Stancevska and Comcare (Compensation) - [2023] AATA 15

Stancevska and Comcare (Compensation) [2023] AATA 15 (12 January 2023)
Division:GENERAL DIVISION
File Number(s): 2018/7330
2018/7331
2018/7332

Re:Ms Snezana Stancevska
APPLICANT

AndComcare
RESPONDENT

Decision
Tribunal:Ms A E Burke, AO Member
Date:12 January 2023
Place:Melbourne

The Tribunal sets aside the decision under review and in substitution decides that Ms Stancevska is entitled to compensation for her claimed injuries of cervical spondylosis and carpal tunnel syndrome pursuant to section 14 of the SRC Act.
...................[sgd].....................................................
Ms A E Burke, AO Member
Catchwords
WORKER’S COMPENSATION –printers assistant – note printing Australia – denial of liability – whether injury is work related – conflicting medical evidence – decision set aside
Legislation
Administrative Appeals Tribunal Act 1975 (Cth)
Safety, Rehabilitation and Compensation Act 1988 (Cth)
Cases
Australian Postal Corporation v Burch (1998) 85 FCR 264
Canute v Comcare (2006) 226 CLR 535
Comcare v Mooi (1996) 69 FCR 439
Comcare v Power (2015) 238 FCR 187
Cross and Comcare [2018] AATA 52
Crouch and Comcare [2013] AATA 608
Dunstan v Comcare [2011] FCAFC 108
Kennedy Cleaning Services Pty Ltd v Petkoska (2000) 200 CLR 286
Mellor v Australian Postal Corporation [2009] FCA 504
Military Rehabilitation and Compensation Commission v May (2016) 257 CLR 468
Reardon and Comcare [2015] AATA 360
Ross and Comcare [2020] AATA 4350
Smith v Comcare [2013] FCAFC 65
Vo and Comcare [2005] AATA 773
REASONS FOR DECISION
Ms A E Burke, AO Member
12 January 2023

The Applicant, Ms Stancevska, applied for review of a decision by the Comcare Review Officer dated 6 August 2018 which denied liability for compensation under section 14 of the Safety, Rehabilitation and Compensation Act 1988 (the Act). The determination denied liability for Ms Stancevska’s claimed conditions of cervical disc prolapse with radiculopathy, an unspecified right shoulder condition, bilateral wrist condition and aggravation of bilateral wrists conditions, as they found the evidence did not demonstrate that they were contributed to, to a significant degree, by her employment at Note Printing Australia (NPA).
On 5 October 2018 Ms Stancevska sought review of that decision by the General Division of the Administrative Appeals Tribunal, stating that she disagreed with the decision in fact and law and her worker’s compensation claim should be accepted.
BACKGROUND
Ms Stancevska commenced working at NPA on 28 April 2014, first in a casual position in the finishing department in a packaging role, and in November 2015 she moved to an ongoing full-time role in the Print Hall as a Printer G5/ Print Hall Operator/ Print Assistant. She was terminated by NPA on 8 August 2019 on the basis that she was unable and unlikely to be able to perform her permanent position. Prior to working for NPA, Ms Stancevska worked in security for Coles for about two years and then worked for 17 years at The Age newspaper as a machine operator in the print centre until her position was made redundant. Ms Stancevska commenced at NPA three days after she was made redundant by The Age.
On 30 January 2017, Ms Stancevska reported an incident which had occurred between her and a co-worker, Mr Smith, in which their right shoulders came into contact with each other as they were walking in opposite directions in the corridor outside of the Print Hall. On the day of the incident, Ms Stancevska reported the incident to the Health and Safety Representative and subsequently to Human Resources. Ms Stancevska described experiencing shoulder pain from this bumping incident.
On 3 February 2017, Ms Stancevska attended general practitioner, Dr Vivek Patel, for treatment following an “accident at work”. The medical notes record:
she was bumped by a person
she is very stressed
having palpitations
she is having pain in her Rt. shoulder
Examination: right shoulder pain on movement
On 7 February 2017, Ms Stancevska attended general practitioner, Dr Jim Ristevski, for treatment. A report by Dr Ristevski dated 28 May 2018 certified that she attended on 7 February 2017 and records: “She stated missed a step on 6 February 2017 and fell injuring her right knee, right shoulder and arm”.
