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[2011] NSWSC 1099
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Devic v NRMA Insurance Limited [2011] NSWSC 1099 (15 September 2011)
Last Updated: 16 September 2011
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Case Title:
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Devic v NRMA Insurance Limited
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Decision Date:
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Before:
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Decision:
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Summons dismissed with costs
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Catchwords:
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ADMINISTRATIVE LAW - application for order in the
nature of certiorari - jurisdictional error - error of law on the face of the
record
- irrelevant consideration - constructive failure to exercise
jurisdiction - assessment by Review Panel of permanent impairment under
Motor
Accidents Compensation Act 1999 - Motor Accidents Authority Permanent Impairment
Guidelines - measurement of impairment of injured shoulder using contralateral
uninjured
shoulder as baseline - adequacy of reasons - whether plaintiff denied
procedural fairness due to insufficient transparency in clinical
findings as to
injury to cervical spine
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Parties:
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Milena Devic (plaintiff) NRMA Insurance Ltd (first
defendant) Motor Accidents Authority of NSW (second defendant) MAS Review
Panel constituted pursuant to s 63 of the Motor Accidents Compensation Act 1999
in MAS matter no. 2009/02/2110 (third defendant)
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Representation
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B Nolan (for the plaintiff) W Fitzsimmons (for
the first defendant)
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- Solicitors:
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NSW Compensation Lawyers (for the
plaintiff) Curwoods Lawyers (for the first defendant) Crown Solicitor's
Office (submitting appearance for the second and third defendants)
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File number(s):
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Publication Restriction:
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Judgment
- HER
HONOUR: On 15 October 2009, Ms Milena Devic was injured in a motor vehicle
accident. Ms Devic has made a claim against the first defendant,
NRMA Insurance
Limited, for damages arising from the injuries she sustained in that accident.
- On
18 March 2010, a Medical Review Panel constituted under the Motor Accidents
Compensation Act 1999 determined that the degree of permanent impairment as
a result of Ms Devic's injuries was not greater than 10%. The legal consequence
of that determination is to preclude Ms Devic from an award of damages for
non-economic loss.
- By
these proceedings, Ms Devic seeks judicial review of that decision. The
application invokes the Court's power to make an order
in the nature of
certiorari under section 69 of the Supreme Court Act 1970.
Legislative framework in which the decision was made
- Ms
Devic's claim against NRMA Insurance is governed by the provisions of the
Motor Accidents Compensation Act . The Act provides that no damages may
be awarded for non-economic loss arising from a motor vehicle accident unless
the degree of
permanent impairment of the injured person as a result of the
injuries caused by the accident is greater than 10% (section 131 of
the Act). It
is accordingly not uncommon to see disputes between injured persons and
insurance companies as to the degree of permanent
impairment in cases where
there the level of impairment falls close to the critical 10% threshold.
- Where
such disputes arise, either party may refer the dispute for assessment to the
Motor Accidents Authority under section 60 of
the Act. On 30 June 2009, Ms Devic
made application to the Authority in accordance with those provisions, seeking
assessment whether
her permanent impairment exceeded 10%. The application
requested an assessment in respect of a strain injury to the lumbar spine,
a
strain injury to the cervical spine and a strain injury in the right shoulder.
- The
dispute was referred in the first instance to single medical assessor appointed
by the Medical Assessment Service, Tai-Tak Wan.
Assessor Wan concluded that the
degree of whole person permanent impairment due to the injuries caused by the
accident was 5% for
the lumbar spine, 0% for the cervical spine and 5% for the
right shoulder, giving a total "whole person impairment" of 10%. A certificate
was accordingly issued together with a statement of reasons finding that Ms
Devic's permanent impairment was not greater than 10%
(the certificate is dated
18 October 2009 on the front page but in fact appears to have been signed on 1
November 2009, according
to the signature page).
- Ms
Devic applied to have that assessment referred to a review panel of assessors,
as allowed under section 63(1) of the Act. Her application
was referred to a
panel of three medical assessors in accordance with section 63(3) of the Act. On
18 March 2010, the Review Panel
confirmed the certificate of assessment issued
by Assessor Wan, in accordance with section 63(4) of the Act.
- It
should be noted that, pursuant to section 63(3) of the Act, an application for
review of the medical assessment of a single medical
assessor may only be
referred to a review panel if the proper officer of the Authority is satisfied
that there is reasonable cause
to suspect that the medical assessment was
incorrect in a material respect. The basis for the referral to a review panel in
the present
case related to Assessor Wan's determination in relation to the
injury to the cervical spine.
