Springfield v Healthcare Supply Partners Pty Ltd

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Springfield v Healthcare Supply Partners Pty Ltd [2025] NSWPIC 439
APPLICANT:	Jacqueline Ann Springfield
RESPONDENT:	Healthcare Supply Partners Pty Ltd
MEMBER:	Anne Gracie
DATE OF DECISION:	27 August 2025
CATCHWORDS:	WORKERS COMPENSATION - Workers Compensation Act 1987; claim for injury to left shoulder and treatment expenses pursuant to section 60; consideration of applicant’s and other witnesses’ statements, medical reports and other treatment records, claim correspondence, and factual material; consideration of injury and causation and main contributing factor; Kooragang Cement Pty Limited v Bates, Nguyen v Cosmopolitan Homes (NSW) Pty Limited, Briginshaw v Briginshaw, Helton v Allen, Federal Broom Co Pty Ltd v Semlitch, Austin v Director General of Education, and Duncan v Roads & Traffic Authority of NSW and Anor considered; Held – the applicant during the course of her employment with the respondent has sustained an injury to her left shoulder; employment being the main contributing factor to the aggravation, acceleration, exacerbation or deterioration of the disease.
DETERMINATIONS MADE:	The Personal Injury Commission determines: 1. Pursuant to s 4 (b) (ii) of the Workers Compensation Act 1987 (the 1987 Act) the applicant has sustained an injury to her left shoulder during the course of her employment with the respondent, employment being the main contributing factor to the aggravation, acceleration, exacerbation or deterioration of the disease. 2. Pursuant to s 60 of the 1987 Act, the left shoulder arthroscopy, biceps tenodesis, synovectomy and manipulation surgery and associated expenses proposed by Dr Moopanar in his report dated 28 October 2024 is reasonably necessary treatment as a result of the injury sustained by the applicant with a deemed date of injury of 7 August 2024. 3. Pursuant to s 60 of the 1987 Act, the past medical expenses claimed by the applicant in the sum of $1,430.31 for general practitioner attendances at Workers Health are reasonably necessary treatment expenses as a result of the injury sustained by the applicant with a deemed date of injury of 7 August 2024. A brief statement is attached setting out the Commission’s reasons for the determination.

STATEMENT OF REASONS

BACKGROUND

Jacqueline Ann Springfield, the applicant has been employed on a full-time basis by the respondent, Healthcare Supply Partners Pty Ltd, as a store person/team leader for over 28 years having commenced employment with the respondent in 1996.
The applicant’s work involves picking and packing orders of pharmaceutical products in boxes. The applicant also performs the role of team leader.
In the Application to Resolve a Dispute (ARD) a deemed date of injury of 7 August 2024 is pleaded and the type of injury is the aggravation, acceleration or exacerbation or deterioration of a disease process in respect of the left shoulder.
The injury description states:
“The Applicants employment with the respondent has required her to engage in repetitive handling and lifting of heavy loads in the capacity of (a) Pick Packer. From on or around late 2023-2024 the Applicant was made to work harder due to staff shortages, causing her to feel compelled to deliver results. She began to feel pain within her wrists in June 2024 due to the increase in work. In September 2024, the Applicant moved to a clinical area of the workplace which was less demanding but still required the repetitive use of her upper limbs to handle and lift heavy loads, ultimately causing injury to her left shoulder.
The Applicant has suffered an aggravation of underlying left shoulder pathology as a result of the nature and conditions of her employment with the Respondent.
The applicant now requires operative treatment by way of left shoulder Arthroscopy to alleviate the ongoing consequences of her work-related left shoulder injury which has failed conservative management.”
The claim for compensation in these proceedings is confined to the proposed left shoulder arthroscopy and associated treatment together with past medical expenses comprising 12 attendances at Workers Doctors, her nominated treating doctors between
19 September 2024 and 31 January 2025 for the purpose of this claim.
The respondent disputes that the applicant has sustained an injury to her left shoulder
In the event that the applicant is successful in her claim in respect of injury, the respondent will no longer maintain the dispute that the treatment claimed is not reasonably necessary treatment pursuant to s 60 of the Workers Compensation Act 1987 (the 1987 Act).

ISSUES FOR DETERMINATION

The parties agree that the following issues remain in dispute:
(a) injury to the left shoulder.

Matters previously notified as disputed

The reasonable necessity of the left shoulder surgery is no longer in dispute.

PROCEDURE BEFORE THE PERSONAL INJURY COMMISSION

The matter was listed for conciliation/arbitration on 19 August 2025. On that day, the applicant was represented by Mr Bruce McManamey of counsel instructed by Ms Panju, solicitor, from Turner Freeman Lawyers. The applicant, Jacqueline Ann Springfield was present, accompanied by her son Andrew. The respondent was represented by Mr Brendan Jones of counsel, instructed by Ms Nichols, solicitor, from Hall and Wilcox Lawyers. Mr Paul Leonard from the insurer, EML was also present.
I am satisfied that the parties to the dispute understand the nature of the application and the legal implications of any assertion made in the information supplied. I have used my best endeavours in attempting to bring the parties to the dispute to a settlement acceptable to all of them. I am satisfied that the parties have had sufficient opportunity to explore settlement and that they have been unable to reach an agreed resolution of the dispute.

EVIDENCE

Documentary evidence

The following documents were in evidence before the Commission and considered in making this determination:
(a)    Application to Resolve a Dispute and attached documents;
(b)    Reply and annexures;
(c)    Application to Admit Late Documents and annexures filed by the respondent on
4 July 2025 admitted by consent, and

(d) Application to Admit Late Documents and annexures filed by the applicant on
13 August 2025 admitted by consent.

