Smith and Comcare (Compensation)

This matter concerned an appeal by Mr Smith against a decision by Comcare regarding the reasonableness of ongoing physiotherapy treatment. The dispute centred on whether the physiotherapy Mr Smith was receiving constituted "medical treatment" in relation to his accepted compensable condition, which arose from a car accident in the course of his employment in July 2005. The case was heard by Deputy President Gary Humphries.

The primary legal issues before the Tribunal were whether the physiotherapy treatment obtained by Mr Smith from 17 September 2015 was in relation to his accepted compensable condition, and whether it was reasonable for him to continue to obtain such treatment. The Tribunal was required to assess the medical evidence to determine the cause and ongoing impact of Mr Smith's pain, and to consider the cost-benefit ratio of the proposed treatment.

The Tribunal placed significant weight on the medical evidence provided by Drs McDonald and Paul, who testified that Mr Smith's soft tissue injury from the 2005 accident had resolved and that his ongoing pain was unrelated to the accident. While Mr Smith asserted his physiotherapy was for the accident-related pain, the Tribunal found the medical experts' opinions, based on their training and expertise, to be the preferable source of evidence regarding the mechanics of his pain. The Tribunal also considered that continued reliance on manual manipulation therapy was unlikely to improve his condition or assist in self-management. Consequently, the Tribunal concluded that ongoing physiotherapy was not reasonable treatment in the circumstances, as it was not obtained in relation to the injury and did not represent a reasonable cost-benefit analysis.

The Tribunal affirmed the decision under review, finding that the claimed physiotherapy did not meet the requirements of section 16 of the relevant Act, as it was neither treatment obtained in relation to the injury nor treatment reasonable to continue to obtain.