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[2018] NSWSC 1421
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Mercy Connect Limited v Kiely [2018] NSWSC 1421 (21 September 2018)
Last Updated: 21 September 2018
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Supreme Court
New South Wales
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Case Name:
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Mercy Connect Limited v Kiely
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Medium Neutral Citation:
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Hearing Date(s):
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11 July 2018
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Date of Orders:
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21 September 2018
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Decision Date:
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21 September 2018
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Jurisdiction:
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Common Law - Administrative Law
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Before:
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Harrison AsJ
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Decision:
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The Court orders that: (1) The decision of the Appeal Panel in
matter number 3761/16 dated 27 February 2018 is set aside. (2) The
decision of the Appeal Panel in matter number 3761/16 is remitted to the Workers
Compensation Commission of New South Wales
to be determined in accordance with
law. (3) Costs are reserved.
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Catchwords:
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ADMINISTRATIVE LAW – Judicial Review – Appeal Panel Assessment
– whether Appeal Panel failed to determine the appeal
– whether
Appeal Panel erred by directing a further medical examination without first
finding an error in the Medical Assessment
Certificate – whether the
Appeal Panel mistook its jurisdiction – failure to consider secondary
psychological injury
– 65A of the Workers Compensation Act 1987 (NSW)
– whether Appeal Panel erred in re-assessing the degree of Whole Person
Impairment – failure of Appeal Panel to
determine whether a deduction
should be made for a pre-existing injury, condition or abnormality – s 323
of the Workplace Injury Management and Workers Compensation Act 1998 (NSW)
– legal unreasonableness
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Legislation Cited:
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Cases Cited:
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Category:
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Principal judgment
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Parties:
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Mercy Connect Limited (formerly known as Mercy Centre Lavington Limited)
(Plaintiff) Rachelle Marcel Kiely (First Defendant) Appeal Panel of the
Workers Compensation Commission; Deborah Moore, Dr Julian Parmegiani, Dr Patrick
Norris (Second Defendant) Registrar of the Workers Compensation Commission
(Third Defendant)
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Representation:
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Counsel: S Blount (Plaintiff) Submitting Appearances (First, Second
and Third Defendants) Solicitors: Astridge and Murray
(Plaintiff) Nevin Lenne Gross – Submitting Appearances (First
Defendant) Crown Solicitor – Submitting Appearances (Second & Third
Defendants)
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File Number(s):
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2018/96656
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Publication Restriction:
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Nil
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JUDGMENT
- HER
HONOUR: This is a judicial review of a decision made by a Medical Appeal
Panel of the Workers Compensation Commission of NSW dated 27 February
2018
relating to s 328(1) of the Workplace Injury Management and Workers
Compensation Act 1998 (NSW) (“WIM Act”). The matter for
this Court to determine is whether or not the Appeal Panel made a jurisdictional
error or whether there is
an error on the face of the record.
- The
plaintiff is Mercy Connect Limited (formerly known as Mercy Centre Lavington
Limited) (“Mercy Connect”). The first
defendant is Rachelle Marcel
Kiely (“Ms Kiely”). The second defendant is the Appeal Panel of the
Workers Compensation
Commission constituted by Deborah Moore, Dr Julian
Parmegiani, and Dr Patrick Norris (“the Appeal Panel”). The third
defendant is the Registrar of the Workers Compensation Commission. The first,
second, and third defendants have filed submitting
appearances. Mercy Connect
relied upon its court book filed 15 June 2018.
- By
summons filed 27 March 2018, Mercy Connect seeks firstly, an order in the nature
of certiorari quashing the decision of the Appeal
Panel; or secondly, in the
alternative, a declaration that the decision of the Appeal Panel is invalid. It
does not specifically
seek that the matter be remitted to the Workers
Compensation Commission to be determine according to law. There has been one
decision
by an Approved Medical Specialist, two decisions by Medical Appeal
Panels, differently constituted, and one judicial review. This
is the second
judicial review.
Background
- Ms
Kiely was born in 1974 and is currently 44 years of age.
- In
March 2009, Ms Kiely commenced employment with Mercy Connect. On 19 April 2011,
Ms Kiely sustained an injury in the course of employment
with Mercy Connect,
including various physical injuries and a psychological injury.
- On
19 November 2015, the solicitor for Ms Kiely wrote to Mercy Connect’s
insurer, Catholic Church Insurance Ltd, making a claim
for lump sum compensation
pursuant to s 66 of the Workers Compensation Act 1987 (NSW) for primary
psychological injury.
- On
13 January 2016, Mercy Connect’s insurer issued a notice pursuant to s 74
of the WIM Act disputing liability of Ms Kiely’s claim. Mercy
Connect says that Ms Kiely’s psychological injury is a secondary, as
opposed
to a primary, psychological injury.
- On
20 July 2016, Ms Kiely commenced proceedings in the Workers Compensation
Commission by way of an application to resolve a dispute,
claiming compensation
under s 66 of the Workers Compensation Act.
- On
24 October 2016, a conciliation/arbitration was held before arbitrator Snell.
The claim for lump sum compensation was referred
to an Approved Medical
Specialist, Dr White (“the AMS”), for assessment of the primary
psychological injury. The order
provided that the AMS was to exclude any
impairment arising from a secondary condition.
- On
29 November 2016, the AMS issued a Medical Assessment Certificate
(“MAC”) assessing Ms Kiely as suffering from a 12%
whole person
impairment (“WPI”) as a result of the primary psychological
injury.
- On
20 December 2016, Ms Kiely lodged an application to appeal the decision of the
AMS together with submissions in support.
- On
23 January 2017, Mercy Connect lodged a notice of opposition and submissions in
support.
- On
15 March 2017, the Appeal Panel revoked the MAC and issued a new MAC, certifying
Ms Kiely as suffering from a 15% WPI.
- 18
April 2017, Mercy Connect filed a summons in this Court seeking judicial review
of the decision of the Appeal Panel.
- On
18 August 2017, the judicial review was heard by Wilson J.
- On
14 September 2018, her Honour delivered judgment, quashing the decision of the
Appeal Panel and remitting Ms Kiely’s appeal
to the Workers Compensation
Commission for determination by a differently constituted Appeal Panel.
- On
26 September 2017, Mercy Connect and Ms Kiely were advised of the members of the
reconstituted Appeal Panel.
- On
20 October 2017, the Appeal Panel wrote to the parties calling for further
submissions.
- On
27 February 2018, the Appeal Panel delivered its decision and statement of
reasons. The Appeal Panel quashed the MAC and substituted
an assessment of 19%
WPI.
- On
27 March 2018, Mercy Connect filed its summons seeking this current judicial
review from the decision of the Appeal Panel dated
27 February 2018.
- I
will deal with these earlier proceedings in more detail later in this
judgment.
The statutory scheme
- It
is convenient that I briefly outline the relevant provisions of the statutory
scheme.
- Section
65A of the Workers Compensation Act contains special provisions for
psychological and psychiatric injury. It relevantly reads:
“65A Special Provisions for Psychological and Psychiatric
Injury
(1) No compensation is payable under this Division in respect of permanent
impairment that results from a secondary psychological
injury.
(2) In assessing the degree of permanent impairment that results from a physical
injury or primary psychological injury, no regard
is to be had to any impairment
or symptoms resulting from a secondary psychological injury.