On 13 February 2017 a Full Incident Report was completed for the injury which occurred on 2 February 2017 in which Ms Stancevska fell in the workplace. The Report recorded: “Suzie missed a step on the Nota Screen and hit both knees on the mat covering the concrete floor. Right knee and shoulder sore, the right knee swelled up”. The report noted that the immediate action taken to rectify was “First aider applied ice pack to the right knee”.
Ms Stancevska lodged several Comcare claims for her claimed injury:
(a)On 27 March 2018 Ms Stancevska lodged a Comcare claim for neck, right shoulder, arm and both wrists. In the form she noted that when she got injured, she was “performing manual physical work over time” and that she had knocked the right shoulder on 30 January 2017 and slipped and fell from the step at work on 6 February 2017.
(b)On 7 April 2018 Ms Stancevska lodged a further Comcare claim for wrists, hands and right shoulder. In the form she stated that when she got injured she was “performing manual physical work and slipped and fell from the stairs, onto the floor, landing on my hands and knees”. She stated that this happened on 6 February 2017 and over the course of her employment.
(c)On the same date Ms Stancevska lodged another Comcare claim for right shoulder and neck. In the form she noted that when she was injured she was “performing manual physical work over time and knocked by a co-worker on the right side of my neck and shoulder”. She stated that this happened on 30 January 2017 and over the course of her employment.
(d)Also on the same date, Ms Stancevska lodged a final Comcare claim for the condition of “repetitive prolonged leaning movement of shoulders, hands and wrist movements” with the physical injury being to arms, wrists, and shoulders. In the form she noted that the tasks she was doing when she was injured was “performing manual physical work; knocking up work; heavy lifting and deboxing” and what happened was “repetitive prolonged work over the course of my employment”.
On 20 June 2018, Comcare declined Ms Stancevska’s claimed conditions of neck and right shoulder conditions, bilateral wrist injuries and an aggravation of bilateral wrist injuries. The delegate stated:
Whilst recognising you have suffered from an ailment, namely, C7 disc prolapse with radiculopathy, I consider your employment was not significant in the causation of this condition.
I am not satisfied you suffer from a specific right shoulder condition.
I am not satisfied you suffer from a specific bilateral wrist condition. I am also not satisfied you suffer from an aggravation of a bilateral wrist condition.
On 6 August 2018, following a request by Ms Stancevska for an independent review of the 20 June 2018 determination, Comcare affirmed, by way of several letters, its determination to decline liability for a cervical disc prolapse with radiculopathy, an unspecified right shoulder condition, bilateral wrists condition and an aggravation of bilateral wrists condition under section 14 of the Safety, Rehabilitation and Compensation Act 1988 (Cth) (SRC Act). The delegate provided the following reasons for the determination:
Discussion
Your claim for neck and right shoulder conditions, as it stands, constitute two separate claims for compensation.
You have claimed that you sustained the conditions as a result of the subject incident of 30 January 2017 and, in the alternative, as a result of the physical nature of the work you performed in your employment over an unspecified period of time.
Subject incident of 30 January 2017 – injury provisions
…. the evidence does not support that you sustained a right shoulder conditions subsequent to the subject incident. In respect of the cervical condition with radiculopathy, there is a lack of opinion held which is supported by clinical explanations and justification to link such to the subject incident.
…
Consequently, the evidence has not demonstrated that your cervical condition arose as a result of the subject incident or that it was aggravated in these circumstances. Rather, it is indicated that your cervical spine condition is constitutional in nature and unrelated to your employment.
…
For these reasons, it has not been established on the weight of the evidence that you sustained a right shoulder condition as a result of the subject incident.
Physical nature of your work – disease provisions
…
The evidence has thus not demonstrated that your claimed conditions were contributed to, by your employment, to a significant degree.
You submitted a claim for unspecified conditions involving your wrists, hands and right shoulder. You have attributed these claim conditions to slip and fall on the sixth of February 2017 when she landed on your hands and performing manual physical work.
On the balance of probabilities, the evidence has not established that you sustained a bilateral wrist condition which arose out of, or in the course of, your employment, being subject incident.
You submitted a claim for unspecified conditions involving your wrists, arm shoulder, you have attributed these claim conditions to repetitive prolonged cleaning and movement of shoulders, hands and wrists.
The evidence as discussed is not confirmed that you have a diagnosed condition from which there is an organic pathology in your wrist to explain your symptoms.
While it is acknowledged that you experience wrist symptoms while performing your duties, this does not equate to employment contributing to an ailment, or an aggravation thereof, to a significant degree
Consequently, the evidence has not established that your employment has contributed to a bilateral condition, or aggravation thereof to a significant degree.
