Karabolovska and Comcare (Compensation)

Karabolovska and Comcare (Compensation) [2020] AATA 5189 (23 December 2020)
Division:General Division
File Number(s): 2018/0353
Re:Rosa Karabolovska
APPLICANT

ComcareAnd
RESPONDENT

DECISION
Tribunal:Deputy President J W Constance
Date:23 December 2020
Place:Sydney

The reviewable decision, being the decision of Comcare to cease payments to Ms Karabolovska for medical expenses and loss of income from 30 September 2017, is affirmed.
..........................[SGD]..............................................
Deputy President J W Constance
CATCHWORDS
WORKERS’ COMPENSATION – whether the Respondent is liable to compensate Applicant in respect of the cost of any medical treatment obtained by her in relation to the compensable injury on or since 30 September 2017 – aggravation of major depressive disorder, recurrent episode – evaluation of medical evidence – where exacerbation of condition by workplace incident transient – where Applicant’s condition had returned to baseline level – decision affirmed
LEGISLATION
Safety, Rehabilitation and Compensation Act 1988 (Cth) 4, 5A, 5B, 14, 16, 19
CASES
Karabolovska v Comcare [2019] FCA 2153
REASONS FOR DECISION
Deputy President J W Constance
23 December 2020
A. INTRODUCTION