The applicant had filed an Application to Admit Late Documents and annexures on
24 July 2025 which was not relied on by the applicant. That document and annexures are not before the Commission.
The respondent had filed an Application to Admit Late Documents and annexures on
13 August 2025 however the respondent only sought to rely on the medical report from Dr Foo dated 26 March 2025 in so far as the history contained in that report only. The applicant objected to this report. Submissions were made by the respondent and the applicant in relation to the report. I rejected the report and provided reasons which have been recorded. In summary, the report was an independent injury management consultant report. The respondent had already relied on three independent medical reports from Associate Professor Waller annexed to the reply. Associate Professor Waller is an orthopaedic surgeon. The applicant has not consulted an injury management consultant for treatment. The report from Dr Foo therefore offends regulation 44 of the Workers Compensation Regulation 2016 in relation to the rule that only one forensic medical report may be admitted into evidence on behalf of a party to the proceedings. I also note that the report from Dr Foo does not appear to be a complete report. The report from Dr Foo was served on
13 August 2025, six days before the conciliation/ arbitration hearing. No explanation was provided for the delay in serving the report. When the matter was listed for preliminary conference on 9 July 2025, the respondent made no mention of the report from Dr Foo. The applicant had not been provided with enough time to address the report either by way of a statement or a supplementary medical report from Dr Herald whom the applicant had seen for an independent medical report for her solicitors. The report is dated 26 March 2025, and the respondent have therefore had the report since about time. In light of the above, I rejected the report from Dr Foo dated 26 March 2025 and the report is not before the Commission.

Oral evidence

There was no oral evidence called. Both counsel made oral submissions which were sound recorded, and a copy of the recording is available to the parties.

Applicant’s evidence

The applicant relied on three statements from the applicant dated 2 September 2024,
24 September 2024 and 19 December 2024. The applicant also relies on a statement from a work colleague, Mr Kevin Ngo dated 15 January 2025 and a statement from another work colleague, Moiz Watto dated 29 January 2025. The applicant relies on an independent medical report from Dr Jonathan Herald dated 26 March 2025 and three medical reports from her nominated treating doctor, Dr Eric Lim, from Workers Health dated 9 September 2024, 23 September 2024 and 19 December 2024. The applicant relies on a medical report from her treating orthopaedic surgeon Dr Moopanar dated 20 January 2025 together with clinical records from Dr Moopanar and Workers Health. The applicant relies on several certificates of capacity issued by Dr Eric Lim, an MRI scan of the left shoulder and wrist dated
21 August 2024 and tax invoices from Workers Doctors as of 5 February 2025. The applicant also relies on two statements addressing the surveillance footage relied on by the respondent. The statements are from Ms Cheryl McOrrie, the applicant’s sister and Ms Cherie Genine O’Rourke, the applicant’s sister-in-law both dated 13 August 2025. I have considered all of this evidence together with the applicant’s oral submissions.

Respondent’s evidence

The respondent relies on two section 78 notices issued pursuant to the Workplace InjuryManagement and Workers Compensation Act 1998 (the 1998 Act) dated 15 November 2024 and 14 January 2025 together with three s 287A review notices issued pursuant to the 1998 Act dated 6 January 2025, 3 February 2025 and 15 May 2025. The respondent relies on statements from two employees from the respondent, Mahavirsinh Zala dated
17 September 2024 and Dawei Shi dated 20 September 2024. The respondent relies on three independent medical reports from Associate Professor Waller dated 28 October 2024, 13 November 2024 and 9 December 2024. The respondent relies on an undated ultrasound of the left arm of Dr Kaitlin Kapoor, a physiotherapy report from Seaton Loitch dated
10 January 2023 and a physiotherapy report from Ross Hoy dated 15 March 2023. The respondent also relies on an MRI scan of the left shoulder and right wrist dated
21 August 2024 and a medical report from Dr Singh dated 3 October 2024. The respondent also relies on three Medical Case Conference reports from the Better Recovery Group dated 13 March 2025, 13 February 2025 and 6 May 2025. Finally, the respondent relies on a desktop investigation report together with photographs and video dated 23 June 2025. I have considered all of this evidence together with the respondent's oral submissions.

Respondent’s submissions

The respondent submits the applicant’s case is predicated on the reports from Dr Herald and Dr Moopanar. The respondent submits that I should reject the opinions expressed in those reports as they have no proper regard to the applicant's prior history of injury, symptoms and what she was doing at work.
The respondent provided a timeline of events, which included two prior motor vehicle accidents on 2 November 2020 and 15 March 2021 together with a summary of the applicants return to work following these accidents and change in duties following her return to work. The respondent submits that Dr Herald and Dr Moopanar have not considered the timeline of events. The respondent took me to what the respondent considers a critical document that is a Fitness for Duties Work Site Assessment prepared by Mr Hoy, physiotherapist, dated 15 March 2023 (page 20 of the reply). The respondent submits Dr Herald and Dr Moopanar have not considered the important information contained in this report in relation to a prior injury to the left shoulder and a change in the applicant’s duties.
The respondent submits the report of Mr Hoy confirms that the applicant injured her left shoulder in the 2021 motor vehicle accident and the injury to the applicant’s left shoulder in the 2021 motor vehicle accident was significant. The respondent submits that the applicant was seen by a specialist, Dr Soo, and had a scan and injections and physiotherapy.
The respondent submits that Dr Moopanar and Dr Herald did not give an explanation as to why the applicant developed left shoulder symptoms. The doctors did not record a description of the applicant’s work duties that could give rise to a shoulder injury. The doctors did not take into account that the applicant was a team leader and as such was not performing the picking and packing work on a repetitive basis. They did not provide a critical analysis of the applicant’s work duties.
The respondent submits that the opinions expressed by Dr Moopanar and Dr Herald were not provided in a “fair climate”.
The respondent submits that Dr Herald was equivocal in relation to causation. He did not expressly state that the applicant’s work was the main contributing factor to the development of her injury. Dr Herald also considered the impact of the prior motor vehicle accident and the applicant’s type 2 diabetes to be possibly causative of the applicant’s left shoulder condition.
The respondent submits that Dr Herald opined that a frozen shoulder could develop if the applicant’s work was primarily at or above shoulder height. The respondent submits that I do not have before me evidence that the applicant’s work was at or above shoulder height. In fact, the statement from Dawei Shi dated 20 September 2024 confirms that the work the applicant performed in the cage was not at shoulder height.
The respondent submits that Dr Moopanar does not specifically address main contributing factor.
The respondent submits that the reports from Dr Lim are outside the purview of a general practitioner and Dr Lim has only become involved with the applicant’s treatment since
19 August 2024. He does not mention the previous motor vehicle accidents, nor does he record an accurate description of the type of work performed by the applicant at her place of employment
The respondent submits that Associate Professor Waller presents the true position in relation to the applicant’s left shoulder. In his last report dated 9 December 2024 he says that given the history of the motor vehicle accident and the applicant working in a supervisory capacity in 2022, employment is no longer a substantial contributing factor to the injury the applicant sustained to her left shoulder.
The respondent took me to the two physiotherapy reports of 10 January 2023 and
15 March 2023 in support of the respondent’s argument since the motor vehicle accident in 2021 there is a history of ongoing problems with the left shoulder and therefore the applicant’s work with the respondent was not to blame for the aggravation of the left shoulder condition.
A joint submission was made by both counsel confirming that it is agreed between the parties that the clinical notes from the applicant’s previous treating general practitioner Dr Tan are not available as Dr Tan has retired and it was not possible for either party to obtain a copy of the clinical notes. It is agreed that no inference can be drawn in relation to the absence of those notes.
Finally, the respondent submits that the two statements attached to the ARD from Kevin Ngo dated 15 January 2025 and Moiz Watto dated 29 January 2025 are self-serving statements and I would not accept what they say about the applicant’s symptoms recorded in those statements. The statements do however demonstrate that the weights the applicant claims she was required to lift has been inflated by the applicant.

