Ordonez Camero v Victorian WorkCover Authority
[2025] VCC 779
•25 June 2025
| IN THE COUNTY COURT OF VICTORIA AT MELBOURNE COMMON LAW DIVISION | Revised Not Restricted Suitable for Publication |
SERIOUS INJURY LIST
Case No. CI-24-04141
| LISSETTE ORDONEZ CAMERO | Plaintiff |
| v | |
| VICTORIAN WORKCOVER AUTHORITY | Defendant |
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JUDGE: | HER HONOUR MANOVA | |
WHERE HELD: | Melbourne | |
DATE OF HEARING: | 19 and 20 May 2025 | |
DATE OF JUDGMENT: | 25 June 2025 | |
CASE MAY BE CITED AS: | Ordonez Camero v Victorian WorkCover Authority | |
MEDIUM NEUTRAL CITATION: | [2025] VCC 779 | |
REASONS FOR JUDGMENT
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Subject:ACCIDENT COMPENSATION
Catchwords: serious injury application – right wrist and pain syndrome -
Legislation Cited: Workplace Injury Rehabilitation and Compensation Act2013, s335(2)(d)
Cases Cited:Kelso v Tatiara Meat Co Pty Ltd (2007) 17 VR 592; Sabo v George Weston Foods [2009] VSCA 242; Victoria WorkCover Authority v Brassington [2021] VSCA 236; AG Staff v Filipowicz; Arnold Ribbon Co Pty Ltd v Filipowicz (2012) 34 VR 309, De Agostino v Leatch [2011] VSC 249; Palmer Tube Mills (Aust) Pty Ltd and Anor v Semi [1998] 4 VR 439; Johns v Oaktech Pty Ltd [2020] VSCA 10; Samaras v Transport Accident Commission [2019] VSCA 255
Judgment: Leave granted
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APPEARANCES: | Counsel | Solicitors |
| For the Plaintiff | Mr J Brett KC with Mr T Nathanielsz | Just Injury Lawyers |
| For the Defendant | Ms S Gold | Russell Kennedy Lawyers |
HER HONOUR:
Introduction
1The plaintiff, Ms Lissette Ordonez Camero, seeks leave pursuant to s335(2)(d) of the Workplace Injury Rehabilitation and Compensation Act 2013 (“the Act”) to bring common law proceedings to recover pain and suffering damages in respect of an injury to her right wrist and pain syndrome which is a complication of the wrist injury.
2The wrist injury is alleged to have arisen out of, or in the course of, her employment as a food and beverage attendant at Marvel Stadium on 20 February 2018.
3The claim was put on the basis of sub-paragraph (a) of the definition of serious injury. Ms Ordonez Camero abandoned her claim under sub-paragraph (c).[1]
[1]Transcript (“T”) 170
4The defendant did not dispute the compensability of the wrist injury. However, argued that in 2021 the plaintiff suffered a separate injury to the right shoulder, in different compensable circumstances and produced consequences to the relevant body function.
5The hearing proceeded in the usual way. The plaintiff was the only witness to give oral evidence and be cross-examined. The parties otherwise tendered various reports from their respective court books. Although supported in court by her husband, Ms Ordonez Camero did not tender any supportive affidavit from him.
The relevant legal principles
6The legal principles are well known and were not in dispute. The Court must not give leave unless it is satisfied, on the balance of probabilities, that “the injury” is a “serious injury”. The plaintiff bears the onus of proving, on the balance of probabilities, the following two criteria:
(a) that the injury is a “serious injury” by reference to the pain and suffering consequences of any impairment or loss of body function, “when judged by comparison with other cases in the range of possible impairments or losses of a body function”;[2] and
(b) that the pain and suffering consequences, when judged by comparison with other cases, in the range of possible impairments or losses of a body function, may be fairly described as being “more than significant or marked, and as being at least very considerable”.[3]
[2]Section 325(2)(b) of the Act
[3]Section 325(2)(c) of the Act
7In determining the application, the Court:
(a) must not take into account psychological or psychiatric consequences of the “injury” for the purposes of sub-paragraph (a) of the definition of “serious injury”. These can only be taken into account for the purposes of paragraph (c) of the definition of “serious injury”;[4]
(b) must make the assessment of “serious injury” at the time the application is heard;[5]
(c) must bring a value judgement to the assessment whether “an injury” satisfies the narrative test.[6]
[4]Pursuant to s325(2)(h) of the Act
[5]Pursuant to s325(2)(j) of the Act
[6]Kelso v Tatiara Meat Co Pty Ltd (“Kelso”) (2007) 17 VR 592; Sabo v George Weston Foods [2009] VSCA 242 at paragraph [67]
8It is not permissible to aggregate two or more injuries suffered in different compensable circumstances.[7] The plaintiff bears the onus of delineating the consequences of the alleged injury arising from the alleged compensable circumstances.
[7]Victoria WorkCover Authority v Brassington [2021] VSCA 236 at paragraph [40], AG Staff v Filipowicz; Arnold Ribbon Co Pty Ltd v Filipowicz (2012) 34 VR 309, De Agostino v Leatch [2011] VSC 249 and T101
The issues before the Court
9There were five issues before the court:
(a) what organic injury arises from the February 2018;
(b) what were the impairment consequences of that injury and do they meet the statutory test
(c) the credibility and reliability of Ms Ordonez Camero, including the reliability of histories to doctors and the contents of her affidavit;
(d) whether Ms Ordonez Camero had impermissibly aggregated the effects of multiple injuries arising in multiple sets of compensable circumstances;
(e) whether the February 2018 right wrist injury caused or contributed to the 2021 injury to the right shoulder.
Summary of findings
10I find that Ms Ordonez Camero’s shoulder injury arising from employment in 2021 was not a consequence of the right wrist injury in 2018.
11While I was not satisfied that Mr Ordonez Camero was a credible or reliable witness, I grant leave as I find there is reliable objective evidence which supported her case.
Background
12Ms Ordonez Camero was born in Mexico in July 1980 and is currently forty-four years of age. She holds a Bachelor of International Business from a university in Mexico, a Masters of Business Administration from a university in Canada, and a Diploma of Events and Bachelor of Events Management from William Angliss Institute in Melbourne. She is right handed.
13Ms Ordonez Camero came to Australia in 2016 on a student visa. Sometime later, she began work fifteen hours a week as a food and beverage attendant for Melbourne Stadiums Limited.
14From October 2017, she remained working in the same role at the same location but “Delaware North Venue Services” (“Delaware”) became her employer.
15On 20 February 2018, Ms Ordonez Camero was working at a function at Marvel Stadium, carrying large and heavy trays containing plates of food, when she began to experience pain in her right arm. The following morning, the pain had moved to her right wrist and hand, and over the coming days spread to her forearm.
16Ms Ordonez Camero took some time off, but her injury did not improve. She attended a doctor, and on 7 March 2018 reported the injury to management and was placed on a return-to-work plan.
17Ms Ordonez Camero said in her oral evidence that on 29 March 2018, she lodged a Workcover claim for “right median nerve compression wrist, hand, forearm carrying 3 heavy function plates during shift” (“the first claim”).[8]
[8]T10 ꟷ T11 and Defendant’s Court Book (“DCB”) 244-245
18Ms Ordonez Camero was placed on a return-to-work plan under the first claim. However she was unhappy with the duties and the hours allocated to her. She discussed her dissatisfaction with her psychologist who made complaints on her behalf to WorkCover.
