Cartajena and Comcare (Compensation)

This matter concerned an application for review of Comcare’s decisions regarding compensation for an applicant who had suffered an acute anxiety reaction and post-traumatic stress disorder (PTSD). Comcare had initially accepted liability for an acute anxiety reaction in 1998. Over two decades, the applicant received various forms of compensation, including medical expenses and incapacity payments. However, Comcare subsequently denied liability for certain treatments and conditions, including hospitalisation costs and ongoing psychological treatment, and later denied liability for permanent impairment and non-economic loss. The applicant sought review of these determinations.

The primary legal issues before the Tribunal were whether the applicant’s conditions, specifically the acute anxiety disorder and PTSD, were ongoing injuries or diseases for the purposes of the *Safety, Rehabilitation and Compensation Act 1988* (Cth), and whether the effects of these conditions had ceased or continued. This determination was crucial for assessing the applicant's entitlement to ongoing compensation for treatment and for permanent impairment. The Tribunal also considered the applicant's credibility as a witness and the consistency and completeness of the medical evidence presented.

The Tribunal noted that the applicant was an unreliable witness, prone to self-serving and inconsistent evidence. The medical evidence was also found to be inconsistent and incomplete, with differing opinions from various medical practitioners regarding the applicant's diagnosis and the causal link between her conditions and her employment. Dr. Spence, for Comcare, opined that the applicant suffered from a chronic adjustment disorder with anxiety, exacerbated by intercurrent stressors unrelated to employment, rather than PTSD. Conversely, other medical professionals supported the applicant's claim for ongoing treatment and permanent impairment.

Ultimately, the Tribunal found that due to the inconsistent and incomplete nature of the medical evidence, it was appropriate to remit certain aspects of the matter back to Comcare. The Tribunal affirmed the reviewable decision in one application. In another application, the Tribunal set aside Comcare’s decision and substituted it with a decision that the applicant was entitled to compensation under s 16 of the Act for treatment related to her acute anxiety reaction and PTSD from 19 June 2017. In a third application, the Tribunal set aside Comcare’s decision regarding permanent impairment and substituted it with a finding of 10% permanent impairment, remitting the matter for further assessment of suffering and costs.