Legislation
Section 14(1) of the SRC Act provides that Comcare is liable to pay compensation in respect of an injury suffered by an employee if the injury results in death, incapacity for work, or impairment.
Section 4 of the Act defines an ailment to mean “any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development)”. Relevantly, the interpretative provision at section 4(1) provides that the words injury and disease have the meanings detailed in sections 5A and 5B respectively of the Act, as follows:
5A Definition of injury
(1)In this Act:
injury means:
(a) a disease suffered by an employee; or
(b) an injury (other than a disease) suffered by an employee, that is a physical or mental injury arising out of, or in the course of, the employee’s employment; or;
(c)   an aggravation of a physical or mental injury (other than a disease) suffered by an employee (whether or not that injury arose out of, or in the course of, the employee’s employment), that is an aggravation that arose out of, or in the course of, that employment;
but does not include a disease, injury or aggravation suffered as a result of reasonable administrative action taken in a reasonable manner in respect of the employee’s employment.
...
5B Definition of disease
(1)In this Act:
disease means:
(a) an ailment suffered by an employee; or
(b) an aggravation of such an ailment;
that was contributed to, to a significant degree, by the employee’s employment by the Commonwealth or a licensee.
(2)In determining whether an ailment or aggravation was contributed to, to a significant degree, by an employee’s employment by the Commonwealth or a licensee, the following matters may be taken into account:
(a) the duration of the employment;
(b) the nature of, and particular tasks involved in, the employment;
(c)   any predisposition of the employee to the ailment or aggravation;
(d) any activities of the employee not related to the employment;
(e) any other matters affecting the employee’s health.
This subsection does not limit the matters that may be taken into account.
(3)In this Act:
“significant degree” means a degree that is substantially more than material.
ISSUES
The key issues for determination are:
(a)Has Ms Stancevska suffered an injury (disease) and, if so, has her employment at NPA contributed to that condition(s) or the aggravation of that condition(s) to a significant degree?
(b)Has Ms Stancevska suffered an injury (other than a disease) and, if so, did it arise out of, or in the course of, her employment with the NPA?
(c)If the answer is yes to either of the above, is Comcare liable to pay compensation?
Evidence before the Tribunal
Witness Statements
Ms Stancevska
Ms Stancevska’s statement of 12 December 2019 states:
On 30 January 2017 I was going from the print hall to an area along a passage way to get a key. As I was coming back Smith slammed into me. I looked up just before contact and saw that he had put his shoulder down and I believed that this showed he was braced for contact and that it was deliberate. After making contact with me Smith didn’t stop or say sorry he just kept on walking. After the contact which I felt immediate pain in my right shoulder.
I told my colleague on the press where I was working what had happened and I also spoke to Yvonne who was the Health and Safety Rep. She said to me that she had had problems with Smith previously and that I should go and report this incident to Human Resources.
Before going to Human Resources, I also told my then supervise on the floor, Mark, about this incident.
I also spoke with the foreman Dean and he said leave it with me but he also told me to go to Human Resources
After work I went to Human Resources and saw a woman there called Val. I explained to her what had happened in October and also about the bumping incident that day. When I saw Val I was crying my right shoulder was very sore. I remember her making notes of the interview and that I spent about 30-40 minutes in her office. She told me to leave with her and she would have a look at the video footage of the incident.
I attended work the following day and in fact kept working my usual hours until going to the GP after work on Friday of that week.
I went to a GP and saw Dr Vivek Patel because my right shoulder was still painful. I told him what had happened, that I had been bumped into and that I was feeling very stressed because of the earlier incidents and the way in which Smith had been behaving towards me. I remember that the GP prescribed some medication for me and told me to put some ice packs on my right shoulder.
…
In about January 2018 I started having physiotherapy and I had about five physio sessions on a treatment plan and then about ten sessions that I paid for myself. I did feel that the physio did seem to release some of the tension in the top of my left shoulder. I had about 10-15 physiotherapy sessions in 2018 and also 2019.
…
On 6 February 2017 I fell down the stairs from the machine that I was working on, I fell onto my right knee and outstretched arms. My right shoulder was still painful from the original bumping incident in January and I felt that it became more painful after I fell on 6 February 2017.
I had about two days off after the fall and also completed an incident report.
After the fall at work I went to see Dr Jim Ristevka on 7 February 2017, the day after the fall.