19On 29 June 2019, Ms Ordonez Camero was spoken to about speaking Spanish at work. When she complained about this, her manager told her she was not permitted to speak Spanish at work at all. This incident caused her to have a panic attack and she ceased work for Delaware on 30 June 2019.
20On 12 September 2019, Ms Ordonez Camero lodged a WorkCover claim in relation to these events. That claim was for “psychological injury for racial and disability discrimination” said to have occurred between 29 and 30 June 2019” (“the second claim”).[9]
[9]DCB 297-298
21In early 2021 Ms Ordonez Camero made a claim for Total and Permanent Disability (“TPD”).
22On 15 April 2021, Ms Ordonez Camero commenced work as office administrator for “Acacia Administrative Services” (“Acacia”).[10] She was working about thirty hours a week with restrictions relating to the wrist injury.
[10]T25
23In October 2021, while working from home during COVID-19 lockdowns, Ms Ordonez Camero suffered an injury to her right shoulder. Ms Ordonez Camero said, in her oral evidence that on 18 October 2021, she made a claim for “right shoulder sub-deltoid bursitis” while working from home from 5 August due to lockdown, “performing computer based tasks … such as formatting and editing of documents, emails, answering phones” (“the third WorkCover claim”).[11]
[11]T29 ꟷ T30 and DCB 89
24Ms Ordonez Camero has not worked since lodging her third WorkCover claim. She remains on weekly payments in respect of that claim.[12]
[12]T92
Treating medical practitioners
Dr Emil Popordanoski, general practitioner (“GP”)
25On 12 October 2020, Dr Popordanoski reported his diagnosis of repetitive strain injury to the right wrist, right wrist synovitis and right bicep tendonitis, and adjustment disorder and anxiety secondary to work-related stress (discrimination and harassment).[13]
[13]Plaintiff’s Amended Court Book (“PCB”) 53-54
26Ms Ordonez Camero had undergone nerve conduction studies to the right median nerve, an MRI scan of the right wrist and mental health assessment. Her progress had plateaued.[14]
[14]PCB 53-56
27On 30 November 2021, Dr Popordanoski reported that his initial examination on 28 February 2018 confirmed swelling, tenderness and warmth around the wrist, with a reduced range of movements and 4/5 muscle weakness. The symptoms varied in frequency and intensity over the years, the common pattern was frequent exacerbations triggered by prolonged activity (manual work with the right hand/arm). Prolonged and comprehensive treatment had been insufficient to provide full resolution of the symptoms.[15]
[15]PCB 64
28On 31 January 2025, Dr Popordanoski reported that around February 2018, Ms Ordonez Camero developed pain, numbness and tingling sensations in her right wrist and hand which she attributed to the repetitive strain of her waitressing duties. The symptoms worsened over time, leading to a significant reduction in her ability to perform work-related and everyday tasks which required fine motor skills.
29The diagnosis was repetitive strain injury of the right wrist, right wrist synovitis and right biceps tendonitis with Complex Regional Pain Syndrome and anxiety secondary to work-related stress. The prognosis was guarded.[16]
[16]PCB 67
30Ms Ordonez Camero’s injuries had a profound impact on her ability to engage in personal care, domestic responsibilities, social interactions and recreational activities. It was unlikely she would fully recover and return to pre-injury functioning.[17]
[17]PCB 68-69
31While Ms Ordonez Camero was working at Acacia, Dr Popordanoski issued Certificates of Capacity which certified her fit for suitable employment and provided:
(a) restrictions of thirty-two hours a week,[18] no lifting more than 1 kilogram with the right hand and no repetitive work with the right hand (carrying, lifting, opening doors and grasping);
(b) the clinical diagnosis was “right wrist repetitive strain injury right wrist synovitis. right biceps tendinitis ? Complex regional Pain Syndrome anxiety (reactive, sec to work related stress, has separate claim)” (sic);[19]
(c) “no capacity for employment” on 11 October 2021. The clinical diagnosis was “right wrist repetitive strain injury, acute flare up right wrist synovitis. right biceps tendinitis, ? Complex Regional Pain Syndrome anxiety (reactive, sec to work related stress” (sic);[20]
(d) “no capacity” from 18 October 2021, and the relevant diagnosis was “anxiety secondary to work related harassment and discrimination (flare up)”.[21]
[18]See Certificates of Capacity dated 14 April 2021 and 28 April 2021 at pages 237 and 239 of the Bundle of Certificates of Capacity. This increased to thirty-eight hours on 24 August 2021. See Certificate of Capacity dated 26 May 2021, Bundle Certificates of Capacity at page 241
[19]See Certificate of Capacity dated 23 September 2021 at page 249
[20]See Bundle of Certificates of Capacity at page 255
[21]See Bundle of Certificates of Capacity at page 257
32Separate Certificates of Capacity had been issued under the three separate claims, but at one stage, Dr Popordanoski began issuing one certificate in respect of the three claims.
Backfocus Physiotherapy
33On 25 October 2019 and on 3 April 2020, a treating physiotherapist reported a diagnosis of repetitive strain injury to the wrist. There had been no prior injuries or conditions affecting the wrist.
34Despite Ms Ordonez Camero’s participation in various therapies, her recovery had been slow due to her employer’s “poor management of her return to work hours … and the stress & anxiety associated with this”.[22] She had failed to return to her pre-injury level of function.[23]
[22]PCB 23
[23]PCB 23-24
Dr Dan Bates, sports and exercise medicine physician
35On 7 April 2021, Dr Bates first assessed Ms Ordonez Camero in order to review and provide an opinion to Dr Popordanoski on her “chronic recurrent and persistent pain to the right arm and right wrist arising from a work-related injury”.[24]
[24]PCB 30
36In particular, Dr Popordanoski requested an opinion on a possible diagnosis of Complex Regional Pain Syndrome. The history recorded on that day includes:
“… the onset of pain on 20 February 2018 with no specific trigger, … she simply developed pain during a shift … .
…
Her pain extends from her right shoulder, down her upper arm and predominantly into her forearm, wrist and fifth digit in the C8 distribution. She describes the pain as a hot, burning pain, 9/10 at its worst at least once per week, and 5-6/10 on average and never 0/10. She has associated pins and needles and numbness that extends to her little finger and then across her hands. She also has an occasional itch and intermittent shooting pain that extends down from her shoulder when it is bad. The pain regularly wakes her at night 4-5 times, and varies each morning depending on her activity the day before. It has been associated with swelling throughout her forearm but she denies any skin colour changes or abnormal sweating. … .
…
On examination she had good range of motion of her elbows and wrists. She had no presence of allodynia. She was hyperalgesic to pin prick on the right through C4, C5, C6, C7 and C8 … There was no abnormal swelling, hair changes or skin colour changes.[25] She had weakness on wrist extension and flexion on the right with abduction of the fifth digit and abduction of the right thumb.
Previous MRI of her wrist was ostensibly unremarkable. Nerve conduction studies, as noted above, were also negative.”[26]
(Emphasis added.)
[25]I want to refer to this in my analysis to say no one observed any such changes which would be objective evidence of sone kind of syndrome affecting the wrist/arm.
