Pancholi v Abraham t/as Chemist Warehouse Balmain Darling Street

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Pancholi v Abraham t/as Chemist Warehouse Balmain Darling Street [2024] NSWPIC 628
APPLICANT:	Pallavibahen Pancholi
RESPONDENT:	Peter Charles Abraham t/as Chemist Warehouse Balmain Darling Street
PRINCIPAL MEMBER:	Josephine Bamber
DATE OF DECISION:	11 November 2024
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; claim for left total knee replacement surgery; respondent disputes the treatment is reasonably necessary; Diab v NRMA Ltd applied; Held – pursuant to section 60 the proposed left knee replacement surgery is reasonably necessary treatment as a result of injury in the course of employment with the respondent; the respondent is to pay for the costs of and incidental to the left knee replacement surgery.
DETERMINATIONS MADE:	The Commission determines: 1. The claim for lump sum compensation is discontinued. 2. Pursuant to s 60 of the Workers Compensation Act 1987 the treatment proposed by Dr Herald of left total knee replacement is reasonably necessary treatment as a result of injury in the course of employment with the respondent. 3. The respondent is to pay for the costs of and incidental to the left knee replacement surgery.

STATEMENT OF REASONS

BACKGROUND

Pallavibahen Pancholi, the applicant, was employed by the respondent, Peter Charles Abraham t/as Chemist Warehouse Balmain Darling Street as a pharmacy assistant. She sustained an injury to her left knee at work on 21 August 2018.
Ms Pancholi discontinued the lump sum claim and the only claim for compensation in these proceedings relates to proposed left knee replacement surgery recommended by Dr Jonathon Herald in report of 6 May 2024. The issue in dispute is whether that surgery is reasonably necessary pursuant to s 60 of the Workers Compensation Act 1987 (1987 Act). The causal aspect of s 60 is not in issue.

PROCEDURE BEFORE THE PERSONAL INJURY COMMISSION

This matter proceeded in arbitration hearing on 15 August 2024 on the MS Teams platform. Mr Stuart Moffet of counsel appeared for Ms Pancholi instructed by Mr Walker and Mr Kovic. The respondent was represented by Mr Paul Barnes of counsel instructed by Mr Russell, solicitor and Abby from the insurer.
I am satisfied that the parties to the dispute understand the nature of the application and the legal implications of any assertion made in the information supplied. I have used my best endeavours in attempting to bring the parties to the dispute to a settlement acceptable to all of them. I am satisfied that the parties have had sufficient opportunity to explore settlement and that they have been unable to reach an agreed resolution of the dispute.

EVIDENCE

Documentary evidence

The following documents were in evidence before the Personal Injury Commission (Commission) and considered in making this determination:
(a)    Application to Resolve a Dispute (ARD) and attached documents;
(b)    Application to Admit Late Documents (AALD) filed by Ms Pancholi dated 19 July 2024 and attached documents,; and
(c)    Reply and attached documents.

Oral evidence

There was no oral evidence. Both parties made oral submissions which have been sound recorded and a copy of the recording is available to the parties.

FINDINGS AND REASONS

Ms Pancholi is presently aged 44. She commenced employment with the respondent in 2015 as a fulltime pharmacy assistant. On 21 August 2018 she tripped on a box that was behind the counter at work and landed on her left knee and face.
As the compensation claimed in these proceedings is confined to the costs of a left total knee replacement it is not necessary to summarise all of her statement and the medical evidence relating to treatment of other body parts.

Legal principles

The case often cited in relation to the issue of “reasonably necessary” treatment is of Diab v NRMA Ltd[1] wherein Roche DP stated at [86]:
“Reasonably necessary does not mean ‘absolutely necessary’ (Moorebank at [154]). If something is ‘necessary’, in the sense of indispensable, it will be ‘reasonably necessary’. That is because reasonably necessary is a lesser requirement than ‘necessary’. Depending on the circumstances, a range of different treatments may qualify as ‘reasonably necessary’ and a worker only has to establish that the treatment claimed is one of those treatments. A worker certainly does not have to establish that the treatment is ‘reasonable and necessary’, which is a significantly more demanding test that many insurers and doctors apply.”
[1] [2014] NSWWCCPD 72, Diab.
In Diab Deputy President Roche cited the decision of Judge Burke in Rose v Health Commission (NSW)[2] with approval and stated:
[2] [1986] NSWCC2; (1986) 2 NSWCCR 32, Rose.
“[88] In the context of s 60, the relevant matters, according to the criteria of reasonableness, include, but are not necessarily limited to, the matters noted by Burke CCJ at point (5) in Rose (see [76] above), namely:
(a) the appropriateness of the particular treatment;
(b) the availability of alternative treatment, and its potential effectiveness;
(c) the cost of the treatment;
(d) the actual or potential effectiveness of the treatment, and
(e) the acceptance by medical experts of the treatment as being appropriate and likely to be effective.

