Galicia and Comcare (Compensation)

This matter concerned an appeal by Ms Galicia against a decision by Comcare to cease her compensation payments. Ms Galicia had been employed by Medibank Private for 28 years, primarily in a customer service role involving extensive computer use, repetitive typing, and prolonged sitting. She had a history of intermittent lower back and neck pain, and in 2012, began experiencing significant pain in her left shoulder. This appeal was heard by Ms Anna Burke, Member, of the Administrative Appeals Tribunal.

The primary legal issues before the Tribunal were whether Ms Galicia's ongoing pain and incapacity for work were a result of a compensable injury sustained during her employment, and whether her employer's liability for her condition had been correctly assessed and managed. Specifically, the Tribunal had to determine if the cessation of compensation payments by Comcare was justified, given Ms Galicia's persistent symptoms and her belief that further medical treatment was necessary. The Tribunal also considered the respondent's contention that Ms Galicia's pain was due to age-related degeneration rather than a work-related injury.

The Tribunal considered extensive medical evidence from various practitioners, including Ms Galicia's general practitioner, orthopaedic surgeons, and a physiotherapist. While some medical opinions suggested Ms Galicia's shoulder pain was not work-related or was due to age-related degeneration, the Tribunal found that the balance of medical evidence indicated she was suffering from pain in her left shoulder and that the initial acceptance of liability for a compensable injury was correct. The Tribunal noted that Comcare had not followed its own clinical framework for assessing reasonable medical treatment, which prioritises empowering the injured person towards independence. The Tribunal ultimately affirmed Comcare's decision of 31 March 2016, finding that Ms Galicia no longer suffered from the effects of the accepted injury and was therefore not entitled to further compensation under sections 16 and 19 of the SRC Act.