[26]PCB 31
37On 14 April 2021 (the day before Ms Ordonez Camero commenced work at Acacia), Dr Bates reported that her right neuropathic upper limb pain was a possible variant of Complex Regional Pain Syndrome, but Ms Ordonez Camero did not meet the diagnostic criteria. The pain was highly intrusive, impacting on family life, ability to paint and ability to work.[27]
[27]PCB 30
38Dr Bates recommended a multidisciplinary approach, continuing the current physiotherapy and adding a mirror therapy; continuing Lyrica 25 milligrams bd and commencing Endep, quarter of a tablet at night, increasing to one to two tablets; conducting an MRI scan and considering an epidural injection at C7-T1 and T2, and a sympathetic ganglion block.[28]
[28]PCB 31
39On 18 August 2021, Dr Bates reported that Ms Ordonez Camero had been travelling reasonably well with use of a topical anti-neuropathic cream, but that she had a flare-up of her pain the day before, particularly throughout her shoulder. She had ongoing pain through the shoulder and upper arm. A medication protocol for pain flare-up management was prescribed.[29]
[29]Ibid. I want to refer to this in my analysis to say he was not aware she was back at work.
40On assessment in October 2021, Dr Bates reported that Ms Ordonez Camero developed some right shoulder bursitis which responded initially to cortisone, but has worsened again, limiting her ability to work. The bursitis was secondary to the upper limb pain which was causing “scapulohumeral dysrhythm and the subsequent bursitis”. He referred Ms Ordonez Camero to Melbourne Shoulder Group for physiotherapy.[30]
[30]PCB 32
41On 24 August 2022, by Dr Bates reported that Ms Ordonez Camero had received a good result with physiotherapy but she was continuing to have:
“… intermittent swelling of her upper limb, alterations and temperature, intermittent skin colour changes in associated with her burning pain and’s allodynia particularly over the shoulder region. This combination of symptoms being in line with diagnosis of complex regional pain syndrome … .”[31]
[31]Ibid
42The diagnosis as at 30 November 2022 was right upper limb Complex Regional Pain Syndrome (loss of grip strength due to pain and direct effect on the motor neurons).[32]
[32]Ibid
43On 13 July 2023, Dr Bates reported his recommendation for an epidural and sympathetic ganglion block due to the anxiety/Post-Traumatic Stress Disorder interacting with her pain syndrome. The report confirms that Dr Bates provided advice about the risks of such a procedure, including bleeding, bruising and other risks to health.[33]
[33]PCB 148
Miss Katherine Davis, physiotherapist at Melbourne Shoulder Group
44On 25 April 2024, Miss Davis reported that following a shift in February 2018, Ms Ordonez Camero experienced insidious onset of symptoms in the forearm and wrist. These symptoms specifically worsened in September 2021, working long hours performing computer-based administrative tasks as an office manager.[34]
[34]PCB 34
45Miss Davis recorded constant persistent symptoms of a sharp intense burning pain. This developed into swelling and tightness in the forearm, with intermittent numbness in the hand. The pain could be flared by different activities. Ms Ordonez Camero was seeing a pain psychologist.[35]
[35]PCB 34-35
46Recent patient rated outcome measures taken in April 2024 indicated an impairment level of 74 per cent based on DASH and 86 per cent from SPADI. There had been no improvement in the scores since the first assessment in February 2022 which showed similar percentages.[36]
[36]PCB 35
47The report provides that Ms Ordonez Camero has significant restriction in lifting, above-shoulder-level activities, forceful pushing or pulling, and repetitive manual tasks with the right arm. Her capacity with specific activity involving the hand and wrist varied. Load limitations had been consistently around 1 to 2 kilograms and repetitive activities around thirty minutes (for example food preparation and painting). She was unable to carry or lift, which restricts external activities like shopping. She was unable to perform her normal household activities without pain provocation and was unable to maintain a level of previous physical activity.[37]
[37]PCB 36
Ms Ordonez Camero’s medico-legal reports
Dr Saleem Khan, consultant in rehabilitation and pain medicine
48On 11 April 2024, Dr Khan reported to Ms Ordonez Camero’s solicitors. As part of the reporting process, Dr Khan had regard to numerous treating doctor reports and radiological investigations.
49Dr Khan noted a history of onset of symptoms (pain in the wrist and hand) following work on 20 February 2018 and over the course of several days thereafter, pain spreading to her forearm.
50In April 2021, Ms Ordonez Camero returned to work as an office manager working thirty hours a week from home and developed shoulder bursitis. She was using a ketamine compound cream, as well as oral Lyrica, Celebrex, Endep, Panadeine and Nurofen to alleviate her pain.
51Ms Ordonez Camero reported difficulty pulling on, or pulling off, tight upper-limb clothing, difficulty donning shoes and socks, difficulty with buttons, and pain when pushing up on the right hand. She had difficulty opening jars, lids and tins. She could not do repetitive food preparation, lift heavy pots, and she had difficulty with mopping, vacuuming and pushing or pulling heavy doors. She had trouble with lifting laundry. Her husband did most of the domestic tasks. She no longer drove. Her sleep was disturbed by pins and needles and she had nightmares and flashbacks of her workplace. She could no longer do training with weights or use a rowing machine, or do yoga, sewing or knitting. She was unemployed and receiving WorkCover payments.[38]
[38]PCB 102-103
52On examination, Dr Khan noted hyperalgesia to pinprick in the right forearm and hand, with no gross sensory loss or global weakness of the right arm in a non-myotomal distribution; and there was no gross swelling, colour or temperature changes. She could make a fist, open her hand and fingers, and her movements appeared grossly normal. The right wrist range of motion was mildly decreased.[39]
[39]PCB 105
53Dr Khan considered Ms Ordonez Camero did not meet all the Budapest criteria to support a diagnosis of Chronic Regional Pain Syndrome. The injury was a repetitive strain injury as a result of duties which placed high stresses on her right arm, particularly on the wrist and hand joints.[40]
[40]Ibid
54She had developed a degree of central sensitisation with somatic neuropathic pain features. The diagnosis was persistent pain affecting the right forearm, wrist and hand. In general, even with appropriate treatment, the natural history of persistent pain is usually characterised by periods of reasonable pain control, interspersed with acute exacerbations which may be precipitated by changes in health status and mood disturbance, as well as weather changes, physical exertion and medication changes.[41]
[41]PCB 106
55On 13 March 2025, Dr Khan provided a supplementary report focusing on the opinion of hand surgeon Mr Thomas. Dr Khan reported that, unlike pain caused by tissue damage, neuropathic pain arises from the nervous system itself, even when there is no sign of obvious tissue injury. Central sensitisation is a condition in which the brain and spinal cord become overly sensitive and reactive to stimuli which would typically not cause pain. The nervous system then amplifies the pain signal. This was characterised by widespread pain, hyperalgesia and allodynia, and may involve fatigue, mood/cognitive issues and sleep disturbances.
56Dr Khan did not agree with the opinion of Mr Robbins that there was no condition affecting the hand/wrist.[42]
[42]PCB 120-121
The Defendant’s medico-legal reports
Dr Marcus Navin, occupational medicine physician
57On 5 July 2018, Dr Navin reported that after the February 2018 injury Ms Ordonez Camero had a period off work, but stopped completely in March 2018. She was reporting pins and needles affecting the palmar aspect of all four fingers waking her in the night with pins and needles in the thumb, the little finger and occasionally in the middle finger. The pins and needles were limited to the fingers and not to the palm of the hand.
58Dr Navin diagnosed a sprain injury to the wrist joint. He considered there may or may not be some minor ligamentous stretching without rupture. He made various recommendations for a return-to-work plan.[43]
[43]DCB 8-11
Dr Joseph Slesenger, specialist occupational physician
59On 2 May 2019, Dr Slesenger reported on the injury at work on 20 February 2018. Ms Ordonez Camero had noticed pain over the base of the wrist, radiating into her hand. She had been investigated with nerve conduction studies and an MRI scan.
