Hall v Opal Healthcare - [2025] NSWPIC 516

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Hall v Opal Healthcare [2025] NSWPIC 516
APPLICANT:	Barry Victor Hall
RESPONDENT:	Opal Healthcare
MEMBER:	John Turner
DATE OF DECISION:	29 September 2025
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; reasonably necessary; material contribution; incapacity; no current work capacity and suitable employment; sections 4, 32A, 33, 37, 60, and Schedule 3 of clause 9 referred to; Kooragang Cement Pty Ltd v Bates, Briginshaw v Briginshaw, Murphy v Allity Management Services Pty Ltd, Rose v Health Commission (NSW), Elliot v Franklins Pty Limited, Bartolo v Western Sydney Area Health Service, Diab v NRMA Limited, and Wollongong Nursing Home Pty Ltd v Dewar applied; Held – the applicant did not sustain injury to his right hip, neck and lower back as alleged; there is an award for the respondent in respect to injury to the right hip, neck and lower back; the right shoulder replacement surgery is reasonably necessary as a result of the injury sustained at work; pursuant to section 60 the respondent is to pay the costs of and associated with right shoulder replacement surgery; the applicant has had no current work capacity and continues to have no current work capacity; the respondent is to pay the applicant pursuant to section 37.
DETERMINATIONS MADE:	The Personal Injury Commission (Commission) determines: 1. That the applicant did not sustain injury to his right hip, neck and lower back on 22 August 2023 as alleged. 2. There is an award for the respondent in respect to injury to the right hip, neck and lower back. 3. That the right shoulder replacement surgery proposed by Dr Macgroarty is reasonably necessary as a result of the injury sustained at work on 22 August 2023. 4. Pursuant to s 60 of the Workers Compensation Act 1987 (the 1987 Act) the respondent is to pay the costs of and associated with right shoulder replacement surgery as recommended by Dr Macgroarty. 5. That the applicant has had no current work capacity since 7 January 2025 and continues to have no current work capacity. 6. The respondent is to pay the applicant pursuant to s 37 of the 1987 Act: (a) $1,465.94 per week from 7 January 2025 to 31 March 2025, and (b) $1,472.24 per week from 1 April 2025 to date and continuing subject to indexation. A brief statement is attached setting out the Commission’s reasons for the determination.

STATEMENT OF REASONS

BACKGROUND

Barry Victor Hall (applicant) has brought proceedings in the Personal Injury Commission (Commission) in which he pleads that he sustained injury to his right upper extremity, right lower extremity, right hip, lower back and neck when on 22 August 2023, whilst in the course of his employment with Opal Healthcare (respondent), he tripped and fell whilst walking down a hallway.
The applicant seeks payment of weekly compensation pursuant to s 37 of the Workers Compensation Act 1987 (1987 Act) from 7 January 2025 to date and ongoing. The applicant…

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.

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Details

Case: [2025] NSWPIC 516
Decision Date: 29 September 2025

CaseChat Overview and Summary

The case of Hall v Opal Healthcare arose in the Workers Compensation Authority of New South Wales. The applicant, Hall, sought compensation from the respondent, Opal Healthcare, for injuries sustained in the course of his employment. Hall claimed injuries to his right hip, neck, lower back, and right shoulder, and sought compensation for the cost of a right shoulder replacement surgery. Opal Healthcare disputed the applicant's claims, arguing that the injuries were either not caused by the employment or were not reasonably necessary.

The primary legal issues before the court were whether the applicant had sustained the injuries claimed, whether these injuries were reasonably necessary and arose from the employment, and if so, what compensation was owed under the Workers Compensation Act 1987. The court had to consider whether Hall's injuries were material contributions to his incapacity and whether he had no current work capacity and suitable employment. The relevant sections of the Act included sections 4, 32A, 33, 37, 60, and Schedule 3 of clause 9. The court also referred to various precedents in its reasoning.

The court found that Hall did not sustain injury to his right hip, neck, and lower back as alleged. However, it did find that Hall had sustained an injury to his right shoulder that warranted the replacement surgery. The court held that the right shoulder replacement surgery was reasonably necessary as a result of the injury sustained at work. Accordingly, under section 60 of the Act, Opal Healthcare was ordered to pay the costs of and associated with the right shoulder replacement surgery. The court also found that Hall had had no current work capacity and continued to have no current work capacity, thus qualifying for compensation under section 37 of the Act. Opal Healthcare was therefore ordered to pay the applicant compensation.

In conclusion, the court awarded Hall compensation for the cost of the right shoulder replacement surgery, but denied compensation for the other injuries claimed. The court found that Hall had no current work capacity and was therefore entitled to compensation under section 37 of the Workers Compensation Act 1987.

Orders