- Ms
Devic seeks an order setting aside the decision of the Review Panel on the basis
that it was vitiated by error on the face of the
record or jurisdictional error.
The application thus invokes the Court's jurisdiction under section 69(1) and
69(3) of the Supreme Court Act . The grounds of review relied upon by Ms
Devic relate both to the assessment in respect of the right shoulder injury and
the assessment
of the injury to the cervical spine. No issue arises in respect
of the assessment of the injury to the lumbar spine.
Decision of the review panel
- As
already noted, the proper officer of the Authority was prompted to refer the
application to a review panel on the strength of an
issue relating to the
correctness of Assessor Wan's assessment the cervical spine. The issue was
whether Ms Devic satisfied the requirements
to be classified within "DRE
impairment category rating I" or "DRE impairment category rating II". Assessor
Wan determined that the
impairment was classified as DRE category I, which
corresponded to a whole person impairment of 0%. The doubt raised in that
respect
arose from an issue as to whether Ms Devic had an asymmetrical range of
movement in the neck, which would be an indication that she
might have qualified
to be classified as DRE category II (corresponding to a whole person impairment
of 5%).
- The
review panel determined that, in order to reach a conclusion as to the
correctness of Assessor Wan's decision on that issue, it
was necessary for them
to re-examine Ms Devic. The examination was undertaken by two of the three
members of the review panel. Although
the decision to re-examine Ms Devic arose
from the need to assess the range of movement in the neck (for the purpose of
considering
the injury to the cervical spine), the panel decided to examine all
injuries at that time.
- The
decision of the review panel records that Ms Devic confirmed the previous
pre-accident medical history and relevant personal details,
the history of the
motor vehicle accident and the history of symptoms and treatment following the
motor vehicle accident from Assessor
Wan's certificate of assessment dated 18
October 2009. Separately, the assessors recorded Ms Devic's history as to her
current status
and their observations upon physical examination.
- The
review panel concluded that the degree of whole person permanent impairment due
to the injuries caused by the accident was 5%
for the lumbar spine, 0% for the
cervical spine and 4% for the right shoulder, giving a total whole person
impairment of 9%. The
panel accordingly confirmed the certificate issued by
Assessor Wan that Ms Devic's permanent impairment was not greater than 10%.
Measurement of the range of movement in the shoulder
- The
errors alleged by Ms Devic relate principally to the manner in which the Review
Panel measured and assessed the range of motion
in her right shoulder. It might
readily be concluded that the undertaking of such a task would not easily lend
itself to legal or
jurisdictional error. Although characterised in different
legal ways, the overarching complaint is that the panel used the range
of
movement in Ms Devic's left shoulder as the baseline for its calculation of the
impairment in the injured right shoulder. In order
to understand the grounds of
review relied upon in respect of that aspect of the panel's decision, it is
necessary to explain the
approach it was required to undertake.
- Section
65(1) of the Motor Accidents Compensation Act provides that medical
assessments are subject to relevant provisions of guidelines issued by the
Authority. The assessment of "upper
extremity impairment" (here, the shoulder)
is addressed in chapter 2 of the Permanent Impairment Guidelines issued
by the Authority.
- The
approach nominated in the guidelines contemplates that impairment will be
evaluated by a series of measurements of range of motion,
but notes that such
measurement can be subject to variation for a number of reasons.
- In
the present case, based on measurements of the range of motion in the right
shoulder alone, the panel assessed an upper extremity
impairment of 9%. However,
measurements on the "contralateral" or opposite side revealed an impaired range
of movement of 3% in the
left shoulder. The panel adopted the left shoulder as a
baseline, and thus reached a final calculation of only 6% upper extremity
impairment (which translates to a whole person impairment of 4%).
- In
taking that approach, the panel had applied clause 2.5 of chapter 2 of the
Authority's Permanent Impairment Guidelines , which states:
If the contralateral uninjured joint has a less than average mobility, the
impairment value(s) corresponding with the uninjured joint
can serve as a
baseline and are subtracted from the calculated impairment for the injured joint
only if there is a reasonable expectation
the injured joint would have had
similar findings to the uninjured joint before injury. The rationale for this
decision should be
explained in the impairment evaluation report.
