BROADHURST AND COMCARE
[2010] AATA 251
•9 April 2010
Administrative Appeals Tribunal
DECISION AND REASONS FOR DECISION [2010] AATA 251
ADMINISTRATIVE APPEALS TRIBUNAL )
) No 2007/3559
GENERAL ADMINISTRATIVE DIVISION ) Re KAREN BROADHURST Applicant
And
COMCARE
Respondent
DECISION
Tribunal Professor RM Creyke Date9 April 2010
PlaceCanberra
Decision The decision under review is affirmed. ......................[sgd]...................
Professor RM Creyke, Senior Member
Dr M Miller, AO, Member
CATCHWORDS
COMPENSATION – extent of permanent injury suffered from compensable injury or previous compensable injuries – appropriate method and Guide to assess impairment – which Table in the Comcare Guide to the Assessment of the Degree of Impairment applies – decision under review affirmed.
Comcare v Kay (1997) 26 AAR 124
Re Jonsson and Marine Council (No 2) (1990) 12 AAR 323
Re Lavery and Registrar of Supreme Court of Queensland (No 2) (1996) 43 ALD 13
Minister for Resources v Dover Fisheries Pty Ltd (1993) 43 FCR 565
Re Neviskia Pty Ltd v Podger, Secretary of the Commonwealth Department of Health (2000) 63 ALD 13
Parker v Military Rehabilitation and Compensation Commission (2007) 96 ALD 624
Re Sawmillers Exports Pty Ltd and Minister for Resources (1996) 41 ALD 657
South Australia v Tanner (1989) 166 CLR 161
Whittaker v Comcare (1998) 86 FCR 532
Williams v Melbourne Corporation (1933) 49 CLR 142
Safety, Rehabilitation and Compensation Act 1988 (Cth), ss 4(1), 24, 25, 27, 28, 67
9 April 2010REASONS FOR DECISION
Professor RM Creyke, Senior Member
Dr M Miller AO, Member
1. Ms Broadhurst suffers a number of conditions relating to her back and legs. She lodged a claim for compensation for lumbar sprain on 20 April 2005 arising out of an incident on 12 April 2005, in which she injured her back lifting equipment out of the boot of a car for work-related purposes. That claim was accepted on 7 June 2005.
2. Ms Broadhurst lodged a claim for permanent impairment for lumbar back pain and leg pain on 10 November 2005, a claim which was rejected by Comcare on 6 February 2006. Ms Broadhurst received further treatment and made a new claim for permanent impairment for low back pain and L4/5 facet joint pain, left side, which referred to her being 'unable to stand/walk/drive for long periods' and her need 'to change posture/stretch every 10-15 mins'. The claim was lodged on 29 September 2006, a claim again rejected by Comcare on 19 December 2006. Ms Broadhurst sought review by the Tribunal on 31 July 2007. She is claiming for a permanent impairment to her legs only, as a claim for the permanent impairment to her back of 10 percent was accepted on 23 July 2003.
3. In the reviewable decision of 28 May 2007, Comcare affirmed the decision of 19 December 2006 that Ms Broadhurst was not eligible for compensation under section 24 of the Safety, Rehabilitation and Compensation Act 1988 (Act) and hence not entitled to compensation for non-economic loss under section 27 of the Act.
Legislation
4. The following sections of the Safety, Rehabilitation and Compensation Act 1988 are relevant.
4(1) Interpretation
aggravation includes acceleration or recurrence.
ailment means any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development).
disease means:
(a) any ailment suffered by an employee; or
(b) the aggravation of any such ailment;
being an ailment or an aggravation that was contributed to in a material degree by the employee's employment by the Commonwealth or a licensed corporation.
injury means:
(a) a disease suffered by an employee; or
(b) an injury (other than a disease) suffered by an employee, being a physical or mental injury arising out of, or in the course of, the employee’s employment; or
(c) an aggravation of a physical or mental injury (other than a disease) suffered by an employee (whether or not that injury arose out of, or in the course of, the employee’s employment), being an aggravation that arose out of, or in the course of, that employment;
but does not include any such disease, injury or aggravation suffered by an employee as a result of reasonable disciplinary action taken against the employee or failure by the employee to obtain a promotion, transfer or benefit in connection with his or her employment.
24 Compensation for injuries resulting in permanent impairment
(1) Where an injury to an employee results in a permanent impairment, Comcare is liable to pay compensation to the employee in respect of the injury.
(2) For the purpose of determining whether an impairment is permanent, Comcare shall have regard to:
(a) the duration of the impairment;
(b) the likelihood of improvement in the employee’s condition;
(c) whether the employee has undertaken all reasonable rehabilitative treatment for the impairment; and
(d) any other relevant matters.
(3) Subject to this section, the amount of compensation payable to the employee is such amount, as is assessed by Comcare under subsection (4), being an amount not exceeding the maximum amount at the date of the assessment.
(4) The amount assessed by Comcare shall be an amount that is the same percentage of the maximum amount as the percentage determined by Comcare under subsection (5).
(5) Comcare shall determine the degree of permanent impairment of the employee resulting from an injury under the provisions of the approved Guide.
…
(7) Subject to section 25, if:
(a) the employee has a permanent impairment other than a hearing loss; and
(b) Comcare determines that the degree of permanent impairment is less than 10%;
an amount of compensation is not payable to the employee under this section.
…
(9) For the purposes of this section, the maximum amount is $80,000.
27 Compensation for non‑economic loss
(1) Where an injury to an employee results in a permanent impairment and compensation is payable in respect of the injury under section 24, Comcare is liable to pay additional compensation in accordance with this section to the employee in respect of that injury for any non‑economic loss suffered by the employee as a result of that injury or impairment.
(2) The amount of compensation is an amount assessed by Comcare under the formula:
where:
A is the percentage finally determined by Comcare under section 24 to be the degree of permanent impairment of the employee; and
B is the percentage determined by Comcare under the approved Guide to be the degree of non‑economic loss suffered by the employee.
(3) This section does not apply in relation to a permanent impairment commencing before 1 December 1988 unless an application for compensation for non‑economic loss in relation to that impairment has been made before the date of introduction of the Bill for the Act that inserted this subsection.
