Nguyen and Australian Postal Corporation
[2003] AATA 218
•7 March 2003
Administrative
Appeals
Tribunal
DECISION AND REASONS FOR DECISION [2003] AATA 218
ADMINISTRATIVE APPEALS TRIBUNAL )
) No N2001/611
GENERAL ADMINISTRATIVE DIVISION ) Re THI HAU NGUYEN Applicant
And
AUSTRALIAN POSTAL CORPORATION
Respondent
DECISION
Tribunal Senior Member M D Allen
Dr M E C Thorpe, MemberDate7 March 2003
PlaceSydney
Decision The decision under review is AFFIRMED.
(Sgd) M D ALLEN
..............................................
Presiding Member
CATCHWORDS
WORKERS COMPENSATION - Whether Applicant suffered work caused injury - Conflict of medical opinion - Preference for opinions using disease criteria set out in the American Medical Association Guide to Permanent Impairment - Distinction between symptoms of a disease and the underlying disease process.
Safety, Rehabilitation and Compensation Act 1988
Commonwealth Banking Corporation v Percival 20 FCR 176
Glavinas v Holden’s Motor Company Ltd (unreported SASC, 25 October 1991, no 61/1990)
Repatriation Commission v Yates 57 FCR 241
Asioty v Canberra Abattoir Pty Ltd 167 CLR 533
REASONS FOR DECISION
Senior Member M D Allen
Dr M E C Thorpe, Member
1. By application made 11 May 2001 the Applicant sought review of a reviewable decision by the Respondent made 16 March 2001 affirming a prior determination ceasing liability of the Respondent to pay compensation to the Applicant pursuant to the Safety, Rehabilitation and Compensation Act 1988.
2. Neither the reviewable decision nor the original determination state with any particularity the injury suffered by the Applicant respecting which compensation was paid. All those decisions refer to is "a claim for compensation in respect of right hand".
3. On 31 August 1993 the Applicant lodged an incident report alleging a pain in the right thumb which radiated up to the neck. She alleged that the onset of this pain occurred whilst sorting mail and in particular indexing.
4. A further incident report was lodged by the Applicant on 11 August 1994 claiming muscular pain in the right hand, wrist and upper limb whilst sorting mail. It appears she claimed that the symptoms had become more severe over the past two week period but had deteriorated generally over the last 12 months.
5. On 22 August 1994 the Applicant lodged a claim for compensation in relation to "R hand & wrist R upper limb pain". A medical certificate by her general practitioner Dr Calligeros dated 1 September 1994 stated that the Applicant suffered from a right lateral epicondylitis and repetitive strain injury to her right hand.
6. A decision was made on 19 October 1994 that the Applicant was entitled to compensation in respect of "lateral epicondylitis right hand" as from 28 July 1994. In addition the Applicant has been on restricted duties because of her complaints since 31 August 1994 except for a brief period from 15 October 1995 to 9 November 1995.
7. Although the original decision to grant compensation referred to a right lateral epicondylitis it was not disputed in these proceedings that in fact the Applicant did not suffer from that condition.
8. In evidence to the Tribunal the Applicant said that she was born in South Vietnam on 5 June 1958. After a short period of casual work for Australia Post from October to Christmas 1984 she commenced permanent employment with the Respondent on 15 April 1985.
9. Initially her duties were at the Rosebery Transit Centre and the majority of the work consisted of loading and unloading containers and sorting mail. In the course of these duties she had to unload bags of mail which could weigh up to 16 kilograms. She stated that if the bags were too heavy she could have asked someone to assist her. After some five to six years she transferred to Rushcutters Bay were there was less dock work but she still had to carry bags and her duties involved sorting small letters..
10. She then moved to the Alexandria Depot and after some two years she started indexing mail which involved key boarding work. This she had to do every day for four hours and she was expected to index 1500 letters per hour, which involved four digits per letter, in other words she had to make 6000 keying strokes per hour.
11. In 1993 after doing indexing she noticed pain in her hand and right arm, she noted that she was using her thumb consistently as she used her thumb to hit the figure zero, and a large number of the post codes dealt with at the Alexandria Depot had a zero in their configuration of numbers.
12. She continued to have pain and in 1994 saw her general practitioner Dr Calligeros who referred her to orthopaedic surgeon Dr Pillemer and also referred her to physiotherapy. In 1994 as a result of her complaints she was placed on light duties and apart from a short period referred to above has continued on light duties to the present.