60Under activities of daily living, Dr Slesenger noted that Ms Ordonez Camero could dress, wash and shower herself, but that her partner had taken over the majority of the domestic tasks. She was no longer going to the gym.[44]
[44]DCB 31-32
61On examination, the right forearm and wrist revealed no trophic changes and no scarring. On palpation, there was tenderness over the flexible aspect of the right distal forearm, and grip strength on the right was mildly weakened and on the left was normal.[45]
[45]PCB 34
62Dr Slesenger diagnosed soft-tissue injury of the right wrist, chronic right wrist pain with evidence of tendinitis, and right elbow bicipital tendinitis. These injuries related to the workplace exposures on 20 February 2018 and had not, as at the time of assessment, yet resolved.[46]
[46]DCB 35-38
Associate Professor Bruce Love, orthopaedic surgeon
63On 3 November 2021, Associate Professor Love reported to Gallagher Bassett on the 5 October 2021 “right shoulder subdeltoid bursitis” injury.[47]
[47]DCB 199
64He recorded a history that Ms Ordonez Camero had worked as an office manager for approximately six months. In September 2021, she began to develop a burning sensation in the right shoulder. The symptoms caused her to perform many tasks with her left (non-dominant) hand. She ceased work on 6 October 2021.
65There was a past history of a right forearm condition which developed on 20 February 2018. Treatment for that condition had included physiotherapy which had ceased a year prior to the report.
66On examination, Associate Professor Love found that the range of movement of the right shoulder was significantly restricted, positive impingement was noted and examination of the right forearm revealed extreme tenderness in the structures about the right elbow, the tenderness being poorly located.[48]
[48]DCB 200
67Associate Professor Love considered that the right shoulder condition was probably a spontaneous condition which had been marginally aggravated by the nature of her work, spending long periods of time on computer. The diagnosis was rotator cuff tendinosis of the right shoulder, made on clinical examination without the benefit of imaging.[49]
[49]DCB 200-201
Dr Timothy Wood, sports and medicine physician
68On 10 May 2023, Dr Wood reported to Gallagher Bassett in relation to the third claim. He recorded a history that Ms Ordonez Camero commenced employment with the current employer in April 2021, working four days a week. This was a new job which she commenced on her return from other WorkCover claims involving her right wrist and harassment. She was working from home due to the COVID-19 lockdowns, performing administrative work in poor ergonomic circumstances. Around August 2021, she started developing shooting pain and burning in the front of her right shoulder. By early October 2021, she had to stop work. The pain at that stage was referring down to her right hand.
69Ms Ordonez Camero was not currently having any treatment. She was last under the care of Dr Bates about a year ago. She was currently seeing a psychologist monthly and her GP three monthly for certificates. She was not taking any regular medication, as the Lyrica was not helping. She had a supply of both Celebrex and Endep in case of significant flare-ups.
70On examination, Dr Wood found Ms Ordonez Camero was able to shrug her shoulder and elevate both arms to almost normal forward flexion and abduction. She reported some burning and discomfort at the end range of movement. Rotator cuff testing revealed mild pain. Hyperalgesia was elicited on palpating the anterior aspect of the shoulder, in particular, over the right biceps. The diagnosis was persisting pain affecting the right shoulder and right wrist. There was also the issue of the harassment claim, all of which were part of a maladaptive neurobiological pain response with multiple biopsychosocial factors impacting on them. Employment was still a cause of the shoulder injury, which started at work, possibly contributed to by poor ergonomic set up.[50]
[50]DCB 208-209
71Ms Ordonez Camero did not feel safe driving due to her poor left grip. At this stage, she was unable to drive a car, but could take public transport short distances. Dr Wood reported Ms Ordonez Camero had no capacity for work, and as there was no previous history of any right shoulder condition. This was a new injury, not an aggravation of a pre-existing injury.[51]
[51]DCB 211
Mr Barclay Reid, general surgeon
72On 10 July 2023, Mr Reid conducted an impairment assessment in relation to the right hand. He obtained a history from Ms Ordonez Camero that pain in the front of the right wrist commenced on 20 February 2018. It radiated to the fingers. A few weeks later, pain spread to the front of the forearm which felt stiff and heavy. She developed intermittent numbness in the whole of the little finger and the proximal part of the thumb corresponding to the proximal phalanx. She returned to work on modified duties in July 2018, which caused an increase of her pain and she stopped on 3 June 2019. He reported that:
“… she began a new job in April 2021 doing office work. Her symptoms became worse again and she ceased all work on 5 October 2021 and has not returned to any form of work since then.”[52]
[52]PCB 82
73The ongoing symptoms were pain in the right wrist, hand and forearm, and a feeling of swelling in the forearm. There was tingling in the thumb and middle finger intermittently, with a weak grip. Fine movements were lacking in coordination and precision. From late 2019, shooting pains from the shoulder region and going down the arm, developed. These were like electric shocks and came on with activity and happened every day. An orthopaedic surgeon, Mr Jason Harvey, could find no explanation for these symptoms and suggested she see a rheumatologist, which did not eventuate.[53]
[53]Ibid
74On examination, Mr Reid reported grip strength was 10, 8 and 8 kilograms on the right and 15, 18 and 15 kilograms on the left. There was pain when she gripped with the right. Her wrist was tender over the hand area and dorsal parts of the wrist joint area. The elbow and forearm were tender at the musculature flexor compartment of the forearm. The shoulder was tender over the AC joint and over the front of the shoulder overlying the biceps tendon. Tests for carpal tunnel syndrome were negative. There was no evidence of tendinitis.[54]
[54]PCB 84
75Mr Reid considered the most likely diagnosis was a muscular injury of the forearm muscles, mainly the common flexors, together with the traumatic synovitis of the right wrist. The persistence of symptoms for five years favoured a chronic complex regional pain syndrome. Ms Ordonez Camero was unfit for any form of work involving the right upper limb.[55]
[55]PCB 85
Dr Debo Gorai, consultant neurologist
76On 4 August 2023, Dr Gorai provided an impairment assessment to Gallagher Bassett. He recorded a history that the wrist pain commenced on 20 February 2018. The following morning, there was a sharp pain in the right wrist, soreness in the forearm, and towards the back of the wrist and the dorsal aspect of the hand. Nerve conduction studies were reported as normal.[56]
[56]PCB 92
77Ms Ordonez Camero was able to carry out all her personal and grooming activities, but would not do household activities, her partner does most of these. Her sleep was affected and her hobbies, like going to the gym, have also been affected as a result of the symptoms and not being able to work, and she has become increasingly stressed and anxious.[57]
[57]Ibid
78Neurological evaluation was carried out. Dr Gorai reported that Ms Ordonez Camero had normal cranial nerves and normal motor strength in upper and lower limbs, but in the right upper limb there was significant involvement of the medial and antebrachial cutaneous nerve, medial ulnar sensory and right radial sensory distribution of symptomatology, and reduction in temperature and pinprick sensation.[58]
[58]PCB 93
79Dr Gorai diagnosed, “chronic regional pain syndrome … from the repetitive strain and prolonged activity on that particular night, back in 2018 and it seemed to be following some nerve territories”.[59]
[59]Ibid
Mr Thomas Robbins, hand and plastic reconstructive surgeon
80On 5 July 2024, Mr Robbins reported his opinion. As part of the report process, Mr Robbins took into account various documents, including Ms Ordonez Camero’s affidavit, three worker’s injury claim forms, treating doctor reports, clinical records, radiological,[60] and medico-legal reports.
[60]Including an ultrasound-guided injection into the right shoulder, an MRI scan of the right wrist, an MRI scan of the cervical spine and an ultrasound of the right shoulder.