Background
5. Ms Broadhurst has an accepted claim for compensation for a lumbar sprain evidenced by disc bulge and annular tear at the L4/5 level in her spine sustained on 12 April 2005. The injury occurred when she was lifting a laptop and a projector (litepro) from the back of a car in the car park of the Royal Australian Air Force (RAAF) Base, Edinburgh, South Australia. Ms Broadhurst was then employed as a Web Manager with the Department of Defence (Defence).
6. Ms Broadhurst also has accepted claims for compensation for:
·low back strain L5/S1 right lumbar facet joint, which occurred on 18 November 1988 as a result of lifting books at work;
·left sacroiliac joint strain, an injury sustained on 18 February 1992, as a result of doing motivational stretching exercises while at the Australian Taxation Office; and
·facet joint inflammation in the lumbar spine, which arose on 20 June 1996, due again to lifting books at work.
7. On 23 July 2003 Comcare accepted a permanent impairment claim for ‘left sacroiliac joint strain’ arising out of the injury on 18 February 1992 only. Comcare did not accept permanent impairment and non economic loss benefits in respect of ‘low back strain L5/S1 lumbar facet joint’, or for ‘facet joint inflammation in lumbar spine’.
8. In the course of Ms Broadhurst's previous claim for permanent impairment on 10 October 2002 for low back strain L5/S1 right lumbar facet joint she had complained that she had trouble sitting or standing for prolonged periods and with walking when the pain was severe. She also said that at night she would 'sometimes need to lay down with a heat pack', and that the pain had caused her to give up sporting activities. In her responses to the non-economic loss questionnaire, attached to a further permanent impairment claim dated 20 May 2003, Ms Broadhurst referred to trouble getting in and out of the car, and difficulty in sitting or standing for prolonged periods due to chronic back pain. She also said she had to 'give up tennis and indoor cricket as it is too painful’, and noted that she could not 'sit for too long'.
9. The present claim is for permanent impairment for her legs. The claim is that the impairment to her legs is secondary (or a sequela) to the accepted permanent impairment to her back, being referred pain from the lumbar spine, and her other compensable back injuries.
10. Ms Broadhurst did not seek medical attention in Adelaide on 12 April 2005, the day of the injury. She did see a doctor following her return to Canberra on 18 April 2005. The medical notes for that visit refer to 'recent flare of back pain'. At the hearing, Ms Broadhurst said she did not go to the doctor immediately because she thought the pain would go away. On 7 June 2005, Comcare accepted liability for the injury and paid for treatment.
11. Several months later Ms Broadhurst experienced pins and needles sensations in her left leg. She also said her left leg felt weaker than her right leg. Ms Broadhurst lodged a claim for permanent impairment on 10 November 2005 in respect of her aggravated back condition. Dr Coyle reported on 17 January 2006 for the purposes of that claim and stated that Ms Broadhurst was suffering from ‘L4/5 intervertebral disc rupture which presumably occurred with the initial incident in 1988 and which has been aggravated by subsequent incidents, especially the most recent on 12 April 2005'. He assessed whole person impairment at 15 percent. However, that claim was rejected on the ground that the impairment was not permanent.
12. Ms Broadhurst lodged a new claim for permanent impairment on 29 September 2006 in which the doctor records the diagnosis as 'low back pain; L4/5 facet joint pain L side' and notes the impairment as 'low back pain; unable to sit for long period.’ Again Comcare arranged for her to be reviewed by Dr Coyle, who provided a report on 28 November 2006 and found a current whole person impairment (WPI) at 8 percent. His report was that 50 percent of her WPI was related to the incident on 12 April 2005 and the remaining 50 percent related to the three preceding compensable incidents. Comcare again rejected the claim on the basis that her degree of impairment did not reach 10 percent. It is that claim which is before the Tribunal. Ms Broadhurst completed the non-economic loss elements in her claim for permanent impairment on 10 November 2005 in which the doctor records the impairments as 'lumbar back pain/leg pain' relating to a diagnosis of 'Left L4/L5 facet joint degeneration and disc bulge.'
13. As a consequence of the 2005 injury, and in conjunction with her earlier injuries, Ms Broadhurst says she is no longer able to dance, garden, play the sports she formerly enjoyed, which included tennis, and indoor cricket, she can only ride her horse rarely, and she has difficulty with activities requiring strength, such as housework and gardening. She is restricted to sitting down or standing for short periods of time. She has difficulty sleeping because of the pain and said in evidence that 'over the last few months my pain has increased at night time'. In September 2005 she was certified as totally unfit and she took time off from work. She returned to work at Defence as a Web manager on 16 hours per week from November 2005, but when they could not provide her with part-time work of a less sedentary nature she resigned in June 2007. From December 2006 she worked at her partner’s café cooking, doing management and supervising, but in September 2008, the cafe was sold.
14. Ms Broadhurst said she formerly lived in a 2-storey house but when she could no longer navigate the stairs the house was sold in June 2009 and she now lives in a single-story dwelling in Bungendore on a small block. She said she cannot walk for more than 200 metres without a rest. She does not have the strength to get out of a chair without levering herself either using the chair's armrests or a table. She has difficulty standing, walking or driving for long periods. She avoids shopping centres since she gets a shooting pain in her legs. She employs a cleaner for heavier domestic duties such as vacuuming, sweeping and cleaning windows. Hanging out clothing is painful. Her partner does the shopping.
15. Her hip and leg pain wake her at night and the pain radiates down her left leg. She is currently only receiving weekly massage for her leg. She has had some cortisone injections in her hip for both hip and leg pain. The injections relieved her hip pain to an extent but had no effect on her leg. The pain in her leg and hip has become worse.
16. Ms Broadhurst is being treated for depression which is at least partly related to her chronic back condition.
Issues
17. The following are the issues agreed by the parties:
·Whether Ms Broadhurst suffered an impairment from the injury on 12 April 2005 and/or her other compensable injuries?
·If so, is the impairment permanent under section 24(2) of the Act?
·The extent of permanent impairment suffered by Ms Broadhurst as a result of her compensable conditions.
·The appropriate method and Guide for assessing this impairment.
·Whether a whole person impairment (WPI) approach is required in this case.
·Whether Ms Broadhurst has suffered a 10 percent WPI under section 24(7) or 20 percent (under section 25(4)) as a result of her conditions?
·If so, what would be appropriate non-economic loss scores in respect of any compensable WPI suffered by Ms Broadhurst?
·Accordingly how much compensation (if any) is Ms Broadhurst entitled to under sections 24 and 27 of the Act?