Applicant’s submissions

The applicant submits that the statements provided by the applicant are detailed and uncontroverted. The respondent has provided no evidence to contradict the work duties performed by the applicant during the course of her employment with the respondent as a team leader, picker/packer.
In her first statement the applicant has disclosed a previous back injury and the two motor vehicle accidents that she has been involved in. The applicant submits that her assertion that she has recovered from the injury is not a medical diagnosis but referable to the applicant having no symptoms following the first motor vehicle accident. The applicant also notes that she states that it was the right side of her neck that was injured in the motor vehicle accidents.
The applicant also provided a chronology of the applicant’s work and left shoulder symptoms since December 2021, which the applicant submits is referable to her work rather than the motor vehicle accidents on 2 November 2020 and 15 February 2021.
The applicant submits that the last motor vehicle accident was nine months before the onset of left shoulder symptoms in December 2021 and there was no record of the applicant injuring her left shoulder in either of the motor vehicle accidents. In this respect, I note that the last motor vehicle accident was ten months before the onset of left shoulder symptoms in December 2021.
The applicant submits that the attendance with the specialist, Dr Soo, physiotherapy and injections around this time were not referable to any injury to the left shoulder arising out of the motor vehicle accident on 15 February 2021 but rather they were necessitated by the nature and conditions of the applicant’s work with the respondent resulting in the onset of left shoulder symptoms in December 2021 and June 2022 when she returned to picking/packing work. The applicant says she continued with symptoms and took six months on long service leave, sick leave and annual leave in early 2022 returning to work in June 2022. She did not make a claim for compensation at this time.
The applicant submits that the physiotherapy reports dated 10 January 2023 and
15 March 2023 relied on by the respondent were referable to this onset of symptoms in the left shoulder during the course of her employment in December 2021 and on her return to picking/packing work in June 2022 rather than from the motor vehicle accident on
15 February 2021.
The applicant submits that the statement from Kevin Ngo is helpful in respect of the type of work the applicant was required to perform from 2023 onwards and the statement from Moiz Watto is helpful in respect of the type of work the applicant had to undertake from 2021. The statements confirm that although the applicant was the designated team leader she was still required to carry out the duties of a picker/packer.
The applicant submits that the respondent's case is based on two physiotherapists reports dated 10 January 2023 and 15 March 2023. The applicant submits the report dated
10 January 2023 confirms that the applicant had physiotherapy for left shoulder capsulitis between 12 December 2022 to 6 January 2023. The applicant submits that there is no evidence before me that the applicant had physiotherapy for her left shoulder prior to this.
The applicant criticizes the report from Mr Hoy physiotherapist dated 15 March 2023 which the respondent has heavily relied on to dispute the applicant’s claim for the left shoulder condition. The applicant points out Mr Hoy was tasked to assess when the applicant could go back to her normal duties. Mr Hoy refers to a motor vehicle accident in 2022. There was no motor vehicle accident in 2022. The applicant submits that this is not just a typographical error but rather confirmation that Mr Hoy was not interested in the origins of the applicant’s frozen left shoulder but rather he was concerned about getting the applicant back to her normal duties at work