(3) No compensation is payable under this Division in respect of permanent
impairment that results from a primary psychological injury
unless the degree of
permanent impairment resulting from the primary psychological injury is at least
15%.
Note: If more than one psychological injury
arises out of the same incident, section 322 of the 1998 Act requires the
injuries to be assessed
together as one injury to determine the degree of
permanent impairment.
(4) If a worker receives a primary psychological injury and a physical injury,
arising out of the same incident, the worker is only
entitled to receive
compensation under this Division in respect of impairment resulting from one of
those injuries, and for that
purpose the following provisions
apply:
(a) the degree of permanent impairment that results from
the primary psychological injury is to be assessed separately from the degree
of
permanent impairment that results from the physical injury (despite section 65
(2)),
(b) the worker is entitled to receive compensation under this Division for
impairment resulting from whichever injury results in
the greater amount of
compensation being payable to the worker under this Division (and is not
entitled to receive compensation under
this Division for impairment resulting
from the other injury),
(c) the question of which injury results in the greater amount of compensation
is, in default of agreement, to be determined by the
Commission.
Note: If there is more than one physical injury those injuries will still
be assessed together as one injury under section 322 of the
1998 Act, but
separately from any psychological injury. Similarly, if there is more than one
psychological injury those psychological
injures will be assessed together as
one injury, but separately from any physical injury.
(5) In this section:
“primary psychological injury” means a psychological injury
that is not a secondary psychological injury.
“psychological injury” includes psychiatric injury.
“secondary psychological injury” means a psychological injury
to the extent that it arises as a consequence of, or secondary to, a physical
injury.”
- Section
66 of the Workers Compensation Act provides as
follows:
“66 Entitlement to Compensation for Permanent Impairment
(1) A worker who receives an injury that results in a degree of permanent
impairment greater than 10% is entitled to receive from
the worker’s
employer compensation for that permanent impairment as provided by this section.
Permanent impairment compensation
is in addition to any other compensation under
this Act.
Note: No permanent impairment compensation is
payable for a degree of permanent impairment of 10% or
less.
(1A) Only one claim can be made under this Act for permanent impairment
compensation in respect of the permanent impairment that
results from an
injury.
...”
Relevant provisions of the WIM Act
- Chapter
7, Part 7 of the WIM Act provides for medical assessment, including the
assessment of the degree of WPI by an Approved Medical Specialist and, by way of
review,
appeal panels. The scheme was designed to take the function of
assessment of injury out of the adversary court system: see Inghams
Enterprises Pty Ltd v Lakovska [2014] NSWCA 194 at [1] per Basten JA.
(“Lokovska”).
- Approved
Medical Specialists are appointed under the WIM Act to deal with medical
disputes, which are defined in s 319 to mean:
“319 Definitions
In this Act:
...
“medical dispute” means a dispute between a claimant and the person
on whom a claim is made about any of the following
matters or a question about
any of the following matters in connection with a claim:
(a) the worker’s condition (including the
worker’s prognosis, the aetiology of the condition, and the treatment
proposed
or provided),
(b) the worker’s fitness for employment,
(c) the degree of permanent impairment of the worker as a result of an
injury,
(d) whether any proportion of permanent impairment is due to any previous injury
or pre-existing condition or abnormality, and the
extent of that proportion,
...
(f) whether impairment is permanent,
(g) whether the degree of permanent impairment of the injured worker is fully
ascertainable.”
- Section
323 provides for the deduction for a previous injury or pre-existing condition
or abnormality. It reads:
“323 Deduction for previous injury or pre-existing condition or
abnormality
(1) In assessing the degree of permanent impairment resulting from an injury,
there is to be a deduction for any proportion of the
impairment that is due to
any previous injury (whether or not it is an injury for which compensation has
been paid or is payable
under Division 4 of Part 3 of the 1987 Act) or that is
due to any pre-existing condition or abnormality.
(2) If the extent of a deduction under this section (or a part of it) will be
difficult or costly to determine (because, for example,
of the absence of
medical evidence), it is to be assumed (for the purpose of avoiding disputation)
that the deduction (or the relevant
part of it) is 10% of the impairment, unless
this assumption is at odds with the available evidence.
Note. So if the degree of permanent impairment is assessed as 30% and subsection
(2) operates to require a 10% reduction in that
impairment to be assumed, the
degree of permanent impairment is reduced from 30% to 27% (a reduction of
10%).
(3) The reference in subsection (2) to medical evidence is a reference to
medical evidence accepted or preferred by the approved
medical specialist in
connection with the medical assessment of the matter.
(4) The Workers Compensation Guidelines may make provision for or with respect
to the determination of the deduction required by
this section.
...”
- Section
325 relates to the medical assessment certificate. It
reads:
“(1) The approved medical specialist to whom a medical dispute is referred
is to give a certificate (a medical assessment certificate) as to the
matters referred for assessment.
(2) A medical assessment certificate is to be in a form approved by the
Registrar and is to:
(a) set out details of the matters referred for
assessment, and
(b) certify as to the approved medical specialist’s assessment with
respect to those matters, and
(c) set out the approved medical specialist's reasons for that assessment,
and
(d) set out the facts on which that assessment is
based.
...”
- Appeals
against medical assessments are governed by ss 327 and 328 of the WIM
Act.
- Section
327 relevantly reads:
“327 Appeal against medical assessment
...
(3) The grounds for appeal under this section are any of the following
grounds:
...
(c) the assessment was made on the basis of incorrect criteria,
(d) the medical assessment certificate contains a demonstrable
error.
...”
And s 328 relevantly reads:
“328 Procedure on appeal
(1) An appeal against a medical assessment is to be heard by an Appeal Panel
constituted by 2 approved medical specialists and 1
Arbitrator, chosen by the
Registrar.
(2) The appeal is to be by way of review of the original medical assessment. The
WorkCover Guidelines may provide for the procedure
on an appeal.
(3) Evidence that is fresh evidence or evidence in addition to or in
substitution for the evidence received in relation to the medical
assessment
appealed against may not be given on an appeal unless the evidence was not
available to the appellant before that medical
assessment or could not
reasonably have been obtained by the appellant before that medical
assessment.
...
(5) The Appeal Panel may confirm the certificate of assessment given in
connection with the medical assessment appealed against,
or may revoke that
certificate and issue a new certificate as to the matters concerned. Section 326
applies to any such new certificate.
...”
- Section
328(2) confines the grounds of appeal which an appeal panel may consider to
those pursued by the appellant: see Lakovska per Barrett JA at [40]
(Gleeson JA agreeing); New South Wales Police Force v Registrar of the
Workers Compensation Commission of New South Wales [2013] NSWSC 1792, Davies
J at [45]-[46]; Cullen v Woodbrae Holdings Pty ltd [2015] NSWSC 1416,
Beech-Jones J at [29]-[38]; and Ferguson v State of New South Wales & Ors
[2017] NSWSC 887 per Campbell J at [12]. In this current judicial review,
the Appeal Panel was confined to whether the assessment was made on the
basis of
incorrect criteria or there is a demonstrable error.