18. Counsel for Comcare contended that Ms Broadhurst had recovered from the last aggravation of her condition which occurred on 12 April 2005 and that the current symptomatology in her presentation was due to the underlying degenerative and arthritic disease in her lumbar spine.
Medical Evidence
The following medical evidence was agreed by both parties.
MRI and other scans
19. An MRI scan of 28 October 2002 showed moderate L4/5 facet joint osteoarthrosis bilaterally and a moderate sized posterior central L4/5 annular tear with associated right posterior paracentral disc protrusion. A second MRI on 9 August 2005 showed posterior L4/5 intervertebral disc annulus tear and minor multilevel facet joint arthropathy.
20. A report of Dr Coyle dated 17 January 2006 noted of the MRI reports that 'there does not appear to have been much change between the two MRI studies.’
21. A third MRI scan of 10 January 2008 showed degenerative changes at L3/4 and especially L4/5 intervertebral discs and widespread facet joint arthrosis. There was bulging of the L4/5 intervertebral disc and central posterior annular tears at both L3/4 and L4/5.
22. A regional bone scan of 8 February 2006 showed left greater trochanteric enthesopathy with mild L4/5 disco-vertebral disease and mild bilateral L3/4 facet joint arthropathy.
23. An ultrasound of the hip on 4 April 2006 disclosed calcific tendinopathy on the left side, with no definite bursitis or tears in the tendons.
Medical Reports
Dr R Crowe, orthopaedic surgeon
24. 21 July 1993: Dr Crowe's report noted back pain (L5/S1) since early 1992, but pointed out that a CT scan did not disclose any significant disc protrusion and no evidence of a spondylosis or spondylolisthesis.
Dr R Westh, orthopaedic surgeon
25. 3 November 1994: said Ms Broadhurst suffered moderately severe degeneration at the L5/S1 level, but no significant disc protrusion. This made it difficult for Ms Broadhurst to play tennis, walk fast, lift weights, to bend, drive distances and to dance. He diagnosed mechanical low back pain with probable vertebral joint dysfunction and/or intervertebral disc disruption caused by the work injury in February 1992, but found no sciatic radiation of her pain and no neurological deficit.
Dr R Still, sports medicine specialist
26. 25 September 1996: Dr Still accepted that Ms Broadhurst’s back pain appeared to be an aggravation of her February 1992 injury which he diagnosed as right sacroiliac joint dysfunction.
Dr J May, sports physician
27. 8 April 2002: Dr May said that Ms Broadhurst had an exacerbation of the L5 back pain which is aggravated by rising from a seated position, prolonged sitting and exercising and was related to the February 1992 injury. The left L5 facet joint had deteriorated over the previous 10 years and Ms Broadhurst had noticed an occasional radiation of pain in the left buttock. In a subsequent entry on Ms Broadhurst's claim for permanent injury in October 2002, Dr May noted that an X-ray had identified osteoarthritis L5 facet joints and disc space narrowing. In a report of 6 November 2002, Dr May had noted a 'small disc injury at L4/5 and degeneration in the facet joints.’
28. 17 February 2006: In a further report Dr May found that Ms Broadhurst was experiencing left leg and hip pain related to the original back injury. She noted that Ms Broadhurst had a long history of lumbar back pain related to an injury at work several years previously. She also noted that Ms Broadhurst complained of pain referred from her lumbar spine into her left buttock and thigh.
Dr KN Chandran, neurosurgeon
29. 4 October 2005: Dr Chandran said an MRI showed dehydration of the L4/5 disc in June 2005 and annular tear. The scan also showed arthropathy at L4/5 more than L5/S1. He also noted that he ‘could not find any neurological deficits or limitation of SLR. Lumbar flexion and extension were restricted to 75 percent of normal range and there seemed to be marked pain on extension.' He reported that this suggested there has been no disc herniation.
Dr W Coyle, orthopaedic surgeon
30. 17 January 2006: Dr Coyle reported that Ms Broadhurst’s back pain was due to an aggravation on 12 April 2005 of the original February 1992 back injury. He assessed 15 percent WPI using Table 9.6 of the Comcare Guide to the Assessment of the Degree of Permanent Impairment (the Guide) for the back and nil percent for the leg injury on Table 9.5, on the basis that there was ‘no loss of lower limb function’, notwithstanding his finding that Ms Broadhurst had difficulty walking more than 200 metres and could not run. He noted that the prognosis for the 12 April 2005 injury was fairly good and that a symptomatic recovery would occur in the next 6 months. In his opinion, the injury led to significant pain on forward flexion and left lateral flexion was also restricted and allegedly painful, but extension was full range and painless. He could detect no neurological deficit in the lower limbs. His diagnosis of the April 2005 incident was 'aggravation of the L4/5 intervertebral disc injury'. He believed that her current condition was related to the incident on 12 April 2005, which had aggravated a pre-existing intervertebral disc injury. He also said he believed Ms Broadhurst's impairment to be 'solely now ... from the compensable injury on 12 April 2005.'
31. 28 November 2006: Dr Coyle assessed Ms Broadhurst's conditions for permanent impairment against Table 9.17 and found WPI at 8 percent, half of which he assessed was due to the incident on 12 April 2005 and the remainder due to the aggravation of her three previous compensable injuries. He also indicated that her low back pain problem was permanent and had been so since 12 April 2005 and said she had no other conditions. However, he said she had back pain 'with some radiation down to the left buttock and left proximal thigh' resulting from the incidents at work from 18 February 1992 and 12 April 2005. He maintained his view that the incident on 12 April 2005 aggravated her previous three injuries and led to Ms Broadhurst's present condition.
32. 4 March 2008: Dr Coyle noted Ms Broadhurst said her pain had 'gradually become worse' since last seen by him in November 2006. Straight leg raising was restricted on the left side to approximately 30 degrees and on the right side to approximately 70 degrees, both aggravating back pain. He could detect no definite neurological deficit in her lower limbs. Her symptoms were almost constant left low back pain, associated with left sciatica or left lower limb pain. His diagnosis was 'lumbar spondylosis associated with at least a prolapse or rupture of her L4/L5 intervertebral disc'. Dr Coyle maintained his opinion that Ms Broadhurst's condition was due solely to her four work-related injuries. Relying on Table 9.17 of the Guide, he assessed Ms Broadhurst as having an 8 percent WPI. The contributions of each of her injuries to her current condition were the same as in his previous report. His assessment of non-economic loss from the Guide was: pain: 4; suffering: 2; mobility: 3; social relationships: 1; recreation and leisure activities: 5; and other loss: 1.