Mr Hoy does not disclose the basis upon which he makes the statement that “Mrs Springfield has been diagnosed with adhesive capsulitis of the left shoulder following a motor vehicle accident sustained in 2022”. The applicant submits that we are not advised where Mr Hoy got this history. We are not told if he got the history from the applicant or from a medical report from Dr Soo. In any event, apart from this reference in the report from Mr Hoy, there is no evidence before me that the applicant was involved in a motor vehicle accident in 2022.
The applicant submits that the respondent tried to relate the physiotherapy, cortisone injections and the visit to the specialist, Dr Soo, to the motor vehicle accident in 2021. The applicant submits this is unfounded. The applicant has said she sought this treatment and advice due to the symptoms she was experiencing at work.
The applicant notes that the respondent’s submission is that the applicant’s medical case is based on the wrong history. The applicant rejects this submission and notes the applicant’s medical case largely focuses on the deterioration in the applicant’s left shoulder condition following her transfer to the cage area in 2023.
The applicant submits that the statement of Mr Zala confirms that the role of team leader also involves performing work as a picker/packer. Mr Zala has worked with the applicant since 2017. In his statement he confirms the applicant advised him of the two motor vehicle accidents she was involved in and confirms that she was away from work for a couple of months. Noticeably Mr Zala does not state that upon her return to work following the motor vehicle accidents, she complained of left shoulder pain. The applicant submits Mr Zala could have given this evidence in his statement if it was available to him.
The applicant then refers to the statement of Danei Shi. The applicant submits that the statement confirms that the applicant performed work as a team leader and a picker/packer and was also required to make up the heavy cardboard boxes. Danei Shi had worked with the applicant since 2021.
The applicant submits that the history taken by Dr Moopanar in his report dated
9 October 2024 is detailed and entirely correct. The applicant submits that once you reject the supposition that the respondent puts forward that the applicant injured her left shoulder in the motor vehicle accident you are left with the work she performed with the respondent. The applicant submits that all of the statement’s from the applicant’s work colleagues support that her work with the respondent involved heavy repetitive use of the upper limbs.
The applicant submits that the criticism made by the respondent that Dr Moopanar did not have full details about the type of work the applicant performed at various times is incorrect. The applicant submits that Dr Moopanar clearly understood what the applicant’s work involved. Dr Moopanar provided his opinion that the applicant's work caused an injury to her left bicep tendon. Associate Professor Waller did not address this finding on the radiology.
The applicant confirmed that the applicant was still in receipt of weekly benefits of compensation in respect of a neck injury and a right shoulder injury.
The applicant submits that on the evidence there was an aggravation of the underlying condition in the applicant’s left shoulder in 2021/2022 which never completely resolved and then a continuation of the aggravation in 2023/2024 when the applicant performed work in the cage.
The applicant submits the Dr Heralds report of 26 March 2025 contains a history that accords with the contemporaneous evidence. Dr Herald takes full details of the applicant's duties with the respondent and the history he records is correct. He provides a diagnosis of left frozen shoulder.
The applicant submits that although the applicant’s statement does not specifically confirm that the work she performed was either at or above shoulder height, that is not critical as Dr Herald opines that the fast paced and repetitive work in the cage area while working in an awkward position and assembling heavy cardboard boxes could have resulted in her bilateral shoulder problems. The cage work in particular that the applicant performed in 2023-2024 played a “significant component in her injury”.
The applicant submits that even if I was to find that the applicant had a pre-existing left shoulder adhesive capsulitis resulting from the motor vehicle accident or some other cause, it was the work in the cage in 2023-2024 that resulted in an aggravation of the condition during the course of the applicant’s employment. Dr Herald confirms that this is the cause of her current symptoms, that is the main contributing factor to her current symptoms.
The applicant submits that the opinion expressed by Associate Professor Waller in his report dated 28 October 2024 is equivocal. He states that the applicant’s frozen shoulder is more likely related to her type 2 diabetes. He gives no further explanation for this opinion. He does not advise if a frozen shoulder condition can develop in a well-controlled type II diabetic.
In the supplementary report dated 13 November 2024 the applicant submits that once again Associate Professor Waller provides an equivocal opinion. He believes the frozen shoulder has developed due to her Type II diabetes however” her employment with the respondent “materially contributed to the aggravation of the left shoulder condition and the aggravation continues”.
The applicant submits in his final report dated 9 December 2024, Associate Professor Waller clearly accepts the incorrect history contained in the report from the return to work physiotherapist Mr Hoy dated 15 March 2023 that the applicant had adhesive capsulitis of the left shoulder resulting from a motor vehicle accident in 2022 and had treatment following the motor vehicle accident including physiotherapy, two cortisone injections and a consultation with a specialist, Dr Soo. It should be noted that in his earlier report the applicant disclosed the motor vehicle accidents to Associate Professor Waller. She disclosed her back injury 1998 and gave a history of the change of her work in 2023-2024. Associate Professor Waller does not ask what type of work the applicant was performing in 2021-2022 but has accepted that she was doing heavy repetitive work involving her upper limbs for over 20 years. He also assumed that the work history provided by Mr Hoy in relation to the applicant’s duties that she was only doing supervisory work in December 2022 was correct however this assumption is incorrect and inconsistent with the evidence.
The applicant submits that noting the reports of Dr Herald and Dr Moopanar and the early reports of Associate Professor Waller and dismissing the final report of Associate Professor Waller as it is based on an incorrect history contained in the report of Mr Hoy, I would be comfortably satisfied that there has been an injury to the applicant's left shoulder during the course of her employment with the respondent either by way of the development of a frozen left shoulder in 2021/2022 or an aggravation of the left shoulder condition in 2023/2024 and the left shoulder surgery proposed by Dr Moonpanar is reasonably necessary and referable to an injury to the left shoulder sustained during the course of the applicant’s employment with the respondent.

Respondent’s submissions in reply

The respondent referred to one further document he had failed to address that is the ultrasound of the left arm, undated, taken by Dr Kapoor (page 18 of the reply). The respondent notes at the time of the ultrasound the applicant was aged 57 and therefore the ultrasound had to be conducted after 20 April 2022. The respondent submits that this was before the applicant’s change of duties in 2023/2024 and her move to the cage area.
The respondent submits that I have to be comfortably satisfied that there was something at work that was the main contributing factor to the development of the left shoulder condition. It is not sufficient to just consider the fact that she had been doing repetitive work for a long period of time. It is important to look at the other factors that were in play and in this respect, Associate Professor Waller and Dr Herald give alternatives as to why the frozen shoulder condition developed and the condition may have happened spontaneously. The respondent concedes that it is true that work may have been a partial contributing factor but not the main contributing factor.
The respondent addresses the submission made by the applicant that the statement of Mr Zala did not mention that the applicant complained of left shoulder symptoms after she returned to work following the motor vehicle accident in 2021. The respondent states that this is consistent with the fact that later in his statement Mr Zala states that he has “no opinion as to what caused the injury”.
The respondent submits that I would not feel a sense of persuasion that the applicant injured her left shoulder at work in 2021/2022. The applicant’s claim is pleaded on the basis that the injury occurred in 2023-2024. The respondent submits that I would not be persuaded that the applicant has established that work was the main contributing factor to her injury.
The respondent notes the applicant made a robust attack on the report prepared by the physiotherapist Mr Hoy. The respondent submits that the report prepared provided by Mr Hoy was a considered opinion. The respondent further submits that if Mr Hoy had felt that work was creating causing the problem to the applicant’s left shoulder he would not have recommended that she return to her normal duties.
The respondent submits that it is completely irrelevant that the applicant is receiving workers compensation payments for her right shoulder and neck and advises that this is a rebuttable admission.
The respondent submits that we do not have any evidence before us in relation to whether or not well managed diabetes would allow the development of a frozen shoulder however the medical opinion that I do have before me is that the Type II diabetes is the cause of the applicant's frozen left shoulder.
The respondent further submits that the report and opinion provided by Dr Herald waxes and wanes and this should be taken into account when I am considering whether I have a real sense of persuasion that the applicant injured her left shoulder at work or whether her left shoulder symptoms are caused by something else.