- It
should be noted that clause 2.5 appears in bold font style. Clause 1.3 of the
guidelines states a "convention" in the guidelines
that if the text is in bold,
it is "a directive as to how the assessment should be performed".
Grounds of review relating to the right shoulder injury
- The
substance of Ms Devic's complaint is that the use of the measurements for the
left shoulder as a baseline represented a wrong
approach, which led the panel to
underestimate the degree of impairment in the right shoulder.
- The
alleged error in approach is described in the summons, variously, as taking into
account an irrelevant consideration, denial of
procedural fairness, constructive
failure to exercise jurisdiction, forming an opinion not reasonably open to the
panel and a failure
to make inquiries. Those allegations were developed further
in submissions as revealing jurisdictional error based on the absence
of certain
matters alleged to be jurisdictional facts, namely, the fact that the
contralateral uninjured joint has a less than average
mobility and the existence
of "a reasonable expectation the injured joint would have had similar findings
to the uninjured joint
before injury".
- Counsel
for Ms Devic acknowledged that the application thus sought to place a number of
different legal characterisations on what
was essentially the same error. It was
sought to draw support for that approach from the judgment of Gaudron J in
Minister for Immigration and Multicultural Affairs v Yusuf [2001] HCA 30;
(2001) 206 CLR 323, where her Honour stated at [41] that there is said to be a
constructive failure to exercise jurisdiction when a tribunal:
misunderstands the nature of its jurisdiction and, in consequence, applies a
wrong test, misconceives its duty, fails to apply itself
to the real question to
be decided or misunderstands the nature of the opinion it is to form.
- In
that context, Gaudron J noted that a constructive failure to exercise
jurisdiction might be disclosed by taking an irrelevant consideration
into
account or by a failure to take a relevant matter into account.
- In
light of the approach taken by the plaintiff, I have to some extent addressed
the errors alleged in respect of that part of the
panel's decision in a global
fashion, distinguishing between individual grounds where appropriate.
Failure to make inquiries
- It
was submitted on behalf of the plaintiff that the Review Panel was "empowered"
under the guidelines (specifically, clause 2.5 set
out above) to proceed as it
did only if:
(a) the contralateral uninjured joint had less than average mobility;
(b) there was a reasonable expectation that the injured joint would have had
similar findings to the uninjured joint before the accident.
- Ms
Nolan, who appeared for the plaintiff, submitted that it was accordingly
necessary for the panel to make "proper inquiry" as to
whether the uninjured
joint genuinely had less than average mobility. Secondly, noting that the power
could only have been exercised
in circumstances where there was a reasonable
expectation that the injured joint would have had similar findings to the
uninjured
joint before the accident, Ms Nolan submitted that it was necessary
for the review panel to reach a state of "reasonable satisfaction"
that the left
uninjured joint was not injured in (or subsequently impaired by reason of) the
accident.
- It
was submitted that the review panel was under a statutory duty to make a
thorough investigation of all of the matters with which
the assessment was
concerned. Reliance was placed in that context on the decision of the High Court
in R v Australian Broadcasting Tribunal; ex parte Hardiman [1980] HCA 13; (1980) 144 CLR
13.
- When
pressed as to the specifics of that contention in oral submissions, Ms Nolan
submitted that, whilst examining Ms Devic, the assessors
ought to have asked the
following questions (at T17.16):
What is the source of pain? Is it coming from your shoulder? Is it coming
from your neck? Are you able to lift your arm any further
with pain? When you
feel that pain, where is it coming from? Your shoulder or your neck? Were you
able to lift your arm up to your
ear before the injury?
- Ms
Nolan further submitted that, even if the panel was not under a duty to make a
thorough investigation, the failure to make inquiries
of the kind set out above
meant that the decision was so unreasonable that no reasonable person would have
so exercised the power
in question. In support of that submission, reliance was
placed on the well known remarks of Wilcox J in Prasad v Minister for
Immigration and Ethnic Affairs [1985] FCA 47; (1985) 6 FCR 155 at 170, where
his Honour said:
It is no part of the duty of the decision-maker to make the applicant's case
for him. It is not enough that the court find that the
sounder course would have
been to make inquiries. But in a case where it is obvious that material is
readily available which is centrally
relevant to the decision to be made, it
seems to me that to proceed to a decision without making any attempt to obtain
that information
may properly be described as an exercise of the decision-making
power in a manner so unreasonable that no reasonable person would
have so
exercised it. It would follow that the court, on judicial review, should receive
evidence as to the existence and nature
of that information.