13. At present whilst working she says the pain is bearable and that she can cope so long as she uses her forefingers to grip letters and does not use her thumbs.
14. At present if she does not work for a couple of days she does not feel pain but when she does experience pain it travels to her face and to her neck. If she uses her thumbs in working, after half an hour her neck is stiff and painful. She gets numbness in the right hand every night while working and it disturbs her sleep.
15. The Applicant stated in examination in chief that she had done courses at a College of Technical and Further Education, being courses to qualify her as a dental assistant and as a library technician. For the last four weeks she has been working on Sundays at Marrickville Library as a Library Assistant and this involves checking in books which requires her to use her right hand and she also has the duty of putting books back on the shelves.
16. Cross-examined she stated that in addition to arm pain she also got what she termed "loud clickings" in her face. She saw her general practitioner who sent her to a dentist and she was given a splint to wear on her teeth. She also consulted a faciomaxillary surgeon who after obtaining an x-ray informed her everything was normal, but advised her to wear a splint every night. She also consulted a neurologist who in the first instance diagnosed a migraine but the medication prescribed for migraine did not help her so that the neurosurgeon’s next prospective diagnosis was referred pain from her neck. After obtaining massage treatment she felt better but she said her neck symptoms are always there. She added that pain starts at the base of the thumb, it radiates up the surface of the arm then to the neck and then to the right side of her head.
17. The Applicant was further cross-examined about the courses that she took at the TAFE College. She admitted that she started the dental assistant course but made the remarkable statement that she did not have any idea of what a dental assistant did until she commenced the course. She stated in addition to the library course she also did a course in welfare. These courses involved her attending lectures and making notes. She also stated that she undertook these courses, as she wanted to improve her English.
18. We reject the Applicant's evidence that she undertook the said TAFE courses in order to learn English. If this were the case why not attempt a more literature based course. Although never put to the Applicant in cross-examination, the history taken by Dr McGill on 13 May 1998 is that:
"Last year and the year before she did a welfare course and this year she has commenced a dental nurse course. She attends the course on Tuesdays from 1.30pm to 7pm and also does some home study. The course lasts for one and a half years and currently she hopes then to become a dental nurse."
That history has the ring of truth, corroborated by the fact she is now utilising her library assistant course to obtain part-time employment.
19. Contained within the documents prepared for the Tribunal pursuant to section 37 of the Administrative Appeals Tribunal Act 1975 there are numerous medical and other reports referring to the Applicant. The first of such documents is the incident report dated 27 September 1993 in which the Applicant complains of pain in her right thumb and says:
"I feel pain in my thumb and it travels up to my neck and stays there until now."
20. Other documents referring to the Applicant are T4, medical certificate by Dr Calligeros dated 11 August 1994, which states the Applicant was suffering from right hand and wrist pain and right upper limb pain.
T14 Report by Dr Calligeros dated 13 September 1994 stating inter alia:
"Mrs Nguyen initially presented to me on 26/7/94 with increasing right shoulder girdle and right forearm pain over the previous 1 week….
On examination she was tender over the anterior aspect of her right shoulder, the right lateral elbow and radial aspect of the right forearm and the soft tissue area between the right 1st and 2nd metacarpal bones.
…
On the 18/8/94 she returned stating that physiotherapy was not helping. On examination she was still quite tender over the right lateral forearm region and right hand between the thumb and index finger."
T17 Report of Dr Pillemer, Orthopaedic Surgeon, dated 31 October 1994 stating inter alia:
"Mrs Nguyen informs me that about a year ago she started developing discomfort in her right hand, particularly in relation to her right thumb. She felt these symptoms came on while she was doing a lot of indexing. She stopped this work and her symptoms did tend to improve.
However in August of this year she was pulling some heavy bags with her right hand when she again developed pain in her right hand and on this occasion it radiated up towards her elbow and even towards her shoulder region and the right side of her neck. She was continued to have problems since then.
…
This patients symptoms are certainly in keeping with a carpal tunnel problem on the right hand side."
T25 Report by Dr Pillemer dated 11 January 1995:
"I saw Mrs Nguyen again today with the E.M.G. test, which was done on the 20th December and reported as being within normal limits.
…She does, however, say that when she does sorting of letters, particularly facing up, she still gets aching in the whole of her right upper limb going up into her neck.
…
Opinion and Treatment: Despite the negative E.M.G. finding, I feel this patient does have an underlying carpal tunnel problem on the right side."