Applicant’s submission in reply to the one further issue raised in submissions in reply by the respondent.

The applicant submits that the left arm ultrasound report from Dr Kapoor was taken some time after April 2022 and before April 2023 as the applicant is noted as being aged 57 at the time of the ultrasound study. The applicant submits that this is consistent with the applicant’s statement evidence in relation to the development of symptoms in December 2021/January 2022 and later in 2022.

Findings and reasons

Section 4 of the 1987 Act defines “injury” as follows:
“(a) means a personal injury arising out of or in the course of employment,
(b) includes a disease injury, which means:
(i) a disease that is contracted by a worker in the course of employment but only if the employment was the main contributing factor to contracting the disease, and
(ii) the aggravation, acceleration, exacerbation or deterioration in the course of employment any disease, but only if the employment was the main contributing factor to the aggravation, acceleration, exacerbation or deterioration of the disease.”
The applicant has the onus of proof in establishing that she has suffered an injury within the terms of s 4 of the 1987 Act.
In relation to the onus of proof in Nguyen v Cosmopolitan Homes (NSW) Pty Limited [2008] NSWCA 246 (Nguyen) McDougall J stated at [44]:
“A number of cases, of high authority, insist that for a tribunal of fact to be satisfied, on the balance of probabilities, of the existence of a fact, it must feel an actual persuasion of the existence of that fact. See Dixon J in Briginshaw v Briginshaw[1938] HCA 34; (1938) 60 CLR 336. His Honour’s statement was approved by the majority (Dixon, Evatt and McTiernan JJ) in Helton v Allen [1940] HCA 20; (1940) 63 CLR 691 at 712.”
The legal test of causation is that discussed by the Court of Appeal in Kooragang Cement Pty Ltd v Bates (1994) 35 NSWLR; NSWCCR 796 (Kooragang) wherein Kirby P (as his Honour then was) said (at [461G]) (Sheller and Powell JJA agreeing) that “[f]rom the earliest days of compensation legislation, it has been recognised that causation is not always direct and immediate”. After referring to earlier English authorities, his Honour added (at [462E]):
“Since that time, it has been well recognised in this jurisdiction that an injury can set in train a series of events. If the chain is unbroken and provides the relevant causative explanation of the incapacity or death from which the claim comes, it will be open to the Compensation Court to award compensation under the Act.”
His Honour said at [463]-[464]:
“The result of the cases is that each case where causation is in issue in a workers’ compensation claim, must be determined on its own facts. Whether death or incapacity results from a relevant work injury is a question of fact. The importation of notions of proximate cause by the use of the phrase ‘results from’, is not now accepted. By the same token, the mere proof that certain events occurred which predisposed a worker to subsequent injury or death, will not, of itself, be sufficient to establish that such incapacity or death ‘results from’ a work injury. What is required is a commonsense evaluation of the causal chain. As the early cases demonstrate, the mere passage of time between a work incident and subsequent incapacity or death, is not determinative of the entitlement to compensation. In each case, the question whether the incapacity or death ‘results from’ the impugned work injury (or in the event of a disease, the relevant aggravation of the disease), is a question of fact to be determined on the basis of the evidence, including, where applicable, expert opinions. Applying the second principle which Hart and Honoré identify, a point will sometimes be reached where the link in the chain of causation becomes so attenuated that, for legal purposes, it will be held that the causative connection has been snapped. This may be explained in terms of the happening of a novus actus. Or it may be explained in terms of want of sufficient connection. But in each case, the judge deciding the matter, will do well to return, as McHugh JA advised, to the statutory formula and to ask the question whether the disputed incapacity or death ‘resulted from’ the work injury which is impugned.”
The above-mentioned legal principles need to be considered in the context of the evidence in this case.
I have considered the medical evidence, the statement evidence and the submissions made by counsel and I am satisfied, on the balance of probabilities, on the evidence before me, that the applicant has sustained an injury to her left shoulder by way of an aggravation, acceleration, exacerbation or deterioration of an underlying disease process during the course of her employment with the respondent. I am also persuaded, on the balance of probabilities, that her employment with the respondent was the main contributing factor to the aggravation, acceleration, exacerbation or deterioration of the disease process in the applicant’s left shoulder. I make these findings for the following reasons.
I accept the applicant as a witness of truth. I accept that the applicant had worked with the respondent for over 28 years in a team leader/picker/packer role.
I accept that the applicant’s work as a team leader also at times involved work as a picker/packer. I do not accept the respondent's submission that they team leader role was supervisory only. This is supported by the applicant’s statements and the statements from the applicant's work colleagues Mr Ngo and Ms Watto. It is also supported by the statements relied upon by the respondent from the other two employees, Mr Zala and Mr Shi.
I accept that the applicant was a hard worker and her work performance was good and I rely on the statements from Mr Zala and Mr Shi in support of this (page 10 and page 15 of the reply).
I accept the applicant's description of her work duties as follows:
“It is a day in day out cycle of picking and packing boxes. The products are different sizes and weights and lots of double thickness boxes to protect the product. The orders are all different, maybe 5 or 3 or whatever is ordered, all different sizes and boxes. The weights are sometimes heavy maybe up to 15 kg-20 kg per box. I would handle about 100 - 150 boxes on a shift. In (sic) a Friday maybe 60-70 boxes. I have to open the boxes up and tape them up to put the product in and then close then (sic) up and bubble wrap the products and seal them up. It is a lot of pick packing and taping. I use my arms and upper limbs a lot. Double thickness boxes are cardboard twice as thick as usual for added security in shipping.” (page 4 of the ARD).
I accept the applicant’s chronology of events set out in her statements that I recount as follows.
In 1996 the applicant commenced work with the respondent. Her normal hours were Monday to Wednesday 7.00am to 3.30pm and Thursday and Friday 6.00am to 2:30pm. She had a 20 minute morning tea break and a 30 minute lunch break. She worked 38 hours per week and had one rostered day off per month.
In 1998 she sustained a back injury at work. She had one year off work and returned to work on light duties than resumed normal duties.
On 2 November 2020 she was involved in a motor vehicle accident on her way to work and sustained an injury to her back and the right side of her neck. She attended her local general practitioner, Dr Tan and had four months off work. She had physiotherapy and rest. On
8 February 2021 she returned to work.
On 15 March 2021 the applicant was involved in a further motor vehicle accident on her way to work. She sustained a strain to the right side of her neck. She saw Dr Tan who organised scans, rest and physiotherapy. She had four to six weeks off work. Dr Tan gave her a clearance to go back to work.
On 10 June 2021 she returned to work. She worked as a team leader but was, at times, required to assist others with picking and packing. She experienced no problems until approximately Christmas 2021.
In December 2021/January 2022 she developed pain in her left arm and left shoulder while doing picking/packing work. She saw Dr Tan and was sent to a specialist (Dr Soo). She had physiotherapy at Precision Physio at St Marys, had a cortisone injection and hydrotherapy. She was prescribed Mobic and Panadol. She continued with pain. No claim for workers compensation made but she took four to six months off on sick leave, annual leave and long service leave. In her statement she stated, “I did not recover from this” (page 6 of the ARD). I accept this evidence.
In June 2022 she returned to picking and packing work.
Between 12 December 2022 and 6 January 2023, she had physiotherapy for a frozen left shoulder at Precision Physio.
In March 2023 she saw the work physiotherapist Mr Hoy and obtained a clearance to go back to work. At that time, she was primarily doing team leader work with not as much work as a picker/packer. She continued with pain in the left shoulder but “had just learned to live with it” (page 6 of the ARD).
In June 2023 she was moved to the GHIV cage area. I accept that the work was difficult in the cage area. It was heavy and repetitive and the applicant had to work in awkward spaces. The work involved constant repetitive use of the upper limbs. I accept that the cage area was short staffed placing further demands on the applicant. This is supported by the statement from Mr Ngo dated 15 January 2025 (page 18 of the ARD). In June 2024 she also commenced to experience pain in her hands and wrists.

