WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); assessment of left upper extremity and cervical spine made in reconsideration MAC in which original assessment was maintained including no assessment for restriction in activities of daily living (ADLs) from the cervical spine injury; whether Medical Assessor (MA) erred in not making an assessment for restrictions in ADLs; Appeal Panel found that the MA erred in failing to provide adequate reasons for concluding that the cervical spine injury caused no restriction in ADLs; Held - MAC revoked.

1. On 25 September 2025 Pamela Brown (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Robert Kuru, a Medical Assessor, who had issued a Reconsideration Medical Assessment Certificate on 27 August 2025.
2. 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.
3. 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.
4. 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.
5. 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 Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA 5).

1. The appellant sustained an injury to the cervical spine and left upper extremity on

2 March 2020 in her employment as a shop assistant with Trinity Retail Pty Ltd (the respondent). 2. The appellant lodged an Application to Resolve a Dispute (ARD) in the Personal Injury Commission (Commission) dated 16 October 2024 in which she claimed lump sum compensation in respect the injury to the cervical spine, left upper extremity, nervous system and scarring - TEMSKI. 3. A Certificate of Determination was issued by the Commission on 10 February 2025. Member Seaton made orders including:

"1. The applicant sustained left carpal tunnel syndrome as a result of injury on 2 March 2020.

1. I remit this matter to the President for referral to a Medical Assessor pursuant to s 321 of the Workplace Injury Management and Workers Compensation Act 1998 for assessment as follows:

(a) date of injury: 2 March 2020

(b) body systems/parts:

(i) cervical spine

(ii) left upper extremity (shoulder and sensory loss-carpal tunnel syndrome)

(iii) scarring (TEMSKI)

(c) method of assessment: whole person impairment."

1. On 20 February 2025 the matter was referred to Dr Robert Kuru, Medical Assessor, for assessment of whole person impairment (WPI) of the cervical spine and the left upper extremity (shoulder and sensory loss - carpal tunnel syndrome) as a result of the injury on

2 March 2020. 2. The Medical Assessor examined the appellant on 11 April 2025 and assessed 5% WPI of the cervical spine and 10% WPI of the left upper extremity. The Medical Assessor made a deduction of one tenth in respect of the left upper extremity pursuant to s 323 of the 1998 Act resulting in an assessment of 9% WPI of the left upper extremity. This resulted in a total of 14% WPI in respect of the injury on 2 March 2020. 3. The appellant applied for Reconsideration of the Medical Assessment Certificate issued on 30 April 2025 (the first MAC) on the basis that the referral to the Medical Assessor omitted referral for scarring (TEMSKI). 4. The appellant also filed an Appeal against Decision of Medical Assessor on 28 May 2025 relating to the allowance for Activities of Daily Living (ADL). 5. On 1 July 2025, delegate Sarah Anderson referred both the Appeal Application (M1- W27488/24) and the Reconsideration Application (W27488/24) to the Medical Assessor for reconsideration. The delegate made the following order:

(a) provide a revised Medical Assessment Certificate (MAC) that includes an (TEMSKI); and

(b) reconsider his opinion in respect of the impact of the applicant's cervical spine impairment on Activities of Daily Living (ADLs)."

1. On 27 August 2025, the Reconsideration Medical Assessment Certificate (MAC) was issued. The Medical Assessor maintained his previous certification of 14%WPI, revised to include an assessment of 0% WPI with respect to scarring (TEMSKI). The Medical Assessor maintained his original assessment of 0% WPI for restrictions of ADL in relation to the cervical spine.

1. 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.
2. 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 there was sufficient information on which to make a determination.

1. 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.

1. 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.