On 25 February 2014 Ms Karabolovska was working for the Australian Tax Office (“ATO”) as a member of the Casual Team when she made a call to a taxpayer to ask him for some information in relation to his business.
What followed was recorded by the Team Leader:
Taxpayer became irritated and irrational at times screaming loudly then quietening down again and suggesting he would harm himself.’
‘Operative continued to talk calmly to the taxpayer, and called for Team Leader support. The conversation with the taxpayer continued until he had calmed down and said he would not harm himself. Procedure for handling Suicide incidents was followed and Support staff reported the incident to police on 000 at 10.19am whilst taxpayer was still on the line. Once taxpayer was sufficiently calm, operative managed to discontinue the call.’
Taxpayer thanked the operative for listening to him.[1]
In these reasons I shall refer to this conversation as the workplace incident.
[1] Exhibit R1 at 102-103.
On 13 June 2014, in accordance with the Safety, Rehabilitation and Compensation Act 1988 (Cth) (“the Act”), Comcare accepted liability to compensate Ms Karabolovska in respect of an injury suffered by her resulting from the workplace incident. The injury was described as an “aggravation of major depressive disorder, recurrent episode”.[2] For the next three years Comcare made payments to Ms Karabolovska by way of compensation for periods of incapacity and for medical expenses incurred for treatment of her injury.
[2] Exhibit R1 at 165.
On 11 October 2017 Comcare determined to cease payments to Ms Karabolovska for medical expenses and loss of income from 30 September 2017 on the ground that “there is no present liability for Comcare to pay compensation under Section 16 (medical treatment) and Section 19 (incapacity benefits) of the SRC Act in relation to the injury [she] sustained on 25 February 2014.”[3] [Emphasis in the original].
[3] Exhibit R1 at 434.
On 6 December 2017 Comcare affirmed the decision of 11 October 2017. I will refer to the decision of 6 December 2017 as the reviewable decision.
Ms Karabolovska has applied to the Tribunal to review the reviewable decision. For the reasons which follow the reviewable decision will be affirmed.
Hearing on remittal
Ms Karabolovska’s application was heard by the Tribunal in May 2019 (“the initial hearing”). On that occasion evidence was taken from witnesses and documents were taken into evidence. The Tribunal published its decision and gave reasons orally for that decision on 3 June 2019. Written reasons for decision were published on 18 June 2019.
Following an appeal to the Federal Court of Australia by Ms Karabolovska, the matter was remitted to the Tribunal to be heard according to law. When the matter again came before the Tribunal the parties agreed that the review could be determined without a hearing in accordance with section 34J of the Administrative Appeals Tribunal Act 1975 (Cth).[4] Subsequently the parties provided the Tribunal with an agreed list of evidence (including both transcript and documents). I have determined this application based on the agreed evidence alone and on the basis of submissions made by Counsel at the initial hearing.
[4] Section 34J provides: If:
(a)   it appears to the Tribunal that the issues for determination on the review of a decision can be adequately determined in the absence of the parties; and
(b)   the parties consent to the review being determined without a hearing;
the Tribunal may review the decision by considering the documents or other material lodged with or provided to the Tribunal and without holding a hearing.
B.   BACKGROUND
The facts set out in the following paragraph are taken from the judgement of the Federal Court,[5] which in turn were taken from the reasons given by the Tribunal following the initial hearing. These facts are not in dispute. They are established by the evidence before me.
[5] Karabolovska v Comcare [2019] FCA 2153 at [7]-[13] inclusive (references to documents omitted).
The applicant was born in 1969. She married in 1991 and has two children of the marriage. The applicant had left calf neurofibroma in 2004 and had surgery for that condition. In 2005, she was referred to Dr Pakula, a psychiatrist, by her pain specialist, Dr Davidson. Dr Pakula diagnosed major depression and chronic pain. She consulted Dr Pakula regularly until at least 2016 and resumed seeing him not long before her matter was heard in the Tribunal.
The applicant ceased work in 2007. She resumed employment when she commenced an entry-level job with the ATO in June 2013. She was promoted prior to the incident. While not the subject of specific findings by the Tribunal, the applicant gave evidence that before the incident she “felt so good because I was progressing. … I finally got to a point where I was, like, at a job that I loved so much and I knew I could finish my degree and I could see a future for me there”
On 25 February 2014 at about 9 AM, the applicant made a telephone call to a taxpayer in the course of her employment with the ATO (the incident). That call lasted about one hour and, as earlier mentioned, included the taxpayer threatening to commit suicide (Tribunal reasons at [4]). While the Tribunal made no other findings about the detail of the call, the applicant described the call in graphic terms in her evidence, explaining that the caller was very angry at the ATO and:
… was yelling a lot … he started saying to me that he was – that he had nobody that cared for him, he was all alone, everybody had deserted him and that he had nothing to live for and then he, like, he was going to hang up and go and, like, he was going to kill himself. … I started getting all scared and I tried to stay calm … I was scared because I can understand when a person is so depressed how low you can get and I tried to convince him that people did care and he – then he’d yell at me and then he’d calm down and he’d say, like a nice thing that – that I cared for him. He was touched that I made the time to sort of try and comfort him, you know. …
She gave evidence that in the meantime, she had alerted her manager and the ATO contacted the police who attended the caller and arrived in time. She said that “I’ve never been more scared, more terrified (indistinct) in my life and thinking that if I just say something, this guy could, you know”. The applicant also gave evidence that after she finished the call, she felt “disorientated” and “I just remember coming out of the door and everything was just like smoky, like, foggy. My head was pounding, my body was that cramped up like never before …”. She said that she was given very kind support by her manager, Maryanne.
Immediately after the incident, the applicant had one or two days off work and then worked in alternative duties for her ordinary hours, 25 hours per week (Tribunal reasons at [7]). The applicant gave evidence that when she went back, “I had to read and I couldn’t comprehend the stuff, I couldn’t see my screen, and even after days went, my vision was still like that. I thought it was just from the headaches, whatever. But the stiffness in my head and in my body took a week or so to get better … and then I wasn’t coping at work”. She gave evidence that she thought that people treated her differently, she started getting panic attacks, and that she was angry with herself and as a result started to self-harm which she had never done before.
On 19 March 2014, the applicant lodged a claim for workers’ compensation in respect of “Stress due to suicide phone call received on behalf of ATO”. In the form, the applicant said that she first noticed that she was ill on the date of the incident at 9:45 AM and sought treatment from a doctor on that date. In answer to the question on the form, “have you ever had a similar symptom, injury or illness, work-related or otherwise?” the applicant answered “Anxiety depression”.
In May the applicant reduced her hours to 15 hours a week. She ceased working shortly thereafter. While not the subject of a specific finding by the Tribunal, the parties were agreed that she ceased work on 22 May 2014.
C. THE RELEVANT PROVISIONS OF THE SAFETY, REHABILITATION AND COMPENSATION ACT 1988 (CTH)
Subsection 14(1) provides:
(1) Subject to this Part, Comcare is liable to pay compensation in accordance with this Act in respect of an injury suffered by an employee if the injury results in death, incapacity for work, or impairment.
Subsection 5A(1) provides:
(1) In this Act:
injury means:
(a)a disease suffered by an employee; or
(b)an injury (other than a disease) suffered by an employee, that is a physical or mental injury arising out of, or in the course of, the employee’s employment; or
(c)an aggravation of a physical or mental injury (other than a disease) suffered by an employee (whether or not that injury arose out of, or in the course of, the employee’s employment), that is an aggravation that arose out of, or in the course of, that employment;
but does not include a disease, injury or aggravation suffered as a result of reasonable administrative action taken in a reasonable manner in respect of the employee’s employment.
Disease is defined in section 5B:
(1) In this Act:
disease means:
(a)an ailment suffered by an employee; or
(b)an aggravation of such an ailment;
that was contributed to, to a significant degree, by the employee’s employment by the Commonwealth or a licensee.
