Qantas Airways Ltd v Worthington

DETERMINATION OF APPEAL PANEL
CITATION:	Qantas Airways Ltd v Worthington [2025] NSWPICMP 779
APPELLANT:	Qantas Airways
RESPONDENT:	Michael Worthington
APPEAL PANEL
MEMBER:	Jane Peacock
MEDICAL ASSESSOR:	Henley Harrison
MEDICAL ASSESSOR:	Robert Payten
DATE OF DECISION:	9 October 2025
CATCHWORDS:	WORKERS COMPENSATION - Workplace Injury Management and Workers Compensation Act 1998; review of Medical Assessment Certificate (MAC); industrial deafness; appeal by employer against a medical assessment that included all frequencies; no error found; the Medical Assessor (MA) must conduct an independent assessment; the MA’s audiogram was entirely consistent with occupational noise exposure over a long history of noise exposure (some 42 years) and the Appeal Panel could discern no error in the MA’s assessment that included all frequencies and for which adequate reasons were given when the MAC is read as a whole; Held – MAC confirmed.

BACKGROUND TO THE APPLICATION TO APPEAL

The employer Qantas Airways (the appellant) lodged an Application to Appeal Against the Decision of a Medical Assessor. The medical dispute was assessed by Dr Brian Willaims, a Medical Assessor, who issued a Medical Assessment Certificate (MAC) on 10 June 2025.
The appellant relies on the following grounds of appeal under s 327(3) of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act):
· the assessment was made on the basis of incorrect criteria, and
· the MAC contains a demonstrable error.
The delegate is satisfied that, on the face of the application, at least one ground of appeal has been made out. The Appeal Panel has conducted a review of the original medical assessment but limited to the ground(s) of appeal on which the appeal is made.
Rule 128 of the Personal Injury Commission Rules 2021 (PIC Rules) and Procedural Direction PIC7 – Appeals, reviews, reconsiderations and correction of obvious errors in medical disputes set out the practice and procedure in relation to the medical appeal process under s 328 of the 1998 Act. An Appeal Panel determines its own procedures in accordance with r 128(1) of the PIC Rules.
The assessment of permanent impairment is conducted in accordance with the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4^th ed
1 March 2021 (the Guidelines) and the American Medical Association Guides to the Evaluation of Permanent Impairment, 5^th ed (AMA 5).

PRELIMINARY REVIEW

The Appeal Panel conducted a preliminary review of the original medical assessment in the absence of the parties and in accordance with the Procedural Direction PIC7.
The appellant did not seek that the worker be re-examined by a Medical Assessor who was also a member of the Appeal Panel. As a result of the Appeals Panel’s preliminary review, the Appeal Panel determined that the worker did not need to undergo a further medical examination because the Appeal Panel did not find error. Absent a finding of error, the Appeal Panel has no jurisdiction to require the worker to undergo a re-examination: see New South Wales Police Force v Registrar of the Personal Injury Commission of New South Wales [2013] NSWSC 1792.

EVIDENCE

Documentary evidence

The Appeal Panel has before it all the documents that were sent to the Medical Assessor for the original medical assessment and has taken them into account in making this determination.

Medical Assessment Certificate

The parts of the medical certificate given by the Medical Assessor that are relevant to the appeal are set out, where relevant, in the body of this decision.

SUBMISSIONS

Both parties made written submissions. They are not repeated in full, but have been considered by the Appeal Panel.

