound by other medical opinions, they do form part of the evidence which we must consider in making our determination.
It is noted that Dr Nagesh in his report dated 6 February 2023 assessed a Class 3 in this category and said:
“Your client cannot live independently. He relies on his wife for cooking, cleaning and shopping. He has a shower 2-3 times per week. He requires prompting from his wife to have a shower.”
This was quite some time before the assessment by the Medical Assessor and the history noted by Dr Nagesh is consistent with that given to the Medical Assessor.
The Panel agree that the Medical Assessor appears to have based his assessment on a criterion not specifically noted in the guidelines, a discrepancy between reported weight loss and objective quite stable weight, rather than the other evidence and the Medical Assessor’s own descriptors of many moderate impairment examples.
For these reasons, the evidence supports a finding of a Class 3 rating in this category.
Turning next to the category of Social and recreational activities, the Medical Assessor assessed a Class 2 and said:
“Mr Vranic states that he stays at home and does not socialise. However, he was on [a] disability support pension for depression when he was injured and it is documented that he had limited social pursuits before the injury. There is mild impairment related to the accepted injury.”
The descriptor for a Class 2 reads: “Mild impairment: occasionally goes out to such events eg without needing a support person, but does not become actively involved (eg dancing, cheering favourite team).”
For a Class 3 it reads: “Moderate impairment: rarely goes out to such events, and mostly when prompted by family or close friend. Will not go out without a support person. Not actively involved, remains quiet and withdrawn.”
We agree that the Medical Assessor’s assessment in this category was not very detailed, and he focussed on the fact that Mr Vranic was in receipt of a disability support pension at the time of the incident the subject of this claim.
The disability support pension is provided on the basis that a person is too impaired to work and is erroneously incorporated into this category by the Medical Assessor rather than Employability.
However, having said that, it is noted that the appellant sustained both physical and psychological injuries in the subsequent incident.
In his statement dated 14 March 2023 Mr Vranic said that:
“Prior to the injury on 12 January 2020 I would regularly play golf and go fishing…this has been hindered by the ongoing chronic pain I suffer from.”
In short, the evidence suggests that Mr Vranic’s physical injuries and pain symptoms have reduced his ability to engage in various social and recreational activities.
However he did tell the Medical Assessor that he “goes to the gym as much as possible. He goes five days per week. He says that he usually goes there around 1.00am and drives himself there.” He also said that “He walks his dog to the park once a week.”
There is no evidence to suggest that he needs a support person or that he needs prompting to go to the gym frequently or walk his dog.
In Botha v Secretary, NSW Department of Customer Service [2024] NSWSC 781 Stern JA noted that there should be no distinction between activities that occur within or outside of the home and that “the focus is on the social and recreational character of an activity.”
In other words, the character of an activity, whether solo or in a group context, must be the focus of the assessment in this category.
Neither is there a requirement that an activity be both “social” AND “recreational”:
Given the activities described by Mr Vranic, we agree that the evidence supports a Class 2 rating in this category.
Turning next to the category of Travel, we note that Mr Vranic drives himself to the gym when he goes “five days per week.”
It is irrelevant whether or not he takes taxis on occasions: it is his ability to travel that is the issue.
In assessing a Class 2, the Medical Assessor said:
“Mr Vranic is unable to drive much but can travel as a passenger. He can use taxis and has been on a train as well. He is afflicted with anxiety and gets angry when he is in the car. He can drive if the roads are empty. There is mild impairment in this domain.”
This statement seems somewhat inconsistent with the Medical Assessor’s comment that he drives himself to the gym five times per week, but we accept the history he obtained and referred to in the body of the MAC.
It is clear however that Mr Vranic has the capacity to travel independently in the local area.
For these reasons, we agree that the evidence supports a Class 2 rating in this category.
Turning finally to the category of concentration, persistence and pace, the Medical Assessor assessed a Class 2 rating and said:
