Medical Appeal Panel: No Modifier for DRE V

In Scott v Woodgate & Partners Pty Ltd [2015] NSWWCC MA 67 the Appellant sought to argue that an Approved Medical Specialist erred by failing to allow a Table 4.2 modifier for persisting radiculopathy after surgery.

The Panel addressed this argument as follows:-

The Panel considered that as radiculopathy is taken into account in assigning the Appellant to a higher DRE lumbar category, it is not appropriate to add an additional 3% under Table 4.2.  Applying such a modifier would in effect provide the Appellant with a double amount for the presence of radiculopathy.  The Panel noted that the modifiers in Table 4.2 are commonly used when workers are assessed in DRE Lumbar Category IV where no provision is made for the presence of persisting radiculopathy following surgery and if the AMS had assessed the Appellant as DRE Lumbar Category IV it would have been appropriate to add an additional 3% under Table 4.2 for persisting radiculopathy following surgery”.

The Medical Assessment Certificate was confirmed.