[89] With respect to point (d), it should be noted that while the effectiveness of the treatment is relevant to whether the treatment was reasonably necessary, it is certainly not determinative. The evidence may show that the same outcome could be achieved by a different treatment, but at a much lower cost. Similarly, bearing in mind that all treatment, especially surgery, carries a risk of a less than ideal result, a poor outcome does not necessarily mean that the treatment was not reasonably necessary. As always, each case will depend on its facts.”

Summary of medical evidence

Dr Jonathen Herald, orthopaedic surgeon, has been treating Ms Pancholi since 26 May 2022. Ms Pancholi says in her first statement that she had started getting lower back pain which was getting significantly worse due to her limping following her left knee injury. Dr Herald refers to this history and on examination he noted she had a limp and a positive straight leg raise on the left side to about 30 degrees. He found effusion in the left knee joint and pain over the anterior aspect of the knee. Dr Herald says the X-rays show patellofemoral osteoarthritis and effusion in the knee joint.[3] He recommended an MRI scan of her left knee.
[3] ARD p 190.
In his report dated 9 August 2022 Dr Herald states that the MRI scans of the knee show some developing osteoarthritis in the medial and patellofemoral compartments and he found on examination effusion in the knee joint. The doctor thought the work injury had flared up arthritis in the knee and recommended a cortisone injection to the knee and anti-inflammatory tablets and thereafter physiotherapy for her back and knee.[4]
[4] ARD p 194.
However, on 8 September 2022 the insurer denied the request for the injection into the left knee.[5] The insurer based this declinature on Dr Gothelf’s opinion that the current symptoms of the left knee are not related to the workplace injury as any soft tissue injury would have resolved.
[5] ARD p 14.
Dr Gothelf in his report dated 19 August 2022 states since his last assessment Ms Pancholi says her left knee pain is constantly worse.[6] He took the history that it is difficult to sit or walk for long periods and she can no longer squat or kneel down. The doctor also takes a history of Ms Pancholi’s inability to now perform various domestic tasks. Dr Gothelf expressed the view that there were inconsistencies on the physical examination and he opines that the left knee soft tissue injury would have resolved by now and the physical examination revealed non-specific symptoms down the left leg for which there is no identified organic pathology. Under the heading diagnosis and opinion that doctor states “On the balance of probabilities and based upon an expected course of recovery of such injury, the left knee condition has ceased”. He later states the potential causes of the ongoing symptoms may be due to the degenerative changes of the lumbar spine which are not considered work related. Then in answer to question 7 he says the cause of the current symptoms has not been identified, so it is unknown when these symptoms will resolve. His answers to questions 11 and 12 states that the treatment recommended by Dr Herald is reasonably necessary to identify the cause of the left knee symptoms.
[6] Reply p 120.
On 26 September 2022 Dr Herald found on examination of the left knee she had effusion and tenderness over the anterior aspect of her knee joint which radiated posteriorly to the Baker’s cyst region. She had pain and crepitus on loading the patellofemoral compartment. He found there was no history of knee pain before the fall at work on 21 August 2018 and the accident had aggravated osteoarthritis in the left knee. He also noted her back symptoms and said he wanted her to have the cortisone injection in the knee to see what percentage was coming from the knee and what percentage from the back. He set out a raft of conservative treatment recommendations.[7]
[7] ARD p 198.
On 6 October 2022 Dr Herald referred Ms Pancholi for an X-ray and intra-articular injection of cortisone and local anaesthetic in the left knee. She was also given anti-inflammatory medication. Dr Herald recommended a left knee arthroscopy and iliotibial band (ITB) lengthening if she did not improve. He noted she was becoming quite depressed.[8] On 1 November 2022 the insurer maintained their denial of the recommended treatment of the left knee.[9] On 3 May 2023 Ms Pancholi received the injection into the left knee, but she states it did not provide her with relief and she feels her left knee is worse.
[8] ARD p 199.
[9] ARD p 20.
