Maricic v The Registrar, Workers Compensation Commission
[2011] NSWCA 42
At a glance
Source factsCourt
Court of Appeal (NSW)
Decision date
2010-12-15
Before
Beazley JA, Hodgson JA, Campbell JA
Source
Original judgment source is linked above.
Judgment (9 paragraphs)
Judgment 1BEAZLEY JA: I agree with the reasons of Hodgson JA and the orders he proposes. 2HODGSON JA: On 15 August 2008, the applicant Biserka Maricic commenced proceedings in the Common Law Division against the first respondent (the Registrar), the second respondent (the Appeal Panel), and the third respondent (Lynch) seeking an order in the nature of certiorari setting aside decisions of the Appeal Panel dated 16 October 2007 and 29 April 2008, and seeking further relief in the nature of mandamus. 3On 8 September 2009 Harrison AsJ ordered that the applicant's summons be dismissed, and ordered the applicant to pay Lynch's costs: Maricic v Registrar, Workers Compensation Commission [2009] NSWSC 925. 4The applicant appealed from that decision. However, by a notice of motion filed in April 2010, the applicant sought an order that her Notice of Appeal be treated as a summons for leave to appeal, and the matter has been dealt with on that basis. The applicant's application for leave to appeal has been heard on the basis that if leave is granted, the appeal will be dealt with without further argument.
Outline of facts 5In October 2004, the applicant suffered an injury at work during her employment by Lynch. 6In December 2006, the applicant lodged an Application to Resolve a Dispute with the Workers Compensation Commission (Red 41 - 97), seeking referral for medical assessment by an Approved Medical Specialist (pursuant to s 293 of the Workplace Injury Management and Workers Compensation Act 1998 ( WIM Act)) as to lump sum compensation, where the degree of permanent impairment was in dispute, and as to the threshold for work injury damages, where the degree of whole person impairment was in dispute. The claim was for whole person impairment of 16 per cent for injury to the cervical spine, thoracic spine, lumbar spine, right lower limb and right knee. The Application was supported inter alia by medical reports from Dr P Endrey-Walder and Dr P Giblin. 7In February 2007, Lynch lodged a Reply to the applicant's Application (Red 98 - 151), contesting her claim for permanent impairment. This Reply was supported inter alia by reports from Dr J M Matheson, including a report dated 27 September 2005 in which Dr Matheson noted that the applicant "held her neck rigidly and would allow no movement in any direction which is not a consistent finding" (Red 107N), that "the minor changes to her neck are just age changes" (Red 108F), that the applicant "has gone on to a lot of illness behaviour which can only be put down to a contrived disorder" (Red 108J) and that "this is a non organic disorder" (Red 108R). 8In May 2007, the Approved Medical Specialist Dr R Middleton issued a Medical Assessment Certificate, certifying whole person impairment of 5 per cent, with 0 per cent impairment attributed to the cervical spine (Red 158L). 9In June 2007, the applicant lodged an application for an appeal against the decision of the Approved Medical Specialist, on the grounds of availability of additional relevant information, and that the assessment was made on the basis of incorrect criteria (Red 162H - J). Although the application form indicated that the applicant required a formal hearing, an email from the applicant's solicitor to the Workers Compensation Commission dated 18 June 2007 stated "I do not require a formal hearing but do require a further examination by the appeal panel at which I wish to be present" (Red 172G). 10In July 2007, Lynch lodged a Notice of Opposition to this appeal. 11On 26 July 2007 a Delegate of the Registrar of the Workers Compensation Commission issued a decision (Red 181 - 2) indicating satisfaction that a ground of appeal was made out under s 327(3)(b) of the WIM Act (the availability of information that was not available before the assessment, namely difficulties occurring during the medical examination itself - these difficulties being due to the absence of an interpreter) and referred the appeal to the Appeal Panel (consisting of an arbitrator Ms J Connelly, and two Approved Medical Specialists Dr M Burns and Dr A Bencsik). 12Dr Burns of this Appeal Panel was appointed to conduct a clinical examination of the applicant, and this took place on 30 August 2007 (Red 184U - W), with an interpreter present (Red 185C). 