My right shoulder and arm were not getting better so I went to the doctor again and was sent for an ultrasound of my right shoulder which was done on 27 April 2017.
On 1 May 2017 I also had an x-ray of my right shoulder.
…
Shortly after the bumping incident I had started getting numbness in my hands more so on the right.
I am right hand dominant.
The numbness on my right side was down the right arm into the three fingers of my right hand starting with the little, ring and middle finger. I also had some numbness in my left hand but it wasn’t going down the arm, it was more in the palm and wrist.
Because my right shoulder was not getting any better I was sent for a right shoulder ultrasound on 15 May 2017 but was told that it didn’t really show much if anything in the right shoulder which was the same as the earlier ultrasound and x-ray.
I continued going to work and doing my usual duties.
One job that I found particularly aggravating my right arm and right hand numbness was a task that was called ‘knocking up’. This is where we prepare reams of the paper used to print the notes on and we have to shake the sheets to release them so that they don’t stick together and jam in the machine. When I had first started at Note Printing we used to spray the table that we did the knocking up because it made the paper slide more easily but this was stopped because we were told that the spray was affecting the notes. I felt that as a result of not using the spray knocking up became much more difficult.
…
Towards the end of 2017 I went to an osteopath about my right shoulder pain and she suggested that in fact my pain might be coming from my neck. She wrote back to my doctor suggesting that I should have a neck MRI.
I had an MRI of my cervical spine done on 9 February 2018 and I was told that I had right C7 nerve root impingement and that this would explain why I was getting the numbness in the fingers my right hand.
I still have pins and needles going down my right arm, pain in my right wrist and the three fingers that I mentioned earlier in my right hand are now completely numb.
I also have restricted neck movement and I get frequent headaches.
…
I had right wrist carpal tunnel surgery done on 23 July 2019. I have found that it has not helped at all with my right arm and hand pain.
Ms Stancevska’s further statement of 1 July 2020 states:
[Mr Smith] made direct physical contact with me and it was a massive shock to my body. I felt as if I had been hit by a brick wall. There was contact with my nose, the right side of my head and my right shoulder. My head reeled backwards with the force of [Mr Smith’s] body slamming into me and I went backwards towards a wall nearby. My right shoulder was immediately painful and I put my hand up to my right shoulder.
…
I thought my right shoulder would feel better when the bruising went away but it didn’t…
I started experiencing some minor numbness in my right arm and in my hands about two weeks after the 30 January 2017 incident and my neck was also sore but the pain in my right shoulder was more prominent, so I just spoke to Dr Lim about my right shoulder pain at the start. I thought that was more important.
I told Dr Lim on a visit on 17 October 2017 about the numbness, pins and needles when they got worse and hadn’t gone away. I explain I’d had those symptoms for a number of months.
On 16 January 2018 I have been doing a lot of heavy lifting at work. The pins and needles in my right arm became much worse after that.
I was seeing an Osteopath, Dr Lana Andalis, for treatment of my injuries and complained to her in January 2018 that the numbness, pins and needles had become worse and more frequent for the past week or so. Dr Andalis told me she thought the symptoms may be coming from my neck, so a cervical spine MRI was subsequently arranged by Dr Lim.
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Whilst working for NPA as a Print Hall Operator my duties were physically demanding…
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I worked at a pace that allowed the machines to continue their run. When the first load finished I needed to unload it before the second round finished. I then helped pack the printed sheets. Throughout my employment I performed lots of repetitive movements using my hands, wrists and shoulders. I have often had to use my shoulders in prolonged movements whilst leaning.
…
The work I performed as a Printing Assistant for NPA was very physically demanding, involving lots of repetitive movement of my shoulders, my wrists and my hands. I had to lean in position for long periods of time, placing strain on my neck.
…
I have severe pain in my neck, at the front, right side of the back of my neck. I also still have severe pain in my right shoulder. There is also still strong pain in my wrists. I still have numbness, pins and needles from my neck through my right arm and my forearm to my wrists. I can’t use my right hand properly.
My neck causes bad headaches and is worse if I cough or sneeze. I can drive only short distances. I have to be careful not to put my neck in positions that make it feel worse. Leaning forward is not good for my neck. I wake up a number of times each night because of the pain in my hands and also from the nightmares.
Being in one position, whether that’s standing, sitting or lying down for a long time, makes the pain worse. It’s difficult for me to lift, twist, bend or hold awkward positions.
My right arm now feels weak and I can’t lifted above shoulder height.