In July 2024 she took four weeks holiday during which time the applicant felt somewhat better however when she returned to work in the cage area, her left shoulder condition deteriorated and she immediately felt a lot worse. The applicant advised Ms Watto, Mr Ngo and Mr Shi of the pain in the left shoulder she was experiencing while carrying out her duties.
On 7 August 2024 the applicant reported her injury to Mr Shi. This is corroborated by the statement from Mr Shi dated 20 September 2024, “Jackie complained to me only in general starting about a month ago. Before this she had not made any complaints about her shoulders or hands.” (page 16 of the reply). On 15 August 2024 she completed an incident report.
In September 2024 she was placed in the clinical trial area for two weeks but was unable to continue and has been certified unfit since 23 September 2024 as noted in the report from Dr Herald dated 26 March 2025 (page 45 of the ARD).
The first radiology report that I have before me is the undated left arm ultrasound report from Dr Kapoor (page 18 of the reply). I accept counsels’ submissions that the report was taken some time between April 2022 and April 2023, as it is noted that at the time of the ultrasound, the applicant was 57 years old. The report notes the following “painful mid left upper arm, cannot lift left shoulder.? Muscle tear. Conclusion: 1. Supraspinatus calcific enthesopathy/tendinopathy region of interest. 2. Subacromial bursitis and impingement”.
At this time, 2022/2023, the applicant was under the care of her general practitioner, Dr Tan. The ultrasound report is addressed to Dr Tan. I do not have the clinical notes from Dr Tan as he has retired and I draw no inference from this. I do however note that I do not have before me the CTP files in respect of the two motor vehicle accidents in November 2020 and March 2021.
In light of this I am left with the applicant’s statement evidence that she experienced pain in her left shoulder at work in December 2021/January 2022 and sought medical treatment from Dr Tan after the onset of symptoms. Apart from a reference to a motor vehicle accident in 2022 in the report from Mr Hoy dated 15 March 2023, for which I have no supporting evidence, on the balance of probabilities I am prepared to accept the applicant's evidence that in December 2021/January 2022 she experienced an onset of pain in her left shoulder during the course of her employment performing picker/packer work. I accept that this work caused an aggravation of the pathology identified in her left shoulder in the ultrasound report from Dr Kapoor.
It is clear from the evidence that from that time the applicant continued to work in her role as a team leader which also involved picker/packer work. She had periods off work but her evidence is that when she returned to work her symptoms increased.
I also accept that when the applicant was moved to the cage area her condition further deteriorated and it was at this time that she made a claim for compensation.
I reject the respondent’s submission that the medical evidence relied on by the applicant cannot be relied on to support the applicant’s claim and that the opinions expressed by Dr Moopanar and Dr Herald were not provided in a fair climate.
In his report dated 20 January 2025, (page of the ARD) Dr Moopanar has taken a detailed history from the applicant in relation to her workplace duties which involved moving multiple heavy boxes in a repetitive manner over the course of 20 years. He notes she reported progressive pain affecting both shoulders. Dr Moopanar has noted that the applicant's work involved repetitive mechanical movement, primarily picking and packing tasks and based on her occupational history Dr Moopanar believes the repetitive workload including handling heavy loads has caused injury to her long head biceps tendon leading to the development of a frozen shoulder.
Dr Herald’s report dated 26 March 2025 (page 44 of the ARD), records the history that the applicant injured her left arm and left shoulder at work in Christmas 2021 and had physiotherapy and a cortisone injection. Dr Herald notes “she stated the pain never improved however she continued working during this injury”. He notes that the applicant was employed by the respondent since 1996 and her duties involved picking and packing boxes between
15kg and 20kg handling 150 boxes a shift. Dr Herald did not have available to him the ultrasound from Dr Kapoor. Dr Herald did have available to him the MRI scan of the left shoulder dated 21 August 2024 (page 106 of the ARD) which showed “supraspinatus tendinosis with mild change of subdeltoid bursitis. Some likely tendinosis of the long head of the biceps. Possibly early adhesive capsulitis”.
Dr Herald diagnosed the applicant's condition as a left frozen shoulder. Dr Herald has attributed the left shoulder condition to working in the cage area in 2023 in an awkward position, involving fast paced picking and packing work and assembling heavy duty cardboard boxes with poor posture. He opines that “I believe her employment at Healthcare Logistics and in particular the change in her role which occurred in June 2023 played a significant component in her injury,” I accept this opinion. Dr Herald has provided an opinion that the applicant’s work in general was causative of her injury and the work she performed in 2023/2024 significantly contributed to her ongoing symptoms.
I reject the medical opinion relied on by the respondent from Associate Professor Waller. Associate Professor Waller has provided three reports dated 28 October 2024,
13 November 2024 and 9 December 2024 (pages 27, 37 and 40 of the reply).
In his first report Associate Professor Waller takes an incorrect history that prior to 2023, the applicant worked in a supervisory capacity not performing the work as a picker/packer. I do not accept this description of the applicant’s duties prior to her move to the cage area in 2023. He does not take a history of the left shoulder symptoms the applicant developed at work in December 2021/January 2022. He records that the applicant had not had any previous problems with her left shoulder. He records that she had a back injury at work in 1998 and a motor vehicle accident in 2020 and a further motor vehicle accident in 2021 he records that the applicant only developed a gradual onset of symptoms in the left shoulder in mid-2023 and he diagnosed adhesive capsulitis left shoulder. He provided the opinion that her left shoulder condition is more likely related to her Type II diabetes. He acknowledged that the MRI scan of the left shoulder dated 21 August 2024 showed chronic degenerative changes but in this first report he was not prepared to consider that the work the applicant performed for 28 years with the respondent could have aggravated the degenerative changes in her previously asymptomatic left shoulder which has resulted in a frozen shoulder.