81Mr Robbins recorded a history of injury to the right wrist in February 2018. Her GP recommended light duties. No light duties were given and she was bullied and isolated at work. The pain worsened and eventually she resigned because of “mental health”.
82Mr Robbins considered the radiological investigations did not show anything significant. The nerve conduction test was normal.[61]
[61]DCB 57
83On examination, the hand, wrist and forearm were of a normal appearance. She had full range of movement of wrist and fingers. On palpation, she complained of tenderness on the front of her wrist. This did not seem severe. Her right grip was reasonable, although less than her [left] grip.[62]
[62](Ibid). While Mr Robbins report repeats “right grip”, I infer that the second reference is to her left grip.
84Mr Robbins reported that Ms Ordonez Camero’s pain did not have an organic basis and there was no physical condition of the right wrist of any significance. Any contribution by the employer would be related to her worker’s claim for mental trauma. There was no chronic pain syndrome and no physical explanation for the pain. From the physical perspective, she had capacity to work. From the mental perspective, she did not.[63]
[63]DCB 58-59
85Mr Robbins was unable to provide a definite diagnosis, but posited the possibility of hysteria or a factitious condition of some kind.[64]
[64]DCB 60
Ms Ordonez Camero’s evidence
Affidavits
86Ms Ordonez Camero swore two affidavits, the first on 22 April 2024 and second on 27 March 2025. In summary, Ms Ordonez Camero deposed as follows:
a)on 20 February 2018, she was carrying heavy trays and plates and experienced pain in her right arm. Her injury did not get better with time off work.
b)In July 2018, she returned to work on light duties, but was not provided regular rotation and was required to perform tedious tasks;[65]
c)in June 2019, a chef and a manager were abusive to her and told her she could not speak Spanish at work. She considered she was ostracised because of her injury, had a panic attack and stopped work on 30 June 2019;[66]
d)in April 2021, she returned to work thirty hours a week as an office manager for Acacia. She found work difficult due to her right wrist symptoms. During the COVID-19 lockdowns, she was working from her dining table at home and started to develop pain in her shoulder. By October 2021, her right arm condition had worsened to the point where she could no longer work;[67]
e)she underwent a nerve conduction study and an MRI scan to her neck, used medication such as Celebrex, Endep and ketamine compound cream, and had treatment from her GP and a physiotherapist. While trying to get pregnant she ceased use of the medication, but had Celebrex and Endep on hand for bad flare-ups;[68]
f)she had a constant burning sensation in her right wrist, forearm and shoulder with constant numbness. The strength and grip of her right hand, were reduced. The right hand and forearm swells and the skin was often discoloured or blotchy. She had sharp, burning shooting pain in her right wrist and forearm. She experienced shooting pain and burning in her right arm emanating from the shoulder and the right arm did not have much functional use;[69]
g)dressing or undressing herself, brushing her teeth, or washing her hair could be difficult. Domestic tasks like mopping, scrubbing, ironing, and tasks requiring the use of two arms, like changing bedding, were also difficult;[70]
h)a number of limitations existed due to pain.[71] These included cooking, cutting meat or vegetables, or stirring a pot, all of which could be difficult and painful. Without her husband, she would find it difficult to feed herself. Holding and using cutlery in the right hand was very troublesome. Shopping, using a mouse and keypad, and even using public transport, were all affected as she worried about her hand being bumped. She could no longer use a rowing machine at the gym;[72]
i)travel to Mexico required special arrangements, such as an empty seat next to her, someone to carry her bags, and special arrangement through security to avoid bumping the right hand.[73]
[65]PCB 10-11 at paragraph [15]
[66]PCB 11 at paragraph [19]
[67]PCB 12-13 at paragraphs [24] and [26]
[68]PCB 10 at paragraph [13]; PCB 12 at paragraph [25] and PCB 13-14 at paragraph [32]
[69]PCB 14 at paragraph [33]
[70](Ibid) at paragraphs [35]-[36]
[71]T9
[72]PCB 15 at paragraphs [37]-[43]
[73]PCB 16 at paragraph [46]
Cross-examination and re-examination
87In summary, Ms Ordonez Camero said the following in her oral evidence:
(a) there was nothing in the first claim about a right shoulder injury;[74]
[74]T12
(b) after lodging the first claim, she was performing light duties and only stopped after she had a panic attack (associated with the second claim);[75]
[75]T13
(c) she had not returned to work for the employer after the second claim and was receiving Certificates of Capacity from her GP pursuant to that claim for “anxiety”. She continued to receive weekly payments under this claim until she commenced work at Acacia in April 2021;[76]
[76]T17 ꟷ T21
(d) she did not consider she was able to return to work on her full pre-injury duties;[77]
[77]T71
(e) while at Acacia, her duties included answering phones, formatting and editing of documents, writing emails, greeting guests, and administrative tasks when working from home on her round dining table, which was not an ergonomic set up;[78]
[78]T28
(f) she tried to return to work after the right shoulder injury, but her employer was abusive and discriminatory and did not want her back. She continues to receive weekly payments under that claim;[79]
(g) she goes to the gym once or twice a month, but could not do any yoga at the moment;[80]
(h) she rarely went shopping for groceries, but could carry small items with her right hand;[81]
(i) she slept six to eight hours a night, which could be relevant to the right arm or anxiety. She did not have restful sleep;[82]
(j) The last time her GP prescribed medication for her was more than six months ago.[83] As at February 2024, she was not taking Celebrex or Endep very often, she avoided it (due to pregnancy plans). She had not returned to Dr Bates since he recommended the injections and she did not have them because of the risks.[84]
(k) her hand was feeling a bit tight and sore during her evidence and she disagreed that it was not swollen, and later she said “it feels like it’s swelling”, and sometimes when it swells there is no visible sign;[85]
(l) she did not agree that she was exaggerating the effects of the 2018 injury;[86]
(m) she could not return to work because of the pain[87]
(n) She only attended the physiotherapist twice in the last year because there was no need for manual manipulation of her arm, she was doing home exercises;[88]
(o) before she worked at Acacia she did not have any shoulder problems, but would feel shooting pain from the shoulder down her arm from time to time, which was not permanent.[89]
[79]T 27-29, T33 and T39 ꟷ T40
[80]T53
[81]T53 ꟷ T55
[82]T55 and T78
[83]T57
[84]T58 ꟷ T60
[85]T63 and T66
[86]T64
[87]T64 ꟷ T65
[88]T85 ꟷ T86
[89]T86 ꟷ T87
Ms Ordonez Camero’s credit
88In an application such as this, the credit of the plaintiff is often of great importance, both directly and indirectly.
89The opinions of medical witnesses and other experts depend upon what they have been told by a plaintiff and upon her behaviour and performance on examination and on testing.[90]
[90]Palmer Tube Mills (Aust) Pty Ltd and Anor v Semi [1998] 4 VR 439 at 448 (per Brooking JA); and Johns v Oaktech Pty Ltd [2020] VSCA 10 at paragraph [76]
90Credit is also important because the Court must be satisfied of the alleged consequences and their impact on the plaintiff’s residual capacity.
