The Court of Appeal held that Section 3.2k of the AMA Guides (4th Edition) does not impose an absolute prohibition on combining peripheral nerve impairment estimates with manual muscle testing estimates; rather, the prohibition against combining with estimates for muscle weakness and atrophy operates to prevent double-counting where the same functional impairment is assessed under multiple methodologies, and does not preclude combining assessments where a Medical Panel has determined that genuinely distinct impairments exist (here, a motor deficit assessed under Section 3.2d and dysaesthesia assessed under Section 3.2k). The Court also held that Section 3.2k permits assessment of partial (not only complete) motor or sensory losses, and that the choice and combination of assessment methodologies under the Guides involves the application of medical expertise and judgment by the assessing panel. Leave to appeal was refused on the basis the proposed appeal had no real prospect of success.
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