Dr G Eaton, occupational physician
33. 6 August 2007: The diagnosis of Ms Broadhurst's conditions was chronic spinal pain consequent upon multilevel disc degenerative diseases and annulus tear at L4/5. He noted that the MRI in 2002 revealed a small right sided disc bulge, but the 9 August 2005 MRI showed a diffuse disc bulge. In his view, this contributed to 'ongoing left lower limb radicular signs.' The injuries under Table 9.17 Lumbar Spine Diagnosis Related Estimates, in the second edition of the Guide, were assessed at 13 percent WPI. Dr Eaton commented:
There are significant signs of radiculopathy with absent ankle reflex on the left lower limb, loss of muscle strength and radiologically demonstrated disc herniation. The loss of the left ankle reflex is likely to be permanent.
I believe that the injury, which occurred on 12 April 2005 is likely to have resulted in the loss of the left ankle reflex due to disc prolapse precipitated in the incident and subsequent nerve damage. This was likely to be the defining event in the development of permanent impairment. …
I am unable to confirm that there has been a significant deterioration in the left sacroiliac joint strain and cannot confirm that there has been a (sic) least a 10% increase in the degree of impairment from that condition.
34. Dr Eaton said the shooting pains in Ms Broadhurst's leg could be muscle spasm or neurological. Since the pain was exacerbated by walking, it was more likely to be due to nerve irritation. He was satisfied that there was some radiculopathy given her experience of pins and needles.
35. 21 March 2008: In this report, Dr Eaton found that under Table 9.7 of the second edition of the Guide Ms Broadhurst would qualify for 20 percent WPI. This assessment was made because:
[Ms Broadhurst’s] walking is restricted to 250m or less at a time (may be able to walk further after resting) and she is unable to negotiate 3 or more stairs or a ramp (up and down) and is unable to rise from sitting to standing position without using 1 hand but can stand without support. … I have not been able to witness Ms Broadhurst walking any distance or walking up stairs etc however it does appear from all reports that Ms Broadhurst has a genuine disability with walking etc as reported.
36. 7 February 2009: Dr Eaton referred to the fifth edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guide), Table 17.1 Principles of Assessment of the lower extremities, and noted that it states:
It is important to ensure that lower extremity impairment discussed in this chapter is not due to underlying spine pathology. If lower extremity impairment is due to an underlying spine disorder, the lower extremity impairment would in most cases be accounted for in the spine impairment rating.
37. For this reason Dr Eaton said he could not use Table 17.5 of the AMA Guide because it applied only when gait derangement was supported by pathologic findings such as X-rays.
38. 6 October 2009: In this report, Dr Eaton found 8 percent impairment under Table 9.17 for the lumbar spine; 0 percent impairment under Table 9.6; 3 percent impairment in regard to spinal root impairment.
Dr G Griffith, consultant surgeon
39. 6 October 2009: Relying on Table 9.17 Lumbar Spine, Dr Griffith found that an 8 percent WPI was appropriate. His report said, Ms Broadhurst was
not suffering from a demonstrable radiculopathy. She has never suffered disc herniation, merely disc bulging'.
40. He found 0 percent impairment under Table 9.6. As for spinal root impairment, he said ‘the presence of radicular pain results in 3% impairment. There is no loss of strength. If this is combined with the DRE spinal impairments involving the lumbar spine, she attracts a combined impairment of Eleven (11)%’.
41. He considered the disc lesion was permanent as was the facet joint arthrosis. The arthrosis, being of constitutional origin, was aggravated by episodes of injury. He considered Ms Broadhurst's perception of pain made a major contribution, coupled with the psychological effects of sleep deprivation and chronic pain.
42. Dr Griffith also noted that at the time of the 1988 and 1992 injuries, there was no evidence of disc problems, nor of degenerative change. He said, however, that in the period 1993 to 2002, there had been progressive degenerative change in the facet joints, typical of the natural history of spondylosis. He denied that this condition could have had its origin in the 1988 injury. However, in his summary of the effects of the 1992 injury he concluded there was acute aggravation of lumbar facet joint arthrosis, principally left sided, but no indication of a disc injury.
43. However, the 12 April 2005 injury resulted in the sudden onset of lower back pain, and Dr Griffith’s report referred 'to the left lower limb as far as the knee'. As he said, 'its characteristics were different to the pain previously suffered in that it was severely aggravated by prolonged periods of sitting, to a lesser extent by standing, bending and lifting and significantly by impulse phenomena'. He concluded that on this occasion the annular tear became conclusively evident with development of disc bulge at L4/5 level and aggravation of facet joint arthrosis at L5/S1. This led to referred pain to the left thigh with persistent left lower lumbar arthralgia. He also noted 'for the first time this pain pattern is strongly suggestive of a disc lesion'. However, on testing he found no aggravation of symptoms in the buttock or lower limbs due to any pressure of the sciatic nerve. He found Ms Broadhurst had not suffered a major disc rupture only a minor bulge at worst. He concluded that the incident on 2005 was responsible for approximately 60 percent of her current symptoms, 40 percent being due to facet joint arthrosis and associated muscle spasm which followed such an aggravation.
44. 15 December 2009: In this report, Dr Griffith found that under Table 9.7 of the 2nd edition of the Guide, Ms Broadhurst would attract a whole person impairment of not more than 10 percent. The assessment was made based on Ms Broadhurst’s assurances of being unable to walk more than 500m, that her lower limbs give way on occasion, and she requires external aids and support when negotiating stairs. Dr Griffith had not personally tested these mobility functions of Ms Broadhurst.
Dr R Mellick, neurologist
45. 7 August 2009: Dr Mellick diagnosed:
chronic back pain with indication of muscle guarding and impaired straight leg raising but no signs or symptoms pointing to radiculopathy. … There is a correspondence between the back pain and the presence of degenerative disease in the lower lumbar region of facet joint arthrosis.
He commented:
It is not tenable to explain the persisting symptoms of the last two years to be due to muscle strain and, on the basis of probability, the chronic symptoms are related to an exacerbation of underlying lumbar degenerative disease.
