| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | Riganias v Cre8tive Roofing Services Pty Ltd [2024] NSWPIC 228 |
| APPLICANT: | Nicholas Riganias |
| RESPONDENT: | Cre8tive Roofing Services Pty Ltd |
| MEMBER: | Kathryn Camp |
| DATE OF DECISION: | 3 May 2024 |
| CATCHWORDS: | WORKERS COMPENSATION - Workers Compensation Act 1987; sections 4(a) and 4(b)(ii); injury simpliciter; aggravation of a disease injury; Rail Services Australia v Dimovski and AV v AW considered; mechanism of injury; identifiable pathological change; Ky v Blue Leaf Food Group Pty Ltd applied; onus of proof; Nguyen v Cosmopolitan Homes applied; increase and worsening of symptoms constitutes an aggravation or exacerbation of a disease injury; Federal Broom Co Pty Ltd v Semlitch applied; section 60(5); claim for medical expenses; whether proposed cervical spine surgery is reasonably necessary as a result of injury; Murphy v Allity Management Services Pty Ltd and Diab v NRMA Ltd considered and applied; Held – proposed surgery is reasonably necessary as a result of the disease injury. |
| DETERMINATIONS MADE: | The Commission determines: 1. The respondent is to pay the applicant’s reasonably necessary costs pursuant to s 60(5) of the Workers Compensation Act 1987 for the proposed C4/5, C5/6, C6/7 disc arthroplasty surgery as recommended by Dr Parkinson in his report of 23 August 2023, as a result of injury to the cervical spine on 14 October 2022. |
STATEMENT OF REASONS
INTRODUCTION
This matter concerns whether the applicant worker sustained an injury to his cervical spine, under s 4(a) and s 4(b)(ii) of the Workers Compensation Act 1987 (the 1987 Act), and whether proposed cervical spine surgery is reasonably necessary as a result of the injury, under s 60 of the 1987 Act. For the reasons discussed below, the worker’s claim for compensation is successful.
BACKGROUND
In December 2021, Nicholas Riganias, the applicant worker, commenced employment as a roof plumber for the respondent, Cre8tive Roofing Services Pty Ltd.
On 14 October 2022, the applicant was at work assisting to install a roof on a rooftop at Western Sydney University when he fell. The applicant claimed that as a result of the fall, amongst other things, he injured his right hand, right shoulder, right elbow, cervical spine, low back, right hip and left knee.
There is no dispute that on this day the applicant suffered a traumatic injury when he fell on the rooftop and sustained a severe laceration to his right hand for which he underwent surgery. The applicant also later underwent surgery on his right shoulder to repair a rotator cuff labral tear.
The respondent’s insurer issued several notices and reviews pursuant to ss 78 and 287A of the Workplace Injury Management and Workers Compensation Act 1998. Of relevance to the present dispute, the respondent denied liability for injury to the applicant’s cervical spine and claim for compensation for proposed cervical spine surgery in the nature of C4/5, C5/6 and C6/7 disc arthroplasty.
On 16 February 2024, the applicant lodged an Application to Resolve a Dispute in respect of a claim for medical expenses for the costs of proposed…
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- Case
- [2024] NSWPIC 228
- Decision Date
CaseChat Overview and Summary
The court examined whether the injury Mr. Riganias suffered could be classified as an aggravation of a disease injury. It was determined that an increase and worsening of symptoms could constitute an aggravation or exacerbation of a disease injury, applying the principle from Federal Broom Co Pty Ltd v Semlitch. The court also considered the onus of proof and applied the precedent from Nguyen v Cosmopolitan Homes, which held that the applicant must prove the causal link between the injury and the aggravation of the disease. The court found that the proposed surgery was reasonably necessary as a result of the disease injury, applying principles from Murphy v Allity Management Services Pty Ltd and Diab v NRMA Ltd.
In conclusion, the court ruled in favour of Mr. Riganias. It was determined that the injury sustained by Mr. Riganias constituted an aggravation of a disease injury, and that the proposed cervical spine surgery was reasonably necessary as a result of the injury. The court ordered Cre8tive Roofing Services Pty Ltd to provide compensation for the medical expenses associated with the surgery.
Orders
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Background
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Evidence
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