In his report dated 13 November 2024, Associate Professor Waller reconsiders his opinion and opines that “her employment with Healthcare Supply Partners has materially contributed to the aggravation of the left shoulder condition and the aggravation continues” Further he states, “her frozen left shoulder is predominantly due to Type II diabetes but her employment has been a substantial contributing factor.”
In this respect Dr Herald notes that the applicant is a well-controlled Type II diabetic. I am not persuaded on the evidence that the applicant’s Type II diabetes is responsible for the applicant’s injury in light of the overwhelming evidence supporting the applicant’s claim that she has performed heavy, repetitive picking and packing work at a fast rate primarily using her upper limbs for 28 years. This is supported by the applicant’s evidence that when she takes a break from work her left shoulder symptoms are reduced however when she returns to work her symptoms considerably increase.
I agree with the applicant’s submission that the final report from Associate Professor Waller dated 9 December 2024 is based on the incorrect history contained in the report from Mr Hoy dated 15 March 2023. On the basis of this report, Associate Professor Waller withdraws his opinion that her employment has been a substantial contributing factor to the development of her left shoulder condition. He accepts Mr Hoy’s history of the left shoulder adhesive capsulitis developing after a motor vehicle accident in 2022. This is an incorrect history and is not supported on the evidence. Associate Professor Waller also accepted Mr Hoy's comment that her job is predominantly administrative based and she is not required to lift anything other than light objects. This description of the applicant’s duties is not supported by the evidence.
At this point I note in the applicant's statement dated 24 September 2024, (page 12 of the ARD), the applicant states “I did not make any report to work because I was not sure what caused it. I thought it was just ordinary soreness. I did not want to lose my job either. I was scared of what may happen if I report this, noting my age and how long I had been there”.
I accept that the applicant’s fear of losing her job explains her presentation to the fitness for duties work site assessment conducted by Mr Hoy on 15 March 2023 where, despite the recorded fact that on clinical examination the applicant continued to exhibit signs of classic adhesive capsulitis with significant stiffness in all directions of her left shoulder, Mr Hoy reached the conclusion that she would be able to perform her usual duties. I find that Mr Hoy did not consider that the applicant’s “administrative” role also involved periods of the picking/packing work.
In light of this, I reject the opinion expressed by Associate Professor Waller in his report dated 9 December 2024 as I find that it is based on an incorrect description of the applicant’s duties and also an incorrect history in relation to the injuries the applicant sustained in the motor vehicle accidents and the incorrect year of the most recent motor vehicle accident which was in February 2021, not 2022.
I do not accept the respondent’s submission that as the applicant’s work was not at or above shoulder height it is not possible for work to be the cause of her left shoulder symptoms. The statements I have previously referred to support the finding that the applicant performed repetitive upper limb movements to carry out the picking/packing duties. I also note Dr Herald opined that the left shoulder condition could have been caused by the working conditions in the cage area. I accept that the type of work performed by the applicant would have aggravated the adhesive capsulitis and the long head biceps tendinosis and the sub deltoid bursitis.
I accept the opinion expressed by Dr Moopanar that the applicant’s work with the respondent has caused trauma to the long head of the biceps tendon which has contributed to the development of her frozen shoulder and the aggravation of the underlying adhesive capsulitis resulting in symptoms. I note in this respect, on examination, Dr Moopanar found a positive “Speeds Test” on assessment on 9 October 2024 (page 62 of the ARD). A Speeds Test is used to detect problems with the long head biceps tendon and the superior labral anterior (SLAP) of the shoulder.
I also accept the applicant’s submission that the applicant reports in her first statement that in the previous motor vehicle accidents she injured the right side of her neck.
The applicant developed a frozen left shoulder in 2021/2022. The genesis of the frozen left shoulder is unclear however, on the balance of probabilities, I accept that it was caused by the work the applicant performed as a picker/packer. I do not accept that it was caused by the applicant’s Type II diabetes. Despite this, even if the frozen left shoulder was caused by the applicant’s Type II diabetes, which I do not accept, I find that the work the applicant has performed for the last 28 years and in particular since 2021/2022 which involved repetitive picking and packing work requiring constant use of the upper limbs and in 2023/2024 when she was transferred to the high paced cage area performing packing work and constructing heavy duty cardboard boxes, in my opinion would have aggravated, accelerated and exacerbated the adhesive capsulitis in the applicant’s left shoulders and her work with the respondent would be considered the main contributing factor to the continuation of her symptoms. As Dr Moopanar points out “she has no other significant risk factors outside of her job” (page 61 of the ARD).
