Chester v Workers Compensation Nominal Insurer - [2022] NSWPIC 219

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Chester v Workers Compensation Nominal Insurer [2022] NSWPIC 219
APPLICANT:	Nikitta Chester
FIRST RESPONDENT:	Kristie Maree Ferris t/as RHONDA’S HAIR BOUTIQUE
SECOND RESPONDENT:	Workers Compensation Nominal Insurer
MEMBER:	Brett Batchelor
DATE OF DECISION:	16 May 2022
CATCHWORDS:	WORKERS COMPENSATION - Claim for the cost of two lots of surgery as a result of injury to the right wrist in the form of carpal tunnel syndrome, and the condition of cubital tunnel syndrome consequent upon such wrist injury, and for weekly benefits for two periods of 14 days each following such surgery; the first respondent was uninsured at the time of injury; the second respondent denied liability for the claim on the basis that the accepted injury to the right wrist did not result in the applicant suffering carpal tunnel syndrome and the condition of cubital tunnel syndrome consequent upon such injury; Held- finding that the applicant worker did suffer from carpal tunnel syndrome as a result of the accepted injury to the right wrist and also from the condition of cubital tunnel syndrome consequent upon such injury; finding that the two lots of surgery to the applicant’s right wrist and elbow were reasonably necessary as a result of injury to the right wrist; finding that the applicant was totally incapacitated for work for the two periods of 14 days each following the two lots of surgery; the second respondent ordered to pay the applicant’s section 60 of the Workers Compensation Act 1987 (1987 Act) expenses as a result of injury to the right wrist, including the costs of surgery, and weekly benefits for the two periods of 14 days each following surgery; the first respondent ordered to reimburse the second respondent for the compensation paid pursuant to the awards in favour of the applicant for section 60 of the 1987 Act expenses and weekly benefits.
DETERMINATIONS MADE:	1. The applicant suffered injury to her right wrist on 1 September 2011 in the form if carpal tunnel syndrome arising out of or in the course of her employment with the first respondent. 2. The applicant’s employment with the first respondent was a substantial contributing factor to the injury suffered by the applicant. 3. The applicant suffered the condition of cubital tunnel syndrome consequent upon injury to the right wrist on 1 September 2011. 4. The surgery performed by Dr Meads on 20 December 2018 and 4 August 2020 was reasonably necessary as a result of injury to the right wrist on 1 September 2011. 5. The second respondent is to pay the applicant’s costs and expenses pursuant to s 60 of the Workers Compensation Act 1987 as a result of injury to the right wrist on 1 September 2011 including the costs of and incidental to surgery on 20 December 2018 and 4 August 2020. 6. The second respondent is to pay the applicant $587.67 per week pursuant to s 36 of the Workers Compensation Act 1987 for the periods from 20 December 2018 to…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2022] NSWPIC 219
Decision Date: 16 May 2022

CaseChat Overview and Summary

In Chester v Workers Compensation Nominal Insurer, the applicant sought compensation for medical expenses and weekly benefits following injuries to the right wrist and elbow. The first respondent was uninsured at the time of the injury, while the second respondent contested the claim. The applicant alleged that the wrist injury caused carpal tunnel syndrome, which subsequently led to cubital tunnel syndrome. The second respondent denied liability on the grounds that the wrist injury did not cause the claimed conditions.

The central legal issues revolved around whether the applicant's carpal tunnel syndrome and cubital tunnel syndrome were indeed caused by the accepted wrist injury, and if the surgeries performed on the wrist and elbow were reasonably necessary due to the injury. Additionally, the court had to determine whether the applicant was totally incapacitated for work for two periods of 14 days each following the surgeries, and the extent of the second respondent's liability under section 60 of the Workers Compensation Act 1987.

The court found that the applicant did suffer from carpal tunnel syndrome as a result of the wrist injury and that the subsequent condition of cubital tunnel syndrome was a direct consequence of the wrist injury. It was also determined that the surgeries on the wrist and elbow were reasonably necessary. Furthermore, the applicant was found to be totally incapacitated for work for the two periods of 14 days each following the surgeries. Consequently, the second respondent was ordered to pay the applicant's section 60 expenses, including surgery costs, and weekly benefits for the specified periods. The first respondent was directed to reimburse the second respondent for the compensation paid to the applicant.

The final orders of the court mandated the second respondent to cover the applicant's section 60 expenses related to the wrist injury, including surgical costs, and weekly benefits for the two 14-day periods following the surgeries. Additionally, the first respondent was to reimburse the second respondent for the compensation paid to the applicant. This decision underscores the importance of establishing causation and necessity in workers' compensation claims, and highlights the role of the nominal insurer in ensuring compensation is provided to injured workers.

Orders