Cremona and Comcare (Compensation)

The Administrative Appeals Tribunal considered a dispute between the Applicant and Comcare concerning the provision of compensation for psychological treatment. The Applicant had a long-standing workers' compensation claim stemming from a workplace injury in 1998, for which liability was accepted for various physical injuries and subsequently for Chronic Pain Disorder associated with psychological factors, later referred to as somatisation disorder. The core of the dispute involved Comcare's decision to cease liability for further psychological consultations provided by the Applicant's treating psychologist, Mr. Craig Holt, from November 2018 onwards.

The Tribunal was required to determine whether the psychological consultations sought by the Applicant from November 2018 were in relation to her accepted injury, somatisation disorder, and whether such treatment was reasonable in the circumstances under section 16 of the *Safety, Rehabilitation and Compensation Act 1988* (Cth). The Applicant contended that the treatment was beneficial and that ceasing it would merely lead her to seek similar support through other government-funded avenues. Comcare argued that if the Applicant was accessing treatment under other government-subsidised schemes and did not appear to require treatment with high frequency, then the treatment paid for by Comcare was not reasonable.

The Tribunal reasoned that for compensation to be accepted under section 16, the treatment must be directly related to the accepted injury. While Comcare had accepted liability for psychological treatment connected to the Applicant's injury for many years, the Tribunal's task was to assess the appropriateness of ongoing treatment from November 2018. The Tribunal noted that the Applicant's accepted injury, somatisation disorder, involves pain with a psychological origin, lacking a physiological basis. Evidence from Ms. Gierlicz and Dr. Varghese suggested that Mr. Holt's ongoing consultations provided psychological support rather than treatment directly related to the accepted injury. Although Mr. Holt's reports referred to the accepted injury, his view that the Applicant's pain symptoms were not purely psychological in origin raised questions about whether his treatment was truly in relation to or assisting the accepted injury.

Ultimately, the Tribunal concluded that from 20 November 2018, the Applicant's claimed ongoing psychological consultations could not be considered medical treatment in relation to her accepted injury, somatisation disorder, nor could they be deemed reasonable in the circumstances. Consequently, the Tribunal affirmed the reviewable decisions made by Comcare on 4 September 2018 and 30 January 2019, which revoked the determination to pay for these consultations.