1. Both parties made written submissions. They are not repeated in full but have been considered by the Appeal Panel.
2. The appellant's submissions include the following:

(a) the failure to make any allowance for restrictions of ADL as a consequence of the cervical spine condition is a demonstrable error;

(b) on an analysis of the evidence in totality, the appellant's ADL are restricted both because of her shoulder and her neck, and this is sufficient to make a finding of at least 1% WPI in accordance with the Guidelines;

(c) the Guidelines provide at 4.33 'Impact of AOL', explicitly that: 'An assessment of the effect of the injury on ADL is not solely dependent on self-reporting, but is an assessment based on all clinical findings and other reports';

(d) the MAC does not adhere to this requirement imposed by the Guidelines, since the MAC contains no reference to how "all clinical findings and other reports" were incorporated into the Medical Assessor's decision making, and indeed provides only the applicant's apparent "indication" that caused him to reach his conclusion - i.e. was solely dependent on self-reporting;

(e) further, the Medical Assessor's reasoning appears to be erroneous as he states that what was indicated was that "her restrictions are actually not in her neck." This is not the test under 4.33, which requires analysis of the restrictions of activity as a consequence of the spine injury, not restrictions in the body system itself. In any event, that "indication" must be given little weight, since the Medical Assessor does find substantial restriction in the neck. The actual examination by the Medical Assessor of the appellant's cervical spine generally is sparse and the Medical Assessor's findings as to how the cervical spine may or may not impact on her ADLs is non-existent;

(f) at page 3 of the MAC, the Medical Assessor records that on physical examination: "There was restricted flexion, extension and lateral rotation of the cervical spine with dysmetria." It is obviously germane to the question of whether the cervical spine injury causes impact on ADL to understand the extent of the restrictions with some precision. Further, the finding of "dysmetria" is not explained, it is fair to conclude that the applicant's cervical spine injury profoundly affects the movement of her head;

(g) ADL impact is to be assessed (per 4.34) by assessing "difference in activity level as recorded and compared to the worker's status prior to the injury";

(h) the Medical Assessor was required to have regard to evidence beyond the appellant's self-reporting (although was required at least to make a proper finding of the self-reporting);

(i) on examination, Dr Bodel included a clear path of his own reasoning when including ADLs, stating: "Her activities of daily living have been moderately compromised in accordance with Item 4.34 and Item 4.35 on Page 28 of the Fourth Edition of the WorkCover Guidelines giving a 2% loading and a 7% Whole Person Impairment overall";

(j) given the Medical Assessor's findings on examination, it is difficult to conceive of the appellant's condition not having an impact on her ADL - given that she is limited in moving her head (and so is limited to short driving trips) and has pain and disrupted movement when looking around;

(k) it is no doubt true to say that the appellant's restrictions are, in part, due to her left shoulder complaint and carpal tunnel syndrome, however the test in Guidelines 4.33 - 4.35 does not require or allow an assessor to decline to make allowance for ADL on the basis that some other cause would otherwise or also restrict ADL. The common law has recognised that an injury (or in this case, a consequence on function) may have more than one cause - March v Stramare (1991 HCA 12; 171 CLR 506);

(l) the assessor's task is to assess whether, as a result of the substantial restrictions of the appellant's cervical spine and dysmetria, she is restricted from undertaking the ADL types set out at 4.34. The Medical Assessor's finding is tantamount to saying that all of her ADL restrictions emanate from her shoulder (without directly stating so), and none of them from her neck but without explanation for how this is so, and without sufficient particularity to assess what and how he reached that conclusion. Such a conclusion is at odds with the available evidence about how impacted the appellant is by reason of her neck pain and restrictions;

(m) as to the path of reasoning, it is not open to a reader of the MAC to know whether the Medical Assessor undertook the examination as required by 4.33 and 4.34 of the Guidelines, since he makes no recording of the pre-injury and post-injury activity level, and took no obvious steps to ensure that ADL impact had been assessed correctly or at all;

(n) accordingly for the reasons above, the MAC contains a demonstrable error, and

(o) at least 1% WPI should be added for restrictions of ADL caused by her neck condition, however, re-examination by the Medical Appeal Panel may also be necessary.