(2) In determining whether an ailment or aggravation was contributed to, to a significant degree, by an employee’s employment by the Commonwealth or a licensee, the following matters may be taken into account:
(a)the duration of the employment;
(b)the nature of, and particular tasks involved in, the employment;
(c)any predisposition of the employee to the ailment or aggravation;
(d)any activities of the employee not related to the employment;
(e)any other matters affecting the employee’s health.
This subsection does not limit the matters that may be taken into account.
(3) In this Act:
significant degree means a degree that is substantially more than material.
Subsection 4(1) defines ailment as:
… any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development).
Subsection 16(1) provides:
Where an employee suffers an injury, Comcare is liable to pay, in respect of the cost of medical treatment obtained in relation to the injury (being treatment that it was reasonable for the employee to obtain in the circumstances), compensation of such amount as Comcare determines is appropriate to that medical treatment.
15.Subsection 19(1) relevantly provides:
This section applies to an employee who is incapacitated for work as a result of an injury …
The injury referred to is an injury in respect of which compensation is payable under section 14.
The remaining subsections of section 19 provide the method of calculation of the amount of compensation payable when the employee has been “unable to work or unable to work at the level at which the employee worked before the injury.”[6]
[6] Subsection 19(2A).
D. ISSUES FOR DETERMINATION
The following issues arise for determination in this application.
(1)Is Comcare liable to compensate Ms Karabolovska in respect of the cost of any medical treatment obtained by her in relation to the compensable injury on or since 30 September 2017?
(2)Has Ms Karabolovska been incapacitated for work as a result of the compensable injury on, or at any time since, 30 September 2017?
E. EVIDENCE AND FINDINGS OF FACT
Evidence of Ms Karabolovska
Ms Karabolovska provided statements dated 13 July 2018[7] and 1 March 2019.[8] She gave evidence at the initial hearing.[9]
[7] Exhibit T1 at 52.
[8] Exhibit T1 at 106.
[9] Exhibit T2 at 5-67.
Ms Karabolovska had not suffered from depression until she was diagnosed with neurofibromatosis. She became really scared and fell ill after she was told that she had tumours on her nerves. She felt a lot better after surgery relieved the pain. She said that she tried a lot of antidepressant medication, all of which affected her very badly.[10]
[10] Exhibit T2 at 27.
In 2012 Ms Karabolovska began looking for employment. She worked in a call centre and then started with the Australian Taxation Office on 15 June 2013. By that time, pain she had experienced in her back in late 2012/early 2013 had settled.
The telephone conversation with the taxpayer on 25 February 2014 lasted for about one hour. Ms Karabolovska has never been more terrified. Following the workplace incident she continued to receive treatment by Dr Pakula and by a psychologist, Ms Jarman.
Ms Karabolovska tried to continue working with the ATO but was unable to continue as she could not comprehend the tasks she was given. She stopped work in May 2014 and ceased employment with the Office in December 2015.
When she gave evidence to the Tribunal on 28 May 2019, Ms Karabolovska said that, at that time, she felt the same as she did when she finished working at the ATO:
I still have my panic attacks, I still – like I – when I go out with people I can’t seem to – like I feel like I don’t fit in anywhere.[11]
[11] Exhibit T2 at 18.
Since leaving the ATO Ms Karabolovska has not attempted to find paid employment. She said:
…… what am I going to do? Like I can’t even make proper decisions at home. Like where would I get employed now. Like for – I can’t do much, like I can’t lift because of that. My mental state is like it has never been before.[12]
[12] Exhibit T2 at 22.
On occasions Ms Karabolovska has not taken the medication prescribed to treat her depression and anxiety.[13]
[13] Exhibit T2 at 47.
In her statement made 1 March 2019, Ms Karabolovska said that she continued to experience the following symptoms as a result of the incident on 25 February 2014:
a.    Nervousness;
b.    Continued thoughts about the Incident;
c.     Fear;
d.    Anxiety;
e.    Depression;
f.   Headaches;
g.    Vision impairment;
h.    Low mood;
i.   Fatigue;
j.   Sadness;
k.     Frustration;
l.   Restlessness;
m.   Hopelessness;
n.    Social avoidance;
o.    Muscular pains;
p.    Jitteriness;
q.    Panic attacks;
r.     Irritability;
s.     Fluctuating appetite;
t.   Sleep impairment;
u.    Memory impairment;
v.     Poor concentration;
w.   Impaired comprehension;
x.     Despair;
y.     Mood swings;[14]
Ms Karabolovska said that the impact of the workplace incident on her mental health is far worse than anything she had experienced previously. She continues to seek treatment for her condition.
[14] Exhibit T1 at 107-8.
Evidence of Mr Karabolovski, the Applicant’s husband
Mr Karabolovski provided statements dated 13 July 2018[15] and 1 March 2019.[16] He gave evidence at the initial hearing.
[15] Exhibit T1 at 58.
[16] Exhibit T1 at 109.
Statement made 13 July 2018
Mr Karabolovski stated in part:
9. Around 2011, my Wife got to the point where she was either recovered or stable and we were all very happy. My Wife was anxious but not to the point which caused concern.
Prior to the Subject Incident
10. It is my opinion that My Wife had recovered and was very happy. My Wife was mentally well and we were all very happy as a family.
…
Current Situation
34. My Wife continues to talk about the incident phone call to date constantly. In my opinion, her mental health has not resolved as a result of the phone call incident.
35. My Wife’s mental condition since the phone call incident continued to date in my opinion.
36. My Wife’s vision problems became markedly worse since the phone call incident in my opinion and continue to date;
Mr Wife continues to struggle with her memory and comprehension and complains about headaches a lot of the time;
In early 2013, Ms Karabolovska no longer suffered pain and was looking for employment. She was excited when she got the job at the ATO. She was happy in her work and gained a promotion.
After the workplace incident Ms Karabolovska appeared moody and not as happy as she was at the beginning of 2013. She started locking herself in the bedroom. Mr Karabolovski was concerned about her welfare and took some carer’s leave to be with her.
When asked how he would describe his wife in May 2019, Mr Karabolovski replied:
Moody. She’s – from time to time, like, she’s depressed. She’s jumping.
…
I just want you to explain what you mean by a few things that you have said there. So what - what do you mean by “moody”?---She - she can’t - many times, like, if I - if we goes with friends, like, we come home, she’s upset. She say, “I can’t” - I go - she doesn’t want to be in the crowd. Then when people talk about jobs, she’s getting upset.
And what - was she ever like that before 2014?---No.
You also used the word “depressed”, and I just want you to explain why you thought she was depressed. What was it about her that gave you that impression?---Like, she - she - she feel like she can’t contribute, like she’s - she went to TAFE, then she was doing uni correspondence, and now she 20 can’t. Like, she doesn’t work. She’s getting - there’s no self-esteem. Like, there’s no confidence in - on her anymore.
You also - - -?---But the - yes.
Sorry. Go ahead. Please, please - - -?---But the biggest part is I worry about her (indistinct) self - hurting herself.[17]
[17] Exhibit T2 at 71.
Statement made 1 March 2019
In the opinion of Mr Karabolovski, Ms Karabolovska’s condition after the workplace incident “is considerably worse and different to how she was prior to the incident.” [18]
Dr Pakula, Treating Consultant Psychiatrist
[18] Exhibit T1 at 110.
Reports
Ms Karabolovska first consulted Dr Pakula in November 2005. At that time he diagnosed Ms Karabolovska as suffering Major Depressive Disorder and an Anxiety Disorder. He was of the opinion that she had symptoms of ongoing pain related to left calf neurofibroma and C7 neurofibroma.[19]
[19] Exhibit R1 at 65.
Dr Pakula reviewed Ms Karabolovska on a regular basis. He provided updated information in further reports in which he referred to Ms Karabolovska’s ongoing difficulty in managing the pain in her left leg, neck and back. He also diagnosed Ms Karabolovska as suffering a Chronic Pain Syndrome as well as the previously diagnosed continuing Disorders.
In May 2008 Dr Pakula reported that Ms Karabolovska’s depression and anxiety were under “very good control”; however, he noted in his report of July 2008 that she continued to suffer pain in multiple sites of her body.[20]
[20] Exhibit R1 at 76.
On 24 April 2013 Dr Pakula reported that following a number of problems experienced by Ms Karabolovska, she had become “quite depressed” and her anxiety level was raised.[21] Her conditions had worsened by July 2013, by which time she believed that she had suffered a significant financial loss. She was working five nights per week at the Tax Office.[22]
[21] Exhibit R1 at 91.
[22] Exhibit R1 at 92.