I really loved my job and the work I did. I really tried to keep working but my entries became worse I wasn’t coping psychologically.
Mr Smith, Printer’s Assistant, NPA

Mr Smith’s statement dated 30 November 2020:
On 30 January 2017 I walked out of the Print Hallthrough a set of turnstiles, between the Print Hall and a corridor, was walking down the corridor. Ms Stancevska known to me as “Suzie” (the applicant) came from a side corridor into the corridor where I was walking and walked towards me on my left. As she approached me she turned in front of me, almost at what seemed the last second, and walked across my path resulting in contact between my right shoulder and her right shoulder. I continued to walk as did the applicant. The applicant continued to walk into a tearoom area.
Mark Kisielewski, Shift Manager, NPA
Mr Kisielewski’s statement dated 22 September 2020:
…I state that while I did not witness the alleged incident described by the applicant she did mention it to me after it occurred. I did not gain the impression from talking to her at the time that it involved the sort of heavy impact the applicant now describes. I do not recall the applicant as being distressed and judging by her reaction at the time, the incident appeared to be the equivalent of people in the street brushing shoulders. The applicant return to work after the alleged incident.
I spoke with Mr Smith after the applicant had seen me and he also gave me the impression that the incident had been the equivalent of people brushing shoulders. I do not recall exactly what Mr Smith said. I was aware that the applicant and Mr Smith did not get along in the workplace and I told both of them to be aware of each other and to respect each other.
…
I disagree with the applicant’s description of her work. It is not physically demanding and is what I would best describe as fairly routine work. The applicant has also omitted to state in her statement that generally most jobs are performed by a team of people, not an individual such as the applicant. This team can be comprised of a Printer and two assistants or two Printers and two assistants, depending on the nature of the job.
…
I state that the applicant’s job is not a high impact or highly repetitive role. While there are certain repetitive actions they are not performed on a constant or ongoing basis as, for example, one would expect to be performed on a production line.
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I state that the work that the applicant performed for NPA was not physically demanding. There is no requirement for an operator such as the applicant to perform repetitive shoulder movements or to lean for long periods as the applicant has claimed. While there is some repetitive wrist action, it is done at an employee’s self-imposed pace.
Stephen Nichols, previously the Applicant’s Supervisor, now Performance Improvement Coordinator, NPA
Mr Nichols’ statement of 2 December 2020:
I am informed that the applicant has claimed that on 16 January 2018 she was undertaking heavy lifting at work.
…
The machine the applicant was working on was a “Nota screen” press. It was one of the easiest machines to work on and did not involve any heavy lifting work.
Valerie Renton, ex-Human Resources staff member, NPA
Ms Renton’s statement of 2 December 2020:
The applicant complained that she was struck by Mr Smith on 30 January 2017. This incident was alleged to have occurred in proximity of the turnstile exit from the Print Hall. The area was at the time surveyed by CCTV equipment for security purposes. I approached the security office to view the CCTV footage and did so in company of a security officer. From my viewing of the CCTV footage it appeared to me that to the extent that Mr Smith and the applicant came into contact with each other the contact was minor.
Following a complaint by the applicant I organised a conference with the applicant, Mr Smith and Mr Smith’s supervisor Mark Kisielewski on 13 February 2017.
…
From the conversation with the applicant I did not gain the impression of any significant injury having been suffered by the applicant in the incident. The applicant and Mr Smith continued to work in the Print Hall on different machines after 30 January 2017.
…
After 30 January 2017 I was contacted and advised that the applicant complained of having fallen on stairs. I attended the applicant. I recall the applicant complained of injury related to her knee. I recall providing some assistance.
Medical Evidence
Dr Jeremy Russell, Neurosurgeon
In a report to Dr Lim dated 5 February 2019, following a review of Ms Stancevska, Dr Russell stated:
Upper limb examination revealed normal tone and muscle bulk. Shoulders were unremarkable. Right bicep flexion was 4+/5 and extension 4/5 with some mild weakness in the wrist as well. The hand was normal. Bicep jerk was 2+ bilaterally, brachioradialis 1 on the right and 2 on the left and triceps 1+ bilaterally. She was Tinel positive over the right wrist but not on the left nor at the elbow.
MRI of the cervical spine performed at MIA on 9 February 2018… shows C3-C4 and C5-C6 disc to be normal. At C5-C6 there is mild/moderate left foraminal stenosis as well as mild right foraminal stenosis. At C6-C7 there is severe right foraminal stenosis severely impinging the exiting C7 nerve and the lower levels are normal.