T30 Report by Dr Joan Chen, consultant in occupational medicine dated 16 March 1995:
"Apparently she had only performed indexing for approximately one week when she became aware of pain between the thumb and index finger…Ms Nguyen despite my querying, insisted that the symptoms had occurred from indexing and FSM coding. During FSM operations, each operator performs coding for a maximum of 30 minutes every two hours. Ms Nguyen apparently asked to be discontinued from indexing and her supervisor apparently obliged."
Dr Chen then after noting that Finkelstein's test for stenosing tenosynovitis was negative opined:
Ms Nguyen appears to have a resolving myofascial pain condition involving the lower shoulder girdle and right forearm. The aetiology of this uncertain. I am not convinced that this was precipitated by keying per se, as it began only within a week of performing the task and her disability has persisted despite having been on restrictions for a prolonged period.
…I have no doubt she has pain, however, the disability is out of proportion to the clinical findings."
T36 Report of Dr Pillemer dated 17 November 1995:
"She is continuing to complain of ongoing symptoms in her right upper limb with pain going up towards her right shoulder and scapular area."
T38 Report of Dr Pillemer dated 1 December 1995:
""I saw Mrs Nguyen again today with her E.M.G. study which was felt to be well within the controlled range. It was also symmetrical with the left side."
T42 Report of Dr Joan Chen dated 1 February 1996:
"PRESENT SYMPTOMS
Ms Nguyen reported having intermittent pain in the right thumb, radiating in to the upper arm…Her right shoulder girdle symptoms have apparently settled…Her predominant symptom is pain around the right thumb.
She had previously omitted to mention when I initially assessed her, that she'd had numbness in the right hand involving the thumb, index and middle finger. The numbness apparently wakes her up a few times a night and has troubled her for over the past 12 months."
After noting that there was no evidence of tendonitis in the right thumb and wrist and that Tinel's test for carpal tunnel syndrome was negative but Phalen's test for carpal tunnel syndrome was positive on the right, Dr Chen opined:
"Ms Nguyen has pain of myofascial origin in the interosseous muscle between the thumb and index finger of the right hand and possible carpal tunnel syndrome in the right wrist."
T50 Report of Dr Calligeros dated 16 January 1998:
"She continues to complain of right arm and right shoulder pains which appears to be related to her repetitive work.
…On the 11/9/97 she presented complaining of increasing forearm, wrist pain and increasing axillary arm pain.
On this occasion she was referred to Dr Kapila who is a hand Surgeon. He felt that her symptoms were due to tenosynovitis…"
T55 Report of Dr H B Kapila dated 12 May 1998:
"…I think she has got pressure on the nerve and should be seen by an orthopaedic surgeon specialising in neck and back problems.
Nothing active can be done regarding her pain in her thumb at this stage apart from analgesics and physiotherapy."
T56 Report of Dr McGill, Consultant Rheumatologist dated 13 May 1998. Dr McGill noted that the symptoms which the Applicant described to him where virtually identical to those she described to Dr Pillemer, that is pain involving the right thumb sometimes radiating up into the forearm, arm and shoulder. Dr McGill noted that a nerve conduction study was performed on 20 December 1994 and was normal. A reported nerve conduction study at the end of 1995 and was again normal and was symmetrical with the asymptomatic left side. Dr McGill went on to note that the Applicant provided a clear history without any apparent embellishment and fully cooperative with the examination. After noting there was no objective evidence of tenosynovitis he stated:
"I am unsure of the cause of her right thumb and upper limb discomfort. The subjective sensory alteration and positive Phalen's test suggests that she may have mild carpal tunnel syndrome and I think that remains a possibility despite the normal nerve conduction studies on two occasions."
He continued:
"Despite my uncertainty as for the exact nature of the problem causing her symptoms, I think it is likely that her symptoms are due to her work as a mail officer."
T60 Report by Dr Loefler, Orthopaedic Surgeon dated 18 June 1998 who stated:
"This lady's history of intermittent neck pain and stiffness is not specific. I am unable to demonstrate a neurological deficit."
T62 Report of Dr H B Kapila dated 26 June 1998. He said:
"I am pleased to inform that Mrs Nguyen is slightly better because there is very little numbness now and no pain at rest. She has a full range of movements. The power in the right hand is 22 and the left is 20. Finkelstein test is still slightly positive."
