He was solid build with height 168cm and weight 85kg.

Flexion one-half normal range, extension one-third, lateral flexion one-half bilaterally, rotation to the right two-thirds and to the left one-half.

Tenderness in the upper cervical spine mid-line and bilateral lower paracervical area.

Reflexes were all of low amplitude but present with reinforcement. Power right equals left. Sensation was reduced in the palmar aspect of both hands, but not on the dorsal aspect in a non-dermatomal distribution.

Upper arm girth; right 30.5cm, left 31cm at 10cm above the elbow.

Forearm girth; right equals left equals 29cm at 5cm below the elbow.

Flexion one-half, extension two-thirds of normal range, lateral flexion three-quarters bilaterally and rotation was two-thirds bilaterally. There was no spasm or tenderness.

Reflexes were symmetrical and of low amplitude. Plantar responses were flexor. Power and sensation were intact in the lower limbs.

Adduction, external and internal rotation were said to be limited by shoulder pain and biceps pain.

Despite his evident anger about the compensation and dispute process, he was

co-operative and consistent in his physical presentation.

Examination findings in the upper limbs confirmed loss of active range of movement in both shoulders, moreso on the right side, and continuing symptoms radiating from the cervical spine into both upper limbs, resulting in restriction with use of the limbs and spine in activities of daily living, particularly heavy to moderate activities.

Unfortunately, the previously performed cervical spine fusion has been unsuccessful. He has had guided CT injections in the peri radicular areas since, resulting in temporary relief of symptoms, indicating that symptoms affecting the arms are originating in the cervical spine.

Under the Table of Maims, an assessment of 10% loss of efficient use of the right arm at or above the elbow and including below the elbow, and 5% loss of efficient use of the left arm at or above the elbow and including below the elbow is appropriate."

1. We adopt Medical Assessor Oate's report.
2. For these reasons, the Appeal Panel has determined that the MAC issued on 1 April 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 Donald Cawthorne and issues this new Medical Assessment Certificate as to the matters set out in the Table below:

Assessment in accordance with the Table of Disabilities for injuries received before

(describe the body part as per Table of Disabilities)

Total amount of permanent% loss of efficient use or impairment

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

Total permanent % loss of efficient use or impairment attributable to this injury (after deduction of any pre-existing impairment in column 4.)

[5] [2009] NSWCA 175.