De Matos v Wideform Pty Ltd - [2021] NSWPIC 67

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	De Matos v Wideform Pty Ltd [2021] NSWPIC 67
APPLICANT:	Antonio De Matos
RESPONDENT:	Wideform Pty Ltd
MEMBER:	Ms Rachel Homan
DATE OF DECISION:	7 April 2021
CATCHWORDS:	WORKERS COMPENSATION- Claim for weekly compensation and section 60 expenses; accepted injury to right hand; applicant subsequently certified fit for pre-injury duties; onset of clicking and triggering in right thumb around 18 months after injury; disputed consequential right thumb condition; Held- opinions of applicant’s treating practitioners and independent expert were consistent and reasoned; respondent’s expert opinion lacked clarity and failed to engage with history, contemporaneous medical evidence and findings on examination of ongoing symptoms and restrictions in injured index finger; applicant sustained consequential right thumb condition; respondent to pay the applicant’s incurred section 60 expenses and weekly compensation in accordance with the applicant’s wages schedule.
DETERMINATIONS MADE:	The Commission determines: 1. The applicant sustained a consequential condition at the right thumb as a result of the injury on 25 July 2018. The Commission orders: 1. The respondent to pay the applicant weekly compensation pursuant to s 37 of the Workers Compensation Act 1987 from 31 July 2020 to date and continuing in accordance with the applicant’s wages schedule dated 1 March 2021. 2. The respondent to pay the applicant’s incurred s 60 expenses in respect of the consequential right thumb condition upon production of accounts, receipts and / or Medicare Notice of Charge.

STATEMENT OF REASONS

BACKGROUND

Mr Antonio De Matos (the applicant) was employed by Wideform Pty Ltd (the respondent) as a carpenter. On 25 July 2018, the applicant sustained an injury to his right hand whilst using a circular saw. Liability for the injury to the applicant’s right index finger, middle finger and palm was accepted by the respondent’s insurer.
The applicant underwent surgery to his right hand and returned to work. In October 2018, the applicant was certified as fit to return to his pre-injury duties.
On 12 May 2020, the applicant sought approval for an ultrasound guided injection to his right thumb. On 20 May 2020, the insurer issued a dispute notice pursuant to s 78 of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act), disputing that the proposed treatment for the right thumb was reasonably necessary as a result of the injury on 25 July 2018.
A further dispute notice maintaining the decision to dispute liability for the right thumb treatment was issued pursuant to s 78 of the 1998 Act on 26 June 2020.
The applicant sought review of the insurer’s decision on 14 July 2020 pursuant to s 287A of the 1998 Act. On 29 July 2020, a further notice was issued maintaining the decision to dispute liability for treatment to the right thumb.
On 4 August 2020 the insurer wrote to the applicant indicating that his entitlement to weekly payments and medical and related expenses under s 60 of the Workers Compensation Act 1987 (the 1987 Act) had ceased. The applicant was advised that…

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.

Continue reading De Matos v Wideform Pty Ltd

Details

AGLC: De Matos v Wideform Pty Ltd [2021] NSWPIC 67
Case: [2021] NSWPIC 67
Decision Date: 7 April 2021

CaseChat Overview and Summary

The matter of De Matos v Wideform Pty Ltd involved a claim for weekly compensation and expenses under section 60 of the relevant act. The applicant, Mr. De Matos, alleged that he sustained an accepted injury to his right hand, which subsequently led to a consequential condition affecting his right thumb. The dispute centred around the nature and extent of this thumb condition, with the respondent denying its existence and contesting liability for ongoing compensation and expenses.

The court had to determine whether the applicant had sustained a consequential right thumb condition following his initial accepted injury, and if so, whether the respondent was liable for the ongoing weekly compensation and section 60 expenses. The court was required to weigh the evidence of the applicant’s treating practitioners, the independent expert, and the respondent’s expert, assessing the consistency and reasoning behind their opinions, and the extent to which they engaged with the medical history, contemporaneous evidence, and observed symptoms and restrictions.

In its reasoning, the court found that the opinions of the applicant’s treating practitioners and the independent expert were consistent and well-reasoned, taking into account the medical history, the contemporaneous medical evidence, and the observed symptoms and restrictions. The court noted that the respondent’s expert opinion lacked clarity and did not sufficiently engage with the history, medical evidence, or the findings on examination. Consequently, the court concluded that the applicant had sustained a consequential right thumb condition, and that the respondent was liable for the applicant’s incurred section 60 expenses and weekly compensation in accordance with the applicant’s wages schedule.

The final orders of the court mandated that the respondent was to pay the applicant’s incurred section 60 expenses and weekly compensation. This decision underscores the importance of the consistency and reasoning behind expert opinions, and the need for those opinions to engage comprehensively with the medical history, contemporaneous evidence, and observed symptoms and restrictions.

Orders