FINDINGS AND REASONS

The procedures on appeal are contained in s 328 of the 1998 Act. The appeal is to be by way of review of the original medical assessment but the review is limited to the grounds of appeal on which the appeal is made.
In Campbelltown City Council v Vegan [2006] NSWCA 284 the Court of Appeal held that the Appeal Panel is obliged to give reasons. Where there are disputes of fact it may be necessary to refer to evidence or other material on which findings are based, but the extent to which this is necessary will vary from case to case. Where more than one conclusion is open, it will be necessary to explain why one conclusion is preferred. On the other hand, the reasons need not be extensive or provide a detailed explanation of the criteria applied by the medical professionals in reaching a professional judgement.
The matter was referred to the Medical Assessor as follows:
“The following matters have been referred for assessment (s 319 of the 1998 Act):
·    Date of injury:   14 July 2024 - deemed
·    Body parts/systems referred:         Hearing Loss
·    Method of assessment:                  Whole Person Impairment”
The Medical Assessor issued a MAC as follows:

Injury deemed to have happened on:	Frequency Hz	Left dB HL Air Bone		Right dB HL Air Bone		Total % BHI	Occupational % BHI
14.7.25	500	10	5	10	5	0.0	0.0
1000	15	15	20	20	0.5	0.5
1500	30	30	35	35	3.4	3.4
2000	45	45	50	50	6.3	6.3
3000	60	60	60	65	6.3	6.3
4000	55	55	55	55	5.2	5.2
6000	55	55
8000	55	40
TOTAL % BHI: 21.7%
Less Pre-existing non-related loss: 0.0%
Less Presbyacusis correction: 1.0%
Add % of severe tinnitus: 0.0%
Adjusted total % BHI: 20.7%
Resultant total BHI of 20.7% = 11% whole person impairment (Table 9.1)