The respondent has submitted that the applicant has exaggerated the weights she was required to lift. I accept that the evidence in this regard varies between 2 to 20kgs however I consider that even a lift of 11kg on a regular, repetitive basis at a fast pace would be sufficient to aggravate an underlying adhesive capsulitis condition. I also note the two work colleagues who performed the same work as the applicant Mr Shi and Mr Ngo both agreed the boxes could weigh up to 15kgs.
The question as to what constitutes “aggravation, acceleration, exacerbation or deterioration” of a disease was dealt with in Federal Broom Co Pty Ltd v Semlitch [1964] HCA 34; (1964) 110 CLR 626 (Semlitch). In Austin v Director General of Education (1994) 10 NSWCCR 373 (Austin) Clarke JA, applying Semlitch, said a judge, faced with the potential application of the ‘disease’ provisions, should ask the following questions:
“(a) Was the applicant suffering from a disease?
(b) If so, was there an aggravation, acceleration, exacerbation or deterioration of it?
(c) If so, was her (his) employment a contributing factor?...”
Deputy President Roche at [93] in Duncan v Roads & Traffic Authority of NSW and Anor [2007] NSWWCCPD 113 (Duncan) applied this test as an “appropriate starting point”.
Since the Workers Compensation Legislation Amendment Act 2012 the above references to “a contributing factor” would be replaced with a consideration of “main contributing factor”.
If these questions are determined in the affirmative, then an injury exists under s 4(b)(ii) of the 1987 Act.
In relation to question (a), Associate Professor Waller has confirmed that the MRI scan of the left shoulder show chronic degenerative change (page 34 of the reply), so the answer to (a) is yes, the applicant is suffering from a disease in her left shoulder.
The next question is: was there an aggravation, acceleration, exacerbation or deterioration of that disease? As Roche DP found in Duncan:
“Assistance is to be gained from the judgment of Burke J in Cant, in particular a passage where his Honour applied the judgment of Windeyer J in Federal Broom:
‘Windeyer J in Federal Broom Co Pty Ltd v Semlitch[1964] HCA 34; (1964) 110 CLR 626 at 639 posed the essential question of whether there has been a relevant aggravation, acceleration, exacerbation or deterioration of a disease as:
‘The question that each poses is, it seems to me, whether the disease has been made worse in the sense of more grave, more grievous or more serious in its effects upon the patient.’
His Honour had previously commented (at 637):
“I therefore find it impossible to conceive of the malady as distinct from its manifestations.
The thrust of these comments is that irrespective of whether the pathology has been accelerated there is a relevant aggravation or exacerbation of the disease if the symptoms and restrictions emanating from it have increased and become more serious to the injured worker.” (at [17])”
In relation to question (b), the applicant’s first statement and the statements from her co-workers and her site manager and operations supervisor all agree the work involves repetitive lifting, picking/packing and assembling cardboard packing boxes that were very stiff and hard to assemble The medical opinions from Dr Moopanar and Dr Herald and the second report from Associate Professor Waller agree that the type of work the applicant was required to perform would have aggravated, accelerated, exacerbated or deteriorated the disease process.
In relation to question (c), I am comfortably persuaded, on the balance of probabilities and on the evidence before me, that it was the applicant’s work duties as a picker/packer with the respondent that has been the main contributing factor to the aggravation, acceleration, exacerbation or deterioration of the disease process in the applicant’s left shoulder. I do not accept the left shoulder condition was caused by the previous motor vehicle accidents or the applicant’s Type II diabetes.
I find that the applicant has established the elements of s 4(b)(ii) of the 1987 Act.
I note that neither counsel took me to the surveillance material contained in the application to lodge additional documents filed by the respondent on 4 July 2025, nor the statements provided by the applicant’s sister, Cheryl McOrrie dated 13 August 2025 and the applicant’s sister-in-law, Cherie Genie dated 13 August 2025 in the application to lodge additional documents filed by the applicant on 13 August 2025. As the statements provided by the applicant’s sister and the applicant’s sister-in-law provided an unchallenged explanation of the photographs in the surveillance material, I am satisfied that the surveillance material is of no consequence and has not been taken into consideration in my decision.
The parties have agreed that in the event that I find in favour of the applicant in respect of injury, the left shoulder surgery proposed by Dr Moopanar as detailed in his request for surgery approval dated 28 October 2024 (page 60 of the ARD) and the associated expenses for that surgery are reasonably necessary pursuant to s 60 of the 1987 Act.
I further note the applicant has made a claim for past medical expenses in the sum of $1,430.31 for 12 attendance is at Workers Health between 19 September 2024 and
31 January 2025 (page 108 of the ARD). Despite the fact the invoice from Workers Health refers to “wrist”, I have cross referenced the dates of attendance with the clinical notes from Workers Health (page 73 of the ARD) and I am satisfied that the attendances between
19 September 2024 and 17 December 2025 relate to the applicant’s left shoulder. The clinical notes from Workers Health that I have before me only go up to 19 December 2024 and therefore I am unable to confirm that the attendances on 20 December 2024,
29 January 2025 and 31 January 2025 are referable to the applicant's left shoulder. I do however note the applicant has been attending Workers Health since August 2024 for the injury to her left shoulder and on the balance of probabilities I am prepared to accept that these attendances were referable (in part) to the left shoulder injury and I am prepared to include those attendances in the order with respect to past medical expenses in the sum of $1,430.31 pursuant to s 60 of the 1987 Act.

[2025] NSWPIC 439

27 August 2025