The
referral
- On
24 October 2016, the Workers Compensation Commission issued a certificate of
determination following a conciliation conference
held by the parties with
arbitrator Snell. (Aff, Murray 14 May 2018, Ex A). The referral was for the AMS,
Dr White, to assess the
degree of WPI arising out of the primary
psychological injury sustained by Ms Kiely as a result of the incident. (My
emphasis).
- Relevantly,
the certificate of determination provided as follows at [3] and
[4]:
“3. The parties request that the AMS referral is to draw the attention of
the AMS to the admission of the applicant referred
to below, and the AMS is to
exclude from the assessment made in respect of the injury in Order 1, any
impairment or symptoms arising from or attributable to, the secondary
psychological condition suffered by the worker as required by Section 65A of
the Workers Compensation Act 1987, in addition to any deduction required
under Section 323 of the Workplace Injury Management and Workers Compensation
Act 1998. (emphasis added)
The following is not a determination of the Commission, however, I note that the
parties have agreed the following:
4. The applicant admits and the parties agree that the applicant, in addition to
the primary psychological injury noted in Order
1 above, suffers a
secondary/consequential psychological condition as a result of physical injuries
sustained on 19 April 2011 within
the meaning of Section 65A of the Workers
Compensation Act 1987.
...”
- On
31 October 2016, the referral was amended to include the following:
“1. MEDICAL DSPUTE REFERRED FOR
ASSESSMENT (s319 1998 Act)
The degree of permanent impairment of the worker as a result of an injury
(s319(c)
Whether any proportion of permanent impairment is due to any previous injury or
pre-existing condition or abnormality, and the extent
of that proportion
(s319(d))
Whether impairment is permanent (s319(f))
Whether the degree of permanent impairment of the injured worker is fully
ascertainable (s319(g))”
The decision of the AMS
- On
29 November 2016, the AMS issued a MAC. The MAC relevantly stated at
1:
“1. DETAILS OF THE MATTERS REFERRED FOR ASSESSMENT
The following matters have been referred for assessment (s 319 of the 1998
Act):
• Date of injury: 19 April 2011
• Body parts/systems referred: Psychological Injury
• Method of Assessment: Whole Person Impairment
...”
- In
his reasons, the AMS provided a detailed overview of the history relating to Ms
Kiely’s injury. (Aff, Murray 14 May 2018,
Ex C, 2-5). Under the heading
“Findings on mental state examination”, he stated at
6:
“...She appeared to have a good understanding about the distinction
between primary psychiatric injury and secondary psychiatric
injury as a
consequence of chronic and physical disability.
When this examiner explored this further, she said, “I’d say a third
of my disability is from my pain”. She said
that if there was a
‘magic wand’ which could relieve her of pain, “I would
absolutely be at least a third better
... I’ve lost interest ... but in
that case, I would try to do more”.
- The
AMS concluded at 8:
“10. REASONS FOR ASSESSMENT
a. My opinion and assessment of whole person impairment
The Whole Person Impairment is 17%.
With regard to apportionment between primary psychiatric injury and secondary
injury related to chronic pain and physical symptoms,
it is noted that there is
no scientific method of accurately apportioning causation.
However, this examiner has arrived at an approximation of apportionment, using
clinical experience and taking into account:
• The physical symptoms
• The psychological symptoms
• This examiner’s experience of other individuals in similar
situations, including their responses to various interventions,
particularly
those that relieve physical symptoms of chronic pain
• Ms Kiely’s own comments regarding apportionment
• Comments by other independent medical examiners.
Therefore, taking into account the above factors and rounding up to the final
score to a whole number, it is this examiner’s
opinion that 12% of Ms
Kiely’s psychiatric disorder can be deemed a result of the primary
psychiatric condition, whilst 5%
can be deemed related to the secondary
psychiatric condition.
...”
- The
AMS found that 5% was the portion related to a secondary psychological injury,
and should be deducted in accordance with s 65A of the Workers Compensation
Act from Ms Kiely’s 17% overall WPI. Accordingly, the AMS issued a MAC
with a 12% WPI.
The decision of the Registrar
(“gatekeeper”) dated 7 February 2017
- On
20 December 2016, Ms Kiely filed an application to appeal against the
AMS’s decision. The grounds of this appeal were that
the assessment was
made on the basis of incorrect criteria and that the MAC contained a
demonstrable error. Both parties relied upon
written submissions and Mercy
Connect lodged a notice of opposition.
- On
7 February 2017, the delegate of the registrar at [5]
stated:
“Upon examination of the MAC and on the face of the application and
submissions made, I am satisfied that a ground of appeal
as specified in section
327(3)(c) is made out in relation to the assessment of whole person impairment
of the appellant’s psychological
injury.”
- In
her submissions to the Appeal Panel, Ms Kiely stated at
[12]:
“It is submitted that the Guides make no provision for the inclusion (as
the AMS has stated) of “the examiners experience
of other individuals in
similar situations, including their responses to various interventions,
particularly those that relieve physical
symptoms of
chronic.”
The decision of the first Appeal Panel
- On
15 March 2017, the first Appeal Panel handed down its decision. It determined at
[47] that there was a demonstrable error made
by the AMS as to his approach to
assessing the secondary condition. It stated at [44]-[46]:
“44. The Panel notes the difficulty faced by the AMS in the circumstances
of this matter. In attempting to quantify the extent
of the assessed impairment
to be excluded, the factors relied on by the AMS cannot provide a reliable
outcome. The physical injuries
are not relevant to considering the impairment
due to the secondary condition; nor is the pain suffered by Ms Kiely; or the
experience
of other individuals suffering pain. The comments of Ms Kiely taken
into account by Dr White compound the unreliability of the outcome
arrived
at.
...
45. This focus on the pain and the other factors does not assist in quantifying
the proportion of impairment due to the secondary
condition the AMS is
attempting to exclude. They bear no relation to the factors to be considered in
the PIRS ratings for example,
although the panel does consider that an attempt
at an assessment using the PIRS categories for the secondary condition would
also
fail. There is mention of Ms Kiely having “lost interest”
because of her pain, but this is not sufficient to quantify
the secondary
condition in terms of the PIRS Categories. The reliance on the irrelevant
factors has led the AMS into a conclusion
without a scientific rationale.
46. The outcome of 5 per cent WPI, or approximately one-third, as being the
portion to be excluded does not have a sound basis. The
factors considered by
the AMS are not valid for the process. This constitutes a demonstrable error on
the face of the Certificate.”
- The
first Appeal Panel continued at [52]-[55]:
“52. Nevertheless, some of the depressive symptomatology associated with
the pain from the physical injuries does contribute
to the overall impairment.
In the Panel’s opinion, the picture here is very similar to one in which
section 323 of the 1998
Act is applicable, and the deductible proportion of the
assessed impairment for a pre-existing injury, condition, or abnormality
is
difficult to ascertain. In those circumstances section 323(2) would be
applicable and a 1/10 deduction would apply provided it
was “not at odds
with” the evidence.
53. In this matter the excluded impairment for the secondary condition is
similarly difficult to establish, and the proportion of
1/10 is not at odds with
the evidence. Given that this approach is stipulated for assessments involving a
pre-existing condition,
the Panel has concluded that it is appropriate to
“borrow” the method from section 323 of the 1998 Act. It is on the
evidence the best means in this matter to identify the excluded proportion due
to the secondary psychological/psychiatric condition.
