Rope and Comcare (Compensation)

The matter before Deputy President O'Donovan concerned three separate decisions made by Comcare, which were under review. The applicant, Mrs Rope, had a longstanding pain condition with both physical and psychological components, for which Comcare had generally provided compensation for various treatments over many years. However, Comcare had recently taken the view that the treatments sought were not effective in bringing about discernible improvement in Mrs Rope's symptoms and therefore were not reasonable to obtain. Mrs Rope contended that while the treatments did not cure her condition, they prevented her symptoms from worsening. The three decisions under review related to claims for reimbursement for a philosophy textbook, approval for enrolment at the University of the Third Age, and approval for further psychological treatment.

The court was required to determine whether the three claims made by Mrs Rope constituted medical treatment that was reasonable for her to obtain, in accordance with the Safety, Rehabilitation and Compensation Act 1988. Specifically, the court needed to assess the reasonableness of the philosophy textbook reimbursement, the University of the Third Age classes (including meditation, mindfulness, yoga, philosophy, and ethics), and the proposed further psychological treatment. A further issue arose as Comcare contended that Mrs Rope's psychological condition was no longer materially contributed to by her employment, despite having previously accepted this basis for compensation.

The Deputy President found that Comcare had consented to varying the decision under review to allow reimbursement for the philosophy textbook, and made that variation accordingly. Regarding the University of the Third Age classes, the Deputy President noted that while these were considered medical treatment, Comcare had found them unreasonable as they were not goal-focused and did not empower the applicant towards self-management. The Deputy President also considered that the applicant's GP had merely endorsed the classes based on past helpfulness, without discussing them in detail. Similarly, for the psychological treatment, Comcare had denied further sessions, reasoning that the applicant had been unable to achieve self-management despite extensive prior treatment. The Deputy President acknowledged the historical context of Mrs Rope's chronic pain condition, originating from a 1987 motor vehicle accident, and the subsequent development of psychological symptoms, which had been accepted as a compensable condition. However, the Deputy President ultimately affirmed Comcare's decisions to reject the claims for the University of the Third Age classes and the further psychological treatment, finding them not to be reasonable medical treatment in the circumstances.