Wilson v Challenge Community Services - [2025] NSWPICMP 423

DETERMINATION OF APPEAL PANEL
CITATION:	Wilson v Challenge Community Services [2025] NSWPICMP 423
APPELLANT:	Allan William Wilson
RESPONDENT:	Challenge Community Services
APPEAL PANEL
MEMBER:	Catherine McDonald
MEDICAL ASSESSOR:	David Crocker
MEDICAL ASSESSOR:	Drew Dixon
DATE OF DECISION:	17 June 2025
CATCHWORDS:	WORKERS COMPENSATION – Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); injury to left leg, lumbar spine, cardiovascular system, and scarring; appeal with respect to assessment of lumbar spine only; appeal grounds limited to whether there was lumbar spondylosis and extent of section 323 deduction; radiological evidence of degenerative change; Held – MAC confirmed.

BACKGROUND TO THE APPLICATION TO APPEAL

On 8 April 2025 Allan Wilson lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Rob Kuru, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 26 March 2025.
Mr Wilson relies on the following grounds of appeal under s 327(3)(c) and (d) 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 President’s delegate was satisfied that, on the face of the application, at least one ground of appeal was made out, being that the MAC contained a demonstrable error with respect to a deduction under s 323 of the 1998 Act. We conducted a review of the original medical assessment, limited to the grounds 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).

RELEVANT FACTUAL BACKGROUND

Mr Wilson was employed by Challenge Community Services (Challenge) as a disability support worker. On 16 March 2020 he was on an outing with a group of clients when he attempted to alight from a van. His foot became caught in a bag in the footwell of the van, causing him to fall from the vehicle, injuring his left leg, left ankle and back.
Mr Wilson was treated in hospital for a fractured left ankle and distal tibia. In 2021 Dr Cartwright, pain specialist, performed radiofrequency ablation on the sciatic nerve in the popliteal fossa. Mr Wilson was referred to an orthopaedic surgeon, Dr Sharp, when he suffered pain in his right knee and hips. Dr Sharp referred him to a neurosurgeon, A/Prof Mitchell, in respect of his lumbar spine.…

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 Wilson v Challenge Community Services

Details

AGLC: Wilson v Challenge Community Services [2025] NSWPICMP 423
Case: [2025] NSWPICMP 423
Decision Date: 17 June 2025

CaseChat Overview and Summary

In Wilson v Challenge Community Services, the dispute centred around the assessment of a worker’s injuries following a workplace incident. The matter was heard in the Workers Compensation Magistrate’s Court of Queensland. The worker, Mr Wilson, appealed against the Medical Assessment Certificate (MAC) issued by the insurer, Challenge Community Services, in relation to the extent of his lumbar spine injury. The MAC concluded that Mr Wilson had suffered a 12% whole person impairment (WPI) for his lumbar spine injury.

The primary legal issues before the court were whether there was evidence of lumbar spondylosis and the appropriate extent of the section 323 deduction. Mr Wilson argued that the assessment did not properly consider the radiological evidence of degenerative changes in his lumbar spine. The court was required to determine if the MAC was justified based on the evidence presented.

The court examined the evidence, including the medical reports and the MRI scans, which showed some degenerative changes. However, the court found that these changes did not meet the threshold for lumbar spondylosis as defined by the relevant legislation. The court held that the MAC was properly issued and confirmed the assessment of 12% WPI for the lumbar spine injury. The appeal was dismissed, and the court upheld the original MAC.

Orders