Eleanor Rope and Comcare

Case [2013] AATA 280

[2013] AATA 280 

Division GENERAL ADMINISTRATIVE DIVISION

File Number

2012/2962

Re

Eleanor Rope

APPLICANT

And

Comcare

RESPONDENT

DECISION

Tribunal

Mr S. Webb, Member
Date 8 May 2013
Place Canberra

  1. The decision under review is set aside. Mrs Rope is entitled to compensation in respect of the costs of attending mindfulness classes as directed by her treating doctor and supported by her psychologist, being medical treatment that it is reasonable for her to obtain in relation to her accepted injury, subject to claim and to periodic review.

  2. Calculation of the amount of compensation, if any, that may be payable to Mrs Rope in respect of travel costs she has incurred in order to obtain this treatment is remitted to Comcare.

  3. The parties have 14 days in which to file submissions as to orders for costs.

    .........................[sgd]..........................................

    Mr S. Webb, Member

    WORKERS COMPENSATION – liability accepted for physical and psychological injuries – depression – chronic pain – medical treatment – meaning of ‘therapeutic treatment’ – meaning of ‘at the direction of’ – classes obtained for a therapeutic purpose at the direction of a treating medical practitioner are within the meaning of ‘medical treatment’ – no requirement for a plan to permanently improve the injury – test of reasonableness – medical treatment is in relation to the injury and reasonable to obtain in the circumstances – decision set aside and substituted

    Safety, Rehabilitation and Compensation Act 1988 (Cth), ss 4(1), 5A, 16

    Bashar v Comcare Australia [2002] FCA 837.

    Capital Territory Health Commission v Cavanagh [1978] FCA 5.

    Re Chowdhary and Comcare (1998) AATA 13003.

    Comcare v Heffernan [2013] FCA 299.

    Comcare v Holt [2007] FCA 405.

    Comcare v Rope (2004) 135 FCR 443.

    Comcare v Watson (1997) 46 ALD 481.

    Re Dunkerley and Comcare [2010] AATA 417.

    Re Heffernan and Comcare [2012] AATA 371.

    Holt v Comcare [2006] AATA 1059.

    Thiele v Commonwealth (1990) 11 AAR 376.

    REASONS FOR DECISION

    Mr S. Webb, Member

    8 May 2013

  4. Eleanor Rope was injured in a motor vehicle accident in 1987 when she was in Commonwealth employment. The injuries she sustained caused her to experience chronic pain and other symptoms. Her symptoms were exacerbated in a fall at work. She ceased employment on invalidity grounds in 1999. Subsequently, she has claimed and been paid compensation in respect of a number of medical conditions, including depression, and for related treatments, including pain management, psychoneuroimmunology and psychological treatment. Following cessation of psychoneuroimmunology treatment, Mrs Rope discussed other treatment options with Dr Welberry, her treating general practitioner of long standing, and with Marion Swetenham, her treating psychologist. As a result, both practitioners supported Mrs Rope to commence a course of study relating to mindfulness.

  5. Mrs Rope lives on a farm outside Canberra and she claimed compensation for the costs of travel to attend classes. Comcare decided to reject the claim by primary determination and on reconsideration. Mrs Rope applied for review.

  6. The background facts follow.

  7. On 19 October 2011 Dr…

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Details
AGLC
Eleanor Rope and Comcare [2013] AATA 280
Case
[2013] AATA 280
Decision Date

CaseChat Overview and Summary

Eleanor Rope has brought this case against Comcare, seeking compensation for travel expenses incurred while travelling from her rural property to Canberra for medical treatment, specifically mindfulness classes. The case was heard and determined by the Federal Court of Australia. The central dispute revolves around whether the travel expenses incurred by Mrs Rope for attending these mindfulness classes, which were recommended by her treating general practitioner as a form of therapeutic treatment, are compensable under the relevant statutory provisions.

The court was tasked with determining whether the mindfulness classes could be classified as 'medical treatment' under section 4(1) of the relevant Act and, if so, whether these expenses are compensable under section 16 of the 1988 Act. This required the court to interpret the statutory language and understand the nature and purpose of the treatment in question.

The court concluded that the mindfulness classes, which were prescribed by Mrs Rope's general practitioner as part of her treatment plan, constitute medical treatment within the meaning of the Act. The court reasoned that such treatment is reasonably necessary for Mrs Rope's accepted injury, aligning with the statutory requirements. Consequently, the decision to deny compensation was set aside. The court found that Mrs Rope is entitled to compensation for the costs of attending these mindfulness classes, subject to claim and periodic review. However, the exact amount of compensation for the travel expenses remains to be determined by Comcare. The parties have been given 14 days to file submissions regarding orders for costs.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

It follows that this matter will be remitted to Comcare to determine the amount of compensation, if any, that may be payable to Mrs Rope in respect of travel expenses she has incurred travelling from her rural property to Canberra for the purposes of obtaining medical treatment in the form of mindfulness classes.Conclusion Mrs Rope has obtained mindfulness classes as a form of therapeutic treatment at the direction of her treating general practitioner. This is within the meaning of ‘medical treatment’ under s 4(1) and for the purposes of s 16 of the 1988 Act. The decision under review will be set aside. Mrs Rope is entitled to compensation in respect of the costs of attending mindfulness classes as directed by her treating doctor and supported by her psychologist, being medical treatment that it is reasonable for her to obtain in relation to her accepted injury, subject to claim and to periodic review. Calculation of the amount of compensation that may be payable to Mrs Rope in respect of travel costs she has incurred in order to obtain this treatment is remitted to Comcare. The parties have 14 days in which to file submissions as to orders for costs.

Ratio Decidendi

Legal Principle Established

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