Singh v HealthScope Operations Pty Ltd - [2025] NSWPIC 560

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Singh v HealthScope Operations Pty Ltd [2025] NSWPIC 560
APPLICANT:	Amarjit Singh
RESPONDENT:	HealthScope Operations Pty Limited
MEMBER:	Carolyn Rimmer
DATE OF DECISION:	17 October 2025
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; claim for proposed surgery; section 60 dispute; whether the surgery to the lumbar spine (namely L4-S1 anterior lumbar interbody fusion and T10 to Pelvis - posterior spinal fusion) is reasonably necessary; Rose v Health Commission (NSW), and Diab v NRMA Ltd considered; Held – proposed surgery reasonably necessary as a result of subject injury.
DETERMINATIONS MADE:	The Commission determines: 1. Respondent to pay the applicant’s s 60 expenses in respect of the treatment proposed by Dr Bhishram Singh, namely, a L4/S1 anterior lumbar interbody fusion (stage 1) and T10 to pelvis, posterior spinal fusion (stage 2) and associated treatment expenses as a result of the injury on 11 November 2021 on production of accounts and/or receipts. A brief statement is attached setting out the Commission’s reasons for the determination.

STATEMENT OF REASONS

BACKGROUND

The applicant, Amarjit Singh (the applicant), was employed by HealthScope Operations Pty Limited (the respondent) as a registered nurse. The respondent was insured by Employers Mutual (NSW) Limited (the insurer) at all relevant times.
In the course of her employment on 21 October 2021 the applicant sustained an injury to her lumbar spine while manoeuvring a patient in a commode chair into a bathroom and the chair got stuck on the door jamb. In the alternative the applicant sustained an aggravation, acceleration, exacerbation or deterioration of a disease in the lumbar spine with the deemed date of injury being 11 November 2021.
The applicant made a claim for medical treatment in relation to a proposed L4-S1 anterior lumbar interbody fusion and T10 to pelvis - posterior spinal fusion in respect of the injury to lumbar spine on 11 November 2021 and associated expenses recommended by Dr Bhishram Singh on 11 March 2025. For convenience, I shall refer to the proposed treatment as the “proposed surgery”.
The insurer issued a s 78 Notice dated 4 April 2025 declining the claim for surgical treatment, namely L4-S1 anterior lumbar interbody fusion and T10 to pelvis - posterior spinal fusion in respect of the injury to lumbar spine on 11 November 2021.
The insurer issued a Review Notice on 13 June 2025 in which the decision of 4 April 2025 was maintained.

ISSUES FOR DETERMINATION

The parties agree that the following issue remains in dispute:
(a) whether the surgery to the lumbar spine, namely L4-S1 anterior lumbar interbody fusion and T10 to Pelvis - posterior spinal proposed by Dr Singh, is reasonably necessary (s 60 of the 1987 Act) as a result of the injury to the lumbar spine on 11 November 2021.

PROCEDURE BEFORE THE PERSONAL INJURY COMMISSION

The parties attended a conciliation conference and arbitration by audio visual link on
13 October 2025. The applicant was represented by Mr Bruce McManamey who was instructed by Ms Panju…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Singh v HealthScope Operations Pty Ltd

Details

AGLC: Singh v HealthScope Operations Pty Ltd [2025] NSWPIC 560
Case: [2025] NSWPIC 560
Decision Date: 17 October 2025

CaseChat Overview and Summary

The case of Singh v HealthScope Operations Pty Ltd involves a dispute over a workers compensation claim, where the plaintiff seeks approval for a proposed surgical procedure. The matter was heard in the Workers Compensation Tribunal of New South Wales. The central issue before the tribunal was whether the surgery, specifically an L4-S1 anterior lumbar interbody fusion and T10 to Pelvis posterior spinal fusion, was reasonably necessary as a result of the injuries sustained by the plaintiff during employment. The decision hinged on interpreting the relevant provisions of the Workers Compensation Act 1987 and determining whether the proposed surgery met the statutory criteria for reasonableness.

The tribunal had to consider whether the surgery was reasonably necessary to alleviate the plaintiff's condition, which resulted from the subject injury. This involved assessing the medical evidence provided by both the plaintiff and the defendant, as well as relevant case law. The tribunal examined previous decisions such as Rose v Health Commission (NSW) and Diab v NRMA Ltd, which provided guidance on the interpretation of the term "reasonably necessary" within the context of workers compensation claims. The tribunal needed to balance the plaintiff's medical necessity against any counterarguments presented by the defendant regarding the proportionality and advisability of the proposed surgery.

The tribunal found that the proposed surgery was reasonably necessary, taking into account the evidence and the established legal principles. The plaintiff's medical experts testified that the surgery was essential to address the debilitating effects of the injuries, which had not responded to conservative treatments. The tribunal concluded that the proposed surgery met the threshold of being reasonably necessary, as it was aimed at significantly improving the plaintiff's quality of life and functional capacity. Consequently, the tribunal ruled in favour of the plaintiff, approving the proposed surgical procedure as a necessary part of the compensation claim.

Orders