- The
contention that the panel ought to have made further inquiries of Ms Devic
during the physical examination is critical to each
of the grounds of review
relied upon by the plaintiff. Upon analysis, it raises a number of difficulties.
- First,
the plaintiff's submissions assume that no inquiries of the kind identified
above (at [28]) were in fact made. Ms Nolan submitted
that the failure to make
such inquiries could be inferred from the fact that there is no reference to the
making of any such inquiries
in the reasons for decision. In that respect, she
relied upon the decision of the High Court in Waterways Authority v
Fitzgibbon [2005] HAS 57; [2005] HCA 57; (2005) 221 ALR 402 at [130] per Haine J:
In the present case, however, reference to the "sufficiency" of the primary
judge's reasons is not to be understood as seeking to
invoke only those
principles. Rather, because the primary judge was bound to state the reasons for
arriving at the decision reached,
the reasons actually stated are to be
understood as recording the steps that were in fact taken in arriving at that
result. Understanding
the reasons given at first instance in that way, the error
identified in this case is revealed as an error in the process of fact
finding.
In particular, it is revealed as a failure to examine all of the material
relevant to the particular issue.
- In
assessing the plaintiff's contention, it is necessary to have regard to the kind
of decision under review. The decision records
the panel's reasons for reaching
their conclusion on the basis of the material before them, including their
physical examination
of the plaintiff. It is not a report of the examination
itself. I do not think it is reasonable to conclude, from the absence of
specific reference to any particular question asked during the process of the
examination, that no such questions were asked. One
would expect the reasons to
record the findings from the examination that were considered pertinent to the
panel's conclusion, but
there is no reason to expect that the reasons should
have recorded every inquiry made along the path to those findings.
- As
to the plaintiff's reliance on the decision of Wilcox J in Prasad , I do
not think it is "obvious that material is readily available which is centrally
relevant to the decision to be made". His Honour's
remarks in that case were
made in a very different context from the present case. They related to the
availability of direct evidence
in the form of statutory declarations concerning
an issue central to the Tribunal's inquiry, namely, whether the applicant's
marriage
was genuine (or whether, conversely, it had been entered into for
cynical migration reasons). The inquiries which it is said the
review panel
ought to have made in the present case fall into a very different class. The
existence or availability of any information
different from that in fact
recorded by the panel is entirely speculative.
- Finally,
the submissions in effect invite the Court to second-guess the performance of a
medical examination. Such a request should
be approached with circumspection, in
my view. The measurement of range of movement in a body joint is essentially a
clinical task.
I do not think there is any basis for thinking that my armchair
judgment as to the proper approach to such a task could sensibly
be relied upon
in preference to the judgments of a panel of medically qualified assessors
employed by the Authority.
- In
my view, those conclusions are fatal to the existence of any of the individual
errors alleged by the plaintiff. One characterisation
of the alleged error is
that the panel constructively failed to exercise jurisdiction in that it took
into account an irrelevant
consideration. Specifically, it is alleged that the
panel took into account measurements for the left shoulder "which were not an
accurate measurement of [Ms Devic's] average range of motion for that joint".
- The
particulars in the summons further allege that, in determining the measurements
taken in respect of the left shoulder as the baseline
measurement for the range
of movement in the right shoulder, the review panel "pursued a line of
questioning and method of examination
such that it failed to elicit from the
plaintiff the correct and true range of motion in her uninjured contralateral
joint [the left
shoulder]".
- Those
allegations assume not only that inquiries should have been made but that the
failure to make them produced incorrect (and therefore
irrelevant) readings. For
the reasons explained above, I do not think those premises are established. I am
not persuaded that the
panel failed to obtain accurate measurements of the range
of motion in the plaintiff's left shoulder joint.
- The
review panel's report of its assessment of the upper limbs includes the
following:
On examination of the shoulder girdle, there was no wasting or asymmetry in
and about the shoulder girdle. There was localised reported
tenderness over the
tip of the right shoulder. Impingement tests were negative and there was no
crepitus palpable in the shoulder
joints.
The range of shoulder movements was repeated to establish consistency and
measured with a goniometer according to the MAA 4 Guides.
Left shoulder
movements were initially noted to be more significantly restricted. When
requested to do her best she displayed an
increased range of abduction of the
left shoulder. She did indicate that there was no injury to the left shoulder as
a result of
the subject motor vehicle accident.