46. He further commented: ‘I do not identify any significant impairment of Ms Broadhurst’s legs. The impairment of straight leg raising is determined by pain which is of lumbar origin’. He estimated her whole person impairment under Table 9.17 as 8 percent on the basis of an assessment ‘of the lumbar spine in relation to DRE estimate, there being muscle guarding, an asymmetric range of movement and no objective signs of verifiable features of radiculopathy’. He rounded down this figure to 7 percent ‘because of the long standing history of flare-ups’. The impairment was permanent, being ‘especially evident during the past two years and to be associated causally with the incident in 2004 (sic)’. He found that the 'chronic symptoms are related to an exacerbation of underlying lumbar degenerative disease'. He noted that although her previous three injuries had led to her being away from work for a day or two at a time, it was not until the 12 April 2005 incident that the condition became sufficiently painful for her to take longer periods off work and subsequently, on medical advice, to resign.
47. 21 September 2009: In a supplementary report, Dr Mellick said he did not consider Ms Broadhurst’s condition could be assessed using Table 9.6.1 of the second edition of the Guide ‘because there is no adequate evidence of spinal nerve root impairment effecting (sic) the lower extremity.’ Further, his assessment of leg impairment in relation to Table 13-12 of the sixth edition of the AMA Guide would be Class 0, 0 percent whole person impairment. However, he would apply Table 16.1 of the AMA Guide, but again he would assess Class 0, 0 percent impairment.
Dr M Morris, physician
48. 13 July 2009: Dr Morris diagnosed either degeneration with the L4/5 disc or from arthritis affecting the apophyseal joints, both apparent in 1992. Both would explain the history of exacerbations of pain due to episodes of strain, for example, from Ms Broadhurst's work-related incidents. He noted 'there is no evidence [from the MRI scan on 9 May 2005] of a paracentral protrusion as was described in 2002'. However, he noted 'the degenerative changes appear to have progressed between the MRI of 2005 and 2008 with further annular tear apparent at the 3/4 disc'. He also noted 'no evidence of sciatica'. His report said: ‘The underlying condition is best described as a pre-existing congenital or constitutional underlying condition, with a contribution from its natural progression'. However, he also conceded that her pain 'could either be from degeneration within the L4/5 disc or from arthritis affecting the apophyseal joints'. The report continued:
…the condition could be expected to be acutely worsened by episodes of strain, some of which may well have related to her work and others, even on her description, clearly not so related, for example, episodes of increased pain arising from indoor cricket and tennis, both of which she has had to give up of recent years. …
In other words … given the diffuse nature of the degenerative change in her lumbar discs and lumbar apophyseal joints, and its steady progression, and given the absence of any specific focal trauma, that particular episodes have only contributed for a limited time, even though one can’t say with certainty how long such a contribution might last.
49. He noted Ms Broadhurst's report that the April 2005 was 'the first time she became aware of pain radiating down into the left buttock and the left thigh as far as the knee'. He noted that her underlying condition 'could be related to her horse riding when she was more involved in it' but could also have been related to the workplace incidents. He said it is clear that she has the symptoms whether or not she is at work.
50. In his view, Ms Broadhurst’s employment did not contribute in any meaningful way to her symptoms. He also assessed her as ‘fully fit for work in the sort of employment she has’.
Dr V Pascall, occupational physician,
51. 26 April 2007: Dr Pascall noted that Ms Broadhurst had periods when her back would just 'flare up' and these episodes 'just happened' and this may be because as Ms Broadhurst was told her condition was 'arthritis of the facet joints'. After a facet joint injection at L5/S1 level on 15 June 2005, Ms Broadhurst reported increasing pain and occasional 'pins and needles' when she 'could not touch the skin of her left thigh because it was tender, but there was no pain down into her legs'. Dr Pascall’s diagnosis was 'degenerative lumbar spine, or lumbar spondylosis'. This affects Ms Broadhurst’s L4/5 disc in particular 'and it appears to be quite longstanding'. She found no evidence of nerve root compression. Nor did she believe 'the description of the thigh sensory changes are consistent with radiculopathy'. However, she conceded that the sensory change 'has elements of neuropathic pain'. She noted that facet joint arthropathy was mild. There was irritation around the left sacroiliac joint and her severe pain when bending may indicate 'facet joint dysfunction'. Some of her back pain 'most likely arises from the degenerative spine'. However, Dr Pascall found she was capable of working a full working week, depending on the type of work.
Medical facts which are not agreed by Comcare
52. That Ms Broadhurst suffered leg pain on 12 April 2005 when Ms Broadhurst injured herself getting equipment out of the boot of her car. Comcare claims Ms Broadhurst did not refer to leg pain in her undated Occupational Health and Safety report nor her initial Comcare claim of 20 April 2005.
53. The report of the Activities of Daily Living Checklist prepared by Lisa Castles and Associates on 27 October 2005, states that Ms Broadhurst experienced pain when walking for more than 10 minutes. Comcare did not wholly accept this statement since no mention was made of the qualifier to that assessment, namely, that this pain varies, or that Ms Broadhurst suffered irritable bowel syndrome from wheat/sugar in her diet which could also affect her tolerance to walking. Also, the report did not mention sleep disturbance due to pain. Comcare accepted other aspects of the report.
Consideration
Whether Ms Broadhurst suffered an impairment from the injury on 12 April 2005 and/or her other compensable injuries?
54. It was conceded by both parties that Ms Broadhurst suffered an 'injury' to her back on 12 April 2005 and that her leg condition, which is the subject of this claim, is secondary to, or a sequela of, that incident in conjunction with her previous back injuries. An issue is whether Ms Broadhurst's leg condition was materially contributed to by her work-related back conditions or whether the material contribution comes principally from her constitutional degenerative back condition?
55. Ms Broadhurst did not report pain to her legs in her initial incident report to the Department of Defence, nor do the medical notes of her visits to the doctor on 18 April 2005, 16 May 2005 or 9 June 2005 refer to leg pain. The notes for 6 September 2005 also state 'Nil radiation of pain or parasthesiae'. In all these contemporaneous reports, Ms Broadhurst is reported as referring only to a flare up of her antecedent back pain. It is not until some months later that she records pins and needles in her legs and it is not until her permanent impairment claim of 10 November 2005 that reference is made to pain in her legs.