Dr Pakula reviewed Ms Karabolovska on 24 April 2014, following the workplace incident on 25 February 2014. He reported:
Rosa has a long history of Anxiety and depressive symptoms. She started seeing me in November 2005 with psychiatric symptom related to neurofibromata. More recently there was a major exacerbation of her anxiety over many months related to a serious loss of finances after making some investments that didn’t work out. More recently Rosa has had an incident at work where she works in the Tax office which has somewhat worsened her anxiety symptoms.
Mental State Examination: Rosa Karabolovski is anxious and tearful. Her mood is distressed. Her affect is tense and anxious. She is jittery and upset. There are no delusions and no hallucinations. Rosa is not currently actively suicidal though she described wanted to go to sleep and not waking up. She continues to have thought about the phone call at work and she said she could relate to the issues the man on the phone was facing. She describes poor eyesight, forgetfulness, disorientation in place and a strong sense of “why me”. She describes some difficulty falling asleep and dozing during the day. She dreams about blood and she dream about being screamed at. She described a major worsening of her vision and she has recently been prescribed glasses. Rosa describes poor concentration and poor memory. She is tearful much more than usual. She continues to have some panic attacks.
Opinion: Rosa Karabolovski is still very anxious. This anxiety has been made much worse by the recent incident at work.[23]
[23] Exhibit R1 at 147.
Ms Karabolovska consulted Dr Pakula again on 13 June 2014. On the same day he issued a medical certificate stating that:
Diagnosis: Aggravation of Major Depressive Disorder, Recurrent Episode
Cause of Condition: Employment Related Incident/Accident on 25.02.2014
Treatment required: Regular psychiatric treatment with supportive psychotherapy and medication of Cipramil antidepressant. Regular psychological therapy with a psychologist utilising psychoteherapeutic techniques.
And is unfit to attend work from
Date: 25.02.2014
And is fit to attend work from:
Date: 13.09.2014.[24]
[24] Exhibit R1 at 176.
Under the heading Current Issues as of Friday, July 18, 2014, Dr Pakula recorded that Ms Karabolovska was worried about difficulties being experienced by a family member. There is no reference to the workplace incident. She described ongoing symptoms of anxiety.[25]
[25] Exhibit R1 at 179.
By letter of 24 July 2014 Dr Pakula requested Comcare fund further treatment of Ms Karabolovska regarding the diagnosis of “Aggravation of Major Depressive Disorder, Recurrent Episode”.[26] Comcare approved the requested funding.
[26] Exhibit R1 at 197.
In his report of 20 August 2014, Dr Pakula refers to Ms Karabolovska’s worry about a family member and the recent suicide of an actor. He does not refer to the workplace incident.[27]
[27] Exhibit R1 at 179.
On 18 December 2014 Dr Pakula noted the continuing diagnosis of “Aggravation of Major Depressive Disorder, Recurrent Episode”. His notes of the consultation refer to an improvement in Ms Karabolovska’s family and financial situations. There is no other reference to concern relating to the workplace incident.[28]
[28] Exhibit R1 at 230-231.
On 28 January 2015 Dr Pakula responded to a series of questions from Comcare bas follows:
You have requested a medical report update on Mrs Karabolovska. I will go through each of the questions you have asked and answers the questions to the best of my ability.
1.    Does Mrs Karabolovska continue to suffer from an aggravation of a major depressive disorder? If the diagnosis has changed please provide details.
As you are aware I am seeing Rosa Karabolovska on a regular basis. More recently I saw her on 9^th September 2015, 31^st October 2014 and most recently on the 18^th December 2014. In my opinion Mrs Rosa Karabolovska continues to suffer from an aggravation of a major depressive disorder, recurrent episode.
2.    What is the prognosis for Mrs Karabolovksa’s current condition?
The prognosis is very poor for Mrs Karabolovska’s current condition. She has suffered from ongoing anxiety and depressive episodes for a number of years. More recently there has been an exacerbation and aggravation of her depressive disorder as well as a number of anxiety symptoms associated with that depressive disorder. In my opinion her condition is chronic now and unlikely to show improvement for the foreseeable future.
3.    In your opinion, does Mrs Karabolovska’s employment continue to significantly contribute to her condition? If so, please explain the basis of your conclusion, having regard to the fact the employment incident occurred almost 12 months ago and Mrs Karabolovska has not returned to work since 25 February 2014.
Mrs Karabolovska did have a number of features of depression and anxiety prior to the incident at work on the 25^th February 2014. However the incident did cause another very severe episode of her major depressive disorder associated with her anxiety symptoms and it is unlikely that she will ever be able to return to work because of the severity and the chronicity of her depressive disorder. Therefore in my opinion her employment does continue to significantly contribute to her condition.
4.    In your opinion, what are the specific factors, both employment and non-employment related that continue to contribute to Mrs Karabolovska’s condition? Please list the employment and non-employment factors and, if possible, specify at the level of contribution for each.
In my opinion the employment factors relate to the incident at work in which she received a telephone call from a man who was expressing suicidal ideation and this had a very profound and aggravating effect on Mrs Karabolovska’s depressive disorder. The non-employment related issues are that Mrs Karabolovska has had a depressive disorder since around 2005 also associated with anxiety. The reason for this previous depressive and anxiety symptoms relate to several neurofibromatosis she suffers from which cause her pain and some disability. Furthermore Mrs Karabolovska has a personality profile in which she generally has a high level of base line anxiety symptoms. In my opinion the employment and the incident on the 25^th February is probably about 80% of the cause of her current illness.
5.    Is Mrs Karabolovska currently medically fit to engage in any type of work?
Mrs Karabolovska is not currently medically fit to engage in any type of work.
6.    If Mrs Karabolovska is not fit to return to work, when do you believe that she would be able to undertake a return to work program?
In my opinion Mrs Karabolovska will never be fit to return to work and she will never be able to undertake a return to work program.