- Having
regard to those remarks, it may be seen that the plainitff's argument invites
the Court to conclude that, by reason of their
failure to pose the questions set
out above (at [28]), the assessors failed to elicit the "correct and true" range
of motion in the
left shoulder notwithstanding the fact that they obtained a
history of tenderness in the right shoulder, repeated the measurements,
undertook them with a goniometer and at some point pressed Ms Devic to "do her
best", resulting in an increased range in the relevant
movement of the left
shoulder.
- Further,
the argument requires the Court to conclude that the measurements, by reason of
the failure to make the inquiries identified,
were wrong and therefore
irrelevant to be taken into account. I do not think there is any basis for me to
reach that conclusion,
which would require me to prefer my own view as to the
proper conduct of a clinical medical examination to that of two qualified
doctors. I do not think it is appropriate for me to venture such a task.
- Separately,
Ms Devic contends that, by reason of the alleged failure accurately to measure
range of movement in the left shoulder
(including by failing to make the
inquiries set out above), the review panel adopted an unfair procedure on
assessment and thereby
denied Ms Devic natural justice. For the reasons already
explained, I am not persuaded that there is any basis to conclude that,
in the
absence of the inquiries identified by counsel for Ms Devic, the process of the
assessment was unfair or that the panel denied
Ms Devic natural justice.
- I
do not think any different consideration is raised by the other ground of review
relied upon in the summons (forming an opinion
not reasonably open to the
panel), which also turns on the contention that the measurements taken of the
left shoulder are demonstrably
wrong. I do not accept that premise, for the
reasons already stated.
- As
noted above, the plaintiff's submissions contended, alternatively, that the
decision was vitiated for want of the existence of
certain jurisdictional facts.
Specifically, it was submitted that the Review Panel had no power to apply
clause 2.5 unless first
satisfied that the contralateral uninjured joint had a
less than average mobility and, further, that there was "a reasonable
expectation
that the injured joint would have had similar findings to the
uninjured joint before the accident". It was submitted that, unless
those
"jurisdictional facts" existed, the decision was a nullity.
- The
term "jurisdictional fact" was considered most recently by the High Court in
Plaintiff M70/2011 v Minister for Immigration and Citizenship; Plaintiff M106
of 2011 v Minister for Immigration and Citizenship [2011] HCA 32 where the
Chief Justice said at [57] (footnotes omitted):
The term "jurisdictional fact" applied to the exercise of a statutory power
is often used to designate a factual criterion, satisfaction
of which is
necessary to enliven the power of a decision-maker to exercise a discretion. The
criterion may be "a complex of elements".
When a criterion conditioning the
exercise of statutory power involves assessment and value judgments on the part
of the decision-maker,
it is difficult to characterise the criterion as a
jurisdictional fact, the existence or non-existence of which may be reviewed by
a court. The decision-maker's assessment or evaluation may be an element of the
criterion or it may be the criterion itself. Where
a power is expressly
conditioned upon the formation of a state of mind by the decision-maker, be it
an opinion, belief, state of
satisfaction or suspicion, the existence of the
state of mind itself will constitute a jurisdictional fact. If by necessary
implication
the power is conditioned upon the formation of an opinion or belief
on the part of the decision-maker then the existence of that
opinion or belief
can also be viewed as a jurisdictional fact.
- I
do not think the requirement that the contralateral uninjured joint have a less
than average mobility could on any analysis be construed
as a jurisdictional
fact. In my view, the determination of that issue is plainly part of the primary
fact-finding task within the
jurisdiction of the Panel.
- Further,
in my view, it is doubtful whether the "reasonable expectation" referred to in
clause 2.5 of the guidelines is properly to
be construed as a jurisdictional
fact. I do not think the fact that clause 2.5 is one of the clauses in bold is
sufficient warrant
for that conclusion and I do not think the statute otherwise
lends itself to that construction. In any event, it is not necessary
for me to
determine that question. In my view, it is clear from the reasons of the Review
Panel that its members were satisfied as
to the existence of that expectation.
The reasons for decision expressly recite the terms of clause 2.5 and state:
Because there was no history of an injury to the left shoulder (confirmed by
Ms Devic), the Panel considered that a baseline range
of movement in the right
shoulder would be that of the left uninjured shoulder.