Nerve conduction studies performed on 2 August 2018 at The Northern Hospital showed evidence of only very mild right carpal tunnel syndrome, however, chronic denervation and reinnervation changes at C5, C6, C7.
My impression is that Snezana has right C7 radiculopathy with possible C6 involvement as well. Thus it would appear that her brachial plexus is prefixed and hence, it is referring to clinical at the C8 dermatome. She has, I think, only very mild carpal tunnel symptoms which could well be explained by the cervical region and I have recommended her not to proceed with the carpal tunnel decompression at this point, as her symptoms may well resolve once we address the neck. I have given her a form for right C7 nerve cool injection as to review her thereafter to try and ascertain if there is a singular or dual nerve involvement. This would be amenable to a posterior approach and right C6-C7 and possibly C5-C6 foraminotomy.
Mr Ash Chehata, Orthopaedic Surgeon
In a medico-legal report dated 14 May 2019, Mr Chehata opined:
Ms Stancevska has developed traumatic carpal tunnel syndrome, as well as an aggravation of cervical spondylosis and subsequent C5, C6 and C7 radiculopathy after being bumped by a colleague, aggravated by a fall down stairs, as well as working as essentially an unskilled manual labourer.
In a supplementary medico-legal report of 2 December 2020, Mr Chehata opined in response to questions posed by Ms Stancevska’s lawyers:
Do you believe, on the balance of probability, our client’s employment with Note Printing Australia Limited has caused, aggravated or exacerbated our client’s injury/condition (namely to her neck and/or right shoulder and/or wrists) to a significant degree? If yes, what incident and/or activity do you attribute the injury/condition from?
I believe on the balance of probability, the client’s employment with Note Printing Australia Limited has certainly contributed to, if not significantly aggravated, both her cervical spine, shoulder and also the development of carpal tunnel syndrome to a significant degree.
Dr Ales Aliashkevich, Neurosurgeon & Spinal Surgeon
In a medico-legal report dated 30 April 2019 Dr Aliashkevich diagnosed Ms Stancevska with:
- Chronic neck, right shoulder and arm pain
- Chronic headache
- Chronic bilateral wrist/hand pain
- Chronic pain syndrome - Mid right carpal tunnel syndrome
- History of work-related injury on about 30/11/2017
- History of work-related injury on about 6/2/2017
- Multilevel cervical spondylosis dominant on C5/6 and C6/7
- Right foraminal C6/7 stenosis with C7 nerve root compression
In a supplementary medico-legal report of 4 December 2020, Dr Aliashkevich opined in response to questions posed by Ms Stancevska’s lawyers:
1. Do you believe, on the balance of probability, our client's employment with Note Printing Australia Limited has caused, aggravated or exacerbated our client's injury/condition (namely to her neck and/or right shoulder and/or wrists) to a significant degree? If yes, what incident and/or activity do you attribute the injury/condition from?
After reading the provided additional materials, I could confirm that your client's condition was very complex and multifactorial. Having regard to her:
- physical and repetitive nature of long-term employment as a printing assistant,
- chronic character of right sided tingling along the arm and forearm since around January 2018 documented by Mr Bhaskar and Dr Andalis,
- exacerbation of pain after attempted return to work,
- no evidence of previous neck problems,
- ability to work full time as a printing assistant until around March 2018,
- failed long-term relief after conservative treatment,
- failed relief after right carpal tunnel decompression on 23/7/2019,
- clinical examination,
- available radiological results,
- available results of neurophysiological investigations,
- available medical documentation, GP notes and reports of other medical specialists,
I still believe that, on the balance of probability, her employment with Note Printing Australia Limited was materially contributing factor to a significant exacerbation of a pre-existing degenerative condition of the cervical spine and aggravation of the right carpal tunnel syndrome.
Dr Jee Lim, General Practitioner
Dr Lim’s medical report of 18 March 2020, opined:
As mentioned in the previous reports, the first injury came on after reported injury at work when she got hit at the right shoulder on 30/1/17. Mrs Stancevska still complains of ongoing neck, right shoulder and arm pain.
Mrs Stancevska has had investigations, including Xrays and ultrasound of right shoulder, dated 1/5/17 and 27/4/17 respectively, MRI right shoulder on 15/5/17 and MRI cervical spine performed on 9/2/18…
Mrs Stancevska has had review with Mr Ivan Bhaskar (neurosurgeon) on 23rd February 2018, and reviewed by Dr Jeremy Russell on 5/2/219…
The other injury relates to a reported fall at work on 6/2/17. Since the fall, Mrs Stancevska reported right neck, shoulder and bilateral wrist pain. The nature of her job, which involves heavy lifting and repetitive right arm motions, can aggravate the symptoms.