1. The respondent's submissions include the following:

(a) the Medical Assessor provided reasons with respect to the assessment impairment for ADL at paragraph 10(b) (page 5) of the first MAC and clarified his position in the Reconsideration MAC stating: "Ms Brown is significantly restricted in her activities of daily living but this restriction relates to her left shoulder";

(b) this is amplified in the description of history outlined under "Additional History since the Original Medical Assessment Certificate" which outlines the impact on the appellant's restrictions of ADL by reference to the right shoulder and arm;

(c) failure to properly apply the Guidelines - paragraphs 4.34 - 4.36 of the Guidelines relate to the assessment of an appropriate percentage for the ADL. Paragraph 4.34 provides that the diagram "should be used as a guide" in determining the appropriate percentage and the Guidelines place emphasis on "as a guide" by applying bold. The Guidelines are a guide only for the assessment of permanent impairment (Habbits v Chilana Pty Ltd [2019] NSWWCC MA 99);

(d) the criteria in paragraph 4.35 have to be considered in the context of an overall discretion given to the Medical Assessor by virtue of the expression "as a guide" in paragraph 4.34. In any event, the Medical Assessor exercised his clinical judgment and his assessment is within the scope allowed by the Guidelines;

(e) self-reporting - the Medical Assessor's reasoning is not "entirely reliant on self-reporting". The Medical Assessor in the Reconsideration MAC noted: "That assessment was made on the basis of my clinical assessment, review of the documentation including the differences of opinion between the reports of

Dr Bosanquet and Dr Bodel. Following review of Ms Brown, I maintain that assessment is correct";

(f) there were no issues with respect to the appellant's consistency on presentation and the Medical Assessor was entitled to consider the self-reporting which is recognised by the Guidelines as an appropriate source to base his assessment, in addition to clinical findings and other reports;

(g) failure to provide adequate reasons - it is clear from the Medical Assessor's reasoning that he did not consider an allowance for ADL was justified. The reasons do not have to be extensive or provide a detailed explanation as to the use of criteria applied in reaching the decision. Having provided clear reasoning for his own decision which sets out the actual pathway of reasoning (Wingfoot v Kocak [2013] HCA 43), the Medical Assessor has fulfilled his requirement of providing adequate reasons;

(h) difference of opinion - any comparison with Dr Bodel's assessment on

19 October 2023 is of little weight because it was conducted some 18 months prior to the Medical Assessor's assessment. The more recent examination of

Dr Bosanquet on 5 March 2024 was more broadly consistent with the findings of the Medical Assessor and supports the conclusion in the Medical Assessor;

(i) a contrary opinion in relation to the extent of impairment that resulted from the alleged impact of the injury on the appellant's ADL does not satisfy the requirement to establish the use of incorrect criteria or demonstrable error by the Medical Assessor: Merza v Registrar of the Workers Compensation Commission [2006] NSWSC 939. It is clear the Medical Assessor considered the evidence of Dr Bodel and was not obliged to accept or reject any particular view but form his own opinion;

(j) ADL - the Medical Assessor assessed 5% WPI consistent with DRE Cervical Spinal Category II which is based on clinical history and examination findings compatible with specific injury with no alteration of the structural integrity. The Medical Assessor noted the appellant's complaints with respect to the cervical spine "on rotation";

(k) the appellant concedes that the restrictions upon ADL are, at least in part, due to her left shoulder complaint and carpal tunnel syndrome. Where the appellant has self-reported that any difficulties she experiences with respect to household tasks is because of her left shoulder injuries, it is open to the Medical Assessor, in his discretion, to find that the restrictions cannot be reasonably attributed to any symptoms in relation to the neck and provide an assessment of 0% WPI;

(l) there is no error in concluding the restrictions complained of by the appellant were not sufficient or supported by the examination findings and other evidence to warrant a WPI assessment;

(m) it was open to the Medical Assessor to use his skill, judgment and expertise to come to the conclusion that he did. The appellant was assessed appropriately, and

(n) no demonstrable error has been made out and the assessment of 14% WPI ought be confirmed.

1. 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.
2. 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.
3. The Appeal Panel reviewed the Reconsideration MAC, the first MAC and the evidence in this matter.

1. The appellant submits that the failure to make any allowance for restrictions of ADL as a consequence of the cervical spine condition is a demonstrable error.

1. Under "Present symptoms" the Medical Assessor wrote: "Currently, Ms Brown has pain down the side of her neck with rotation. She has pain in the tips of all of the fingers of her left hand. She has subjective weakness in her left hand."
2. The Medical Assessor wrote:

Ms Brown reports she is significantly restricted in activities of daily living because of her arm. She has difficulty cleaning and doing housework."