- Accordingly,
even if any of the requirements of clause 2.5 meets the test for a
jurisdictional fact, I am not persuaded that the Review
Panel determined the
matter in the absence of any such fact.
- For
those reasons, I am not persuaded that the Review Panel's decision in respect of
the injury to the right shoulder entailed error.
- It
was submitted on behalf of the defendant that, even if I had concluded
otherwise, I ought not to have exercised my discretion to
grant an order in the
nature of certiorari, for the following reasons. It was acknowledged on behalf
of the plaintiff that, even
without the comparator of the left shoulder
measurements as a baseline, the impairment to the upper extremity would have
been 9%,
which corresponds to a whole person impairment in respect of the
shoulder of 5%. Since the only other impairment was also 5%, the
total
impairment would accordingly still have been "not greater than 10%", regardless
of application of clause 2.5 of the guidelines.
In those circumstances, it was
submitted that the Court should have declined to remit the matter in any event,
in accordance with
the principles stated by the High Court in Stead v State
Government Insurance Commission [1986] HCA 54; (1986) 161 CLR 141.
- Ms
Nolan submitted that, if a new assessment were ordered, the whole matter would
be at large again and that, unless the Court could
conclude, without
equivocation, that there was no possibility of a different outcome upon further
assessment, the plaintiff was entitled
to have the matter remitted.
- With
the utmost respect, I think that submission overstates the position. Whether the
error in question is properly characterised
as an error of law on the face of
the record or jurisdictional error, the Court retains a discretion to refuse
relief if that appears
to be the proper course, although it may be acknowledged
that, in the case of jurisdictional error, the discretion not to grant the
relief sought would be exercised rarely. The relevant principles are discussed
in the recent decision of this Court in NRMA Insurance Limited v Ainsworth
[2011] NSWSC 344 at [96-106] per Rothman J.
- I
am inclined to the view that, even if the plaintiff had established error of the
kind alleged in the present case, I would not have
exercised my discretion to
grant the relief sought, for the reasons contended for by Mr Fitzsimmons on
behalf of the first defendant.
However, in the result, it has not been necessary
for me to determine that question.
Grounds of review relating to the injury to the cervical spine
- The
second ground of review relied upon in the summons is that:
In assessing the extent of injury to the cervical spine the review panel
employed a methodology which was not transparent and thereby
denied the
plaintiff procedural fairness.
- The
matter was put perhaps slightly differently in the submissions on behalf of the
plaintiff , where it was contended that the clinical
findings of the review
panel were "insufficiently transparent to fulfil the minimum legal standard of
reasons incumbent upon the
review panel to quell the controversy which gave rise
to the referral of the review".
- As
already noted, the Review Panel was constituted pursuant to a referral arising
from the existence of reasonable cause to suspect
that Assessor Wan was
incorrect in respect of his assessment of the impairment occasioned by the
cervical spine injury. Assessor
Wan had recorded clinical findings relating to
neck movement which appeared to be asymmetric and might have indicated
dysmetria.
The significance of those findings is considered below.
- It
was uncontroversial in the proceedings before me that the Review Panel was under
an obligation to give reasons for its decision:
cf Campbelltown City Council
v Vegan [2006] NSWCA 284; (2006) 67 NSWLR 372 at [117] per Basten JA; McColl
JA agreeing at [33]; Handley AJA agreeing with "much of [his Honour's]
reasoning" at [1].
- The
decision in Vegan was concerned with medical assessment under the
Workplace Injury Management and Workers Compensation Act 1998 but is
plainly equally persuasive in the present context. In that case, Basten JA noted
at [130] the well established proposition
that a failure on the part of a
tribunal exercising judicial functions to give reasons for its decision will
constitute an error
of law which will permit the decision to be set aside on
appeal, where the right of appeal is limited to errors of law. His Honour
did
not consider it necessary to determine whether such a failure also constitutes
jurisdictional error in relation to the statutory
mandate of the relevant panel
under that legislation.
- The
plaintiff relied upon the discussion by Basten JA in Vegan as to what is
required in order to fulfil a minimum legal standard of adequate reasons. On the
subject of adequacy of reasons of an
Appeal Panel under the workplace injury
legislation, his Honour said (at [121-122]):
121 Where it is necessary for the Panel to make findings of primary fact, in
order to reach a particular conclusion as to the existence,
nature and extent of
any physical impairment, it may be expected that the findings of material facts
will be set out in its reasons.