The employer appealed.
In summary, the appellant submitted on appeal that the Medical Assessor made an assessment on the basis of incorrect criteria and/or made demonstrable errors which included the following:
(a) the Medical Assessor has erred in recording his assessment of occupational BHI in particularly by including all the lower frequencies from 500Hz, and
(b) failing to provide adequate reasons for so doing.
In summary, the respondent worker Michael Worthington (the respondent) submitted that there is no error and no assessment on the basis of incorrect criteria and the final assessment of 11% WPI should be confirmed.
The Medical Assessor took a history as follows:
“Brief history of the incident/onset of symptoms and of subsequent related events, including treatment:
The history I obtained from Mr Worthington is as follows.
Hearing Loss
He gave a 10 year history of bilateral gradually progressive hearing loss.   He said the right is equal to the left. He said without hearing aids he has difficulty hearing conversation, has difficulty hearing in background noise and needs to increase the volume of the television above others.   He said he obtained hearing aids 2 weeks ago. He said they help his hearing.
Tinnitus
He gave a history of a ringing since 1990’s. He said it was initially intermittent but now is constant and bilateral. He said the right is equal to the left. He said it does not interfere with his daily activities during the day and said he ‘ignores it’. He said it does not interfere with sleep induction at night. He said he has had no treatment for his tinnitus. He said he has not discussed his tinnitus with his GP or a treating ENT Specialist.
Vertigo / dizziness
He gave no history of vertigo.
·    present treatment: Please see above
·    present symptoms: Please see above
·    details of any previous or subsequent accidents, injuries or condition:
PAST HISTORY
He gave no history of hereditary deafness. He gave no history of direct ear or head trauma or blast injury.   He gave no history of otitis media or ototoxic exposure. He gave no history of Military Service or recreational noise exposure. He gave no history of otalgia (ear pain) or otorrhoea (ear discharge). He gave no history of ear surgery.
He gave a history of raised cholesterol and hypertension both treated with tablets. He gave no history of heart disease, stroke, diabetes, thyroid disease, meningitis, mumps, measles, allergic rhinitis or asthma. He gave no history of motor vehicle accidents. He said he is a non smoker. He gave no history of sleeping disorders.
Prior Industrial Deafness Claim: he said no.
·    general health:   Please see above.
·    work history including previous work history if relevant:
OCCUPATIONAL HISTORY
·    QANTAS, NSW, 28.9.1984-present as a Pilot for 42 years and Pilot and Training Captain for the last 26 years. He said he was exposed to the noise of jet engines, aircraft noise, auxiliary power units, sirens, alarms, tarmac noise and walking around aircraft for inspections and aircraft training simulator with hydraulic pumps and noise in the cockpit. He said his shift was 40 hours per week but he had variable flight hours and flight simulation.   He said he was in noise 8-16 hours per day. He said he had to raise his voice to have a conversation at 1 metre. He said hearing protection was worn since the 1990’s.”
That is, there is a history of noise exposure spanning 42 years.
The Medical Assessor recorded his findings on physical examination as follows:
“On examination I observed the following.
Ears
Otomicroscopy
Right Ear:
His right external auditory canal had mild exostosis.
His visible right tympanic membrane is intact.
Left Ear:
His left external auditory canal had mild exostosis.
His visible left tympanic membrane is intact.
Weber Test: Using the 512Hz tuning fork his Weber test was central.
Rinne Test: Using the 512Hz tuning fork his Rinne test is positive bilaterally.
Nose
Anterior rhinoscopy showed caudal deviation of the nasal septum to the left.
Throat
His oropharynx is normal.
He had no cervical lymphadenopathy.”
An audiogram was conducted on the day of examination and the Medical Assessor noted as follows:
“My pure tone audiometry was performed on 4.6.25 in a suitable sound attenuated environment, being a sound proof booth, with a calibrated audiometer. His responses were repeatable and I considered accurate auditory thresholds were obtained. His pure tone audiogram showed a bilateral sensorineural hearing loss maximal in the high frequencies.”
That is, an audiogram was obtained by the Medical Assessor, on repeated testing, that was consistent with bilateral sensorineural hearing loss across all frequencies and maximal in the high frequencies.
The Medical Assessor summarised the injury and his diagnosis as follows:
“summary of injuries and diagnoses:
He has suffered from occupational noise exposure causing partial and bilateral occupational noise induced hearing loss.”
The Medical Assessor noted in regard to consistency of presentation as follows:
“consistency of presentation
The worker presents as a person who has been exposed to occupational noise as described above. His presentation is consistent with my clinical examination.
The consistency of his presentation with the other medical reports and other material sighted has been discussed below in Reasons.”
The Medical Assessor outlined the facts of which his assessment was based and explained his impairment assessment as follows:
“THE FACTS ON WHICH THE ASSESSMENT IS BASED
The facts on which I have based my assessment of whole person impairment are:
My medical history, my physical examination, my pure tone audiometry, NSW workers compensation guidelines for the evaluation of permanent impairment, 4^th edition, 1 April 2016, reissued 1.3.21, and the 1988 NAL Tables for determining the percentage loss of hearing as prescribed in the Guides and AMA5 where applicable.
REASONS FOR ASSESSMENT
a. My opinion and assessment of whole person impairment
In making that assessment I have taken account of the following matters:-
Mr Worthington has a history of bilateral hearing loss and bilateral tinnitus. He gave a history of occupational noise exposure as described above. The above medical history demonstrates no other competing medical cause for his hearing loss. Physical examination and pure tone audiometry indicate a bilateral sensorineural hearing loss maximal in the high frequencies. The responses I obtained upon pure tone audiometry are repeatable on ascending and descending threshold measurement and I considered them to represent accurate auditory thresholds. The configuration of his sensorineural hearing loss is one wholly caused by his occupational noise exposure as described above.
Therefore considering his medical history and physical examination including pure tone audiometry, I formed the opinion that his sensorineural hearing loss is caused by occupational noise exposure.
In my opinion his tinnitus does not fall within the class of severe tinnitus because it does not interfere with activities of daily living. I have assessed his tinnitus as 0%.
My audiogram in tabular form

Injury deemed to have happened on:	Frequency Hz	Left dB HL Air Bone		Right dB HL Air Bone		Total % BHI	Occupational % BHI
14.7.25	500	10	5	10	5	0.0	0.0
1000	15	15	20	20	0.5	0.5
1500	30	30	35	35	3.4	3.4
2000	45	45	50	50	6.3	6.3
3000	60	60	60	65	6.3	6.3
4000	55	55	55	55	5.2	5.2
6000	55	55
8000	55	40
TOTAL % BHI: 21.7%
Less Pre-existing non-related loss: 0.0%
Less Presbyacusis correction: 1.0%
Add % of severe tinnitus: 0.0%
Adjusted total % BHI: 20.7%
Resultant total BHI of 20.7% = 11% whole person impairment (Table 9.1)

