1. On 23 June 2025, the appellant, Jetstar Airways Pty Ltd, lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Graham Gumley, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 26 May 2025.
2. 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, and
   • 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. Mr Azad was employed by the appellant, working in baggage. He suffered a physical injury on 30 December 2019, when he was pushing a set of wheeled stairs and slipped. He landed on his right arm whilst he maintained grip with his left arm. This placed all of his weight on the left arm, which began developing pain, mainly around the shoulder. About one month later, he began developing right shoulder pain. He had investigations, surgical repair of both shoulders, and ongoing physiotherapy.
2. He brought a claim for lump sum compensation to the Personal Injury Commission (Commission). The dispute about the degree of permanent impairment was sent to a Medical Assessor, who assessed 22% whole person impairment. The appellant appeals against that assessment.

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 the worker should undergo a further medical examination because there was an apparent inconsistency in the MAC that could not be resolved through the documentary materials available to the Appeal Panel. It is also noted that this point was conceded by the respondent worker. Having identified error, it was appropriate that a re-examination take place.

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. Medical Assessor Alan Home of the Appeal Panel conducted an examination of the worker on 30 October 2025 and reported to the Appeal Panel.

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. In summary, the appellant submits that there is an inconsistency between the measurement of restricted movement in both upper extremities and the findings of permanent impairment. The appellant notes that the figures contained are provided without explanation, and the impairment in the left shoulder was higher than the right, inconsistent with comments throughout the report that the right shoulder is more restricted than the left. This is the ground of appeal that was conceded by the respondent worker. The appellant also raises two additional grounds, being a failure to consider the reports of Drs Gehr and Rimmer, as well as an incorrect date of injury and incorrect references to AMA 5.
3. As indicated, in reply, the respondent worker's submissions have conceded the incorrect recording of figures in the certificate. The respondent suggested the matter should be referred back to the Medical Assessor.

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. The appeal concerns the impairment figures recorded in the MAC, for both shoulders. The Appeal Panel's consideration of the matter is limited to that issue (per Basten JA in Queanbeyan Racing Club Ltd v Burton [2021] NSWCA 304 at [26]):

"Secondly, s 328(2) requires that the review 'is limited to the grounds of appeal on which the appeal is made.' Because the gateway function of the Registrar is satisfied if 'at least one of the grounds' has been made out, it appears that the Appeal Panel is not limited to the ground held by the Registrar to have been made out, but may consider all grounds of appeal raised in the appellant's application. On the other hand, it is clear that the Appeal Panel is not permitted to look for errors which are not part of 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. It is noted that in response to the appeal, the respondent worker suggested that the matter be referred back to the Medical Assessor. Ultimately, a delegate of the President determined the matter should proceed to an Appeal Panel, with reasons provided on 23 July 2025. The Appeal Panel is thus seized with jurisdiction to determine the appeal. Noting the error identified by the appellant and conceded by the respondent, with which the Appeal Panel agrees, the only appropriate resolution of the matter was to conduct a re-examination of the worker. That re-examination took place on 30 October 2025, conducted by Medical Assessor Home.
4. The report of the re-examination is as follows:

Mr Mohammad Azad attended the rooms of Dr Alan Home, at 603/379 Pitt Street Sydney on 30 October 2025, for clinical assessment to assist the Medical Panel.

Mr Azad attended the assessment unaccompanied.

MEDICAL HISTORY

He states that he has no prior history of shoulder pain on either side. There is no other relevant medical or family history.

DETAILS OF SUBJECT ACCIDENT

Mr Azad sustained injury when assisting a co-worker to move a wheeled set of stairs from an aircraft. He recalls that his foot slipped, causing him to take greater weight with his left arm. He recalls experiencing a painful click at the left shoulder. Subsequently there was a complaint of ongoing left shoulder pain, and restricted motion.

After general practitioner review he was referred to Dr Kirsch, who arranged for MRI scan imaging of the left shoulder. There was a finding of a partial thickness tear of the supraspinatus tendon.

Mr Azad states that he was advised to undertake rotator cuff repair surgery. The operation was performed on 12 January 2021, at St George Private Hospital.

Following the surgery his shoulder was managed in a sling for 6 weeks. He then commenced range of motion exercises, before progressing to a strengthening program.

During his recuperation from the left shoulder surgery, he developed right shoulder pain. This was subsequently investigated by Dr Kirsch, and the diagnosis of a right rotator cuff tear was made on the right side.

Mr Azad confirms subsequent surgery, performed 24 January 2024, at St George Private Hospital, consisting of a right shoulder rotator cuff repair and acromioplasty procedure.

He states that he continued to experience bilateral shoulder pain, despite the treatment.

He has continued to attend physiotherapist for passive treatment about his shoulders. He also undertakes exercise, as previous prescribed by his physiotherapist.

His doctor has recommended he attend an exercise physiologist to further advise about strengthening exercise.

Currently, Mr Azad is undertaking home exercise.

He reports the use of analgesia most days, including Ibuprofen and Paracetamol. He takes medication each night to assist his sleep pattern.