“Mr Vranic describes not being able to remember things and not being able to maintain his focus. However, that was not evident during the assessment. He stated that he could not remember the name of his medications but was able to direct his wife in getting the bottle of CBD oil. That suggests that he is independent in managing his medication. There is mild impairment in this domain.”
Earlier in the MAC, the Medical Assessor said: “He says that he spends his time watching TV, fishing programs and sports.”
The descriptor for a Class 2 reads: “Mild impairment: Can undertake a basic retraining course, or a standard course at a slower pace. Can focus on intellectually demanding tasks for periods of up to 30 minutes, then feels fatigued or develops headache.”
For a Class 3 it reads: “Moderate impairment: Unable to read more than newspaper articles. Finds it difficult to follow complex instructions (eg operating manuals, building plans), make significant repairs to motor vehicle, type long documents, follow a pattern for making clothes, tapestry or knitting.”
We repeat our earlier comment that the examples in Table 11.1 are examples only and are not exclusive.
In this case, on the Medical Assessors’s own findings, the appellant is “unable to remember things” and cannot maintain focus. As he said:
“He says that he spends his time watching TV, fishing programs and sports. He watches it 24 hours. He says that his concentration is reduced and he sometimes puts salt in his coffee instead of sugar. He says that he is unable to read because of reduced concentration and his wife reads legal and medical correspondence to him.”
In his discussion regarding “consistency” the Medical Assessor observed that:
“Mr Vranic and his wife were familiar with the Psychiatric Impairment Rating Scale as they provided specific responses pre-emptively, without direct questioning. For instance, Mr Vranic exhibited a reaction of surprise and seemed to emphasise a sense of embarrassment when his wife spontaneously reported issues with his personal hygiene, such as failing to change his underwear regularly.”
The Medical Assessor seems to have focussed on this aspect of the appellant’s presentation when addressing this category, although he does not specify to what extent the “familiarity” with the PIRS was attributable to the appellant and not his wife.
It is clear however that his wife assisted him with the interview, suggesting he needed such assistance when describing his symptoms and difficulties in this category. It is not unusual for anyone to feel embarrassed when talking about hygiene issues.
As the Medical Assessor made no record of any examination findings, the only specific cognitive findings described are that the degree of impairment in focus the appellant reported was ‘not evident’ and that the appellant was ‘able to direct his wife in getting the bottle of CBD oil’. The latter behaviour, demonstrating a single memory of where a regularly used item is located, adds nothing to ascertaining concentration, persistence and pace..
In addition, both IME’s, Dr Bisht and Dr Nagesh, also rated a Class 3.
Mr Vranic’s description of his difficulties in this category do not fit within the descriptor for a Class 2 rating.
On all of the evidence, he cannot “focus on intellectually demanding tasks for periods of up to 30 minutes…” although can undertake non-intellectually demanding tasks such as watching TV for much longer. He has relinquished more demanding tasks such as reading medical and legal correspondence, indicative of an inability to read more demanding matters than newspaper articles.
For these reasons, we agree with the appellant’s submission that a Class 3 rating in this category is consistent with the evidence.
This then means that the ratings are:
(a)    Self-care and personal hygiene – Class 3;
(b)    Social and recreational activities – Class 2;
(c)    Travel – Class 2;
(d)    Social functioning – Class 2;
(e)    Concentration, persistence and pace – Class 3; and
(f)    Employability -- Class 5.
This then means that the aggregate scores are 3, 2, 2, 2, 3, and 5, a total of 17 with a median score of 3 resulting in 19% WPI.
The Medical Assessor deducted one-tenth in respect of the pre-existing condition which is not the subject of appeal.
The final WPI is thus 17%.
For these reasons, the Appeal Panel has determined that the MAC issued on
21 November 2024 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:	W26076/24
Applicant:	Tihomir Vranic
Respondent:	Workers Compensation Nominal Insurer (iCare)

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 Ankur Gupta 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)
Psychological	12/01/2020	Chapter 11	Chapter 14	19%	1/10th	17%
Total % WPI (the Combined Table values of all sub-totals)					17%

[2025] NSWPICMP 208

26 March 2025