13On 16 October 2007, the Appeal Panel issued its Certificate giving a whole person impairment of 6 per cent, including 0 per cent for the cervical spine (Red 189), and also issued its Statement of Reasons. Relevantly, these reasons set out findings reported by Dr Burns and the Panel's own conclusions as follows: 26. Dr Burns examined the appellant and his findings are reported below. Findings on examination 27. Cervical spine - There was tenderness over the left side of the base of the neck but no evidence of muscle spasm or muscle guarding. The range of motion in the appellant's cervical spine revealed a 75% decrease in both flexion and extension. Rotation to the right was possible to 70 [degrees] but rotation to the left was absent. Lateral bending to the right was 20 [degrees], but lateral bending to the left was absent. The appellant reported that she felt she could turn to the left, but that it caused pain so she refused to do so. This appeared to be inconsistent with the observation of her in the waiting room at the end of the consultation when she was noted to turn her head to the left at least 30 [degrees] to speak to her husband. It was felt that her inability to turn to the left was voluntary and not due to genuine muscle spasm or muscle guarding. 28. Shoulders - There was no localised tenderness and the range of motion in both shoulders was essentially normal. Neurological examination of both upper limbs revealed normal power tone and reflexes. There: was no evidence of muscle wasting in either upper limb. Sensation was reported as being decreased in the entire left arm. This did not follow a nerve root pattern. 29. Lumbar spine - Examination of the lumbar spine revealed global tenderness. The lumbar lordosis was normal and there was no evidence of muscle spasm or muscle guarding. The appellant was able to flex forward with her fingertips at the upper shin level. Back extension was decreased by 50%. Lateral bending to the left was 50% of the amount of lateral bending to the right. Straight leg rising was 45 [degrees] on the right and 60 [degrees] on the left. On the right she reported back pain going down the lateral aspect of the right leg, which appeared to follow an anatomical pathway. In the seated position straight leg rising was 80 [degrees] bilaterally. There was a negative sciatic stretch test. The physical examination though did not support radiculopathy. There was no evidence of significant muscle wasting or weakness in either lower limb and her reflexes were symmetrical. Additionally there was no evidence of a positive nerve root tension sign. The appellant did report decreased sensation but this did not follow a nerve root pattern. 30. Power, tone and reflexes were noted to be normal in both lower limbs. The appellant reported a decrease in sensation in the entire right leg. This appeared to be slightly worse over the lateral aspect of the thigh and foot. It did not follow a nerve root pattern. 31. Right Knee - The examination of the right knee revealed no localised tenderness. No joint effusion was present. Movements in the right knee were from full extension to 115 [degrees] of flexion. There was no ligamentous instability. PANEL CONCLUSIONS 32. The Panel discussed the findings on examination of Dr Burns and in addition conducted a review of the material before it. We have come to our own conclusions about the impairments suffered by the appellant. 33. Cervical spine - examination of the appellant's cervical spine revealed no evidence of genuine organic signs. The only positive finding in the formal examination was decreased rotation to the left side but this was inconsistent with her later movements and for this reason we do not accept her decreased rotation was genuine. Accordingly we believe that her cervical spine should be rated as DRE Cervical 1. We disagree with Dr Endrey-Walder and Dr Giblin's assessments and do not agree that the appellant should be assessed as DRE 2 as we say there was no genuine muscle spasm or guarding, no non verifiable radiculopathy and the appellant's non uniform loss of range of movement was inconsistent. 34. Lumbar spine - we believe that the appellant should be classified as DRE Lumbar Category 2. Dr Middleton did not make an allowance for the appellant's activities of daily living but based on the history taken we believe it is appropriate to do so. Taking these into account we believe that the figure of 7% is appropriate with a deduction of 1/10th for her pre-existing degenerative disease. Whilst degenerative disease was present there is no objective evidence of the degree of impairment that it was causing. We therefore disagree with Dr Matheson who says that the applicant's lumbar spine impairment is all due to her pre-existing degenerative disease and unrelated to the incident on 18/10/04. We accept that the appellant's loss of range of movement is genuine and the deduction we have allowed is supported by the MRI. 35. Right knee - there is no assessable impairment. This opinion is consistent with the clinical findings on examination by Dr Burns, the AMS and Drs Endrey-Walder, Rowe and Giblin. 