91Where there are relevant prior or subsequent injuries, multiple accidents or claims, credit and reliability can be crucial to the ability of a court to make findings about the subject injuries and whether they can be said to meet the statutory test.[91]
[91]Samaras v Transport Accident Commission [2019] VSCA 255 at paragraph [153]
92There were a number of grounds for the defendant’s submission that Ms Ordonez Camero was not credible or reliable and I address each below:
Dishonest omissions in the affidavits
93Counsel for the defendant submitted Ms Ordonez Camero dishonestly omitted the following matters from her affidavit:
(a) having made a TPD claim (and received compensation under the claim) shortly prior to commencing employment with Acacia;[92]
(b) having made the second and third WorkCover claims, and being in receipt of weekly payments and household help services under the third Workcover claim continuously from 2021 to the date of hearing.[93]
[92]T95 ꟷ T96
[93]T96
94Counsel for the defendant also submitted, in effect, that the histories to some doctors and the first affidavit were misleading on the question of Ms Ordonez Camero’s ability to drive.[94]
Omission in the affidavit of having made a TPD claim shortly prior to commencing employment with Acacia
[94]T54 ꟷ 55, 121
95There is no reference to a TPD claim in either affidavit.
96The TPD claim documents were not before the Court. Ms Ordonez Camero accepted that she had made the TPD claim in early 2021 and that she had been applying for work in 2020.[95]
[95]T23 ꟷ T24
97On 15 April 2021, Ms Ordonez Camero commenced work with Acacia.
98Ms Ordonez Camero said she did not depose to applying for work and making the TPD claim in her affidavit because she did not know if those things were relevant.[96]
[96]T24
99When asked about her understanding of the purpose of the TPD claim, Ms Ordonez Camero said:
“How I understood it, that was explained to me, it's like the capacity to do exactly what I was able to do before, it's no longer possible.”[97]
[97]T22
100I accept the defendant’s submission that it was open to Ms Ordonez Camero to disclose the fact of the TPD claim and explain it in her affidavit. However, I do not accept that failure to do so was dishonest.
101It would have been open to the defendant to issue a notice to produce for the TPD documents. In the absence of the documents, I am unable to make a finding about their relevance to Ms Ordonez Camero’s application or about dishonesty, as there is insufficient evidence to support such a finding.
Omitting from the affidavit any reference to the second and third WorkCover claims and to being in receipt of weekly payments and household services under the third WorkCover claim
102Ms Ordonez Camero accepted there was no reference to the second and third claims in her affidavits. Her Senior Counsel submitted this was not of any consequence, as the defendant is the recipient of the serious injury application and that agency was aware of the existence of those claims.
103In the circumstances of this case and the contents of Ms Ordonez Camero’s affidavits, I reject that submission for reasons which follow.
104The purpose of an affidavit is not to inform the authority only of things it does not already know. That would require the authority to make separate enquiries of its own agents to determine if they have other claims, what the nature of those claims might be, and how they may, or may not be, relevant to the subject application. Such a requirement would cause an extraordinary burden on the assessment process and create significant delay in processing serious injury applications.
105In the event the Serious Injury Certificate is not granted by the authority, the affidavits are tendered in support of an application. The purpose of the affidavit is to inform the Court of all matters relevant to its assessment of the application.
106Senior Counsel for Ms Ordonez Camero also submitted that Ms Ordonez Camero’s claim was for pain and suffering damages only, so the receipt of weekly payments was not relevant.
107I reject that submission.
108The affidavit provides that, after the February 2018 injury, Ms Ordonez Camero had some time off, returned to work on an inadequate program, and a year later ceased work due to harassment. After about twelve months, she began work at Acacia, but found the work difficult due to the right wrist symptoms, which got worse and worse. From about August 2021, she had shooting pain in her shoulder, and by October her right arm condition had become so bad she could no longer work.
109In cross-examination however, it became apparent the affidavit failed to inform the reader that Ms Ordonez Camero was off work and receiving statutory benefits and weekly payments under three different claims. This created the wrong impression of the reason for which she was currently off work.
110I accept that inability to work is not now being relied on as a pain and suffering consequence. However, it appears, from paragraph 51, that at the time the affidavit was sworn, that was the intention. Ms Ordonez Camero deposed:
“I do not know what work I will be able to do in the future given the limits of my injury and my education, training and experience in Australia. I had invested so heavily in education and work experience, and it upsets me greatly that I will not be able to use it.”[98]
[98]PCB 17
111I consider the affidavits are misleading. The reader of the affidavits is left with the impression that all of Ms Ordonez Camero’s current physical limitations and inability to work are attributable to the 2018 injury.
112Senior Counsel for Ms Ordonez Camero submitted that no finding about a deliberate attempt to deceive can be made, as at all times the VWA was aware of the various claims.
113I accept that submission. I am unable to find that the omission was deliberately dishonest. That would require some additional evidence. Further, it was never put to Ms Ordonez Camero that she had deliberately sought to mislead. Her explanation for the omission is that she did not know it was relevant, as she thought she was deposing only to matters about her wrist injury.[99]
[99]T33 ꟷ 34
114That is a plausible explanation. However, there were occasions in her evidence when Ms Ordonez Camero accepted information about the third claim being relevant.[100]
[100]T33 ꟷ 34, 48
115In the circumstances, I consider the omission impacts negatively on the reliability of Ms Ordonez Camero.
Impact of arm injury on ability to drive
116In the first affidavit, Ms Ordonez Camero deposed as follows:
“It is difficult for me to drive for prolonged periods as it is hard for me to hold my right arm to the steering wheel.”[101]
[101]PCB 15 at paragraph [43]
117Dr Khan noted a history that Ms Ordonez Camero has not driven since the injury.[102] Dr Wood noted that Ms Ordonez Camero was currently unable to drive and she stated that she does not feel safe driving due to her poor left (sic) grip”.[103]
[102]PCB 117
[103]DCB 211
118In cross-examination, Ms Ordonez Camero was asked these questions and gave these answers:
Q: “And you've told some people that you can't drive?---
A: Yes
Q: Have you ever driven in Australia?---
A: Not in Australia.
Q: Okay. So you don't have an Australian driver's licence?---
A: No.
Q:So even before the injury in 2018 you weren't driving in Australia?---
A:In Australia, no.
Q:Okay. So when you tell people you have difficulty driving, you're really just talking about those times that you've been back to Mexico?---
A:Yes.
Q:Because it's not part of your lifestyle to drive in Australia? ---
A:No, because of the arm.
Q: Okay, but you lived in Australia for years before your arm? ---
A: Yes.
Q: And you didn't have an Australian driver's licence?---
A: No, correct.
Q: So you'd never driven in Australia?---
A: Correct.”[104]
(Emphasis added.)
[104]T54 ꟷ T55
119Having accepted that she did not hold an Australian driver’s licence and had never driven in Australia, even before her injury, Ms Ordonez Camero (again) attempted to tell the Court the reason for this was because of her arm.
120There are reports in evidence referring to driving only in Mexico. However, her affidavit makes no such qualification and suggests to the reader that she finds it difficult to drive (in Australia) on account of the injury only. At the commencement of her evidence, Ms Ordonez Camero made corrections to her affidavit,[105] but this portion of the affidavit was not clarified.
[105]T8 ꟷ T9
121Like the omission of information about the second and third claims, the failure to inform the Court about the true circumstances of her driving limitations created a false impression in the reader of the affidavits.
Another example of misleading
122In cross-examination, counsel for the defendant asked Ms Ordonez Camero about the third claim form. Ms Ordonez Camero said she typed the contents of the form herself.[106]
[106]DCB 89-90
123The claim was for:
“Right Shoulder Subdeltoid Bursitis”;
“working from home since 5 August due to lockdown. On 5 October I felt intense pain from my shoulder down, I had to stop work”; and
“I was performing computer based tasks for my role, such as formatting and editing of documents, emails, answering phones”.[107]
[107]DCB 89
124In answer to the question, “Have you previously had another injury/condition or personal injury claim that relates to this injury/condition”, Ms Ordonez Camero typed “No”.[108]
[108]DCB 90
125When asked if it was correct she had not had pain in the shoulder before, Ms Ordonez Camero answered “[n]ot in that way.”[109]
[109]T46
126If that answer is correct, then the answer on the claim form is misleading.