1. On examination the Medical Assessor found that "There was restricted flexion, extension and lateral rotation of the cervical spine with dysmetria".
2. The Medical Assessor stated that he was unable to review any imaging related to the injuries.
3. The Medical Assessor stated that the facts on which he based his assessment of WPI were: "A thorough history, a comprehensive physical examination, a review of the documentation made available by the Personal Injury Commission with reference to the SIRA Guidelines (2021) and AMA-5."
4. Under "Reasons for Assessment" the Medical Assessor wrote:

"The cervical spine is assessed according to AMA 5 page 392 15.5 as DRE Category II (5% whole person impairment).

No further impairment was assessed for restrictions of activities of daily living. Ms

Brown indicated that her restrictions are actually not in her neck."

1. In commenting on the other medical opinions, the Medical Assessor wrote:

"With respect to the report by Dr Bodel dated 27 October 2023, I found similar restricted range of motion in the shoulder and have assessed similar impairment for it. I am in agreement with the assessment of the cervical spine as DRE Category II, although I have not assessed further impairment for restrictions of activities of daily living."

1. Under "ADDITIONAL HISTORY SINCE THE ORIGINAL MEDICAL ASSESSMENT CERTIFICATE WAS ISSUED" the Medical Assessor wrote:

"Further history was obtained with respect to the restrictions of activities of daily living. Ms Brown indicated that she is unable to reach overhead to hang clothes on a line and she is using clothes horses instead. She is unable to reach overhead to clean cobwebs. She is able to vacuum using her right arm but has to stop at times to relieve pain in the right shoulder. She is able to make her bed using fitted sheet but is unable to lift her mattress for a non-fitted sheet due to her shoulder. She is no longer able to chop wood, again due to her shoulder. She is able to carry wood with her right arm but is unable to use her left, as it shoots pain into her shoulder. She is able to cook using her right hand alone. She needs help, however to hold a pot, again unable to use her left arm. Ms Brown is no longer able to wear a bra. She has difficulty toileting and getting dressed, again only able to use her right arm. If she tries to throw or kick a ball with her 15 year old son, it again flares pain in her left shoulder."

1. Under "Evaluation of Permanent Impairment - Assessment and Reasons" the Medical Assessor wrote:

"Cervical Spine: This is assessed according to AMA 5 page 392 15.5 as DRE II, 5%

whole person impairment. Reconsideration was made with respect to restrictions of

activities of daily living. As noted in my previous report and following reconsideration,

Ms Brown is significantly restricted in her activities of daily living but this restriction

relates to her left shoulder. Whilst she has pain and restricted movement in her neck, there is no evidence of there being a significant underlying pathology in the neck and I note Dr Bosanquet in his IME dated 5 March 2024 has assessed the cervical spine as DRE Category I. The report of Dr Bodel dated 27 October 2023 has not been included in the documentation for review. From my reconsideration today, I confirm my original assessment of 0% whole person impairment for restrictions of activities of daily living consequent to the cervical spine."

1. The Medical Assessor under "My brief comments regarding the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs:" wrote:

"The applicant submitted "in relying solely on self-reporting and potentially considering overlapping restrictions".

That assessment was made on the basis of my clinical assessment, review of the

documentation including the differences of opinion between the reports of Dr Bosanquet and Dr Bodel. Following review of Ms Brown, I maintain that assessment is correct."

1. In her statement dated 27 May 2024, the appellant wrote:

"55. My neck is constantly sore and aches. The pain in my neck is on average an eight (8) out of ten (10). My neck feels like it is burning and gets hot. Sometimes it feels like it pinches lower down near my shoulder.

1. I have to be careful when I turn my neck to the right because it hurts. I have restricted movement in my neck as a result of the workplace accident.
2. My left shoulder is useless. The pain never goes away including of nighttime. I am now required to sleep with a pillow under my left arm otherwise I experience pain and my arm and hand go numb.
3. I have difficulty wearing a bra because the straps irritate my left shoulder. Getting dressed is a difficult task.
4. I use my right arm and hand to do almost everything, and I can feel my right shoulder starting to ache every now and again. I am afraid that my right shoulder will become injured due to overcompensating for my left shoulder.
5. The range of movement in my left shoulder and arm is limited. I avoid using my left shoulder to do anything physical as I do not want to aggravate it. If my left shoulder and neck conditions flare, it takes days for me to recover and for it to go back down to the usual baseline pain level I experience.
6. Even driving I have to be careful that I don't overuse my left shoulder and neck. I am required to get out of the car and take breaks to rest and stretch.