T63 Report of Dr H B Kapila dated 21 July 1998. In this report he noted that the Applicant had been off work for the last three weeks and that had helped her. She said that she had no pain at rest. On examination he found a full range of movements and Finkelstein's test was negative. There was no pain in the elbow, shoulder or neck.
T64 Report of Dr H B Kapila dated 11 August 1998. In this report Dr Kapila noted the Applicant had been off for six weeks and said she felt much better. He continued:
"Her main problem is that she is doing a dental nurse's course and when she is trying to mix up the powder with water with a spatula she gets a bit of pain."
T69 Report by Dr Joan Chen dated 28 October 1998. Dr Chen commenced her report by stating:
"Ms Nguyen informed me that she perceives her condition to be worsening. She complained of increasing pain in the right lower shoulder girdle, extending into the axilla and pain between the thumb and index finger."
Dr Chen went on to opine that the Applicant had myofascial type pain in the right lower shoulder girdle and in the first interosseous muscle between the right thumb and index finger.
T70 Report of Dr H B Kapila dated 30 October 1998:
"She is still using the splint for de Quervain's disease and she feels very comfortable and sleeps reasonably well with the splint on."
T75 Report of Dr H B Kapila dated 18 May 1999:
"I saw Mrs Nguyen today and she is having a lot of pain in the first web space of her right hand as a result of repetitively picking up letters at work.
…
She was also tender in the area of her elbow and shoulder."
T86 Report of Dr McGill dated 20 March 2000. Dr McGill noted under Work History:
"…She has completed her dental nurse training and she did some dental nurse work experience but she had difficulty mixing the preparations because of right thumb pain and she has no immediate plan to change to dental nursing."
On examination Dr McGill noted:
"Phalen's test did not produce symptoms of median nerve dysfunction although she did experience some pain radiating from the wrist up into the hand. There was no evidence of de Quervain's tenosynovitis nor epicondylitis. Despite tenderness of the right thenar eminence, there was no palpable or visible abnormality of that region."
Dr McGill then stated"
"She continues to report sensory symptoms in the right hand which may be due to very mild carpal tunnel syndrome. Even if she has mild carpal tunnel syndrome, I do not believe that can account for the localised pain and tenderness in the right thenar eminence."
He then stated:
"I think it is possible that her work activities are continuing to aggravate her thumb and further comment may be possible following the further imaging studies of her thumb."
T99 Report of Dr H B Kapila dated 5 December 2000. In that report he stated that the Applicant had "signs and symptoms suggestive of right carpal tunnel syndrome clinically".
T103 Report of Dr McGill dated 16 December 2000: Dr McGill noted that MRI evidence was of mild osteoarthritic change in the CMC joint of the right thumb. He then went on to state:
"Thus, although minor abnormalities were detected in the MRI, none of those abnormalities accounts for the symptoms she reported and she did not have any MRI abnormality that one would expect to interfere with her performing normal work duties."
He further added:
"…most of her symptoms can not be explained by median nerve dysfunction."
Dr McGill then ended his report by opining that the Applicant was probably fit for full normal duties but that a progressive upgrade in her work duties would be the appropriate approach.
21. As can be ascertained from the above documents, the Applicant’s complaints of pain have been varied and examining medical practitioners have had difficulty in making any firm diagnosis.
22. In addition to the reports detailed above, Dr McGill gave evidence in these proceedings. He stated that he had considered tenosynovitis as a diagnosis but rejected it, neither had he found any evidence of de Quervain's disease.
23. Whereas Dr McGill thought that most of the Applicant's symptoms could be explained by carpal tunnel syndrome, it was at the mild end of carpal tunnel syndrome. More importantly, he opined that keyboard activities are not associated with carpal tunnel syndrome neither was the radiation of her symptoms consistent with carpal tunnel syndrome. Mail sorting could cause an exacerbation of symptoms in someone with existing carpal tunnel syndrome.
24. Cross-examined Dr McGill stated that he found the Applicant to be a clear historian who showed not signs of embellishment and that he did not have a differential diagnosis that really held together. He did note that the Applicant had osteoarthritis at the base of her right thumb and whereas this was not caused by work, when doing work she could have aggravated her symptoms. The Applicant had however, minor disabilities that should not have interfered with functioning.
25. Dr Faithfull examined the Applicant on 16 January 2003. In his report of 20 January 2003 he diagnosed the Applicant as having a right carpal tunnel syndrome. He added:
"In my view, although the nerve conduction studies have been normal, the history and physical findings are those of carpal tunnel syndrome."