54. Using this analogous method, the Panel finds that the primary injury
comprises 9/10 of the impairment.
55. Applying this finding to the overall assessment by the AMS of 17 per cent
WPI gives 15 per cent WPI for the primary psychiatric/psychological
injury, as
reflected in the Panel’s new certificate.”
- Accordingly,
the first Appeal Panel ordered that the AMS’s MAC be revoked and issued a
new certificate. It made a new WPI assessment
of 15%, being the original 17% WPI
found by the AMS (prior to his 5% deduction) with a 2% deduction for secondary
psychological injury.
The first Appeal Panel calculated this 2% by
“borrowing” the 10% deduction approach for pre-existing injury,
condition
or abnormality in s 323(2) of the WIM Act. (At
[53]).
First judicial review in this Court before Wilson
J
- By
summons filed 18 April 2017, Mercy Connect sought an order in the nature of
certiorari or alternatively, a declaration setting
aside or declaring invalid
the decision made by the first Appeal Panel on 15 March 2017; and an order in
the nature of prohibition.
- The
grounds of the review were firstly that the first Appeal Panel made a number of
jurisdictional errors and/or error of law on the
face of the record, or
alternatively, the first Appeal Panel constructively failed to exercise its
statutory power in making the
decision. The AMS’s quantification of the
secondary psychological injury as 5% WPI was not in dispute. There were four
errors
identified by Mercy Connect. These were as follows.
- The
first error identified was that the first Appeal Panel was restricted in its
review to the specific grounds of appeal on which
the appeal was made in
accordance with s 328(2) of the WIM Act. It therefore wrongly determined
(at [43]-[46]) that the AMS’s decision was afflicted with a
“problem” that involved
“irrelevant factors” and
featured a conclusion which did not have a “scientific rational”.
The first Appeal
Panel determined that the AMS’s finding of 5% WPI did not
have a sound basis and it constituted “demonstrable error”.
It did
not have the jurisdiction or power to make this determination as they did not
constitute the grounds of appeal on which the
appeal was made. Further or
alternatively, the conclusion of the first Appeal Panel that the factors listed
by the AMS were irrelevant
was wrong in law and misconstrued and misapplied the
relevant law. The first Appeal Panel also failed to set out its reasons for
its
conclusions in that it failed to set out its actual path of reasons and/or
failed to do so in sufficient detail so as to enable
the Court to see whether
the opinion did or did not involve any error of law.
- The
second error identified was that the first Appeal Panel incorrectly considered
the appeal at large and continued to make its own
determination as to Ms
Kiely’s WPI.
- The
third error was that the first Appeal Panel misconstrued and misapplied its
powers, or that it constructively failed to exercise
its power in determining
reasons at [52] and [53] that it could “borrow” the calculation of
impairment methodology from
a different and otherwise inapplicable provision of
the workers compensation legislation, being s 323(2) of the WIM Act. Such
a borrowing of a statutory provision that did not apply to the appeal was
impermissible and it thereby failed to make its own
assessment of WPI as it was
required to do according to law.
- The
fourth error was that the decision was afflicted by legal unreasonableness
within the meaning of Minister for Immigration and Citizenship v Li
[2014] FCAFC 1; (2013) 249 CLR 332 and is thereby invalid. The first Appeal Panel wrongly
determined that there was a dispute about a number of factors concerning the
AMS’s decision when there was not. It also acted irrationally or
illogically in criticising the AMS when it stated at [44]
that “physical
injuries are not relevant to considering the impairment due to the secondary
condition, nor is the pain suffered
by Ms Kiely, or the experience of other
individuals suffering pain”, and then stated later at [52] that
“some of the
depressive symptomatology associated with the pain from the
physical injuries does contribute to the overall
impairment.”
Wilson J’s decision
- On
14 September 2017, Wilson J handed down her decision in Mercy Centre
Lavington Ltd v Kiely & Ors [2017] NSWSC 1234. (“Mercy
Centre”).
- So
far as the first and second errors are concerned, Wilson J stated at [49] and
[52]-[55] that the first Appeal Panel had fallen
into error by considering
matters which were not raised by Ms Kiely on appeal and should not have been
considered. Under s 328(2)
of the WIM Act, an appeal panel is limited in
its review to the grounds of appeal. Ms Kiely had not argued the quantification
of the secondary psychological
injury as a ground of appeal to the first Appeal
Panel. Nor had Ms Kiely raised on appeal that the AMS had made an error in the
factors
taken into account, other than his reference to his experience of other
individuals in similar situations. The first Appeal Panel
had therefore fallen
into error by revising the quantum of the secondary psychological injury,
finding errors with factors taken
into consideration by the AMS, and referring
to the physical injuries as being irrelevant to the consideration of secondary
impairment.
- Her
Honour went on to find at [56], [57] and [60]-[63] that the third error had been
established because s 323 of the WIM Act had been incorrectly relied upon
by the first Appeal Panel. In making its assessment over the proportion of
impairment to be excluded
as secondary injury, the first Appeal Panel had found
there was difficulty in separating primary and secondary psychological injury
and resolved this by relying upon s 323 of the Act. Wilson J held at [57] that
“it was not open to the [Appeal Panel] to utilise
s 323 as the methodology
adopted by which to determine secondary psychological impairment pursuant to s
65A of the [Workers Compensation Act]”. This was because s 65A of
the Workers Compensation Act and s 323 of the WIM Act serve
different purposes. Section 65A is directed towards compensation while s 323
concerns the assessment of impairment. (At [60]).
The first Appeal Panel had
relied upon s 323 to assess the quantum of impairment to be deducted and failed
to take into account the
available medical evidence. (At [61]). Her Honour also
noted that even if s 323(2) was available to assess an appropriate deduction,
it
is “not open-ended” as the ten per cent deduction can only be made
in circumstances where it would be too difficult
or costly to make a more
specific medical assessment. This was not the case here was there was a great
deal of evidence the first
Appeal Panel could have referred to. (At [62]).
Accordingly, the use of s 323 for this purpose amounted to an error of law.
- In
relation to the fourth error concerning legal unreasonableness, Wilson J found
at [64] that due to the first, second and third
errors, the decision was
unreasonable.
- Her
Honour ordered that the decision of the first Appeal Panel be set aside and that
the matter be remitted to the Workers Compensation
Commission for determination
by a differently constituted appeal panel.
The decision of the
second Appeal Panel
- At
a preliminary review on 20 October 2017, the second Appeal Panel constituted by
an arbitrator, Ms Deborah Moore, and two AMSs and
psychiatrists, Dr Julian
Parmegiani and Dr Patrick Morris, issued a number of directions to the
parties.
- The
Appeal Panel made two directions in its preliminary review dated 20 October
2017. They are as follows:
“DIRECTIONS
The Panel has determined that the parties are to file written submissions
addressing the issue of the Appellant’s current level
of function and how
she has been affected, if at all, subsequent to the injury by reference to the
criteria set out in the PIRS Scale.
Submissions are to be lodged by 30 November 2017.
The Panel has determined that the appellant worker should submit herself for a
clinical examination...”
- It
later explained the basis of its direction for re-examination in its statement
of reasons at [14] as follows:
“As a result of that preliminary review, the Appeal Panel determined that
the worker should undergo a further medical examination
because of the nature of
the injury and the comments made by Wilson J.”