Where facts are in dispute, 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. More importantly,
where more than one conclusion is open, it will be necessary
for the Panel to
give some explanation of its preference for one conclusion over another. That
aspect may have particular significance
in circumstances where the medical
members of a Panel have made their own assessment of the applicant's condition
and have come to
a different conclusion from that reached by other medical
practitioners, as set out in reports provided to the Panel.
122 On the other hand, to fulfil a minimum legal standard, the reasons need
not be extensive or provide detailed explanation of the
criteria applied by
medical specialists in reaching a professional judgment: see Soulemezis
at 273-274 (Mahoney JA) and 281-282 (McHugh JA). At least, that will be so
where the medical science is not controversial: if it is,
a more expansive
explanation may be required.
- In
its reasons for decision in respect of the cervical spine in the present case,
the Review Panel said:
On inspection of the neck, the posture, alignment and contour were normal.
There was reported tenderness over the lower cervical spine
centrally. There was
no muscle spasm and no muscle guarding. There was no dysmetria - the Panel
observed and also measured range
of motion and found on repeat examination of
the three principal planes:
Flexion and extension - three quarter range;
Lateral bending to the right and left - three quarter range;
Rotation to the right and left - half normal range.
- The
Panel concluded its deliberations as to the issue of the cervical spine strain
in the following terms:
As to the assessment of permanent impairment of the cervical spine, the Panel
noted that clinical assessment had revealed a symmetrical
range of neck movement
(no evidence of dysmetria) and no evidence of muscle guarding or spasm (as
defined in the MAA Guidelines page
24).
The distribution of the left upper extremity symptoms were not confined to
any specific dermatomal distribution which would satisfy
the criteria for "non
verifiable radicular pain" (as defined in the MAA Guidelines page 24). The Panel
therefore concluded that the
condition satisfied DRE Category 1 of the
Cervicothoracic spine, which translates to a 0% Whole Person Impairment under
Table 72,
page 110, of the AMA Guides.
There was no objective clinical features suggestive of radiculopathy which
would satisfy the criteria for DRE III (as defined in the
MAA Guidelines page
25).
- The
assessment of the degree of permanent impairment arising from the strain to the
cervical spine was to be made in accordance with
the Authority's guidelines, as
required by section 65 of the Act. In supplementary submissions filed after the
conclusion of the hearing, the parties explained that those guidelines use
the
American Medical Association Guides to the Evaluation of Permanent
Impairment, 4 th Edition, 3 rd printing (1995) as their basis.
- The
approach required in the guidelines in respect of assessment of impairment of
the spine is for the assessor to establish the Diagnosis
Related Estimate or
"DRE" category for the injury. Clause 4.1 of Chapter 4 of the Authority's
guidelines provides:
Only the Diagnosis Related Estimate (DRE) is to be used for the evaluation of
impairment of the spine, as modified by this chapter.
- The
task of the review panel was accordingly to determine the relevant DRE category
in accordance with the American Medical Association
Guides as modified in the
guidelines issued by the Authority.
- The
possibilities were DRE category I or II, defined as follows:
DRE Cervicothoracic Category 1: Complaints and Symptoms
Description and Verification: The patient has no significant clinical
findings, no muscle guarding ..., no documentable neurologic
impairment, no
significant loss of structural integrity on lateral flexion and extension
roentgenograms, and no indication of impairment
related to injury or illness
...
DRE Cervicothoracic Category II: Minor Impairment
Description and Verification: The clinical history and examination findings
are compatible with a specific injury or illness. The
findings include
significant intermittent or continuous muscle guarding that has been observed
and documented by an assessor, non-uniform
loss of range of motion (dysmetria,
...) or non-verifiable radicular complaints. There is no objective sign of
radiculopathy and
no loss of structural integrity.
- As
noted on behalf of the defendant, the review panel expressly considered the
criteria for classification in category II, being guarding,
dysmetria and
radicular complaints. The review panel found, following examination, that none
of those criteria was evident and assessed
the injury as falling within category
I on that basis.
- In
my view, as submitted on behalf of the defendant, the findings of the review
panel addressed the relevant criteria and were clear
and unequivocal. Further,
in my view, once the nature of the relevant task (as prescribed in the relevant
guidelines) is understood,
it may be seen that the reasons given by the Review
Panel were perfectly adequate. Ground 2 is not made out.
- For
those reasons, the summons should be dismissed with costs.
**********
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