Meyer v Gunnedah Shire Council - [2024] NSWPIC 295

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Meyer v Gunnedah Shire Council [2024] NSWPIC 295
APPLICANT:	Jeanette Meyer
RESPONDENT:	Gunnedah Shire Council
MEMBER:	Sophie Jones
DATE OF DECISION:	3 June 2024
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; claim for compensation for medical treatment pursuant to section 60; whether the applicant sustained a consequential condition in her left shoulder as a result of the workplace injury to her right shoulder; whether the treatment expenses claimed for proposed left shoulder surgery are reasonably necessary; Held – the applicant sustained a consequential condition in her left shoulder; the left shoulder surgery proposed is reasonably necessary medical treatment pursuant to section 60; the respondent is to pay the applicant’s section 60 expenses in respect of the proposed left shoulder surgery and associated hospital fees, anaesthetist fees and rehabilitation costs.
DETERMINATIONS MADE:	The Commission determines: 1. The applicant sustained a consequential condition in her left shoulder as a result of the workplace injury to her right shoulder. 2. The surgery proposed by Dr Allan Young in his report dated 7 September 2023, specified as left shoulder arthroscopic release and manipulation + subacromial decompression + distal clavicle excision +/- rotator cuff repair, is reasonably necessary medical treatment, pursuant to s 60 of the 1987 Act. 3. The respondent is to pay the applicant’s s 60 expenses in respect of the left shoulder surgery proposed by Dr Young and associated hospital fees, anaesthetist fees and rehabilitation costs.

STATEMENT OF REASONS

BACKGROUND

On 15 August 2020, Ms Jeanette Meyer (the applicant) sustained an injury to her right shoulder while working as a lifeguard for Gunnedah Shire Council (the respondent). In February 2021, the applicant’s right shoulder injury was further aggravated in a subsequent incident that occurred at the same workplace.
Following physiotherapy and cortisone injections, the applicant underwent surgery to her right shoulder performed by Dr Allan Young on 23 March 2022, which was approved by StateCover Mutual Limited (the insurer).
The applicant made a claim on the insurer for a consequential condition in her left shoulder as a result of injury to her right shoulder and sought compensation for the cost of proposed left shoulder surgery.
The insurer issued notices pursuant to s 78 of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act) on 28 September 2023 and 4 December 2023, disputing liability for the left shoulder condition and the associated surgical procedure requested by Dr Young.
The present proceedings were commenced by lodgement of an Application to Resolve a Dispute (Application) in the Personal Injury Commission (Commission) on 25 March 2024.
The applicant seeks compensation pursuant to s 60 of the Workers Compensation Act 1987 (the 1987 Act) for the cost of left shoulder surgery proposed by Dr Young on 7 September 2023, specified as left shoulder arthroscopic release and manipulation + subacromial decompression + distal clavicle excision +/- rotator cuff repair, and associated hospital fees, anaesthetist fees and rehabilitation costs.

ISSUES FOR DETERMINATION

The parties agree that the following…

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 295
Decision Date: 3 June 2024

CaseChat Overview and Summary

Meyer sued Gunnedah Shire Council for compensation under the Workers Compensation Act 1987. Meyer claimed compensation for medical treatment expenses after sustaining an injury to her right shoulder in the course of her employment. Meyer claimed that the injury resulted in a consequential condition in her left shoulder, requiring surgery. The council denied the claim, arguing that Meyer had not sustained a consequential condition in her left shoulder, and that the proposed surgery was not reasonably necessary.

The court had to decide whether Meyer had sustained a consequential condition in her left shoulder as a result of her right shoulder injury, and if the treatment expenses claimed for the proposed left shoulder surgery were reasonably necessary. The court considered medical evidence and reports from treating specialists. The court found that Meyer had sustained a consequential condition in her left shoulder and that the proposed surgery was reasonably necessary to alleviate her symptoms.

The court ordered the council to pay Meyer's expenses for the proposed left shoulder surgery and associated hospital fees, anaesthetist fees and rehabilitation costs. The court found that the council had failed to establish that the proposed surgery was not reasonably necessary. The court concluded that the council was liable for the expenses claimed by Meyer.

Orders