7.    If Mrs Karabolovska is not fit to consider a return to work at this time, please comment on any rehabilitation assistance which Comcare or the Australian Taxation Office could provide to assist Mrs Karabolovska in returning to work.
In my opinion no amount of treatment will assist Mrs Karabolovska in returning to work.[29]
(Errors in original.)
[29] Exhibit R1 at 251-252.
On 4 March 2015 Dr Pakula reported that Ms Karabolovska continued to improve in terms of her anxiety and was not thinking about work as much as previously.
Dr Pakula reported to the Health Consultant at the ATO on 24 May 2015.[30] In his opinion, at that time, Ms Karabolovska’s prognosis was “very poor” as she “has a background of difficulty coping with stressful situations and chronic pain due to Neurofibromata. She has had previous difficulty coping at work places.”[31]
[30] Exhibit R1 at 260.
[31] Exhibit R1 at 265.
On 27 May 2015 Dr Pakula again interviewed Ms Karabolovska. She told him that she had almost lost $5,000 as a result of an attempted scam. Dr Pakula reported, in part:
Rosa Karabolovski remains quite anxious and unfortunately she is very fragile in terms of being conned by scammers. She does not make sensible decisions in her life. Her thinking is quite disorganised at times and she makes major errors in judgement on some critical issues in her life.
Opinion: Rosa Karabolovski is still quite anxious and she is rather disorganized due to her anxiety.[32]
[32] Exhibit R1 at 266.
On 25 August 2016 Ms Karabolovska was suffering from anxiety about surgery she was to undergo the following day and had been having panic attacks. Dr Pakula reported that she was coping very well.[33]
[33] Exhibit R1 at 297.
After a consultation on 3 November 2015 Dr Pakula reported that Ms Karabolovska still had agoraphobia and prominent anxiety symptoms. She remained anxious and disorganised.[34]
[34] Exhibit R1 at 303.
Ms Karabolovska next consulted Dr Pakula on 26 May 2016. At that time she had ongoing panic attacks, a baseline level of anxiety that was distressing and a low mood. Her motivation level was not very good.[35]
[35] Exhibit R1 at 324.
Dr Pakula’s report after a consultation on 2 March 2017 notes that he discussed with Ms Karabolovska the marital difficulties she was experiencing and her distress arising from other family issues. She continued to be “anxious and distressed”.[36]
[36] Exhibit R1 at 375.
On 29 September 2017, after he became aware that Comcare had advised Ms Karabolovska of its intention to cease payments in respect of her accepted injury, Dr Pakula wrote to Comcare, in part as follows:
Rosa Karabolovski has had an anxiety and depressive disorder prior to her work with the ATO. However, she was in remission from that depression and anxiety prior to her starting work with the ATO. She no longer had any symptoms of the anxiety and depressive disorder when she started work with the ATO. I felt that she could enter the workforce again.
After the index incident at the workplace there was an episode of quite marked anxiety and depressive symptoms which has continued to this day from the index incident in 2014. Associated with this has been a reduction in her vision which has occurred only after the incident at work. The level of distress that has occurred from the work place incident has led to suicidal ideation amongst her other depressive and anxiety symptoms.
……….
In my opinion then, this current episode of depression, anxiety and poor eyesight is related to the index incident which occurred at the ATO in 2014 and was a new episode of depression and anxiety and not related to the previous history of anxiety and depression that Rosa had suffered from previous to her employment with the ATO.[37]
[37] Exhibit R1 at 432-433.
On 1 April 2018, Dr Pakula reported in part:
In my opinion Rosa Karabolovska does continue to have ongoing symptoms of anxiety and depression related to the index incident at the ATO in 2014. At my most recent review on Wednesday, February 28, 2018 Rosa had quite marked anxiety interspersed with panic attacks. She displayed depressive symptoms with poor short-term memory and still described poor vision. Her suicidal ideation has settled, and she was no longer having clear suicidal ideation. She does not enjoy her life. These symptoms do appear to have continued since the incident at the Tax Office in 2014.[38]
Oral evidence at the initial hearing[39]
[38] Exhibit T1 at 3.
[39] Exhibit T2 pp103-124.
Ms Karabolovska was referred to Dr Pakula as she was feeling very anxious and depressed about the disabilities caused by the pain she had at that time. Her physical complaints were treated by surgery which was largely successful.
Ms Karabolovska’s anxiety and depression had improved gradually from about 2009. With the encouragement of Dr Pakula, she commenced employment with the Australian Taxation Office in 2013 “as she had got a lot better”.[40] She was coping very well and her anxiety and depression were under quite good control.
[40] Exhibit T2 at 104.
The following exchange took place between Counsel for Ms Karabolovska and Dr Pakula:
Now, in your opinion, is there a bright line between a new psychiatric injury, as compared to an aggravation of an injury? What’s the difference in those two concepts in your view?--- Well, if a person already has had a history of anxiety, and they still have some minor residual symptoms, there’s not a completely clear line of differentiation between them. However, in this case, the disorder had settled significantly. The anxiety was due to the pain, due to the neurofibromatosis disorder she had. That had largely settled and then there was another incident which caused somewhat different symptoms of anxiety, more an acute stress reaction, rather than anxiety related to the previous pain that she had. So, I look at it as a new and separate disorder.[41]
[41] Exhibit T2 at 104-105.
The last consultation before Ms Karabolovska ceased to attend her workplace was on 24 April 2014. Dr Pakula said:
…… she was very unwell when I saw her. She was very anxious and she couldn’t focus properly. She had pain in her abdomen. Her mood had become very anxious. She had poor concentration. Her vision had seemed to suffer and she couldn’t - she described not being able to see properly. So, there was a dramatic worsening of her anxiety and depression at that time.[42]
[42] Exhibit T2 at 105.
Dr Pakula described the symptoms shown by Ms Karabolovska in April 2019 compared to those in about 2008 – 2010 as “somewhat qualitatively different”.[43] Previously her symptoms were those seen in an individual suffering pain whereas her symptoms in 2019 were similar to those experienced by people with an acute stress disorder.
[43] Exhibit T2 at 106.
Dr Burek, Consultant Psychiatrist