Dr Faithfull believed that the condition was work caused.
26. Cross-examined Dr Faithfull agreed, carpal tunnel syndrome did not explain the "clicking" in the Applicant's teeth nor did carpal tunnel syndrome result in localised pain in the shoulder.
27. Questioned regarding the cause of the Applicant's carpal tunnel syndrome, Dr Faithfull stated that the work place was a possibility and that he implicated the work place, as he could not find any other cause. He referred to loading and unloading mailbags and repetitive activities. He agreed that the Applicant's arthritic changes were not work caused.
28. Although Dr Kapila who specialises in hand surgery has seen the Applicant on numerous occasions, he was a most unsatisfactory witness. Pressed in cross-examination it became apparent that in reality he had no idea of the nature of the duties performed by the Applicant.
29. Dr Kapila's diagnosis of the Applicant's condition has varied over the years. For example:
30 October 1998 (T70) He referred to the Applicant having "de Quervain's disease".
5 December 2000 (T99) He referred to the Applicant having "signs and symptoms of right carpal tunnel syndrome clinically".
Exhibit A4 dated 2 July 2002 He opined under the heading DIAGNOSIS "it appears to me she has early arthritis in the CMC joint of the right thumb and also tenosynovitis of the muscles of the thenar and forearm muscles and also the back of the neck and shoulder".
On being questioned by Tribunal Member Dr Thorpe, Dr Kapila was unsure of what the diagnosis of the Applicant's condition was and he resorted to verbosity without real meaning.
30. As we understand Dr Kapila's evidence, although he stated in Exhibit A4 that the Applicant did have “symptoms” of carpal tunnel syndrome, he did not make a diagnosis of that condition as the objective tests for carpal tunnel syndrome, namely Phelan's test and the nerve conduction studies were both negative.
31. Dr Harvey, Orthopaedic Surgeon, saw the Applicant at the request of the Respondent on 26 March 2002. In his report of 25 March 2002 (Exhibit R2) Dr Harvey stated:
"This patient complains of pain in the right upper limb, but I don't think this can be explained on the basis of any significant musculoskeletal pathology."
32. In an earlier report dated 18 October 2002 (Exhibit R4) Dr Harvey stated:
"…I think the statement that the patient has a "lateral epicondylitis right hand" is nonsensical because the lateral epicondyle is a bony prominence on the lower end of the right humerus at the elbow and is not in the region of the hand. However, when I examined the patient I did not consider that she had a lateral epicondylitis and my reasons are set out in my report dated 27.3.02. I have viewed the conduction studies that were carried out by Dr Calligeros. These are normal and do not offer any possible explanation for the patient's complaints…"
33. In a subsequent report Dr Harvey took issue with Dr Kapila's diagnosis of tenosynovitis stating inter alia:
"I would agree that one can only have a tenosynovitis in those areas where there are tendons covered by a synovial sheath. There are no such tendons in the thenar muscles, neck muscles or about the shoulders."
We note also that Dr McGill in his report of 20 March 2000 found no evidence of tenosynovitis.
34. Cross-examined Dr Harvey stated that carpal tunnel syndrome was unlikely to cause pain in the shoulder and neck and to get pain radiating up the forearm one would have to have severe carpal tunnel syndrome (which the Applicant does not have). He added that he did not think that the Applicant's pain has any basis in organic disease. She was complaining of pain and tenderness over multiple areas of the arm and he could not explain this on the basis of physical disease. As to pain around the right thumb, there were multiple reasons for this, but no one had been able to demonstrate any pathology on objective tests.
35. More importantly Dr Harvey stated that he did not make a diagnosis of carpal tunnel syndrome as the Applicant had normal nerve conduction studies. Asked the basis of this opinion he stated it was derived from the 5th Edition of the American Medical Association Guide to the Evaluation of Permanent Impairment.
36. Whereas Dr Harvey was unable to refer the Tribunal to the exact reference in the guide apart from stating the relevant discussion commenced at page 492, thereof the Tribunal consulted the guide itself. A perusal of the guide confirms Dr Harvey's statement that the said guide negates a diagnosis of carpal tunnel syndrome (or as it terms it entrapment/compression neuropathy) in the absence of documentation by electroneuromyographic studies.
