Arbon and Comcare (Compensation)

This matter concerned an application for review of a decision by Comcare to cease funding the Applicant's gym and hydrotherapy program. The Applicant sustained a back injury in 1996, which was aggravated in 2001, with the latter aggravation forming the basis of his accepted condition for compensation purposes. Comcare had previously agreed to fund the Applicant's gym and hydrotherapy treatment, but later determined that the Applicant no longer suffered the effects of the accepted condition and that the ongoing costs of the program were not reasonable. The Applicant sought an order that Comcare remain liable for the costs of his gym and hydrotherapy treatment.

The Tribunal was required to determine whether the Applicant continued to suffer the effects of the accepted condition, whether the gym and hydrotherapy treatment was obtained in relation to that condition and was reasonable in the circumstances, and consequently, whether Comcare was liable to pay for the program from 19 September 2016. The Tribunal noted that the Applicant's entitlement to compensation was based on the aggravation of his intervertebral disc disorder in 2001.

The Tribunal found that the Applicant's current back symptoms were wholly attributable to a pre-existing degenerative disease of his spine, which had been rendered symptomatic by the 1996 injury and aggravated in 2001. Crucially, the Tribunal concluded that the effects of the accepted injury and aggravation were no longer present in the Applicant's presentation, meaning his symptoms would likely persist even without the prior work-related incidents. Furthermore, the Tribunal found that the gym and hydrotherapy program did not augment the Applicant's existing regimen of home-based exercises and walking. Consequently, the cost of the program was not justified and not considered "reasonable" under the relevant legislative framework. The decision under review was affirmed.