14On 12 November 2007, the applicant's solicitor wrote to the Workers Compensation Commission applying for re-consideration of the Appeal Panel's decision, relying inter alia on an allegation of Dr Burns' failure to afford the applicant procedural fairness (Red 191). This letter enclosed a statutory declaration by the applicant (Orange 47 - 48), which was not in evidence before the associate judge and is not relied on before us to establish error, but is relied on in relation to the exercise of discretion should error be established. 15On 24 April 2008, the applicant's solicitor wrote to the Workers Compensation Commission asking for a copy of the report of the examination of the applicant that Dr Burns had provided to the Appeal Panel. 16On 29 April 2008, the Appeal Panel (constituted as before) declined to alter or amend or rescind its decision of 16 October 2007, giving the following reasons: 8. The panel has considered the submissions of the appellant and it is clear that she has a different recollection of the examination to that which is held by Dr Burns, particularly in relation to the cervical and lumbar spine. 9. Where there is a dispute between the account provided by Dr Burns and the appellant we prefer the account provided by Dr Burns as he is an independent approved medical specialist without a vested interest in the outcome whom we accept has conducted a proper examination in accordance with AMA5 and the WorkCover Guides. 10. In relation to the appellant's shoulders and Dr Burns' opinion that there was no muscle wasting in either arm it is important to remember that Dr Burns was only examining the appellant's shoulders in order to properly assess her cervical spine. There was no need to examine the shoulder girdle. The appellant was wearing clothing on the day which allowed easy access to the upper and lower arms and so Dr Burns was able to examine her arms above and below the elbow without difficulty. He used a tape measure to measure the diameter of her arms. 11. In relation to the examination of the appellant's knees we note that crepitus on its own does not attract a permanent impairment rating. The appellant did not report any patellofemoral pain (only a deep ache within the knee) and no patellofemoral tenderness was noted. The requirements of Table 17.31 were therefore not satisfied. 12. In coming to our original decision we took into account the clinical findings of Dr Burns in addition to all the material on the file which included a number of medical reports. 13. We do not accept the appellant's submissions that it was the duty of the examining doctor to put to her for comment every finding which may have been adverse to her interests. The duty of an Approved Medical Specialist is to observe, examine and assess in accordance with AMA5 and the WorkCover Guides. The doctor must compare the subjective symptoms with the objective medical and clinical evidence. 14. Dr Burns is an Approved Medical Specialist who has qualifications in the relevant specialty and who has undertaken the requisite training in the use of the WorkCover Guides. He was appropriately qualified to conduct the examination of the appellant. 17On 23 June 2008, the Appeal Panel declined to provide the applicant with a copy of Dr Burns' report (Red 206 - 7). 18On 15 August 2008, these proceedings were commenced by summons, which gave the following particulars of the grounds for the orders sought: PARTICULARS The Decisions were erroneous because: (a) The Appeal Panel misdirected itself and/or asked itself the wrong question as to the requirements of procedural fairness under the Workplace Injury Management and Workers Compensation Act 1998 (NSW) ("the Act") and consequently did not provide the applicant with a copy of the report of Dr Mark Burns dated 3 September 2008 upon which the Decision were based; and (b) In so doing, the Appeal Panel denied the Plaintiff procedural fairness. 19By a letter dated 24 October 2008, the Crown Solicitor advised the applicant's solicitor that the Workers Compensation Commission had informed it that there was no report from Dr Burns; and the associate judge accepted that there was no written report given by Dr Burns to the Appeal Panel.