- In
accordance with the directions, both parties provided written submissions.
Neither party agitated a deterioration in Ms Kiely’s
condition and both
agreed that the AMS’s initial assessments were correct.
- On
23 January 2018, Dr Parmegiani re-examined Ms Kiely and made the following
observations:
“Ms Kiely’s medical history was not in dispute. The purpose of the
examination was to determine the psychiatric impairment
arising from Ms
Kiely’s primary psychiatric injury.
Ms Kiely reported a number of persistent psychiatric symptoms. She suffered
daily panic attacks, which lasted up to 20 minutes. Symptoms
included
palpitations, shaking, shortness of breath and a fear of impending doom. Panic
attacks occurred daily. Ms Kiely felt calmer
at home, and she avoided going out
when possible. She explained that her attacker lived locally, and over the past
12 months Ms Kiely
saw her on four or five occasions. This rekindled Ms
Kiely’s anxiety.
Ms Kiely slept poorly from 2 am to 5 am. She suffered nightmares about the
assault every night, and she often woke up startled. Ms
Kiely feared going to
sleep because she feared nightmares. Ms Kiely lacked energy, motivation and
concentration. She spent a significant
part of her day ruminating about the
incident of 18 April 2011, and management’s reaction. Ms Kiely explained
that she wanted
to report the incident to police, but management threatened to
terminate her position if she reported the incident. The perpetrator
later
threatened others with a knife and police eventually charged her. The CEO of the
service was stood down.
Ms Kiely felt that life was not worth living, but she did not formulate a
suicide plan. Her mood was not reactive, and she could
not identify enjoyable
activities.
Ms Kiely suffered cervical pain and pain in her right shoulder. She felt
frustrated with her physical limitations. She was unable
to perform physically
demanding tasks, including lifting her grandchildren or exercise at a gym. Ms
Kiely said, ‘I’ve
got used to the pain. It’s been nearly seven
years’. She however remained angry with management about her physical
injury,
because Ms Kiely believed it could have been prevented.
Ms Kiely lacked appetite, and she only ate one meal per day. She gained 12 kg in
weight, and she attributed the weight gain to side
effects of medication. Ms
Kiely was under the care of Dr Swift, a psychiatrist. Dr Swift prescribed
diazepam 15mg per day and Mogadon
10mg at night. Ms Kiely was previously on
100mg Endep, a tricyclic antidepressant, for migraines. Dr Swift increased the
dose to
200mg per day, with the aim of improving Ms Kiely’s depression. Ms
Kiely was also prescribed quetiapine two tablets at night.
She did not know the
dose. She managed pain with Panadeine Forte eight tablets per day and gabapentin
900mg at night.
Ms Kiely was a well-groomed 43-year-old woman of above average weight. She wore
jewellery and makeup. She was punctual for her appointment
and cooperative with
the interview process. Ms Kiely’s emotional expression was reduced in
range, and she rarely smiled. She
acknowledged remaining angry about the
circumstances surrounding the incident of 18 April 2011. She thought about it
every day, and
before going to sleep.
Ms Kiely’s psychiatric impairment was rated in accordance with the
WorkCover Guidelines for the evaluation of personal impairment.
Impairment
arising from a physical injury was not taken into account when rating her
psychiatric impairment.”
- Dr
Parmegiani undertook a new PIRS assessment as follows:
“Arranging the classes in ascending order: 2, 2, 2, 3, 3, 5. Median = 2.5
= 3. Aggregate = 17. This is equivalent to a whole
person psychiatric impairment
of 19%.”
- On
27 February 2018, the second Appeal Panel provided reasons. The second Appeal
Panel agreed and adopted Dr Parmegiani’s medical
assessment and set out
its reasons for accepting his assessment at [41]-[45]. It
stated:
“Dr Parmegiani has differed in his assessments only with respect to
self-care and personal hygiene.
Notwithstanding the Respondent’s submissions as to any
“deterioration” since the prior assessments of Dr Klug and
the AMS,
it must be remembered that an AMS is required to assess a worker on the day of
examination.
The Appellant made no suggestion that she had “deteriorated” since
her previous assessments. Dr Parmegiani noted in the
body of his report some
difficulties the Appellant experienced in this regard such as a lack of appetite
and that she showered “most
days” on a background of a person who
acknowledged her “obsessiveness with cleanliness”.
His assessment properly reflects those difficulties, and is consistent with his
obligation to use his clinical judgement and expertise
in making an
assessment.
For these reasons, the Appeal Panel has determined that the MAC issued on 29
November 2016 should be revoked, and a new MAC should
be issued. The new
certificate is attached to this statement of reasons.”
- The
new MAC issued by the second Appeal Panel stated that the WPI was
19%.
The present judicial review
- On
27 March 2018, Mercy Connect filed a summons in this Court for judicial review
of the second Appeal Panel’s decision dated
27 February 2018. I have
already set out the orders sought earlier in this judgment.
- For
ease of understanding, any reference to “Appeal Panel” is a
reference to the second Appeal Panel, being the focus
of the present judicial
review.
Grounds of appeal
- There
are seven grounds of judicial review. They are as follows:
- (1) The Appeal
Panel failed to determine Ms Kiely’s appeal;
- (2) The Appeal
Panel made directions that Ms Kiely should have a further examination before
determining whether there was an error
in the MAC;
- (3) The Appeal
Panel mistook its own jurisdiction on appeal with the Supreme Court’s
jurisdiction on judicial review;
- (4) The Appeal
Panel failed to make a finding as to the percentage of Ms Kiely’s
psychological injury due to agreed secondary
psychological injury under s 65A
of the Workers Compensation Act. This included a failure to consider
Ms Kiely’s agreed secondary psychological injury, a failure to make a
finding on Ms Kiely’s
secondary psychological injury, and a failure to
give sufficient reasons for a court on review to understand whether the Appeal
Panel
had considered and made a finding for Ms Kiely’s secondary
psychological injury or not;
- (5) The Appeal
Panel failed to consider making a deduction for pre-existing condition or
abnormality under s 323 of the WIM Act;
- (6) The Appeal
Panel failed to give reasons for its revision of Ms Kiely’s WPI; and
- (7) The Appeal
Panel’s decision is legally unreasonable.
- In
the alternative, the plaintiff assets that grounds 1 to 6 above are errors on
the face of the record pursuant to s 69 of the Supreme Court Act 1970
(NSW).
- Ms
Kiely has filed a submitting appearance. Hence, she has not filed any written
submissions.
- I
shall deal with these judicial grounds of review in order.
Ground
1 – Failure to consider Ms Kiely’s appeal
- This
ground concerns the failure of the Appeal Panel to determine Ms Kiely’s
appeal. Mercy Connect submitted that the Appeal
Panel was required to determine
whether any ground in Ms Kiely’s appeal filed 20 December 2016 had been
made out. The grounds
of appeal were that the AMS had impermissibly made an
assessment of the secondary psychological error, and had impermissibly taken
into account his experience of other individuals in a similar situation. These
grounds were also been identified by Wilson J: see
Mercy Centre at [53].
