Highlights of Noteworthy Decisions

Decision 459 15
29/05/2015
M. Crystal
  • Board Directives and Guidelines (maximal medical rehabilitation)
  • Permanent impairment {NEL} (arrears)
  • Maximal medical rehabilitation (multiple dates)

In Decision No. 199/05, the Tribunal found that the worker had entitlement for systemic lupus erythematosus (SLE). The Board assessed the worker for a NEL award, but divided the permanent impairment into separate components and granted the NEL award for the skin condition component and musculoskeletal condition component retroactive to July 1993, and the NEL award for the respiratory condition component retroactive to May 1995.

The worker appealed a decision of the Appeals Resolution Officer denying retroactivity of the respiratory component to July 1993.
The Board policy on maximal medical rehabilitation is Operational Policy Manual, Document No. 11-01-05. It is apparent from the policy that, where a single compensable condition is comprised of more than one component, where each component reflects a set of symptoms which is distinct from the others, each component may be associated with a different MMR date, particularly where the onset of symptoms for the respective components does not occur at the same time.
Where a worker suffers an organic injury which reaches MMR on a particular date and subsequently develops a psychological condition due to emotional reaction to the injury, which reaches MMR at a later date, the appropriate MMR date for the psychological condition will be determined according to the medical information for the psychological condition. The same applies to a case where different sets of symptoms, all associated with the same compensable condition, arise at different time. The fact that all the various symptoms arise from one compensable condition does not mean that all aspects of that condition will necessarily have the same MMR date.
On the evidence in this case, the worker was experiencing significant respiratory symptoms in July 1993, related to the diagnosis of SLE. In the circumstances, the MMR date for the respiratory component of the worker's SLE entitlement should also be in July 1993. The appeal was allowed.