1. My workplace injuries restrict me on a day-to-day basis. I have severe difficulty performing activities of daily living including, garden work, dressing, meal preparation, washing clothes, groceries and generally lifting items above my head.
2. It has also impacted my normal social activities and my ability to perform work."
3. Dr James Bodel in a report dated 27 October 2023 noted under "Activities of Daily Living":

"This lady can drive a short distance in an automatic car.

1. Dr Bodel assessed DRE Cervical Category II level of assessable impairment in accordance with the description in Table 15-5 on Page 392 of AMA5. He noted that there was asymmetry of movement and guarding but no clinical sign of radiculopathy and applied a base rating of a 5% WPI.
2. He wrote:

"Her activities of daily living have been moderately compromised in accordance with Item 4.34 and Item 4.35 on Page 28 of the Fourth Edition of the WorkCover Guidelines giving a 2% loading and a 7% Whole Person Impairment overall."

1. Dr John Bosanquet, consultant orthopaedic surgeon, in a report dated 5 March 2024 wrote:

There is constant pain with no pain free days. It does not vary. She sleeps with a

pillow under the arm. She is able to lift above her head but this causes pain in her

neck. She can lie on the shoulder for only 10 minutes. There is occasional

paraesthesia and numbness. There is some weakness and a cup can slip out of her

With regards to her neck, she complains of pain throughout her whole neck and restricted flexion, extension, rotation and lateral bending."

"Ms Brown lives in a house with her 15 year old son who is at school. She uses the

right arm for cleaning and vacuuming. She is unable to hang clothes on the line and

has an indoor clothes horse. She is able to perform cooking and has difficulty

cleaning the bathroom. She does the shopping. Her son carries the groceries. She is paying someone to mow the lawns with a ride-on mower. She is able to drive but not for long distances.

She was hyperalgesic throughout her left trapezius, less so on the right. She was

Range of movement: She had full flexion, extension, rotation and lateral bending to both sides."

1. In a report dated 23 April 2024, Dr Bosanquet commented that when he examined the appellant, she had a full range of movement in her cervical spine. He noted that there had been no radiological investigations on which he could comment. He wrote: "Thus, in light of the full range of movement and with reference to AMA 5, Page 392, Table 15-5, Ms Brown has a DRE Cervical Category I, with 0% whole person impairment."
2. In a report of a CT scan of the cervical spine dated 14 May 2022, Dr McCormack, radiologist, found:

"At C5/6, there is bilateral uncovertebral osteophytes and associated disc bulge, small on the left and large on the right. There is moderate right foraminal narrowing of the exit foramen for the right C6 nerve with possible irritation and mild narrowing on the left."

1. In a report of MRI of the cervical spine dated 6 July 2024, Dr Y Khong, radiologist, noted a history of ongoing neck and left shoulder pain radiating to the left upper limb. He wrote:

"C4-5: Anterior osteophytes. No significant stenosis of the central canal or left foraminal stenosis. There is moderate right foraminal stenosis of the exiting right C5 nerve root.

CS-6: Anterior osteophytes. No significant central canal or left foraminal stenosis. There is moderate right foraminal stenosis of the exiting right C6 nerve root, secondary to uncovertebral osteophytes."

