Hopkins and Comcare (Compensation)

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Hopkins and Comcare (Compensation) [2016] AATA 742 (23 September 2016)

Division

GENERAL DIVISION

File Number

2015/1177

Re

Joan Hopkins

APPLICANT

And

Comcare

RESPONDENT

DECISION

Tribunal

Deputy President Dr C Kendall

Date

23 September 2016

Place

Perth

The decision under review is set aside.  In substitution it is decided that:

·     The applicant has suffered incapacity since 19 November 2014 (the date Comcare ceased liability payments). 

·     Incapacity has been caused by an accepted condition defined as a diffuse pain syndrome of soft tissue origin, associated with cervical and thoracic spine symptoms with associated muscle contraction headache. 

·     Any medical treatment the applicant has required since 19 November 2014 has been in relation to her accepted condition.

· Comcare is liable to continue paying compensation to the applicant for incapacity payments or medical treatment as of 19 November 2014 pursuant to section 16 and 19 of the Safety, Rehabilitation and Compensation Act 1988.

The Tribunal remits this matter to the respondent for reassessment of the applicant’s claims for compensation in accordance with the reasons outlined herein.

The Tribunal orders, pursuant to section 67(8) of the SRC Act, that the Respondent pay the Applicant’s reasonable legal costs and disbursements, as agreed, or, in the absence of agreement, as assessed, in accordance with Section 6.9 of the Tribunal’s Guide to the Workers’ Compensation Jurisdiction.

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

Deputy President Dr C Kendall

CATCHWORDS

COMPENSATION – applicant made claim in 1992 for neck injury and associated headaches – applicant medically retired in 2002 – applicant received compensation payments from that date on – on basis of new medical report respondent determined in 2014 that applicant suffers from a constitutionally-based problem and that condition is no longer work related – whether accepted condition materially contributed to in a material degree by applicant’s employment with the Commonwealth – applicant found to have suffered an injury that has resulted in incapacity such that applicant is entitled to ongoing compensation – decision under review set aside

LEGISLATION

Safety, Rehabilitation and Compensation Act 1988 – sections 4(1), 14, 16 and 19

CASES

Cheung v Administrative Appeals Tribunal (2009) FCA 241

Comcare v Reardon [2015] FCA 1166
Military Rehabilitation & Compensation Commission v May [2016] HCA 19
Su v Comcare [2011] AATA 934;

Telstra Corporation Limited v Hannaford (2006) 90 ALD 263

REASONS FOR DECISION

Deputy President Dr C Kendall

23 September 2016

BACKGROUND

  1. Joan Hopkins was born on 18 December 1951.  She is 65 years of age. 

  2. Ms Hopkins worked as a clerk for the Department of Social Services (now known as Centrelink) until 20 August 2000, when she was medically retired.

  3. On 3 April 1992, Ms Hopkins lodged a compensation claim in relation to an injury she claims she suffered to the ligaments in her neck.  In her claim form, Ms Hopkins described her injury as “gradual onset over 1-2 years but probably sudden onset of unimaginable pain resulting from reaching over a desk to retrieve paper which had fallen behind it” (T4 at 7). Ms Hopkins’ claim…

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Details
Case
[2016] AATA 742
Decision Date

CaseChat Overview and Summary

This matter concerned an appeal by Ms Hopkins against a decision by Comcare to cease compensation payments. Ms Hopkins had lodged a claim in 1992 for a neck injury and associated headaches, which was accepted by Comcare. She was medically retired in 2002 and had received compensation payments and medical expenses from Comcare since that time. In 2014, based on new medical evidence, Comcare determined that Ms Hopkins suffered from a constitutionally-based problem and that this condition was no longer work-related. The appeal was heard by Deputy C Kendall P.

The central legal issue before the court was whether Ms Hopkins' accepted condition, described as a diffuse pain syndrome of soft tissue origin, associated with cervical and thoracic spine symptoms with associated muscle contraction headache, was contributed to in a material degree by her employment with the Commonwealth. Consequently, the court had to determine if this condition constituted a "disease" and therefore an "injury" under the relevant legislation, and if her incapacity for work and need for medical treatment since Comcare ceased payments were a result of this injury.

The court found that Ms Hopkins continued to suffer from the defined ailment after Comcare ceased liability payments. Crucially, the court determined that this ailment was materially contributed to by her employment with Centrelink, thus satisfying the definition of a "disease" and "injury" under the *Safety, Rehabilitation and Compensation Act 1988* (Cth). The court reasoned that the effects of her injury had caused her incapacity for work and warranted medical treatment since 19 November 2014, making Comcare liable for ongoing compensation payments.