It says that the Appeal Panel has not addressed or determined these grounds of
appeal and that consequently, there was a
failure of the Appeal Panel to
exercise its jurisdiction under s 328(2) of the WIM
Act.
Consideration
- Section
328(2) of the WIM Act provides that the procedure is to review the
original medical assessment of the AMS.
- The
referral to the AMS was made on the basis that the AMS excluded from his
assessment “any impairment or symptoms arising
from or attributable to,
the secondary psychological condition.” Ms Kiely’s subsequent appeal
to the first Appeal Panel
was made on two grounds; firstly, that the AMS’s
assessment was made on the basis of incorrect criteria; and secondly, that
the
MAC contained a demonstrable error. These grounds were confirmed in judicial
review before Wilson J in Mercy Centre at [53]. Her Honour summarised the
submissions accompanying the two grounds of appeal as being that the AMS had
impermissibly made
an assessment of the secondary psychological injury, and had
impermissibly taken into account his experience of other individuals
in a
similar situation. As her Honour remitted the decision back to be decided by a
newly constituted appeal panel, the task of the
second Appeal Panel was to
review the original AMS’s MAC on the same grounds of appeal.
- In
its decision dated 27 February 2018, the Appeal Panel adopted the WPI assessment
of 19% made by Dr Parmegiani following his re-examination
of Ms Kiely on 23
January 2018, and made orders to revoke the AMS’s original MAC and issue a
new MAC. The Appeal Panel’s
reasons for doing so are contained in
[41]-[45] of its decision, which I have set out earlier in this judgment.
However, nowhere
in its reasons does the Appeal Panel address whether the AMS
had impermissibly made an assessment of the secondary psychological
error. Nor
does the Appeal Panel consider whether the AMS’s approach in taking into
account his experience of other individuals
in similar situations was
permissible. These were the grounds upon which the original appeal was made and
the Appeal Panel was obligated
to determine them in accordance with s 328(2) of
the WIM Act.
- It
is my view that the Appeal Panel has not addressed the grounds of appeal raised
here. As it did not address the grounds of appeal,
it failed to exercise its
statutory task and misconstrued its statutory duty.
Ground 2
– Seeking a further medical examination
- Ground
2 is that the Appeal Panel’s determination that Ms Kiely should undergo a
further medical examination by Dr Parmegiani
before determining whether there
was an error in the MAC.
- Mercy
Connect submitted that the Appeal Panel fell into jurisdictional error by
examining Ms Kiely before determining whether there
was an error in the MAC. The
Appeal Panel stated that it had issued a direction for Ms Kiely to be
re-examined because of the nature
of the injury and the comments made by Wilson
J. According to Mercy Connect, these reasons are insufficient and do not
indicate that
the Appeal Panel had identified for itself an error to enliven its
jurisdiction to re-examine Ms Kiely. In particular, Mercy Connect
says that the
decision of Wilson J cannot be construed as finding an error in the MAC for two
reasons. Firstly, the Supreme Court
on judicial review cannot enter into a
consideration of the merits of an appeal; and secondly, Wilson J made no
specific finding
of error in the MAC, only of errors in the first Appeal
Panel’s decision.
- Mercy
Connect further submitted that even if the Appeal Panel determined that Ms
Kiely’s condition had deteriorated and re-examined
Ms Kiely on this basis,
the deterioration was not the basis of Ms Kiely’s appeal. In addition,
even if the Appeal Panel gave
the parties an opportunity to be heard on the
ground of deterioration: see Siddick v WorkCover Authority (NSW) [2008]
NSWCA 116 at [104] (McColl JA with Mason P and Giles JA agreeing), its failure
to identify an antecedent error as alleged by Ms Kiely in her appeal
remains a
jurisdictional error.
Consideration
- In
Campbelltown City Council v Vegan (2006) 67 NSWLR 372; [2006] NSWCA 284
(“Vegan”), Basten JA considered the limited scope of the
Appeal Panel’s jurisdiction at [137] as follows:
“Two factors suggest that such an approach [to deal only with the error
found] would also be appropriate in relation to the
powers of the Appeal Panel.
First, if the Appeal Panel’s powers were at large, the need to specify
grounds of appeal limited
to particular categories, would be rendered largely
otiose. Secondly, the Appeal Panel is not a tribunal which has any powers other
than those necessary to deal with the appeals in question. Thus, unlike this
Court, it is not necessary to consider whether broad
existing powers are
exercisable in a particular case or not. On a tentative view, the approach
adopted by the primary judge in the
present case may have been in error and the
powers of the Appeal Panel may be limited to addressing, and if thought
necessary, correcting,
errors identified in the certificate granted by the
approved medical specialist, as specified by the appellant.
...”.
- Vegan
was upheld in Pitsonis v Registrar of the Workers Compensation Commission
(2008) 73 NSWLR 366; [2008] NSWCA 88 [48]-[49].
- In
New South Wales Police Force v Registrar of the Workers Compensation
Commission of New South Wales, Davies J stated that it is necessary for an
Appeal Panel to identify a demonstrable error in a MAC before it is permitted to
order
a re-examination. His Honour at [34] stated:
“...if an assessment can be carried out in the course of an appeal that
assessment cannot take place before the Appeal Panel
has determined that there
is an error in the certificate leading to the need for a further assessment.
Such an assessment may be
needed because the Panel, although in a position to
revoke a certificate for error, is not in a position to issue a new one without
such an assessment.”
- In
summary, these authorities support the proposition that the Appeal Panel had a
limited jurisdiction in conducting its appeal and
was obliged to identify a
demonstrable error in the MAC prior to directing any re-examination of Ms
Kiely.
- The
Appeal Panel did not identify a demonstrable error arising from the MAC upon
which to justify its direction for further re-examination
of Ms Kiely. Nor can
the Appeal Panel rely upon the “nature of the injury” and Wilson
J’s decision as being sufficient
to identify such an error.
- When
the Appeal Panel sought submissions from the parties, both parties agreed that
there had been no deterioration in Ms Kiely’s
medical condition. Further
the parties agreed that the AMS’s initial assessments were correct. What
was in issue was the explanation
of how the AMS arrived at the 5% WPI for the
secondary psychological injury, and whether the AMS had impermissibly taken into
account
his experience of other individuals in a similar situation. In my view,
the Appeal Panel has not identified a demonstrable error
in the MAC so they were
not entitled to conduct the re-examination. Accordingly, the Appeal Panel has
misconstrued its statutory
duty.
Ground 3 –
jurisdiction
- Ground
3 of the judicial review concerns the Appeal Panel having erred by mistaking its
jurisdiction. Mercy Connect submitted that
the Appeal Panel confused its
appellate jurisdiction with the review powers of the Supreme Court. In support
of this submission,
Mercy Connect drew this Court’s attention to [19] of
the Appeal Panel’s statement of reasons dated 27 February 2018,
in which
it stated that “both parties had made written submissions...and were
expanded upon at the hearing before Wilson J”.
It also referred to [22] of
the Appeal Panel’s decision, in which it stated that “this matter
has been the subject of
prior appeals.” In other words, Mercy Connect says
that the Appeal Panel had incorrectly mistaken its jurisdiction as being
part of
an appeal process that includes the Supreme Court and that it incorrectly
concluded that it did not need to make findings
already made by the Supreme
Court.