127I consider the defendant has successfully established Ms Ordonez Camero is an unreliable witness in relation to the impact of her right wrist/arm condition on her ability to drive and work, as she has contributed to a false or misleading picture of these matters in her affidavit, or in her evidence, or in a form she completed.
Impression of Ms Ordonez Camero as a witness
128Ms Ordonez Camero is an intelligent, educated and articulate woman. She was able to answer directly and in detail about the three claims, about her injuries and about her restrictions. A significant number of answers she gave to questions were direct and responsive.
129However, during some of her evidence, it appeared to me she was evasive and reluctant to admit what was plain on the document being put to her. For instance, counsel for the defendant showed Ms Ordonez Camero a letter from Gallagher Basset addressed to her, relating to approval for household help.[110] She accepted that the letter referred to the employer as Acacia and the date of injury as 5 October 2021, but when asked whether she agreed it was in relation to the third claim, Ms Ordonez Camero said. “I don’t recall how the GP makes the application, I think he just puts a few claims in”.[111]
[110]DCB 185
[111]T39
130Later in her evidence, Ms Ordonez Camero admitted she understood, when she read the letter, that it was about the third claim.[112]
[112] T46 ꟷ T47
131I accept the submissions made by Senior Counsel for Ms Ordonez Camero that any inadequacy in the histories noted by the experts is not attributable to any established intent to conceal. Counsel for the defendant specifically disavowed any suggestion that Ms Ordonez Camero had deliberately provided a false history.[113]
[113]T97
132However, that does not completely dispose of the point made by the defendant. Whether or not Ms Ordonez Camero deliberately provided the false history or not is beside the point. If doctors have acted on a false history, however that may have occurred, their opinions may be infected or compromised by such a false history. As I have found her to be unreliable, that also creates difficulty for accepting her evidence without corroboration or objective evidence.
133Overall, each individual failure to depose to relevant information or to correct a misleading statement, may not by itself warrant more than an unreliability finding of Ms Ordonez Camero as a witness. However, I consider the cumulative effects of the matters I have outlined above lead inevitably to an unfavourable impression of Ms Ordonez Camero’s credit as a witness. Therefore, I treat her evidence with caution and must look closely to objective evidence.
Issues and submissions
Plaintiff’s submissions
134It was submitted on behalf of Ms Ordonez Camero that:
(a) the 2018 injury can be isolated and examined and meets the necessary test;
(b) the shoulder injury can be seen as a sequel of the wrist injury;
(c) viewed in isolation or in combination with the effects of the 2018 injury, the initial wrist injury which developed complications of a pain syndrome is “a serious injury” with an organic basis to which work was a significant contributing factor;
(d) the weight of the evidence supports the existence of an organic pain syndrome and the Court should reject the opinion of Mr Robbins, as he is an outlier and has not provided a path of reasoning;
(e) the defendant did not rely on any surveillance or other material to call into doubt Ms Ordonez Camero’s claims.
Defendant’s submissions
135The defendant submitted that:
(a) it is impermissible for Ms Ordonez Camero to aggregate the impairment consequences arising from different sets of compensable circumstances. She must identify what consequences flow from the 2018 injury and delineate its consequences separately from the shoulder injury which occurred with a different employer;
(b) where doctors have provided opinions which treat Ms Ordonez Camero’s right wrist/arm shoulder injury as “one job lot” they ought to be treated with caution, as the doctors were not aware that there have been different sets of compensable circumstances;
(c) Ms Ordonez Camero has not attended a pain specialist – the doctor who diagnosed her was a sports and medicine physician and he is not qualified to diagnose Chronic Regional Pain Syndrome;
(d) Ms Ordonez Camero is unreliable and her alleged pain consequences are not supported by the objective evidence, such as treatment. She is not having any treatment.
Analysis
Right shoulder
136It is convenient to deal with the right shoulder claim first.
137I reject Ms Ordonez Camero’s submission that the right shoulder injury which occurred at work with Acacia in 2021 “can be seen as a sequel of the wrist injury”.[114] I make this finding for the following reasons:
(a) there was no right shoulder injury or symptoms alleged in the claim form for the first claim;
(b) in June 2019, when assessed by Dr Slesenger, a thorough physical examination was conducted and no history or issue was detected with the right shoulder;[115]
(c) in October 2020, when Dr Popordanoski reported his diagnosis of repetitive strain injury to the right wrist, he made no reference to any symptoms in the right shoulder;[116]
(d) Dr Bates recorded a contemporaneous history on 18 August 2021 of “a flare of her pain yesterday” throughout the shoulder. He was not aware, it seems, that Ms Ordonez Camero was working at Acacia;[117]
(e) the third claim provided that Ms Ordonez Camero first noticed the injury or condition of the right shoulder around 23 September 2021.[118] In her oral evidence, Ms Ordonez Camero said she included this date because it was around that time she started feeling discomfort in the shoulder.[119] Associate Professor Love recorded that the of onset of shoulder symptoms occurred in September 2021;[120]
(f) Dr Wood considered the circumstances of the Acacia injury to the shoulder, the previous work history and harassment claim, and concluded that the shoulder injury was a new injury, not an aggravation of a previous injury, and it arose in employment with Acacia;[121]
(g) I reject the submission by Senior Counsel for Ms Ordonez Camero that Mr Campbell provides any support for a connection between the 2018 wrist injury and the shoulder injury. Mr Campbell did not record any history relating to Acacia or the third claim. He recorded that the shoulder was “the next progression” from the wrist injury. In his view, Ms Ordonez Camero may have a thoracic outlet syndrome, but provided no opinion on any connection between the wrist and shoulder injuries;
(h) I reject the submission by Senior Counsel for Ms Ordonez Camero that Dr Bates supports the alleged connection. Dr Bates recorded pain extending from the shoulder down the arm in April 2021. In her oral evidence, Ms Ordonez Camero said she had not had shoulder pain of the kind she had in September 2021, before that date. The inference to be drawn from this evidence (together with the remainder of the evidence) is that, whatever symptoms Ms Ordonez Camero may have had in the shoulder following 2018, they were of a different kind to the symptoms she experienced while at work with Acacia.
(i) By October 2021, Dr Bates diagnosed bursitis in the right shoulder “secondary to her upper limb pain”,[122] however was apparently not aware that Ms Ordonez Camero had been working at Acacia, had a poor ergonomic setup in her working-from-home arrangement and had made a WorkCover claim about that.
[114]T177
[115]DCB 33
[116]PCB 54
[117]PCB 31
[118]DCB 90
[119]T30
[120]DCB 199
[121]DCB 211
[122]PCB 32
The right hand/wrist injury
138Bearing in mind that Ms Ordonez Camero applies in a gateway proceeding and no decision about liability to pay damages is made, nor any issue estoppel created, I have determined to grant Ms Ordonez Camero’s application for leave. My reasons follow.
139I reject the evidence of Mr Robbins, which I was told forms the primary basis of the defendant’s position.[123] Mr Robbins provided no path of reasoning for his opinion that there was no organic cause for Ms Ordonez Camero’s pain. He is an outlier. All other experts, including experts commissioned by the defendant, consider there was a physical cause for Ms Ordonez Camero’s wrist/hand pain.