56. Dr Pascall and Dr Morris are of the view that Ms Broadhurst's leg pain was due to the progression of her degenerative arthritic condition of the spine. Dr Morris conceded that work-related injuries would have increased the strain on her back but he was not prepared to say for how long that effect would last. Dr Pascall notes that on occasions her back would 'flare up' and these episodes 'just happened', suggesting that it was not necessarily activities at work which aggravated her back. Dr Pascall also noted that the damage to Ms Broadhurst's L4/5 disc in particular was longstanding and that at least some of her back pain arose from her degenerative spine condition.
57. Dr Morris noted that the degenerative changes in Ms Broadhurst's back condition had progressed between the MRI in 2005 and 2008 and said her condition was best described as a 'pre-existing congenital or constitutional underlying condition, with a contribution from its natural progression'. He suggested that this condition would be 'acutely worsened by episodes of strain, some of which may well have related to her work and others ... clearly not so'. Her underlying condition could be related to workplace incidents or, for example, to her horse riding. In his view, her workplace did not contribute in any meaningful way to her symptoms.
58. The predominant medical evidence, however, supports a finding that the pain Ms Broadhurst suffers was aggravated by her employment. Dr Griffith said that the progressive degenerative change in Ms Broadhurst's facet joints was typical of the natural history of spondylosis and that her perception of pain coupled with the psychological effects of sleep deprivation and chronic pain would have made a major contribution. On the other hand, he said that since a disc protrusion can cause referred pain to the buttocks or legs, it was his impression that the incident on 12 April 2005 resulted in a disc protrusion or an exacerbation of her existing disc degeneration. He also said it was more likely the incident in 2005 which caused the problem, since the classic cause of a disc protrusion is lifting, twisting and bending and in simultaneously lifting a ‘litepro’ and a laptop out of the boot of the car Ms Broadhurst would have been engaged in such movements.
59. Dr Griffith did acknowledge that if the pain in Ms Broadhurst’s legs had been due to a disc protrusion in April 2005, he would have expected intense pain at the time, which did not appear to have been the case. However, he said that sometimes the effect of a disc protrusion is slower and only emerges on exertion, and some individuals were more stoic than others. Ms Broadhurst would be in the stoic category given her eight year history at that time of back pain. On that basis, he found that 60 percent of her current symptoms was due to the incident in 2005 and the remaining 40 percent to the facet joint arthrosis and associated muscle spasm, which followed an aggravation of the kind which arose in 2005.
60. The opinion of Doctors Coyle (who ascribed 50 percent of her symptoms to the 2005 incident and the rest to her other three compensable injuries), Griffith, Eaton and Mellick was that it was work-related incidents which contributed to Ms Broadhurst's condition.
61. Although it is clear from her earlier claims for permanent impairment that Ms Broadhurst was claiming limitations on her sporting activities and on walking, sitting and standing as early as 2002,[1] the Tribunal is satisfied, on the evidence, that those limitations became considerably more pronounced following the 12 April 2005 work-related incident. As Dr Griffith said, the pain Ms Broadhurst suffered after 12 April 2005 had characteristics which 'were different to the pain previously suffered in that [they were] severely aggravated'. Similarly, as Dr Mellick said, it was not until the 12 April 2005 incident that the condition became sufficiently painful for her to take longer periods off work and subsequently, on medical advice, to resign. Prior to then, after the three previous injuries, the evidence was that Ms Broadhurst took one or two days off work at most following the incidents. This evidence establishes to the Tribunal's satisfaction that it was the aggravation of her spinal conditions, principally due to the work-related incident on 12 April 2005, which caused Ms Broadhurst's leg condition to become symptomatic.
Is the impairment permanent under section 24(2) of the Act?
[1] ST5.
62. The predominant medical view is that the condition is permanent, that is, 'likely to continue indefinitely'.[2] Doctors Coyle, Eaton, Griffith, and Mellick all provided assessments of permanent impairment for the purposes of Ms Broadhurst's claim. Dr Morris, in his report, said the condition would progressively get worse, and it was conceded by Comcare that Ms Broadhurst’s condition was permanent. In those circumstances, the Tribunal finds that Ms Broadhurst's condition met the requirement of permanence under section 24(2) of the Act.
The extent of permanent impairment suffered by Ms Broadhurst as a result of her compensable conditions
[2] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 4(1). Definition of 'permanent'.
63. Section 24(1) of the Act provides for a right to compensation where a permanent impairment has arisen from a compensable injury. Section 24(3) of the Act sets the quantum of the compensation in terms of a percentage of a prescribed maximum sum. The minimum threshold of 10 percent for any one injury is fixed by section 24(7). Section 24(5) authorises the determination of the relevant percentage impairment by reference to the Guide. The power to make the Guide is contained in section 28, and the Guide is binding on all concerned, including the Tribunal.[3] The Guide is a legislative instrument.[4] The relevant version of the Guide is the second edition, which applies to claims for permanent impairment received by Comcare on or after 28 February 2006. Since Ms Broadhurst’s claim was made on 29 September 2006, it must be considered under the second edition of the Guide.
[3] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 28(4).
[4] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 28(3A).
64. The Tribunal accepts that the Guide does not determine the existence of permanent impairment. This must be assessed without regard to the Guide, generally with the assistance of medical advice. The role of the Guide is limited to assessing the percentage of the permanent impairment. As the Full Court of the Federal Court noted in Whittaker v Comcare:
…it is only permissible for Comcare to turn to the Guide once it has reached the conclusion, after taking into account the matters listed in s 24(2) of the Act, that the employee has suffered an injury which has resulted in a permanent impairment. The Guide then becomes relevant, but only insofar as it contains the criteria by reference to which Comcare must assess the degree of that employee’s permanent impairment. The Guide, which has this limited role, should not be allowed to limit the general legislative purpose.[5]
[5] Whittaker v Comcare (1998) 86 FCR 532 at 545.
65. Whittaker is also authority for the finding that where two Tables are both applicable, the decision-maker must assess the degree of permanent impairment under the Table which yields the most favourable result to the employee.[6]
Which Table?
[6] Id at 544-545. This principle is also contained in the Guide itself at Principle 8, p 13.
66. The extent of Ms Broadhurst's permanent impairment according to the Guide requires identification of the relevant table for assessment purposes. Finding the correct table for assessing the level of impairment for referred pain in the lower extremities has plainly been a matter of considerable difficulty. In particular, confusion arose over use of Table 9.7 of the Guide, the table for assessing lower extremity function.