Dr Burek assessed Ms Karabolovska on 19 May 2014 at the request of Comcare. He provided reports dated 27 May 2014[44] and 23 July 2014.[45]
[44] Exhibit R1 at 155.
[45] Exhibit R1 at 195.
Dr Burek provided the following diagnosis:[46]
Axis I              Major depressive episode (currently relapsed since February 2014).
Axis II             No prominent personality traits seen at interview.
Axis III            Pain and disability associated with neurofibromatosis.
Axis IVDistress about her psychologic conditions, multiple deaths in the family, financial losses, and dissatisfaction with her new house
Axis V             GAG 60 to 51.
[46] Exhibit R1 at 159-160.
In the opinion of Dr Burek, Ms Karabolovska’s condition at the time of the assessment was an aggravation of a preceding or underlying condition. The effects of the events of 25 February 2014 had not ceased. She also had an ongoing sadness about the death of her cousin.
Ms Jarman, Clinical Psychologist and Psychotherapist
Ms Jarman has been treating Ms Karabolovska since 2 June 2014 on referral by Dr Pakula and later, her General Practitioner. Ms Jarman provided reports dated 15 December 2014, 5 June 2016 and 14 September 2017 and gave evidence at the initial hearing.
Report dated 15 December 2014[47]
[47] Exhibit R1 at 225.
Ms Karabolovska was referred for assessment and treatment of major depressive disorder. At the initial consultation Ms Karabolovska presented with anxiety and distress; she was having panic attacks and was having difficulty in socialising and in leaving her home. She was also having difficulty with concentration and cognition and an overwhelming sense of public shame and humiliation as people in her office had observed her during the workplace incident. She was engaging in acts of self-harm.
Ms Karabolovska’s presentation was consistent with a diagnosis of major depressive disorder and generalised anxiety disorder. As she was minimally responsive to the initial treatment of cognitive behaviour therapy, the treatment was revised to acceptance and commitment therapy, to which she was more responsive. Testing showed that Ms Karabolovska’s symptoms had consistently reduced over the time Ms Jarman had been treating her, except for a worsening of her condition at a consultation on 14 December 2014.
At the time of this report Ms Jarman considered that Ms Karabolovska would not be able to return to work in the near future, if at all. The fact that her family did not support her return to work was a further barrier to her return.
Report dated 5 June 2015[48]
[48] Exhibit R1 at 267
Ms Jarman reported that Ms Karabolovska remained anxious and moderately depressed. She remained in a vulnerable psychological state but was functioning better than throughout 2014. Ms Karabolovska was unable to return to work at that time.
Ms Jarman did not consider that Ms Karabolovska’s condition was permanent and was hopeful that she would continue to improve.
Report dated 14 September 2017[49]
[49] Exhibit R1 at 427.
Ms Jarman reported, in part:
From our first consultation and frequently across the course of treatment, Ms Karabolovska stated as a primary concern the loss of vision which she became aware of immediately after the workplace incident. Ms Karabolovska experienced great distress about this and stated on numerous occasions it was “killing me” and that was experiencing significant “loss and grief” about her vision. The level of psychologic distress Ms Karabolovska experiences about this unfortunately has not changed over time and remains significantly high. I have noted that Ms Karabolovksa engaged in avoidance of situations, events, memories and feelings as a primary means to manage her psychological symptoms. However, Ms Karabolovska is not able to avoid the loss of vision as she is constantly reminded of it during her waking hours. The loss of vision has become psychologically fused with the workplace incident because she became aware of the loss of vision immediately after the incident. I note in the report from her optometrist, Zac Trikkis, dated 22/7/2019 that “she admits to not being able to wear reading glasses because it reminds her of the suicidal events & I have suggested she sees her psychologist again as she is obviously having trouble dissociating (sic) her vision loss to the said event”. I agree with this statement and confirm that much of our treatment efforts had focussed on a number of evidence-based therapies to this end, however, unfortunately this was not effective and Ms Karabolovska has not been able to dissociate the vision loss from the incident, and as a result is constantly reminded of the incident.[50]
[50] Exhibit R1 at 428.
Ms Jarman ceased treating Ms Karabolovska[51] as she had received a sufficient dose of treatment with little effect. In her opinion, Ms Karabolovska’s treatment needed to be psychiatric.
[51] Prior consultation was on 7 April 2016, exhibit T1 at 83.
Ms Jarman concluded:
In my opinion, Ms Karabolovska’s current mental state and decline in her mental health is linked to the workplace incident. Ms Karabolovska is unable to use avoidance to the extent she would normally as a means to cope because she is constantly reminded of the incident with her vision loss during her waking hours. Unfortunately, the vision loss is fused psychologically with the workplace incident and has remained resistant to change despite best treatment efforts. The incident was highly traumatic for Ms Karabolovska and has had a significant and long-lasting impact on her mental health.
Oral evidence[52]
[52] Exhibit T2 at 84-94.
During the time that Ms Karabolovska’s condition was slowly improving, she rarely acknowledged that improvement as her emotional distress was so great.[53]
[53] Exhibit T2 at 88.
Treatment ceased at the end of 2015 or early 2016.[54]
[54] Exhibit T2 at 89.
Dr Zsadanyi, Consultant Psychiatrist
Dr Zsadanyi assessed Ms Karabolovska on 5 August 2014 and 18 October 2016 at the request of the Australian Taxation Office and its Insurer respectively. The purpose of the initial assessment was to determine her capability to continue a rehabilitation program. The second was to assess Ms Karabolovska’s claim for permanent impairment.
Dr Zsadanyi provided reports dated 19 August 2014[55] and 14 December 2016.[56]
[55] Exhibit R1 at 201.
[56] Exhibit R1 at 350.
Report of 19 August 2014
Under the heading Presenting Complaint, Dr Zsadanyi noted that Ms Karabolovska told him that apart from the pain she suffered, “some of the other triggers for her depression had been deaths in the family and moving house.”[57] He also reported that she told him that during the weekend prior to the workplace incident a celebrity had committed suicide. In his opinion it seemed that Ms Karabolovska had strongly identified with the celebrity and her death.
[57] Exhibit R1 at 203.
Report of 14 December 2016