1. The appellant submits that the MAC contained a demonstrable error in that the Medical Assessor failed to properly apply the Guidelines by failing to make a pre-and post-injury analysis of restriction of activity.
2. The Appeal Panel notes that cl 4.34 of the Guidelines provides that 0%, 1%, 2% or 3% WPI is to be added if there is a "difference in activity level as recorded and compared to the worker's status prior to the injury."
3. The Appeal Panel is satisfied that the Medical Assessor did not engage sufficiently in an analysis of a pre-and post-injury restriction of activity as required by cl 4.34 of the Guidelines.
4. The appellant submits that the Medical Assessor's only disclosed reasoning is entirely reliant on "self-reporting" (with all of the attendant dangers that an applicant may not have understood what was asked, or why it was relevant, and if asked more questions may have explained or elucidated their response). The Appeal Panel rejects this submission as the Medical Assessor stated that his assessment was based on "A thorough history, a comprehensive physical examination, a review of the documentation made available by the Personal Injury Commission".
5. The Appeal Panel notes, however, that the Medical Assessor made no reference to the appellant's statement and the relevant paragraphs of her statement set out at 36 above. In particular, no reference was made by the Medical Assessor to the problems she has driving. Both Drs Bodel and Bosanquet noted that the appellant had problems driving long distances.
6. The appellant submits that the Medical Assessor has not recorded any information permitting a proper analysis of his reasoning, and therefore whether the conclusion (not to allow ADL) is correct. The Appeal Panel accepts that the information and findings provided in the first MAC and Reconsideration MAC were limited. The Medical Assessor found that the appellant had pain with rotation and restricted movement in her neck and dysmetria. The Medical Assessor only reported findings in relation to the range of movement and did not comment on whether there is other pathology in the neck such as muscle guarding or tenderness.
7. The Appeal Panel accepts that the Medical Assessor relied in the main on the appellant's report during the examination that her restrictions were due to her left shoulder problems. Although the Medical Assessor stated that he took into account in his assessment the history obtained, the physical examination and a review of the documentation, he did not adequately explain how his findings on physical examination supported a finding that her neck condition caused no restriction in ADL.
8. The Appeal Panel noted that the Medical Assessor in the first MAC and Reconsideration MAC stated that he reviewed no imaging. The Appeal Panel noted that the documents provided included a cervical spine CT scan report dated 14 May 2022 and a cervical spine MRI scan report dated 6 July 2024.
9. The Appeal Panel notes that the findings in the CT scan of 14 May 2022 and MRI scan of

6 July 2024 demonstrate that the appellant has pathology in the cervical spine which most probably causes referred pain to her left shoulder. Such referred pain should be taken into account when assessing whether there is a restriction in ADL caused by the neck injury. 10. The Appeal Panel accept that the Medical Assessor did not provide adequate reasons in making the finding that the injury to the cervical spine caused no restriction in ADL. The failure to provide adequate reasons is a demonstrable error. 11. The Appeal Panel having reviewed the evidence in this matter accepts that there is a restriction in ADL because of both her shoulder and her neck pain. 12. The Appeal Panel note that the appellant in her statement of 27 May 2024 said that she had no problems and no restrictions before the subject injury. She described caring for her father for two years prior to the injury. The Appeal Panel notes that the appellant has problems with driving because of her neck. Dr Bosanquet noted that the appellant had problems lifting above her head as this causes pain in her neck. 13. The Appeal Panel, taking the radiology reports into account and the evidence in this matter including the appellant's statement, is satisfied that the appellant has some restriction of ADL because of the neck injury. The Appeal Panel considers that the restriction is really limited to recreation and garden activities and 1% WPI should be added to the 5% WPI assessment of the cervical spine. 14. The Appeal Panel assesses 6% WPI of the cervical spine which is combined with 9% WPI of the left upper extremity to total 15% WPI as a result of the injury on 2 March 2020. 15. For these reasons, the Appeal Panel has determined that the MAC issued on 27 August 2025 should be revoked, and a new MAC should be issued. The new certificate is attached to this statement of reasons.

This Certificate is issued pursuant to s 328(5) of the Workplace Injury Management and Workers Compensation Act 1998.

The Appeal Panel revokes the Medical Assessment Certificate of Medical Assessor Robert Kuru and issues this new Medical Assessment Certificate as to the matters set out in the Table below:

Chapter, page and paragraph number in NSW workers compensation guidelines

Chapter, page, paragraph, figure and table numbers in AMA 5 Guides

Proportion of permanent impairment due to pre-existing injury, abnormality or condition

Sub-total/s % WPI (after any deductions in column 6)

Total % WPI (the Combined Table values of all sub-totals)

The above assessment is made in accordance with the SIRA NSW Guidelines for the Evaluation of Permanent Impairment for injuries received after 1 January 2002.