On 5 June 2023 she underwent an MRI of the left knee. On 25 July 2023 she saw Dr Herald and reported that the cortisone injection gave her no relief. She had been doing physiotherapy and taking anti-inflammatory tablets which have not helped her. Dr Herald records that she has a lot of pain in the knee and was developing secondary back pain with radiculopathic symptoms to her foot. On examination Dr Herald found effusion in the knee joint and a 30-45 degree range of motion. He recommended X-rays of the knee to check the patellofemoral alignment and MRI scans of the back.[10]
[10] ARD p 200.
On 9 August 2023 X-rays of both knees were undertaken. Dr Herald reported on 17 August 2023 that Ms Pancholi continued to have bilateral knee pain and on examination she had tenderness over her retropatellar surface bilaterally and some patellofemoral maltracking, she also had back pain. Dr Herald again recommended a knee arthroscopy, ITB release, chondroplasty and Synvisc injection.[11] On 18 August 2023 Dr Herald sent the insurer the quote for this treatment for the left knee.[12]
[11] ARD p 201.
[12] ARD p 205.
On 28 November 2023 the insurer denied liability for the then proposed left knee arthroscopy, ITB release, chondroplasty and Synvisc injection.[13] The insurer relied on a further opinion from Dr Gothelf which included his view that alternative treatments had not been exhausted such as attending on a pain specialist and spine surgeon to see if the lumbar symptoms were due to the lumbar spine and not the left knee.
[13] ARD p 25.
On 16 December 2023 Dr Herald issued a report to Ms Pancholi’s solicitors.[14] He advises after an extensive period of conservative treatment surgery has been considered for her knees. The doctor says he did not have available to him Dr Gothelf’s report dated 17 October 2023. He states that the only cure for arthritis is well known to be a total knee replacement but Ms Pancholi wishes to avoid this due to her young age. He says the patellofemoral arthritis is progressing predominantly due to maltracking and so he recommends a knee arthroscopy and ITB lengthening or lateral release. He says this procedure would help with centralisation of the patella in the hope of preventing further wear but if she was older a total knee replacement could be considered. He describes the injury as an aggravation of the osteoarthritis in the left knee.
[14] ARD p 206 and Reply p 135.
On 21 December 2023 Dr Herald reported to Dr Vastrad that Ms Pancholi was continuing to have left knee pain, back pain and right knee pain. He notes that Ms Pancholi said as a result of her limping she thought she was developing secondary symptoms in her back and right knee. On examination he found effusion in both knees and patellofemoral maltracking, with the left being a lot worse than the right. Dr Herald noted that Dr Gothelf recommended a review by a neurosurgeon and a pain specialist. Dr Herald said these referrals might not be a bad idea but if there was no improvement or her pain was deemed not to be from her back he would re-request the knee surgery.[15]
[15] Reply p 141.
On 4 January 2024 the insurer reviewed their decision but maintained their declinature notwithstanding further evidence from Dr Herald in his report dated 16 December 2023.[16]
[16] ARD p 31.
On 25 January 2024 Ms Pancholi consulted Dr Mohabbati, Sydney Pain Management Centre.[17] The doctor reported that Ms Pancholi had an antalgic gait and that the left knee appeared to be the main troubling issue with severe pain. The doctor stated that she needs to follow the expert advice from Dr Herald. On 28 March and 13 May 2024 the doctor reviewed Ms Pancholi.
[17] ARD p 212.
Ms Pancholi also consulted Dr McKechnie, neurosurgeon. In his report dated 21 March 2024 he recorded that Ms Pancholi had a reduced range of movement in the left knee on examination and she walked with an obvious limp.[18] On 15 April 2024 Dr McKechnie reported that she was still complaining of persistent pain in her back and knees, mainly on the left side which he said was mostly due to lumbar radiculopathy. However, later in this report he states that he has suggested that Ms Pancholi return to her orthopaedic surgeon as “it appears her knee pathology is the main problem.”[19] Dr McKechnie in report dated 9 July 2024 states that most of her pain would not be consistent with a lumbar radiculopathy. He refers to the MRI scan showing mild left L4/5 lateral recess stenosis due to a disc protrusion touching but not displacing or compressing the left L5 nerve root according to the radiology report. He says he has returned her to the orthopaedic surgeon as her main problems appears to be her knee pathology.[20]