Consideration
- As
the Appeal Panel has misconstrued its statutory duty on other grounds, it is not
necessary for me to address this ground of judicial
review. However, in the
event that I am wrong, my view would have been as follows.
- While
the Appeal Panel did make some oblique statements at [19] and [22] of its
reasons, these statements were made in the context
of the Appeal Panel
summarising the parties’ submissions and the procedural history of the
matter. Therefore, I would have
found that to consider these statements as
evidence of the Appeal Panel misconstruing its jurisdiction would involve this
Court incorrectly
adopting an overly zealous approach to language with an eye
finely tuned for error: see McGinn v Ashfield Council [2012] NSWCA 238
per McColl JA at [17] (Sackville AJA and Gzell J agreeing); Walsh v
Parramatta City Council (2007) 161 LGERA 118; [2007] NSWLEC 255 at [67] per
Preston CJ citing Minister for Immigration and Ethnic Affairs v Wu Shan
Liang (1996) 185 CLR 259; [1996] HCA 6 at 291.
- Accordingly,
judicial review ground 3 has not been made out.
Grounds 4 and 5
– Failure to consider secondary psychological injury and adoption of 19%
WPI
- Grounds
4 and 5 of the judicial review raise similar issues. While it is not necessary
for me to decide these grounds of review, I
will make some observations because
they raise significant issues.
- Ground
4 of this judicial review is perhaps the more significant one. It concerns the
alleged failure of the Appeal Panel to consider
secondary psychological
injury.
- Ground
5 concerns the Appeal Panel having erred by considering and revising the WPI of
Ms Kiely.
- In
relation to ground 4, Mercy Connect submitted that the Appeal Panel failed to
consider secondary psychological injury pursuant
to s 65A of the Workers
Compensation Act. The first Appeal Panel found at [41]-[42] of its decision
that the AMS made no error in his general approach to excluding secondary
psychological injury, although they did take issue with the factors taken into
account by the AMS in assessing the 5% WPI to be excluded.
(At [43]). This was
not subject to appeal and Wilson J did not comment adversely upon it. However,
the Appeal Panel adopted the finding
of Dr Parmegiani from his re-examination of
Ms Kiely, and found that Ms Kiely suffered from a 19% WPI. Mercy Connect
submitted that
there is no reason why Dr Parmegiani should not have expressly
considered and applied a deduction for secondary psychological injury.
Mercy
Connect says that the Appeal Panel has either made a jurisdictional error by
failing to consider whether a deduction for secondary
psychological injury under
s 65A of the Workers Compensation Act should be made; or has made a
jurisdictional error by failing to calculate total WPI for psychological injury
and then deducting the
percentage of WPI due to secondary psychological
injury.
- In
the alternative, Mercy Connect submitted that the Appeal Panel made a
jurisdictional error by failing to give reasons sufficient
for a court on review
to understand whether a deduction for secondary psychological injury has been
made or not, and the extent of
any deduction. According to Mercy Connect, Dr
Parmegiani was vague as to whether the 19% WPI included a reduction of secondary
psychological
injury or not.
- In
relation to ground 5, Mercy Connect submitted that the Appeal Panel misconstrued
its statutory duty by reconsidering and revising
Ms Kiely’s WPI. Applying
the reasoning of Wilson J, this constitutes an error. According to Mercy
Connect, an issue before
her Honour in the first judicial review concerned the
first Appeal Panel’s revision of the 5% deduction for secondary
psychological
injury. However, her Honour found that the 5% secondary
psychological injury was not an issue on appeal before the first Appeal Panel.
The second Appeal Panel has again revised the 5% secondary psychological injury
in re-assessing Ms Kiely’s WPI.
- As
best as I can understand them, Mercy Connect’s submissions concerning
grounds 4 and 5 appear to be contradictory. Where ground
4 is related to the
Appeal Panel having failed to consider secondary psychological injury, ground 5
is framed as the Appeal Panel
having revised the 5% secondary psychological
injury by re-assessing Ms Kiely’s WPI as 19%. During the hearing, counsel
for
Mercy Connect confirmed it was his position in relation to ground 5 that
“the Appeal Panel has again revised the 5 per cent,
which was the subject
of the first review...”. (T12.16-17). In any event, as I have already
determined that the Appeal Panel
misconstrued its statutory duty on an earlier
ground, I do not consider it necessary to reconcile this inconsistency, subject
to
my following comments.
Consideration
- For
convenience, s 65A of the Workers Compensation Act (which I have set out
earlier in this judgment) requires a distinction to be drawn between primary
psychological injury and secondary
psychological injury. Under s 65A(1), no
compensation is payable for permanent impairment that results from a secondary
psychological injury. When an AMS (or Appeal Panel)
assesses the degree of
permanent impairment resulting from a primary psychological injury, no regard
can be had to any impairment
or symptoms resulting from a secondary
psychological injury in accordance s 65A(2).
- The
statutory scheme comprising of the WIM Act and the Workers
Compensation Act creates a two-step approach in assessing the degree of WPI
for a psychological injury. The assessor must first calculate the entire
degree
of psychological injury in line with the PIRS categories. The secondary
psychological injury must then be assessed and deducted
in accordance with s 65A
of the Workers Compensation Act, leaving the primary psychological injury
remaining.
- This
two-step process accords with the referral of the Workers Compensation
Commission on 24 October 2016. This referral provided
for the AMS to assess the
degree of WPI arising out of the primary psychological injury sustained by Ms
Kiely as a result of the
incident, excluding “any impairment or symptoms
arising from or attributable to, the secondary psychological
condition.”
- On
23 January 2018, Dr Parmigiani in his re-examination report
stated:
“Ms Kiely’s psychiatric impairment was rated in accordance with the
WorkCover Guidelines for the evaluation of permanent
impairment. Impairment
arising from a physical injury was not taken into account when rating her
psychiatric impairment.”
- While
Dr Parmigiani calculated the entire degree of psychological injury as required
in step one above, he does not appear to have
considered the degree of secondary
psychological injury in step two as required under s 65A of the Workers
Compensation Act. The Appeal Panel then accepted his assessment of 19% WPI
without any qualification for secondary psychological assessment. However,
as I
have previously set out, Wilson J in Mercy Centre stated at [52] that an
Appeal Panel is “confined to determining the grounds of appeal on which
the appeal is made”. Her
Honour then concluded at [53] and [55] that the
first Appeal Panel’s decision was made outside of s 328(2) of the WIM
Act because the AMS’s quantification of secondary psychological injury
was not raised on appeal.
- Putting
aside the fact that the Appeal Panel incorrectly conducted a re-examination
without first identifying an error, together with
the parties having agreed that
the AMS’s initial assessments were correct in their written submissions,
the Appeal Panel was
not obliged to consider the quantification of secondary
psychological injury as this issue was not raised on appeal. Nor was the
Appeal
Panel obliged to revise the WPI when this was not raised as a ground of appeal.
Had it been necessary for me to express a
view (which it is not), I would have
determined that the Appeal Panel had misconstrued its statutory task on both
these grounds.
Ground 6 – Failure to consider deduction
under s 323
- Ground
6 concerns the failure of the Appeal Panel to consider whether it should make a
deduction for Ms Kiely’s previous pre-existing
condition or injury under s
323 of the WIM Act. This issue was not raised on appeal.