67. Table 9.7 is found in Part I relating to the lower extremities. The problem with the use of Table 9.7 lies in the introductory words to that Table which make it a pre-requisite that there be an ‘objectively identified orthopaedic or neurological conditions arising in and affecting the lower extremities’ before the Table applies. Further, the introduction to Table 9.7 specifically states that Table 9.7:
is not to be used to assess lower extremity impairment arising as a result of nerve root compression, or other neurological sequelae of other spinal conditions. These should be assessed under:
·Table 9.6.1, Table 9.6.2a or Table 9.6.2b (tables dealing with Spinal Nerve Root Impairments and Peripheral Nerve Injuries Affecting the Lower Extremities)…; or
·Table 9.15: Cervical Spine…; or
·Table 9.16: Thoracic Spine…; or
·Table 9.17: Lumbar Spine. (emphasis added)
68. The structure of the Tables in Part 1 dealing with the musculo-skeletal system is that Table 9.7 deals with impairment to lower extremity/limb functions such as walking or standing due to orthopaedic (deformities or disease) or neurological (nerve-related) conditions of the lower limbs themselves; and Table 9.6 relates to spinal nerve root and peripheral nerve injuries affecting the lower limbs. There is no table in Part I for an impairment which covers referred pain with no physiological or neurological source in either the spine or the lower limbs.
69. To find a table for assessing referred pain requires recourse to Part III. That Part covers nonverifiable radicular root pain, that is, pain which has no identifiable origin, or which produces weakness in the lower limbs. Table 9.15 deals with the cervical spine; Table 9.16 with the thoracic spine, and Table 9.17 with the lumbar spine. The result is that impairment where it is due to an identifiable physiological cause or to nerve disorder is covered in Part I, and where there is no identifiable origin for the pain, is covered in Part III.
70. It was contended by Comcare that as the impairment to Ms Broadhurst’s legs was not due to any ‘identified orthopaedic or neurological condition arising in and affecting the lower extremities', Table 9.7 of the Guide was inapplicable.
71. Counsel for Ms Broadhurst maintained that the insertion of the italicised words into the introduction to Table 9.7 was not authorised since no such limitation was included in the Act. Counsel suggested that where there was any inconsistency between the terms of the Act and the Guide, the terms of the Act take precedence over the subordinate legislative instrument.[7] As counsel contended, ‘a subordinate instrument, the Guide, cannot alter or qualify the statutory burden imposed … by s 24(5) of the SRC Act by introducing into the determination a notion of what would have occurred but for the injury’.[8] As counsel said, if the Guide is inconsistent in the sense that it ‘could not reasonably have been adopted as a means of attaining the ends of the power’ it is invalid.[9]
[7] South Australia v Tanner (1989) 166 CLR 161; Minister for Resources v Dover Fisheries Pty Ltd (1993) 43 FCR 565
[8] Parker v Military Rehabilitation and Compensation Commission (2007) 96 ALD 624 at 636,
[9] Williams v Melbourne Corporation (1933) 49 CLR 142 at 155.
72. The argument requires the finding of an inconsistency. This argument appears to be based on the observation of Finn J in Comcare v Kay[10] that 'Section 24 of the SRC Act on its face is unconcerned with the location of an injury. Rather its focus is on whether “permanent impairment” results from an injury'.[11] In other words, the requirement for an ‘identified orthopaedic or neurological condition’ before there can be a finding of an impairment assessable under Table 9.7 has no warrant in the Act.
[10] Comcare v Kay (1997) 26 AAR 124.
[11] Id at 129.
73. To so argue raises a number of difficulties. In the first place, the argument fails to note the subsequent comment of Finn J in Comcare v Kay in the same passage:
In the application of the Tables the location of an injury can only be a matter of moment if for a particular Table this is made so in the assessment of the degree of permanent impairment with which that Table is concerned.[12]
[12] Ibid.
74. Table 9.7 makes the location of an injury a matter of moment in light of the overall structure of the Guide and of the specific Tables in Parts I and III of the Guide.
75. The Tribunal notes that there is also a view that the Tribunal, on separation of powers grounds, should presume the validity of subordinate legislation. The suggestion, however, has not strongly been pursued and generally the Tribunal has been prepared to find invalidity.[13] The justification is that since subordinate legislation is made in the exercise of executive power, and the jurisdiction of a tribunal extends to deciding issues of executive validity, the Tribunal has jurisdiction to invalidate subordinate legislation. Resolution of this issue is not required in this case.
[13] Compare Re Jonsson and Marine Council (No 2) (1990) 12 AAR 323 (Tribunal decided issue); ReSawmillers Exports Pty Ltd and Minister forResources (1996) 41 ALD 657; Re Lavery and Registrar of Supreme Court of Queensland (No 2) (1996) 43 ALD 13; Re Neviskia Pty Ltd v Podger, Secretary of the Commonwealth Department of Health (2000) 63 ALD 257. See also A N Hall 'Judicial Power, the Duality of Functions and the Administrative Appeals Tribunal' (1994) 22 Federal Law Review 13 at 45-47.
76. Third, there is a logic to the structure of the Tables as discussed at paragraphs 67 to 69. That logic is supported by the AMA Guide which is the source of the adaptation of the Guide adopted in Australia.[14] In this context it is instructive that the AMA Guide (5th ed.) Table 17.1 noted in its Principles of Assessment of the lower extremities:
It is important to ensure that lower extremity impairment discussed in this chapter is not due to underlying spine pathology. If lower extremity impairment is due to an underlying spine disorder, the lower extremity impairment would, in most cases, be accounted for in the spine impairment rating.
[14] Guide (2005), 12.
77. In other words it is a principle in the AMA Guide which has been imported into the Guide that if there is no objective pathology in the lower limbs, and the lower limb condition is attributable to an objectively identifiable condition in the spine, then the limb condition should be assessed as part of the spinal condition. Presumably this is in part to avoid double assessment, a principle which is also included in the Guide. In these circumstances, it can be assumed that the requirement that Table 9.7 not be used where there is no ‘objectively identified orthopaedic or neurological condition arising in and affecting' the lower extremities parallels that principle. That is consistent with the content of Part 1. On the basis of these findings, the Tribunal accepts that the italicised words in the table are not invalid or unauthorised.