37. Early reports by for example by Drs Chen and McGill that opined that the Applicant suffered a carpal tunnel syndrome were tentative only. Dr Faithfull noted that nerve conduction studies were normal but made a diagnosis of carpal tunnel syndrome in any event. His opinion can be contrasted with that of Dr Kapila, who in the absence of both a positive Phelan's test and nerve conduction studies refused to make that diagnosis. Given the support Dr Harvey finds in the AMA Guide 5th Edition, we find that we are more persuaded by his opinion that the Applicant's symptoms cannot be answered by a diagnosis of carpal tunnel syndrome.
38. We are strengthened in this finding given the diffuse nature of the Applicant's complaints. A perusal of the medical reports as contained in the section 37 documents will show that she has complained of pain not only at the wrist but also the forearm, shoulder, neck, head at various times. At the end of the day therefore, having regard to the opinion of Dr Harvey and the admission by Dr Kapila that he really did not know what was wrong with the Applicant, we find that we are not satisfied on the balance of probability that the Applicant does suffer from a carpal tunnel syndrome.
39. Even if the Applicant did suffer from a carpal tunnel syndrome, which is regarded as mild by those medical practitioners who support that diagnosis, on the material before us we are not satisfied that the said condition was caused by work as opposed to there being an exacerbation of symptoms whilst the Applicant was at work. It seems clear on her own evidence that her symptoms resolve when away from work.
40. Although various diagnoses have been suggested for the symptoms experienced by the Applicant, the only condition which is supported by objective testing is that the Applicant has osteoarthritis at the base of her right thumb as revealed by the MRI scan. There is no suggestion that this condition is work caused although the symptoms of that disease will be exacerbated by her work. Apart from this, the range of symptoms referred to by the Applicant in evidence cannot be explained on physical grounds.
41. That is not necessarily the end of the matter in as much as was pointed out in Commonwealth Banking Corporation v Percival 20 FCR 176 at 178 that the symptoms of a disease are part of that disease. Further, as was said by Bollen J in Glavines v Holden’s Motor Company Ltd (unreported SASC, 25 October 1991, no 61/1990):
"The mind, temperament and character of a man or women does not move and have its being only in areas capable of strict characterisation as physical or psychiatric. If there is something about the victim of a tort, which makes him or her feel pain and thereby be incapacitated, he or she is entitled to adequate damages and compensation for the effects of that tort even though the symptoms cannot be defined by any conventional label."
42. This matter is a classical example of the principles stated above. We have no reason to doubt the Applicant's evidence and medical practitioners who have seen her, particularly Dr McGill, who do not consider that she was feigning illness. Notwithstanding this however, we note that whenever she has complained of pain whilst performing any duties she has been relieved from those duties. More importantly however, it appears from her own evidence that her symptoms resolve when she is away from work. However, that the Applicant's symptoms become worse while she is at work does not mean that any underlying disease process has been aggravated, see Repatriation Commission v Yates 57 FCR 241 at 249 where Lindgren J after referring to Asioty v Canberra Abattoir Pty Ltd 167 CLR 533 at 540 said:
"The importance for present purposes of the passage quoted above is in its recognition of the distinction between and the aggravation of a pre-existing disease, and in the references to the disease of dermatitis as underlying to more permanent aggravation and to enhance susceptibility. The passage quoted earlier from Heap’s Case is generally similar. Those passages recognise that an occurrence or worsening from time to time of symptoms caused by work or service may not compel an inference that there has been an aggravation caused by work or service of a pre-existing disease."
43. In this matter we are satisfied that what the Applicant is experiencing are symptoms of some indeterminent ailment which occur when she is working. In the same way that other people who perform physical tasks may experience aches and pains at the end of the day. Her symptoms then resolve with rest. She has been extensively investigated and as stated above her symptoms cannot be explained on physical grounds. As Dr McGill pointed out in his recent report "there is no reason why she cannot do her normal duties".
44. Given the material which has been placed before us, we are not satisfied that the Applicant has suffered any injury as that term is defined in section 4 of the Safety, Rehabilitation and Compensation Act 1988 and consequently the decision under review is affirmed.
I certify that the 44 preceding paragraphs are a true copy of the reasons for the decision herein of Senior Member M D Allen and Dr M E C Thorpe, Member.
Signed: .......................................................................................
AssociateDate/s of Hearing 19 and 20 February 2003
Date of Decision 7 March 2003
Counsel for the Applicant Mr K Morrissey
Solicitor for the Applicant McClellands Solicitors
Counsel for the Respondent Miss R Henderson
Solicitor for the Respondent Sparke Helmore
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