[123]T122 ꟷ T130
140I accept the submission by Senior Counsel for Ms Ordonez Camero that there are objective findings made by doctors which support the existence of an organic condition. Some of these are as follows:
(a) Dr Gorai made findings of:
“… significant involvement of medial and antebrachial cutaneous nerve, medial ulnar sensory nerve and right radial sensory distribution of symptomatology and reduction in temperature and pin prick sensation.”;[124]
(b) while it appears that Dr Gorai was unaware of the 2021 shoulder injury at Acacia, his findings do not relate to the shoulder, they relate to the medial forearm, which is what Ms Ordonez Camero maintains has been a problem since 2018. There was no evidence the bursitis in the shoulder caused the medial forearm issues;
(c) Dr Slesenger found evidence of tendinitis in the forearm, and reduced grip strength;
(d) Associate Professor Love found extreme tenderness in the structures about the elbow;
(e) Mr Reid found reduced grip strength on the right associated with pain. The wrist and forearm musculature were tender;
(f) Dr Khan noted hyperalgesia in the forearm with global weakness.
[124]PCB 93
141I consider the weight of the evidence supports a conclusion that Ms Ordonez Camero suffered from a pain syndrome (either Complex Regional Pain Syndrome, repetitive strain or persistent pain) affecting her right wrist and forearm (to the exclusion of her shoulder, which is affected by bursitis, but which is not included in the chronic pain diagnosis). This evidence includes:
(a) initial complaints of pins and needles, or tingling sensations, or numbness in the fingers recorded by Dr Popordanoski, Dr Bates, Dr Navin and Miss Davis, all close in time to the 2018 injury;
(b) pain, limitation of movement and reduced grip strength of the wrist and hand, consistently reported and confirmed on testing from 2018 to the present (albeit the reduced grip strength has improved on more recent testing);
(c) consistent history of swelling in the hand and forearm commencing sometime after the 2018 injury and continuing to the present. Although it appears no expert has actually seen the swelling, it is clear they all accept Ms Ordonez Camero’s history of swelling;
(d) consistent complaints of pain and limitation of movement and restricted abilities to use the right wrist and hand from 2018 to the present. All experts who assessed Ms Ordonez Camero recorded such complaints;
(e) aside from Mr Robbins, whose opinion I reject, not one expert considers Ms Ordonez Camero is exaggerating or making up her alleged symptoms;
(f) Dr Bates ultimately diagnosed Complex Regional Pain Syndrome. While he may have described himself as a sports physician, he clearly had experience in diagnosing pain conditions;
(g) Dr Gorai accepted that Ms Ordonez Camero’s symptoms had continued for five years and were consistent with a chronic complex regional pain syndrome;
(h) Dr Khan, a pain physician, diagnosed central sensitisation with neuropathic pain affecting the right forearm, wrist and hand, consistent with “persistent pain” affecting that area;
(i) Dr Slesenger diagnosed soft-tissue injury of the right wrist and chronic wrist pain with evidence of tendinitis;
(j) Dr Popordanoski diagnosed repetitive strain;
(k) unlike in other cases seen in this jurisdiction, there was no reference in any report to “abnormal illness behaviour” or the complaints being not consistent with what was expected on objective assessment. I consider experts such as Dr Khan (pain specialist) and Dr Gorai (neurologist) to be well qualified to assess alleged symptoms and to diagnose a pain syndrome.
142I reject the defendant’s submission that Ms Ordonez Camero has not disentangled the consequences of the right hand/wrist injury from those of the right shoulder.
143While it may be correct to say a number of experts have treated the shoulder and wrist complaints as “one job lot”, that does not mean Ms Ordonez Camero has failed to disentangle, or that the doctor’s reports do not isolate separate injuries and consequences (regardless of their understanding as to how or when the shoulder injury arose).
144I accept the submissions of her Senior Counsel that the opinions clearly state the diagnosis and consequences of Ms Ordonez Camero’s right hand and wrist, and separately, of the shoulder. For example:
(a) Dr Popordanoski reported that Ms Ordonez Camero’s ability to perform fine motor tasks with her hand was affected by the wrist injury;
(b) Dr Bates referred to chronic pain and restriction affecting the right wrist and arm, and that she also had bursitis in the shoulder;
(c) Miss Davis reported burning pain in the arm and hand with swelling and tightness in the forearm and pain localised to the shoulder;
(d) Dr Khan reported restrictions in use of the hand to open jars, cook and put on clothing;
(e) almost all doctors have reported pins and needles or numbness in the fingers associated with the right wrist injury.
145Aside from Mr Robbins, all doctors accept that Ms Ordonez Camero has an organic or physical condition affecting her right wrist.
146No doctor attributes the restrictions and symptoms in the hand to the shoulder injury.
Permanence
147There was no dispute that Ms Ordonez Camero’s right wrist/hand injury and associated consequences were permanent.
Impairment consequences
Consequences of the injury
Pain
148In Kelso,[125] Dodds-Streeton JA said:
“The endurance of permanent daily pain requiring frequent medication, must, according to ordinary human experience, raise a real prospect of a ‘very considerable’ consequence.”
[125]At paragraph [199]
149The weight of the evidence supports the existence of a chronic pain condition of some kind. The relevant body function is that of the dominant hand. It appears that even when Ms Ordonez Camero returned to work in an administrative role, her right hand and wrist symptoms persisted and were accommodated by modified duties or hours.
150All of the experts accept that Ms Ordonez Camero has pain on use of the right hand or wrist for daily activities including self-care, cooking, domestic duties and work.
Medication and medical treatment
151Ms Ordonez Camero is trying to become pregnant and has ceased use of medications, she has some on hand in the event of a flare-up of pain. I consider the inability to use prescribed medication for family planning reasons to be a significant consequence, given that doctors have accepted she has chronic pain affecting her wrist/hand/forearm.
Work capacity
152Senior Counsel for the defendant did not rely on inability to work as a pain and suffering consequence. It appears Ms Ordonez Camero was willing to return to work despite the shoulder injury.
Sleep
153Ms Ordonez Camero deposed to her sleep being affected, especially when she rolls over onto her right side. Given the presence of the right shoulder condition and the difficulties with her credit, I am unable to make specific findings about the impact of the right hand/wrist condition on her sleep.
Mobility
154Ms Ordonez Camero does not drive in Australia. I do not accept she is unable to use public transport of travel without special arrangements, as there was no corroboration of these matters.
Activities of daily living
155As the majority of the experts have accepted that Ms Ordonez Camero’s activities of daily living are impacted by the right hand/wrist injury, I find there is evidence to support an impact. In particular, dressing herself, shopping, carrying bags, or changing sheets would all be affected, as she would be doing at least some of these activities with her right hand.
Sports and hobbies
156I do not accept that Ms Ordonez Camero cannot go to the gym on account of her right hand injury. While it may impact her use of some equipment, it can have no impact on the use of treadmill or stepper equipment using the left hand. Her right hand is not paralysed and she could use it, albeit with some discomfort, if she really wanted to attend the gym. The same reasoning applies for yoga. These activities could be pursued with some modification.
Conclusion
157I find Ms Ordonez Camero is currently affected by a pain syndrome or condition which produces chronic pain in her wrist and right hand. The condition is likely to last for the foreseeable future.
158The presence of chronic pain and restriction of movement associated with use of the dominant hand is a very considerable consequence. The injury is to her dominant arm and doctors accept it affects many aspects of her daily life. This, in the range of other possible impairments, is in my view, at least very considerable. I grant her leave to commence proceedings.
159I will hear the parties with respect to costs.
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