[18] Reply p 150.
[19] Reply p 152.
[20] AALD p 9.
On 8 May 2024 Dr Herald made request to the insurer for approval of total replacement arthroplasty of the left knee including a revision of the patella-femoral joint replacement to the total knee replacement and patellar resurfacing and associated costs.
On 14 June 2024 the insurer issued a further s 78 notice disputing liability for the total replacement arthroplasty of the left knee based upon Dr Gothelf’s opinion that the progression of the left knee arthritis was constitutional and the workplace injury had not altered the underlying pre-existing left knee arthritis.[21]
[21] ARD p 42.
However, in the preliminary conference on 6 August 2024 the respondent’s solicitor stated that the only dispute was whether the proposed total knee replacement was “reasonably necessary” treatment, that the causal aspect of s 60 of the 1987 Act was not in issue. This was confirmed by me in a written direction issued immediately following the preliminary conference. Furthermore, at the outset of the arbitration hearing the respondent’s counsel confirmed this was still the respondent’s position.
Dr Herald in his report dated 16 July 2024 considers Dr Gothelf’s reports.[22] He says given Ms Pancholi’s age of 44 it is unlikely her arthritis can be considered to be due to old age or constitutional factors. He says it is predominantly patellofemoral and in his opinion is related to her work injury. He adds that whether the proposed knee replacement is reasonably necessary, he says both Dr McKechnie and Dr Mohabatti suggest the need to deal with the underlying cause of the pain before moving on with further pain management or lumbar spine treatment and so the total knee replacement is reasonably necessary. He repeats that the knee arthritis is considered post-traumatic due to an aggravation of an underlying degenerative disease from her fall.
[22] AALD p 10.
Dr Endrey-Walder, general and trauma surgeon, provided medico-legal reports for Ms Pancholi dated 30 October 2019,[23] 6 February 2020,[24] 28 November 2022[25] and 9 July 2024.[26] In his first report he found that Ms Pancholi had suffered a compacting injury to the anterior compartment of the left knee to the patello-femoral joint, which he described as significant. He found a painful click in the joint and associated restriction in the range of flexion. He stated the long-term concern was chondral damage at the back of the patella which he said is likely to continue to deteriorate, giving rise to osteoarthritic changes for which she will need to see an orthopaedic surgeon.
[23] ARD p 45.
[24] ARD p 53.
[25] ARD p 55.
[26] AALD p 1.
In his 2022 report Dr Endrey-Walder on examination he found restricted range of motion in the left knee compared to the right knee. He commented on Dr Gothelf’s view that the left knee soft tissue injury would have been expected to resolve by now, stating that the symptoms have not resolved. Dr Endrey-Walder found Ms Pancholi had ongoing pain in the left knee affecting her ambulation and he supported Dr Herald’s recommendation for steroid injection into the left knee for diagnostic purposes to ascertain the symptoms coming from the knee as distinct from the back. He states that Dr Gothelf’s opinion is not consistent with the MRI scan dated 21 June 2022 which showed evidence of multiple pathologies, especially patches of Grade 4 chondral damage which were either caused by of significantly contributed by the injury in August 2018.
Dr Endrey-Walder issued a further medico-legal report dated 9 July 2024.[27] He recounts the treatment Ms Pancholi has had for her left knee and notes on 25 January 2024 she was seen by Dr Mohabatti at the Sydney Pain Centre who apparently was on the view that the left knee difficulties were her main problem. Dr Endrey-Walder also refers to Dr Herald on 6 May 2024 being of the view that Ms Pancholi was developing end-stage arthritis of her knees. He also noted Dr Gothelf’s opinion in his report dated 11 June 2024. On examination he found that Ms Pancholi walked extremely slowed with a left-sided limp. He acknowledged his examination of Ms Pancholi was sub-optimal due to her complaints of pain. He expresses the view that the reason for the left knee pain was the significant aggravation she suffered on 21 August 2018. He concludes by stating that it is his view that the left total knee replacement procedure recommended by Dr Herald is reasonable and seemingly necessary given the severity of her symptoms in the left knee.
[27] AALD p 1.