Dr Zsadanyi expressed the opinion that, in view of the time which had elapsed from the workplace incident, it was likely that her impairment arising from the aggravation would continue indefinitely. He was unable to specify the duration of the existing impairment she was suffering. Her strong identification with the death of the celebrity resulted in Ms Karabolovska’s condition worsening.
Ms O’Garr, Psychologist
In 2014 Ms Karabolovska was referred to the Anxiety Management Day Program (South Coast Private Hospital) by Comcare.
On 29 September 2014, Ms O’Garr reported, in part:
In lieu of the entrenched nature of Rosa’s rigid thinking styles, it is recommended that treatment using Acceptance and Commitment Therapy is better suited for Rosa. It is my understanding that this type of treatment is being provided to her by her private psychologist, and as such is recommend as part of her ongoing care and management.[58]
Ms Karabolovska attended six out of the eight sessions. She continued to describe feeling distressed.
[58] Exhibit R1 at 217
Dr McDonald, Consultant Psychiatrist
Dr McDonald assessed Ms Karabolovska at the request of the Australian Taxation Office on 23 December 2014. He provided a report dated 16 January 2015.[59]
[59] Exhibit R1 at 239.
Ms Karabolovska reported less panic attacks than she did earlier in 2014. She continued to avoid travelling more than five minutes away from her home. She felt better than when she was trying to perform at work but still felt life was a struggle. She described her mood as “tired, anxious, agitated and scared”.[60]
[60] Exhibit R1 at 241.
Dr McDonald reported, in part:
Ms Karabolovska appears to have a significant predisposition for mood and anxiety disorders. Her temperament as a child was always very sensitive and prone to worry and anxiety. Her mother is a great worrier. Her first long episode was triggered by an illness. Her second most recent episode was triggered by a stressful telephone call about suicide. Subsequently, Ms Karabolovska has lapsed into a negative mindset, behaviours which perpetuate her anxiety and depression, and her daily life remains restricted.[61]
He made the following diagnosis:
Ms Karabolovska’s prognosis is guarded. Her first episode of anxious depression lasted some years. This current episode has now lasted ten months. She remains very vulnerable and reliant upon her husband. On the balance of probabilities, it appears likely that she is likely to remain very anxious and depressed with significant resultant impairment for about the next two years.[62]
[61] Exhibit R1 at 243.
[62] Exhibit R1 at 244.
Dr McDonald was of the opinion that Ms Karabolovska’s failure to respond to Cognitive Behaviour Therapy was further evidence that she was likely to remain impaired for the next couple of years. It was clear from the report of Ms O’Garr that Ms Karabolovska was unable to implement the CBT approaches.
Dr Walker, Consultant Psychiatrist
Dr Walker assessed Ms Karabolovska on 26 April 2017 at the request of Comcare. He provided reports dated 1 August 2017,16 August 2017[63] and 27 March 2019 and gave evidence at the initial hearing.
Report dated 1 August 2017[64]
[63] Exhibit R1 at 407.
[64] Exhibit R1 at 396.
In the opinion of Dr Walker:
Ms Karabolovska was predisposed to develop psychiatric conditions. She describes always having been a worrier, having had a “hard life growing up” and a family history of anxiety.
The phone call that Ms Karabolovska took at work on 25 February 2014 does not contribute to her anxiety and/or depression. This “incident” aggravated her anxiety and depression.
……….
It is likely that her current symptoms and conditions represent a natural progression of her pre-existing condition.[65]
Report dated 27 March 2019[66]
[65] Exhibit R1 at 401-402.
[66] Exhibit T1 at 206.
Dr Walker reviewed further material for this report. He confirmed the opinions he expressed in his first report.
Oral evidence
Dr Walker gave evidence that:
The natural history of moderate to severe anxiety and depression that has been present for a long time is that it will wax and wane. So people will have times in life when they seem to – and can function better and times in life where their function deteriorates and their symptoms increase. That is well understood psychiatrically, it’s well understood clinically. All of us who have longstanding relationships – treating relationships with patients, we see that. The second thing I will say is Ms Karabolovska continued working for several months after that phone call and in my mind that is consistent with my view that whilst the phone call certainly was unpleasant, certainly aggravated her symptoms at the time in February 2014, I didn’t see it as an ongoing stressor or aggravator for her conditions or symptoms.[67]
[67] Exhibit T2 at 176-177.
When asked to assume that Ms Karabolovska was very reluctant to take medication and had self-ceased medication, Dr Walker said that this did not change the opinions he had expressed. His reasoning was that:
Clinically people with high baseline anxiety or long standing conditions of anxiety seem to be exquisitely sensitive to side effects of medication … Also I would have expected that if the incident was causal to her ongoing symptomatology and impairment that she’d be seeking treatment for it. That would be what we could normal illness behaviour. When we’re sick we seek help for that.[68]
In his opinion the effects of the workplace incident should have ceased after Ms Karabolovska ceased working at the ATO.[69]
[68] Exhibit T2 at 177.
[69] Exhibit T2 at 182.
In relation to the incidents of Ms Karabolovska self-harming, Dr Walker agreed that if a patient with a long history of psychiatric difficulty only self-harmed after a particular event, that would suggest that the event had something to do with the self-harming.[70]
[70] Exhibit T2 at 193.
Dr Jones, Consultant Forensic and General Psychiatrist
Dr Jones assessed Ms Karabolovska in March 2018 at the request of her Solicitors. He provided reports dated 30 April 2018 and 25 September 2018 and he gave evidence at the first hearing.
Report dated 30 April 2018[71]
[71] Exhibit T1 at 5.
Dr Jones diagnosed Ms Karabolovska as suffering “a prolonged episode of major depression (Major Depressive Disorder) on a background of longstanding chronic depressive illness. There is also likely a longstanding Generalised Anxiety Disorder, which manifests itself with longstanding anxiety, particularly about her vision.”[72]
[72] Exhibit T1 at 16.
Dr Jones reported further:
There are significant pre-existing conditions and predisposing factors in Ms Karabolovska’s case. …… She had recovered She had recovered to the point where she sought work and succeeded in commencing work, at the ATO. This is where the traumatising incident occurred which, combined with worry about problems with vision and her health, her mental state has deteriorated significantly. Her depressive disorder relapsed, and she became quite unwell and continues to have ongoing symptoms and incapacity.
………..
In my view, Ms Karabolovska’s exacerbation and/or relapse of her chronic depressive disorder arose in the course of her employment, triggered by the index incident, the phone call at work.
……….
Ms Karabolovska continues to suffer from the effects of the incident as the deterioration, and/or relapse, of her chronic Major Depressive Disorder, continues to cause her symptoms and prevent her from returning to her previous level of functioning. Her chronic anxiety (Generalised Anxiety Disorder) was also elevated by the incident and has remained high.[73]
Report dated 25 September 2018[74]
[73] Exhibit T1 at 16-17.
[74] Exhibit T1 at 96.
Having considered further material provided to him, Dr Jones confirmed the opinions expressed in his earlier report.
Dr Champion
Dr Champion assessed Ms Karabolovska on 6 July 2018 at the request of the Solicitors for Comcare. He provided reports dated 9 July 2018 and gave evidence at the initial hearing.
Report dated 9 July 2018[75]
[75] Exhibit T1 at 158.
On the basis of Ms Karabolovska’s presentation at the assessment, Dr Champion “considered the history she provided and the presentation to be consistent with a significant level of current anxiety, and this was probably accompanied by a depressive disorder not conspicuous at the time of the examination.[76] His diagnosis was:
…… a Chronic Adjustment Disorder with anxious and depressive symptoms and associated Chronic Panic Disorder with Agoraphobia and Chronic Pain Syndrome, all resulting from an underlying constitutional personality disorder (unspecified).[77]
[76] Exhibit T1 at 165.
[77] Exhibit T1 at 187.
Dr Champion expressed the opinion that the type of chronic illness suffered by Ms Karabolovska does wax and wane over time. The fact that she was able to remain in employment by the ATO for nearly eight months was consistent with his diagnosis and his opinion that any aggravation of her condition in February 2014 was of short duration, a matter of days or weeks.[78] It is a relevant consideration that Ms Karabolovska has not persevered with a significant treatment regime.[79]