78. Given these findings, the question is whether Table 9.7 applies to Ms Broadhurst’s conditions. Following the incident on 12 April 2005, Doctors Chandran, Coyle, Griffith, Mellick, Morris and Pascall all found no neurological damage or no radiculopathy. Dr Eaton, however, was more cautious. He noted that the 2005 MRI scan showed 'a more diffuse disc bulge' than the one in 2002 and found 'significant signs of radiculopathy'. He said the shooting pains in Ms Broadhurst's leg could be muscle spasm or neurological but it was more likely to be nerve irritation. Based on this medical evidence, the Tribunal has found and the parties have accepted that no ‘objectively identified orthopaedic or neurological condition' was present in Ms Broadhurst’s legs.
79. As a consequence, the Tribunal finds that an alternative table to Table 9.7 must be relied on. That is unfortunate for Ms Broadhurst, since had Table 9.7 been available, it was the most favourable for Ms Broadhurst. Dr Eaton had found that under Table 9.7, Ms Broadhurst would qualify for 20 percent whole person impairment, and Dr Griffith had found that she would attract a whole person impairment of not more than 10 percent.
80. In rejecting use of Table 9.7, the Tribunal is not ignoring Principle 8 of the Guide that 'where two or more tables ... are equally applicable to an impairment' the decision-maker should rely on the table which is most favourable to the applicant.[15] Table 9.7 is not 'applicable' to Ms Broadhurst's impairment since her referred leg pain does not fall within the specific criteria of the Table.
Alternative Table for purposes of assessment
[15] Guide, Principle 8, 13.
81. Counsel for Ms Broadhurst contends that the correct table for purposes of assessment is Table 9.7 of the second edition of the Guide and no other tables in the Guide are appropriate. Nor, in counsel’s view, are there suitable tables in the fifth or the sixth editions of the AMA Guide. The Tribunal has not accepted the first proposition as the earlier discussion indicates. Nor, with some qualification, does it agree with the second proposition.
82. Nonetheless, the evidence suggested that identification of an appropriate table was not easy. Prior to the hearing, the medical experts were at various times asked by Comcare to provide an assessment either on Table 9.5 or Table 9.6, Table 9.17, and subsequently on Table 13.15 of the fifth edition of the AMA Guide edition or Table 13.12 (6th edition). Table 16.1 of the AMA Guide was also at one stage said to be relevant. In some cases the medical expert has been required to make an assessment under two or more of these tables. The result was an absence of consistency in the assessments making it difficult to come to a conclusion on this issue.
83. Despite its nomination, Table 9.5, which covers amputations, is not relevant. An alternative table relied on was Table 9.6 titled 'Spinal Nerve Root Impairments and Peripheral Nerve Injuries Affecting the Lower Extremities'. Dr Coyle found 15 percent whole person impairment on that Table notwithstanding there was no neurological damage. Dr Mellick said, however, that Ms Broadhurst's condition could not be assessed using Table 9.6.1 of the Guide 'because there was no adequate evidence of spinal nerve root impairment affecting the lower extremity'. Dr Griffith also found 0 percent impairment under that Table 'as she does not fulfil the criteria of that table'. The Tribunal concurs with the views of Drs Mellick and Griffith and finds that Table 9.6 is not applicable.
84. This leaves Table 9.17 Lumbar Spine - Diagnosis-Related Estimates. Counsel for Ms Broadhurst took particular issue with use of Table 9.17 of the Guide for the purposes of assessment, since the calibration of an 8 percent or 13 percent level of impairment does not correlate with the minimum 10 percent threshold in the Act for permanent impairment. The Tribunal notes that it is unfortunate that this disjunction between bands of percentages has been inserted into the Guide and expresses the hope that in the forthcoming republication of the Guide, this issue will be addressed to avoid the obvious problems of assessment it has created for medical experts and others.
85. Assessments were, however, made relying on that Table. Dr Coyle assessed Ms Broadhurst’s level of impairment under that Table in the 8 percent band. Drs Griffith, Coyle and Morris came to the same assessment, although Dr Mellick discounted that assessment to 7 percent 'because of the long standing history of flare-ups'. That rating is appropriate since it applies to 'nonverifiable radicular complaints, defined as complaints of radicular pain without objective findings'. The higher rating of 13 percent is not applicable since it requires 'significant signs of radiculopathy' and with the exception of Dr Eaton, none of the doctors found evidence of radiculopathy. Significantly, Dr Eaton assessed Ms Broadhurst under that Table at 13 percent. The Tribunal concurs with the views of the majority of the medical experts that 8 percent would be the appropriate assessment under Table 9.17, given the absence of evidence of any neurological source in her spine for the pain in Ms Broadhurst's legs. This means the assessment does not reach the threshold of 10 percent WPI.[16]
Did the 2003 permanent impairment decision by Comcare involve an ‘interim’ payment of compensation?
[16] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 25(4).
86. Section 25(3) of the Act authorises Comcare to make an interim determination and payment pending the making of a final assessment of permanent impairment. However, an interim assessment is only made 'on the written request of an employee' prior to the making of a final assessment.[17] No evidence was provided of any such written request by Ms Broadhurst, nor of the designation of the 2003 assessment as 'interim'. In those circumstances, it can be concluded that the 2003 finding of permanent impairment was a final, not an interim, finding of permanent impairment.[18] It follows, that unless the increase in her level of impairment is a further 10 percent, that is at least 20 percent in total, no further compensation is payable (section 25(4) of the Act). Since, under Table 9.17, Ms Broadhurst's assessment was only 8 percent, she is not eligible for compensation for the further permanent impairment due to the pain in her legs.
[17] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 25(1).
[18] Safety, Rehabilitation and Compensation Act 1988 (Cth) s 25(3).
87. There is no need in these circumstances, to consider the remaining issues.
88. The decision under review is affirmed.
89. Pursuant to section 67(1) of the Act, costs incurred by parties in respect of the reviewable decision will be borne by those parties.
I certify that the 89 preceding paragraphs are a true copy of the reasons for the decision herein of Professor RM Creyke, Senior Member and Doctor Michael Miller AO, Member.
Signed: .........................[sgd].........................................
C. Kocak, AssociateDate/s of Hearing 11 February 2010
Date of Decision 9 April 2010
Counsel for the Applicant Allan Anforth
Solicitor for the Applicant Capital Lawyers
Counsel for the Respondent Lorraine Walker
Solicitor for the Respondent Dibbs Barker
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