Submissions

As both counsel’s submissions have been recorded I will not repeat them verbatim. The main thrust of each parties’ submissions is summarised below.
Ms Pancholi’s counsel submitted that she wishes to have this surgery as she has tried other forms of treatment such as physiotherapy, injections, pain management, hydrotherapy and exercise physiology, and she says she suffers from significant pain and restriction in her left knee. He also refers to her statements where she sets out her limitations to perform activities of daily living.
Counsel referred to the medical evidence which illustrates the conservative treatment Ms Pancholi has undertaken noting that she had physiotherapy from November 2018. He submits that she was not always getting physiotherapy but the disease process has overtaken conservative measures which have been unsuccessful at stabilising her left knee. He submits that the medical evidence from Dr Herald and Dr Endrey-Walder bear out her complaints as several doctors have seen her limp and she has experienced effusion in the knee. Flexion/extension exercises elicited painful click in patellofemoral joint. He submits that this clicking is evidence of damage giving rise to the osteoarthritis.

He also drew attention to MRI scans which have shown joint effusion and elongated Baker’s cyst, oedema in subcutaneous tissues of infrapatellar tendon and minor degenerative changes in knee.
Ms Pancholi’s counsel submitted that Dr Gothelf plays down her left knee problems for instance, Dr Gothelf stated there was no appreciable effusion but counsel submits that this not consistent with treaters who examined Ms Pancholi all the way through. In addition, counsel noted that Dr Gothelf found no clicking but Dr Endrey-Walder found significant clicking in left knee.
It was also submitted that Dr Gothelf felt the injury was soft tissue and that the injury had ceased and it was argued that this opinion is not relevant because “injury” has been conceded the respondent and the only issue is whether surgery is reasonably necessary treatment.
It was submitted that the mechanism of injury was the fall and so this comes within s 4(a) of the 1987 Act and the fact is that the pathology is worsening and that Dr Gothelf’s view that effects of the injury had ceased cannot be accepted.
Counsel submitted that it is a relevant consideration that the Sydney Pain Management Centre recorded that pain was impacting on Ms Pancholi’s mental health. Furthermore, Dr Herald found that although Ms Pancholi is young, she is suffering physically and mentally and weighing risks he recommends she has a left total knee replacement. It was submitted that Ms Pancholi has seen Dr Herald many times and his opinion should be accepted. Dr Herald did follow Dr Gothelf’s suggestion of Ms Pancholi seeing a neurosurgeon and pain management specialist and neither can ameliorate her left knee pathology. Counsel also relies upon the opinion of Dr Endrey-Walder who believes a left total knee replacement is “reasonable and necessary” given severity of symptoms in knee. Counsel acknowledges this is not the test in s 60 of the 1987 Act but he argues it is a stricter test.
In addition counsel relies upon Dr McKechnie’s view that most of pain is not consistent with lumbar radiculopathy, based on the MRI scans. Finally, it was submitted that when weighing the need for a total knee replacement, the doctors have applied caution due to her age and they have taken into account that conservative measures have not been successful and that the left knee is impacting on her due to her altered gait and has an impact on her mental health.
Ms Pancholi’s counsel submits that Dr Gothelf expresses the view that a total knee replacement is reasonable treatment for osteoarthritis of the knee however, he only discounts it being reasonably necessary because he says the left knee condition now is not related to the work injury.
The respondent submitted that Ms Pancholi is very young to have a total knee replacement particularly as medical literature finds that a knee replacement has a 10 to 15 year lifespan. In addition, it was argued that Dr Herald changed his position from recommending conservative treatment to arthroscopic treatment and then to advising a total knee replacement.
It accepts that the legal principles to apply are those set out in Diab and argues that purpose of the treatment is to alleviate the consequences of the injury and one needs to ask, is treatment essential to worker?
The respondent relied upon the opinion of Dr Gothelf who on examination says left knee had no crepitus with motion of the patella from 0 to 90 degrees passively and no appreciable effusion. He found the knee was stable to varus/valgus stress and further examination difficult due to complaints of pain. Counsel referred to the inconsistencies on examination found by Dr Gothelf and his finding that left knee was a soft tissue injury and that injury has ceased, and his view that the ongoing left knee symptoms do not have appreciable cause.
In relation to Dr Herald, the respondent argues that he has not explained why he now recommends a total knee replacement when a year earlier he had not adopted this approach because of Ms Pancholi’s young age.
The respondent also argued that the MRI scans of the left knee from 2 November 2018 show that degenerative changes were already present and more recent scans have almost identical pathology. Counsel submits that Dr Gothelf’s opinion should be accepted and he considers that the knee injury did not contribute to the need for knee surgery and that any progression of the osteoarthritis was constitutional and would have occurred regardless of injury.
In relation to Dr Endrey Walder the respondent says his opinion is ambivalent because he uses term “seemingly necessary” and counsel argues that the underlying tenor of the opinion raises the question whether the doctor suggests other conservative treatment could be adopted.
In reply Ms Pancholi’s counsel submitted that Diab does not require that the treatment be absolutely necessary and that Dr Endrey-Walder’s opinion is not rendered unreliable by his use of the expression “reasonable and seemingly necessary”. Counsel also submitted that the respondent had clearly stated that causation was not in issue at the outset of the hearing and therefore any submissions about Dr Gothelf’s views about causation should be ignored. The respondent’s counsel did not demur from this position at the conclusion of the hearing.