CURRENT SYMPTOMS

Mr Azad states that he experiences right shoulder pain, of average intensity 6/10 on a Visual Analogue Scale (VAS). There is restricted motion at the joint. He cannot lie comfortably over his right shoulder at night. He limits lifting to no more than 1-2 kilograms with the right hand. He does not undertake overhead lifting.

At the left shoulder he describes similar, but less severe symptoms, with average intensity of pain at 4/10 (VAS). There is slightly improved movement on the left side. He cannot lie comfortably over his left shoulder for more than 40 minutes.

He is right hand dominant. He reports a comfortable sitting tolerance. He currently has a chauffeur for trips between 10-30 minutes, and occasionally as much as one hour, 4-5 times daily. He has undertaken work over the past 4 months.

There is no disability for standing, walking, forward bending at the waist, crouching, kneeling or stair climbing. His sleep pattern is disturbed by shoulder pain. He dresses in a modified fashion.

SOCIAL HISTORY

He is married, without children. He smokes 4-5 cigarettes daily.

At his home he helps his wife with light bench height tasks. His wife performs the major cleaning. He does shop for odds and ends. He lives in an apartment and there are no gardening requirements.

He has not resumed previous active hobbies of gymnasium based exercise.

He does, however, undertake walking for exercise.

He did not return to work as a baggage handler following the subject accident.

PHYSICAL EXAMINATION

Mr Azad presents as a 51 year old, standing 168 centimetres, and weighing 68 kilograms.

Cervical spine

Examination of the cervical spine reveals normal spinal curvature. There is no muscle spasm. There is a full range of active cervical spine motion in all planes.

Right shoulder

Examination of right shoulder reveals healed surgical scars. The anterior scar measures 1.5 centimetres in length and 1 millimetre in diameter. The posterior arthroscopy scar is barely visible.

The scars are barely visible due to good colour match with the surrounding skin, no tethering, no suture marks, no contour defect, and no trophic changes.

At the right shoulder the range of active motion is measured by Goniometer Methods and was re-tested on 3 occasions, with the range of motion being consistent on each attempt. The maximum range is set out as follows:

Impingement signs are mildly positive. There is some pain declared with resisted movements across the rotator cuff.

Left shoulder

Examination of the left shoulder reveals 2 barely visible arthroscopy scars, one anterior and one posterior, without adverse features. The scars are not visible due to good colour match. There is no tethering, no trophic changes, and no contour defect.

At the left shoulder the range of active motion is measured by Goniometer Methods and was re-tested on 3 occasions, with the range of motion being consistent on each attempt. The maximum range being set out as follows:

Pain is also declared on resisted movements across the left shoulder.

There is normal MRC Grade 5/5 power on both sides. Impingement signs are mildly positive, bilaterally.

SUMMARIES AND DIAGNOSIS

In summary, Mr Azad sustained a left shoulder injury necessitating rotator cuff repair.

He suffered a consequential injury on the right side, also necessitating rotator cuff repair surgery.

There is a persisting restriction of motion, due to subacromial scarring and residual cuff tendinopathy. There is a restricted range of active shoulder motion on each side.

CONSISTENCY

Mr Azad was consistent throughout the assessment. He dressed in a modified fashion, consistent with underlying shoulder pathology.

ASSESSMENT OF IMPAIRMENT

Mr Azad's condition satisfies the criteria for permanency, set out in the Workers Compensation Guidelines.

Right shoulder

Impairment is determined using Figures 16-46, 16-43 and 16-46, AMA5, pages 476, 477 and 479 respectively, as set out in the Table below:

Upper Extremity Impairment AMA Guides (4th Ed)

Using Table 16-3, AMA5, page 439, a 14% Upper Extremity Impairment rating converts to an 8% Whole Person Impairment rating.

Left shoulder

Impairment is determined using Figures 16-46, 16-43 and 16-46, AMA5, pages 476, 477 and 479 respectively, as set out in the Table below:

Upper Extremity Impairment AMA Guides (4th Ed)

Using Table 16-3, AMA5, page 439, a 9% Upper Extremity Impairment rating converts to a 5% Whole Person Impairment rating.

Combined

The combined Whole Person Impairment rating is 8% combined with 5%. Using the Combined Values Chart, AMA5, pages 604-606, there is a combined 13% Whole Person Impairment rating.

I have considered a deduction for any previous injury, or pre-existing condition or abnormality. There is no evidence of the same.

There is no deductible proportion.

Comparison to previous assessments

The clinical findings of active shoulder motion at the current assessment are similar to those found by the MA, at the time of his assessment in May 2025.

The findings at this assessment are disparate from those set out by Dr Rimmer in October 2024. The Assessor has undertaken the assessment using the methodology set out in the Guidelines, and relies upon the findings at this assessment."

1. The Appeal Panel adopt the findings on assessment, figures, and conclusions reached on re-examination. In circumstances where an apparent and obvious ground of appeal was made out, and conceded by the respondent, it is unnecessary to deal with the other two grounds of appeal raised by the appellant. The Appeal Panel also note that in respect of the submission regarding the additional tests performed by the Medical Assessor, they are simply provocation tests and do not impact the assessment of impairment in any way.
2. Accordingly, the MAC will be revoked and replaced with a new certificate. 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 Graham Gumley 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)