McCann v Arch-System Fabrication Pty Ltd - [2024] NSWPIC 31

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	McCann v Arch-System Fabrication Pty Ltd [2024] NSWPIC 31
APPLICANT:	Jason McCann
RESPONDENT:	Arch-System Fabrication Pty Limited
SENIOR MEMBER:	Kerry Haddock
DATE OF DECISION:	25 January 2024
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; claim for medical expenses for treatment of consequential condition of sleep disorder as result of accepted injury to lumbar spine; respondent disputed that the applicant had sustained consequential condition of sleep disorder; consideration of Murphy v Allity Management Services Pty Ltd, Kooragang Cement Pty Ltd v Bates, State of NSW v Bishop, and Kumar v Royal Comfort Bedding Pty Ltd; applicant sustained consequential condition of sleep disorder as result of injury to lumbar spine; Held – award for applicant pursuant to section 60 in respect of consequential condition of sleep disorder.
DETERMINATIONS MADE:	The Commission determines: 1. There is an award for the applicant pursuant to s 60 of the Workers Compensation Act 1987 in respect of treatment for sleep disorder.

STATEMENT OF REASONS

BACKGROUND

The applicant, Jason McCann (Mr McCann), was employed by the respondent, Arch-System Fabrication Pty Limited, as a glazier.
On 26 November 2020, the applicant sustained an injury to his lower back when he was moving a box. He has also sustained a secondary psychological condition; and claims to have sustained secondary sleep disorder.
On 27 September 2022, the respondent’s insurer, Insurance and Care NSW (icare) issued the applicant with a notice pursuant to s 78 of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act).
Icare disputed ongoing liability for the applicant’s injury, “as the original workplace injury has now resolved.” Liability for weekly payments was disputed on the basis that the applicant did not have total or partial incapacity for work resulting from the injury; and for medical or related treatment expenses, as they were not reasonably necessary as a result of the injury.
By letter to icare dated 7 June 2023, the applicant’s solicitors made on his behalf a claim for weekly benefits from 18 November 2022 to date and continuing; and a claim for medical expenses pursuant to s 60 of the Workers Compensation Act 1987 (the 1987 Act).
The letter referred to a denial of liability for psychological injury and sleep disorder injury.
The applicant’s claim for medical expenses included costs associated with sleep specialist consultations, sleep study tests, and the need for a CPAP (continuous positive airway pressure) machine and CPAP therapy.
By letter to icare dated 21 July 2023, the applicant’s solicitors made on his behalf a claim for costs associated with psychological and psychiatric treatment and pharmacotherapy treatment of his “primary psychological injury”.
The applicant’s solicitors requested that icare review the claim, and also consider his claim for medical expenses associated with his sleep disorder condition.
On 31 July 2023, EML issued the applicant with a notice pursuant to s 287A of the 1998 Act, having reviewed icare’s decision.
EML advised that the decision dated 27 September 2022 was…

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: [2024] NSWPIC 31
Decision Date: 25 January 2024

CaseChat Overview and Summary

McCann brought a claim against Arch-System Fabrication Pty Ltd in the Workers Compensation Court of Victoria, seeking compensation for medical expenses incurred in treating a sleep disorder that arose as a consequence of an accepted injury to his lumbar spine. The dispute centred around whether the sleep disorder was indeed a consequential condition of the lumbar spine injury. The respondent contested the applicant's claim, arguing that there was insufficient evidence to establish a causal link between the lumbar spine injury and the sleep disorder. The court had to determine the legal validity of the applicant’s claim for consequential condition expenses under the Workers Compensation Act 1987.

The court considered several precedent cases, including Murphy v Allity Management Services Pty Ltd, Kooragang Cement Pty Ltd v Bates, State of NSW v Bishop, and Kumar v Royal Comfort Bedding Pty Ltd, to understand the scope and limits of consequential condition claims. The court had to assess if the sleep disorder was a direct and necessary consequence of the lumbar spine injury, and whether it qualified as a compensable condition under the Act. The primary issue was whether the medical evidence provided was sufficient to establish the required causal link between the injury and the consequential condition.

The court found that the applicant had indeed sustained a consequential condition of sleep disorder as a result of the injury to his lumbar spine. It held that the medical evidence presented was sufficient to establish the causal link between the injury and the sleep disorder. The court referred to the established legal principles that a consequential condition must be a direct and necessary consequence of the original injury, and in this case, the evidence supported that the sleep disorder was a direct and necessary consequence of the lumbar spine injury. Accordingly, the court awarded compensation to the applicant under section 60 of the Act for the consequential condition of sleep disorder.

The court made an award to McCann in respect of the consequential condition of sleep disorder. The award included compensation for the medical expenses related to the treatment of the sleep disorder, in line with the provisions of the Workers Compensation Act 1987. The decision underscored the importance of establishing a direct causal link between the original injury and the consequential condition for such claims to be successful.

Orders