Determination

Applying Diab, I find that Dr Herald has made it clear that a total left knee replacement is the appropriate treatment to deal with Ms Pancholi’s left knee osteoarthritis condition. The only caveat is her age at 44, normally too young to undergo such surgery as the respondent says it is highly likely she would need other knee replacements in her lifetime. However, Dr Herald has weighed up this risk and nonetheless wishes to proceed. It is the case that a year ago he had recommended another regime of treatment but the insurer did not approve that treatment and her condition has continued to worsen. I find that Dr Herald’s opinion and recommendations should be accepted. He is the treating surgeon and he has seen Ms Pancholi a number of times over the years and therefore I find he is in the best position to judge what treatment she requires.
The alternate treatment is a continuation of the physical therapies under taken by Ms Pancholi, however, these have not proved to be effective. Ms Pancholi has tried physiotherapy, injections to the knee, pain management, hydrotherapy and exercise physiology. She also consulted Dr McKechnie who has provided an opinion excluding the lumbar spine as a cause of her left knee pain.
The cost of the total knee replacement is not a significant factor in this case.
Dr Herald is of the opinion that a total knee replacement will actually be effective to relieve Ms Pancholi of pain and restriction of movement in the knee. Dr Gothelf does not really cavil with this type of surgery being an appropriate or effective treatment for osteoarthritis. Furthermore, it is a type of treatment that is recognised by medical specialists as an appropriate treatment for osteoarthritis.
The real difficulty in this case is that Dr Gothelf characterizes the injury as a soft tissue injury to the left knee. This diagnosis was the basis for his subsequent opinions about whether the proposed total knee replacement surgery is reasonably necessary treatment. The doctor also found that because the injury was soft tissue it should have recovered well before now and he could offer no explanation for the continuation of Ms Pancholi’s symptoms. Dr Gothelf refers to “the expected course” of recovery of such an injury. However, he did not revise his diagnosis when the symptoms did not follow the expected course, when they did not abate. Dr Gothelf also discounted that Ms Pancholi’s left knee injury caused her to walk with a limp or have a click in the knee despite other doctors observing these symptoms. I prefer the opinion of Dr Herald to that of Dr Gothelf because of these factors. In addition, it is relevant to consider that Dr Herald has not rushed into his recommendation for a total knee replacement. He even adopted Dr Gothelf’s suggestion that pain management and a consultation with a neurosurgeon may help with the diagnosis and treatment of Ms Pancholi. However, both Dr McKechnie and Dr Mohabatti found that the left knee was her main problem and referred Ms Pancholi back to Dr Herald’s care.
Furthermore, I am not persuaded that Ms Pancholi’s symptoms in her left knee are due to constitutional factors. I accept her counsel’s submission that the injury to her left knee has aggravated the underlying degenerative condition and it has worsened because of that aggravation. There is no evidence that she was symptomatic in her left knee before the fall on 21 August 2018.
I find that the surgery proposed by Dr Herald is reasonably necessary treatment as a result of the injury Ms Pancholi sustained in the course of her employment with the respondent on 21 August 2018.

[2024] NSWPIC 628

11 November 2024