Mrs Stancevska also reports bilateral wrists injury, where she experiences bilateral wrists pain and numbness. The injury was attributable to her job, which involves repetitive wrist/arms motions and heavy lifting.
Mrs Stancevska had Xrays and ultrasound of bilateral handsome rates on 19th October 2017…
Mrs Stancevska required some pain relief with the oral analgesia (voltaren and lyrica) and physiotherapy. Therefore, it will be important to continue the physiotherapy and oral analgesia.
…
In view of the ongoing neck, shoulder, wrists symptoms, I would recommend orthopaedics (shoulder) and neurosurgeon reviews.
Since the last report in April 2019, Mrs Stancevska had surgery (right carpal tunnel release) on 23/7/2019…
Mrs Stancevska reported these neck, right shoulder and bilateral wrists symptoms after injuries is at her work since Jan 2017. She stated she has had no symptoms prior to these injuries
I understand that Mrs Stancevska worked as a printer assistant, involving heavy duties including heavy lifting and repetitive right shoulder motions. Due to her ongoing symptoms, which includes pain, restricted neck, right shoulder and bilateral wrists movements, she is unable to perform her pre-injury duties and hours.
Mr Ronald Haig, Consultant Orthopaedic Surgeon
In his medico-legal report of 19 June 2018, Mr Haig opined:
I believe there are two pathologies, namely:
i.Prolapsed cervical disc which has been demonstrated radiologically, the report of which reads “Right C5 nerve root impingement in its foramen is present. Bilateral mild C6 nerve root contact is seen. Mild central canal stenosis at C5/6 and C6/7”.
ii.Her hand/wrist symptoms are typical of a bilateral carpal tunnel syndrome and indeed on examination there is convincing evidence, certainly on the right side, of this. As stated she has been booked for nerve conduction studies which are to be performed in early August.
…
I believe the symptoms in her right shoulder likely started in early 2017 for she underwent an MRI of the right shoulder in May. The symptoms in the right upper extremity would appear to have been of more recent onset, namely early 2018.
The symptoms in her wrists/hands she stated began in early 2017.
…
I do not believe there is any causal connection between her right neck/shoulder/ upper extremity pain/paraesthesia and her employment. I do not believe as a result of the “bumping” incident one could sustain a prolapsed cervical disc. I believe this is more likely constitutional in origin.
I would pass similar comment about her carpal tunnel syndrome. I do not believe it is related to her employment, but rather is constitutional in origin.
…
I do not believe her conditions are an aggravation, acceleration or recurrence of any pre-existing or underlying condition. They are in fact de novo conditions.
…
I believe she could return to work in alternative duties, but these would have to be of a purely sedentary nature.
Dr Gautam Khurana, Brain & Spine Surgeon
Dr Khurana’s medico-legal report of 23 September 2019, opined:
Diagnosis
Chronic cervical spondylosis (structurally unrelated to the incident/incidents of early 2017). Right carpal tunnel syndrome/mild right median neuropathy (probably constitutional with symptomatic exacerbation by repetitive work activities claimed, but only unilateral median neuropathy found despite bimanual work activities).
…
She did not report to me a specific work incident in early 2018, but rather that her main symptoms started from the pair of incidents claimed to have occurred in late January and early February of 2017 - that is, a year prior to the symptomatic exacerbation noted by the osteopath and Mr Bhaskar in early 2018. There are historical discrepancies, and this is quite evident in the underlined parts of the Document Portfolio Review. I cannot see any acute pathology (e.g., soft disc or traumatic fracture-dislocation) on the MRI imaging but there is substantial pre-existing pathology that would have predated any claimed injury of 2017/2018 by many years. As a result of the historical discrepancies and the imaging findings, I cannot reasonably conclude that her work has significantly contributed to the cervical spondylosis or cervical radiculopathy… Her bimanual work could exacerbate such symptoms, but structurally, in the absence of a specific and reliable history of a traumatic work event that resulted (in close temporal proximity) in the radicular symptoms arising, the work did not cause the condition (physically).
…there is substantial pre-existing structural pathology in the cervical spine. That is, an underlying spondylotic disease process is evident in the cervical spine on the imaging (see attached key images). That process substantially accounts for the applicant’s current neck and arm symptoms.