[78] Exhibit T2 at 151-153.
[79] Exhibit T2 at 168.
Oral evidence
When he gave evidence at the initial hearing, Dr Champion said that Ms Karabolovska does not have the capacity to sustain employment by reason of her condition which would have “a gentle wax and wane almost without the need for a stressor being present.”[80]In his opinion the contribution of the workplace incident to Ms Karabolovska’s psychological condition would have ceased by the time she left the ATO in December 2015.[81]
[80] Exhibit T2 at 158.
[81] Exhibit T2 at 169.
CONSIDERATION
Having considered all of the evidence to which I have referred, I am satisfied on the balance of probabilities that prior to 30 September 2017, Ms Karabolovska had ceased to suffer from the aggravation of her depression and anxiety, being the aggravation which occurred on 25 February 2014. Since 30 September 2017 any medical expenses she has incurred and any incapacity for work have been a result of factors other than the aggravation of her pre-existing injury.
I did not have the benefit of either Ms Karabolovska or Mr Karabolovski giving evidence before me. I am not satisfied that the recollection of either witness was always reliable.
As Counsel for Comcare pointed out, Mr Karabolovski did not appear to fully understand the content of his statement, even allowing for the fact that it was drafted as a legal document. He was not a good historian, particularly as to the sequence of events.[82]
[82] Exhibit T2 at 78.
At times their evidence varied, particularly on the possibility that they had lost a significant amount of money. Despite Ms Karabolovska’s concern, Mr Karabolovski stated that the earnings of their super fund went up and down and that the only issue was the commission being charged by a particular fund manager.
I am satisfied that as a result of her depression and anxiety, the reliability of Ms Karabolovska’s evidence was diminished by her conviction that her worsening eyesight was caused by the workplace incident and her failure to adhere to the treatment regime prescribed for her.
In any event, the issue in this application is to be determined by an evaluation of the various opinions expressed by the health professionals.
Dr Pakula has the benefit of treating Ms Karabolovska over many years. His opinion that the effects of the aggravation of Ms Karabolovska’s depressive condition are continuing are supported by other practitioners. However, Dr Pakula did not satisfactorily explain why he considered that the depressive condition suffered by Ms Karabolovska after the workplace incident was “a new and separate disorder” or how the symptoms of the new condition differed from those she had suffered previously.
Three months after the workplace incident Dr Burek diagnosed Ms Karabolovska as suffering a major depressive episode, relapsed since February 2014. He noted that at the time of his assessment, she had ongoing sadness from the death of a relative.
I have taken into account that Ms Karabolovska suffered other stressful events around the time of the workplace incident, including the stress associated with the death of a relative, the death of an actor, her belief that she had suffered a significant financial loss, moving to a new home and the deterioration of her vision.
The deterioration of her vision is clearly a matter which has caused Ms Karabolovska considerable distress. However, there is no record of her complaining of this to her medical professionals immediately after the incident and I note that the Tribunal has found that it was not caused by the workplace incident. I am satisfied that Ms Karabolovska’s obsession with this condition was a result of her pre-existing condition and that her workplace was just the setting in which that condition manifested itself.
Ms Jarman, Psychologist, treated Ms Karabolovska from June 2014. In September 2017 she considered that the loss of vision was of significant concern to Ms Karabolovska. When Ms Jarman ended treatment in early 2016 she was of the opinion that Ms Karabolovska’s condition was still “linked” to the workplace incident.
In assessing the weight to be given to Ms Jarman’s opinion, I have taken into account her view that the opposition of Ms Karabolovska’s family was a barrier to her return to work and that she did not consider that her condition after the workplace incident was permanent.
Dr Zadanyi assessed Ms Karabolovska in August 2014. He noted that deaths in the family and her distress occasioned by moving house had been other triggers for her depression. Also, he was of the opinion that Ms Karabolovska had strongly identified with the celebrity and her death and this had caused her condition to worsen.
In March 2018 Dr Jones was of the opinion that Ms Karabolovska continued to suffer from the exacerbation of her pre-existing condition. However he acknowledged that there were significant “pre-existing conditions and predisposing factors”[83] in her case.
[83] Exhibit T1 at 16-17.
I prefer the evidence of Dr Champion to the evidence of those who are of the view that Ms Karabolovska continues to suffer the effects of the workplace incident.
Dr Champion is a very experienced Consultant Psychiatrist who provided a detailed report and who explained the reasons for his conclusions in that report and when he gave evidence to the Tribunal. He addressed the issues arising from the material provided to him and the history taken from Ms Karabolovska.
I accept his opinion that the reports and consultation notes of Dr Pakula from 2005 until 2018 gave “a clear, chronological, clinical picture commencing almost a decade before the index incident at the ATO in early 2014.”[84]
[84] Exhibit T1 at166.
Dr Champion considered the notes of Dr Pakula’s consultation with Ms Karabolovska on 24 April 2013, prior to her commencing work with the ATO on 15 June 2013. I accept the evidence of Dr Champion that:
[The] problems reported at this assessment reveal significant mental state dysfunction in the areas of depression and anxiety and of the need for antidepressant medication in increasing dose levels, as well as providing a specialist psychiatric diagnosis of depression in the period immediately prior to commencing work with the ATO. Also reported are several psychosocial stressors active at that time. When I examined Ms Karabolovska she claimed that she had been in remission from depression/anxiety when she joined the ATO but that was clearly not the case in the period leading up to her employment by the ATO in June 2013.[85]
[85] Exhibit T1 at 166-167.
Further, based on the evidence of Dr Champion, I am satisfied that Ms Karabolovska continued to suffer problems in mental state function in late 2013 with the recommended continuation of her current antidepressant medication. I am satisfied also that in early 2014, before the workplace incident, she suffered ongoing distress arising from her concern that she had suffered financial loss.[86]
[86] Exhibit T1 at 168.
I accept the opinion of Dr Champion that the exacerbation of Ms Karabolovska’s mental condition caused by the workplace incident was transient and that prior to the time of his assessment, her significant anxiety/depressive disorder had returned to its baseline level of dysfunction.
Dr Champion’s views are supported by the reports of Dr McDonald and Dr Walker.
When Dr McDonald assessed Ms Karabolovska in December 2014 he reported that she appeared to have “a significant predisposition to mood and anxiety disorders.”[87] He considered that the depression and anxiety arising from the workplace incident would remain for about two years.
[87] Exhibit R1 at 243.
Dr Walker shared the view that Ms Karabolovska was disposed to develop psychiatric conditions and that it was likely that her mental condition in April 2017 was a natural progression of her pre-existing condition.
For the reasons stated I am satisfied that Comcare is not liable to compensate Ms Karabolovska for the cost of any medical treatment obtained by her, or any incapacity for work suffered by her, since 30 September 2017.
F. CONCLUSION
The reviewable decision, being the decision of Comcare to cease payments to Ms Karabolovska for medical expenses and loss of income from 30 September 2017, will be affirmed.

I certify that the preceding 121 (one hundred and twenty-one) paragraphs are a true copy of the reasons for the decision herein of Deputy President J W Constance.

.............................[SGD]...........................................
Associate
Dated: 23 December 2020

Date(s) of hearing: 15 July 2020 (heard on the papers)

[2020] AATA 5189

23 December 2020

Key Legal Topics

Areas of Law

Employment Law

Administrative Law

Legal Concepts

Appeal

Causation

Judicial Review

Procedural Fairness

Statutory Construction