The decision under review was set aside. In its place, the court decided that Ms Hopkins' incapacity and need for medical treatment since 19 November 2014 were caused by her accepted condition, which was materially contributed to by her employment. Comcare was therefore liable to pay compensation for incapacity payments and medical treatment from that date.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

This outline reads as follows:1.I was born on the 18th December 1951 and at the time of suffering my injury employed I was [sic] as a Clerk by the Department of Social Security (now Centrelink) (“DSS”).2. I commenced working for DSS in approximately 1984.3.At the time of suffering my injury my duties at DSS required me to work at a computer and desk for the duration of my work day. At that time the ergonomic setup of the desk, chairs and computer was terrible and I was constantly looking up and down and from side to side.4.In the course of carrying out my duties at DSS I developed significant headaches and pain to my neck. This pain gradually worsened until the 20th March 1992 when I was unable to continue carrying out my work duties.5.I subsequently made a claim for workers’ compensation and that claim was accepted by Comcare.6.After my claim was accepted I participated in a graduated return to work program and eventually increased my hours to full time hours. Unfortunately whilst I was determined to undertake my duties on a full time basis the pain I experienced when doing so (and particularly of an evening) was unbearable.7.I required anti-inflammatory and analgesic medications, deep heat and other topical ointments just to continue to work.8.Over time I gradually broke down and was unable to continue working. My doctor initially reduced my hours however my symptoms continued to prevent me from carrying out my work duties.9.As a result of my injuries and medical advice obtained from doctors I attended at the request of DSS, I was medically retired by DSS on the 7th April 2000.10.At that time I was suffering severe headaches and significant pain and restriction of movement to my neck, shoulders and upper back. The pain was so severe I was unable to sleep. I would experience headaches (similar to the severity of a migraine) that prevented me from carrying out day to day tasks.11.Unfortunately after being medically retired my injuries, symptoms and restrictions did not improve.12.In 2002 I applied to Comcare for compensation for permanent impairment and non-economic loss. I was assessed as suffering a 32% whole person impairment and my claim for this compensation was approved by Comcare on the 20th August 2002.13.Since that time I have continued to suffer from headaches and intrusive pain to my neck, shoulders and upper back. The severity of my headaches has reduced however the frequency of the headaches has decreased.14.Prior to Comcare ceasing payment of my medical expenses I would undergo physiotherapy once a week, acupuncture several times a month and hydrotherapy approximately 3 times a week.15.I have continued to require medication to alleviate the symptoms of my work injuries.16.I have only been able to carry out menial daily tasks with the combination of the treatment outlined above and the medication. The duration of time I can carry out these tasks is also very limited.17.I have attempted to undertake university studies however I am unable to read for prolonged periods of time. I managed to last approximately 6 months before my work injuries forced me to withdraw from university.18.I have been certified totally unfit for work by my general practitioner since I was medically retired.19.As a result of my work injuries I have been unable to participate in arts and crafts; I cannot read books for prolonged periods of time and I am only able to undertake extremely limited housework and gardening tasks.20.If I over-exert myself I am forced to take additional medication to cope with the pain and then rest.21.If I walk too fast or too far my pain increases. Despite this I attempt to go for a walk every day and have managed to increase my walking tolerance to 45 minutes to 1½ hours each day depending on the speed I walk or the surface on which I am walking.22.From the date I was medically retired until the 19th November 2014 Comcare paid all of my medical expenses and paid incapacity payments to me on a fortnightly basis.23.I have obtained medical certificates for the duration of that time.24.As my incapacity payments have now ceased I have been forced to apply for a disability pension from Centrelink. I have also been issued with a healthcare card to assist with obtaining my medication.25.As a result of my reduced income I have been forced to compromise my medical treatment. My medications have now been limited and I am no longer able to attend physiotherapy, acupuncture or hydrotherapy as often as I did.26.Unfortunately the physiotherapy, acupuncture and hydrotherapy combined with my medications was what enabled me to maintain my quality of life. My quality of life has now decreased however as a result of my financial position I am unable to improve it.27.I have now been forced to sell my house because I could not afford to pay the bills.28.Since I injured myself in 1992 I have not been involved in any motor vehicle accidents or any other type of accident.29. I have not suffered any other injuries to my neck, shoulders or upper back.30.I continue to suffer from the injuries I sustained in the course of my employment at DSS on the 20th March 1992.MEDICAL EVIDENCEReport of Dr R Agnello dated 27 June 1983 (R4)

Decision

Reasons for decision

Further, the Tribunal finds: a)In the period following the date of Comcare ceasing liability payments on 19 November 2014, Ms Hopkins continued to suffer from an ailment as that term is defined in the SRC Act, described as “a diffuse pain syndrome of soft tissue origin, associated with cervical and thoracic spine symptoms with associated muscle contraction headache”; b)This ailment was contributed to in a material degree by her employment with Centrelink;c)Ms Hopkins thus suffered “a disease”, hence “an injury”, as those terms are defined in the SRC Act at the relevant date;d)From 19 November 2014 until the present: ·the effects of her injury caused incapacity for work for which Comcare was liable to pay compensation; and ·the effects of her injury warranted medical treatment for which Comcare is liable to pay compensation. DECISION For the reasons outlined above, the decision under review is set aside. In substitution it is decided that Ms Hopkins’ incapacity since 19 November 2014 (the date of ceasing liability) has been caused by an accepted condition defined as a diffuse pain syndrome of soft tissue origin, associated with cervical and thoracic spine symptoms with associated muscle contraction headache. Further, any medical treatment Ms Hopkins has required since 19 November 2014 has been in relation to her accepted condition. Comcare is therefore liable to pay compensation to Ms Hopkins for incapacity payments or medical treatment as of 19 November 2014 pursuant to sections 16 and 19 of the SRC Act.

Ratio Decidendi

Legal Principle Established

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