O’Day and Comcare (Compensation)

This matter concerned an appeal by Mr O’Day against a decision by Comcare to cease liability for ongoing osteopathic treatment. Mr O’Day sustained a musculoligamentous strain to his neck and back in a motor vehicle accident in July 1991. While initially compensated for osteopathic treatment, Comcare ceased liability in 2000, though this decision was later overturned on internal review. Mr O’Day sought to continue receiving compensation for osteopathic treatment, arguing that his accepted injury was chronic and required ongoing treatment to manage his symptoms, particularly as he could not take anti-inflammatory medication due to other health conditions. The Administrative Appeals Tribunal was required to determine whether the osteopathic treatment was obtained at the direction of a legally qualified medical practitioner, whether it was therapeutic in the context of his accepted condition, and if it was reasonable for him to continue obtaining such treatment in the future.

The Tribunal considered various medical opinions and evidence regarding Mr O’Day’s condition and treatment. It noted that while initial osteopathic treatment was provided following a referral from his general practitioner, Dr Whelan, and that Mr O’Day had responded favourably to it at the time, the situation had evolved over approximately 25 years. The Tribunal accepted the opinions of Mr Shannon and Mr Haig, who suggested that Mr O’Day’s reliance on osteopathy reflected an unreasonable dependency unrelated to his accepted injury. They also indicated that a self-managed exercise program would be equally effective and that there was no reason to believe his pain would increase without osteopathic treatment. The Tribunal found that the symptoms Mr O’Day continued to experience, particularly in his lower back, had been exacerbated by his persistent obesity, and that after 25 years of treatment, there had been no measurable improvement or change in his degenerative back condition.

Ultimately, the Tribunal concluded that while the osteopathic treatment initially qualified as eligible medical treatment under the Act, it was no longer reasonable treatment in relation to his accepted injury. The Tribunal found that the benefits of the treatment were transient and substantially outweighed by the consequences of dependency and financial costs. Therefore, the Tribunal found that it was neither reasonable nor in Mr O’Day’s best interests for osteopathic treatment to continue under the Act.