The Medical Assessor made brief comment on the other medical opinions before him as follows:
“My brief comments regarding the other medical opinions and findings submitted by the parties and, where applicable, the reasons why my opinion differs
Statement by Mr M Worthington 15.4.25
Comment
I have read and considered this statement.
Report by Dr G Hunter 29.8.24
Comment
I have read and considered this report. I prefer my history, examination, audiogram and assessment.
Dr Hunter states ‘I am of the opinion the hearing loss found between 1500Hz to 4000Hz is due to the lengthy history of reported noise exposure, and I have utilised these frequencies in my assessment of noise-induced hearing loss’.
Dr Hunter made a loading of 1% for severe tinnitus.
Dr Hunter assessed 11.0%WPI due to industrial deafness.
Report by Dr K Howison 24.1.25
Comment
I have read and considered this report. I prefer my history, examination, audiogram and assessment.
Dr Howison states ‘I confirm that Mr Worthington did not wear ear protection …’.
Dr Howison states ‘… I would consider that the frequencies 2000, 3000 and 4000 Hz in each ear have been damaged by unacceptable noise levels and I have used these frequencies in the calculations for noise induced hearing loss’.
Dr Howison made a loading of 1% for severe tinnitus.
Dr Howison assessed 8.0%WPI due to industrial deafness.”
The appellant points to the assessments by the other IMEs and submits that the Medical Assessor didn’t adequately explain why his opinion differed. The appellant points out that
Dr Hunter, the IME who was qualified to provide an opinion on behalf of the respondent worker, only included the frequencies from 1500 Hz and Dr Howison, the IME who was qualified to provide an opinion on behalf of the appellant included the frequencies from 2000Hz whereas the Medical Assessor included all the losses from the lower frequencies. There was no loss at 500Hz so that is irrelevant but certainly the Medical Assessor did include the loss from 1000Hz.
The Medical Assessor is clearly cognisant of the opinions of the other IMEs whose reports are in evidence before him. He states that he prefers his own audiogram and assessment. The role of the Medical Assessor is to provide an independent assessment. The MAC must be read as a whole. The Medical Assessor very clearly explained that he obtained repeatable responses from his own pure tone audiometry and took into account the configuration of the audiogram on the background of a long history of occupational noise exposure across some 42 years with no competing courses identified in the history taken or in the evidence before him:
“Mr Worthington has a history of bilateral hearing loss and bilateral tinnitus. He gave a history of occupational noise exposure as described above. The above medical history demonstrates no other competing medical cause for his hearing loss. Physical examination and pure tone audiometry indicate a bilateral sensorineural hearing loss maximal in the high frequencies. The responses I obtained upon pure tone audiometry are repeatable on ascending and descending threshold measurement and I considered them to represent accurate auditory thresholds. The configuration of his sensorineural hearing loss is one wholly caused by his occupational noise exposure as described above.
Therefore considering his medical history and physical examination including pure tone audiometry, I formed the opinion that his sensorineural hearing loss is caused by occupational noise exposure.”
It is not the occupational BHI figures that you look at to determine whether the losses are consistent with noise induced occupational hearing loss, rather you look at the decibel levels as per the audiogram more specifically the progression of the decibel levels with decibel levels at the higher frequencies that are affected first. Here the audiogram is entirely consistent with occupational noise exposure over a long history of noise exposure (some 42 years) and the Appeal Panel can discern no error in the Medical Assessor’s assessment that included all frequencies (noting 500Hz is irrelevant because it is 0) and for which adequate reasons were given when the MAC is read as a whole.
For these reasons, the Appeal Panel has determined that the MAC issued on
10 June 2025 should be confirmed.

[2025] NSWPICMP 779

9 October 2025