Couch v Electus Distribution Pty Limited

Couch, a worker, brought a case against Electus Distribution Pty Limited, his employer, in the Workers Compensation Court of Victoria, seeking coverage for medicinal cannabis treatment as part of his workers' compensation. The primary issue before the court was whether the medicinal cannabis treatment was reasonably necessary and if the employer should bear the costs associated with such treatment. The court was required to determine the applicability of relevant legal criteria, specifically those set out in Rose v Health Commission (NSW) [1986] NSWCC 2; 2 NSWCCR 32 and Diab v NRMA Ltd [2014] NSWWCCPD 72, to assess the necessity of the proposed treatment. The court acknowledged that the criteria in Diab were not exhaustive and emphasised that the determination of whether a treatment is reasonably necessary depended on the specific facts of each case.

The court found that the original determination did not adequately address the necessity of the medicinal cannabis treatment, nor did it sufficiently consider the specific circumstances of Couch's case. The court emphasised that the criteria for determining the reasonableness of necessary treatment should be applied flexibly, taking into account the individual circumstances of the worker and the nature of the injury or condition. The court also highlighted that the cost of the treatment was a relevant factor but not the sole determinant in deciding whether the treatment was reasonably necessary. Based on these considerations, the court concluded that the original determination was flawed and required re-evaluation by another member of the tribunal.

Accordingly, the court revoked the original determination and remitted the matter for redetermination by another member, ensuring that the new determination would properly consider the specific facts and circumstances of Couch's case and the relevant legal criteria. This decision underscores the importance of a thorough and nuanced approach in assessing the necessity of medical treatments under workers' compensation legislation.