- Mercy
Connect submitted that the amended referral states that the medical dispute
referred for assessment includes, under s 319(d)
of the WIM Act, whether
any proportion of permanent impairment is due to any previous injury or
pre-existing condition or abnormality. Mercy Connect
says that there is an
abundance of medical evidence as to the psychological, primary psychological and
secondary psychological injury
on which the Appeal Panel could have formed an
opinion as to pre-existing injury, condition or abnormality. The Appeal Panel
failed
to take into account considerations and evidence it was bound to take
into account in relation to Ms Kiely’s pre-existing condition:
see
Minister for Aboriginal Affairs v Peko Wallsend Ltd [1986] HCA 40; (1986) 162 CLR
24.
- In
its supplementary submissions, Mercy Connect also submitted that the Appeal
Panel was obliged to consider a deduction under s 323
of the WIM Act in
respect of the primary psychological injury. This is to be distinguished from
the first Appeal Panel’s incorrect use of s
323 to quantify secondary
psychological injury. The fact that the initial AMS made no s 323 deduction from
the primary psychological
injury did not relieve the Appeal Panel of the
requirement to consider that issue afresh in accordance with the referral. In
support
of this submission, Mercy Connect referred to Roads and Maritime
Services v Rodger Wilson [2016] NSWSC 1499, where Fagan J stated at
[26]:
“Once the Appeal Panel had determined that Dr
Anderson’s Medical Assessment Certificate should be revoked it was
incumbent
upon them, as a matter of law, to apply the WorkCover Guides fully in
arriving at a fresh assessment and issuing a new certificate.
That necessitated,
in the present case, consideration of any contribution to the assessed WPI of
15% (derived by application of par
3.18 of the WorkCover Guides) which should be
attributed to the pre-existing injury. In Drosd v Workers Compensation
Nominal Insurer [2016] NSWSC 1053 Garling J explained this as follows:
“[59] Having found error in the MAC issued by the AMS, the Appeal Panel
revoked the MAC and determined for itself that the
plaintiff’s whole
person impairment relating to the left lower extremity was 10%. It did so in a
shorthand way. That shorthand
way was to adopt the assessment of the AMS because
no party had challenged it. This shorthand way, whilst arguably permissible, did
not relieve the Appeal Panel from its statutory obligation to conduct its
assessment according to law.”
...”
Consideration
- This
ground of judicial review seems to be more akin to a merits review.
- The
referral provides that the AMS was to consider in his assessment “any
deduction required under section 323 of the [WIM Act]”. In
addition, the amended referral dated 31 October 2016 required the AMS to
consider “whether any proportion of permanent
impairment is due to any
previous injury or pre-existing condition or abnormality, and the extent of that
proportion...”. The
AMS in his assessment noted that Ms Kiely had two
previous accidents, injuries or conditions, being repeated incidents of sexual
assault between the ages of 8 and 14. (At 3). Despite this, the AMS found that
there was no relevant previous injury, pre-existing
condition or abnormality.
Accordingly, there was “no deducible proportion”. (At 9). However,
no reasons were given by
the AMS as to why this finding was made.
- Importantly,
the issue of whether a 323 deduction should have been made by the AMS was not
raised by Ms Kiely as a ground of appeal
before the Appeal Panel. Had this been
raised as a ground of appeal and had the Appeal Panel found the requisite error
to conduct
its re-examination, then the Appeal Panel in conducting a fresh
assessment would have been obliged to consider whether any deduction
was
required for impairment due to a previous injury, or pre-existing condition or
abnormality. This is not the case here.
- Accordingly,
had it been necessary for me to consider this ground of judicial review, I do
not consider that the Appeal Panel misconstrued
its statutory duty by not
considering the s 323 deduction.
Ground 7 –
unreasonableness
- Ground
7 concerns the Appeal Panel’s decision being unreasonable.
- Mercy
Connect submitted that the decision is unreasonable to the standard of legal
unreasonableness. A decision that is legally unreasonable
may give rise to
jurisdictional error, either because the unreasonable outcome is indicative of
underlying procedural error, or because
there is no evidence and intelligible
justification for the outcome: see Minister for Immigration and Citizenship v
Li [2014] FCAFC 1; (2013) 249 CLR 332 at [76] (“Li”), Minister for
Immigration and Border Protection v Singh & Anor [2014] FCAFC 1; (2014) 231 FCR 437, and
Minister for Immigration and Border Protection v Stretton [2016] FCAFC 11; (2016) 237 FCR
1. Mercy Connect submitted that the Appeal Panel’s decision was an
unintelligible outcome due to the 19% WPI being adopted with
no apparent
explanation of the way secondary psychological injury was dealt with, as well as
the failure of the Appeal Panel to understand
and exercise its
jurisdiction.
Consideration
- In
Li, the High Court stated at [75]-[76]:
“In Peko-Wallsend, Mason J, having observed
that there was considerable diversity in the application by the courts of the
test of manifest unreasonableness,
suggested that “guidance may be found
in the close analogy between judicial review of administrative action and
appellate review
of a judicial discretion”. House v R holds that it
is not enough that an appellate court would have taken a different course. What
must be evident is that some error
has been made in exercising the discretion,
such as where a judge acts on a wrong principle or takes irrelevant matters into
consideration.
The analogy with the approach taken in an administrative law
context is apparent.
As to the inferences that may be drawn by an appellate court, it was said in
House v R that an appellate court may infer that in some way there has
been a failure properly to exercise the discretion “if upon the
facts [the
result] is unreasonable or plainly unjust”. The same reasoning might apply
to the review of the exercise of a statutory
discretion, where unreasonableness
is an inference drawn from the facts and from the matters falling for
consideration in the exercise
of the statutory power. Even where some reasons
have been provided, as is the case here, it may nevertheless not be possible for
a court to comprehend how the decision was arrived at. Unreasonableness is a
conclusion which may be applied to a decision which
lacks an evident and
intelligible justification.”
- In
order to find that an error on the basis of legal unreasonableness, this Court
must be satisfied that the decision is unreasonable
or plainly unjust, or that
the decision lacks an evident and intelligible justification.
- While
I accept that several errors arose in the Appeal Panel’s decision, I do
not consider that these meet the threshold of
being either unreasonable or
plainly unjust, or lacking an evident and intelligible conclusion. The Appeal
Panel reached their conclusion
on WPI by accepting Dr Parmegiani’s
findings. The mere fact that the Appeal Panel made errors in doing so does not
automatically
result in the decision being unreasonable in the relevant
sense.
- Accordingly,
judicial review ground 7 fails.
Conclusion
- The
result is that grounds 1, 2, 4 and 5 of the judicial review have been made out.
The decision of the Appeal Panel in matter number
3761/16 dated 27 February 2018
is set aside. The decision of the Appeal Panel in matter number 3761/16 is
remitted to the Workers
Compensation Commission of New South Wales to be
determined in accordance with law.
- Costs
are reserved.
The Court orders that:
(1) The decision of the Appeal Panel in matter number 3761/16 dated 27 February
2018 is set aside.
(2) The decision of the Appeal Panel in matter number 3761/16 is remitted to the
Workers Compensation Commission of New South Wales
to be determined in
accordance with law.
(3) Costs are reserved.
********
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