…
I do not believe she is in a position to carry out gainful work.
…
The treatment of this condition, e.g., via dual ACDFs, therefore, is also not properly related to work. Rather, it is mainly related to the underlying advanced cervical pathology that would have predictably required treatment
Dr Murray Stapleton, Plastic & Hand Surgeon
Dr Stapleton’s medico-legal report of 12 June 2019, opined:
Symptoms of carpal tunnel compression began sometime in 2017 when she was noted that when she awakened her sleep, she said the digits of both hands were numb, with pins and needles affecting the right more than the left hand. Her local doctor organised a nerve conduction study which took place on 17 August 2018; i.e., after she had ceased to work for NPA. The result of that nerve study showed mild right-sided carpal tunnel syndrome and no evidence of carpal compression on the left-hand side.
…
Currently, then, this lady has not worked for twelve months and, if there was any suggestion of work causing or aggravating the problem, it would be not observed as it is here that, in the twelve months, there has been no change in her symptoms at all.
…
This lady would suffer from carpal tunnel compression whether she worked at NPA or, indeed, if she did not work at all. It is a condition of gradual progression and if she does not have surgery in the near future her symptoms will get worse with time, for it is, as I have stated, a condition of gradual progression.
CONTENTIONS
Ms Stancevska
The Applicant contended that she is entitled to compensation for her claimed injuries pursuant to section 14 of the SRC Act.
The Applicant contended that her cervical disc prolapse condition with radiculopathy, right shoulder condition and bilateral wrist conditions have arisen in the course of her employment with NPA and/or have been significantly contributed to by her employment with NPA, and/or and have been aggravated, accelerated and exacerbated by her employment with NPA.
The Applicant contended that her work at NPA included duties that were physically demanding and often highly repetitive, as detailed and referred to in her Statement dated 12 December 2019 and in her Further Witness Statement dated 1 July 2020. She contended that she suffered her claimed injuries as a result of these physically demanding and highly repetitive manual duties.
The Applicant contended that she was injured on 30 January 2017 in the workplace when she sustained a particularly heavy knock to the right side of her body from a co-worker, Mr Smith.
The Applicant contended that she suffered a further injury on or about 6 February 2017 when she missed a step and fell in the workplace.
The Applicant contended that after the 30 January 2017 incident and her fall in February 2017, she continued to perform physically demanding and highly repetitive manual work duties for NPA for over a year.
The Applicant contended that she has been totally incapacitated for work as a result of her claimed injuries and she remains totally incapacitated for work as a result of her claimed injuries.
The Applicant contended that she has required medical treatment for her claimed injuries, and she continues to require medical treatment for her injuries.
The Applicant contended the medical treatment and medication she has obtained for her claimed injuries constitute reasonable treatment and reasonable rehabilitation within the meaning of the SRC Act.
Comcare
The Respondent contended that Ms Stancevska was not entitled to compensation for her claimed injuries pursuant to section 14 of the SRC Act, as none of her conditions were contributed to, or aggravated to a significant degree, by her employment at NPA and therefore the determination should be affirmed.
The Respondent contended that Ms Stancevska:
(a)was likely to have suffered bilateral carpal tunnel syndrome in respect of her wrists which can be an ailment for the purposes of the SRC Act but argued was not contributed to, to a significant degree, as provided by section 5B of the SRC Act, by her employment at NPA. The Respondent contended that, if the wrist condition was not accepted as carpal tunnel syndrome, no other diagnosis has been made in respect of Ms Stancevska’s wrists which constitutes a disease for the purposes of section 5B of the SRC Act;
(b)suffered from cervical disc prolapse with radiculopathy probably in January 2016. This was likely to be an injury simpliciter but it did not arise out of, or in the course of, her employment. If any underlying degeneration of the cervical spine was relevant to the cervical disc prolapse, it was an ailment, but it was not contributed to, to a significant degree, by the Applicant’s employment; and
(c)had not suffered any injury to the right shoulder for the purposes of the SRC Act.
In their final written submission to the Tribunal, the Respondent provided the following legal analysis on “Disease (ailment or aggravation of ailment) (section 5B) or injury which is not disease (section 5A)”. They argued the following authorities should be relied upon by the Tribunal:
(a)Ross and Comcare [2020] AATA 4350, where Senior Member Dr Evans-Bonner identified the questions that the Tribunal must ask in order to identify whether there exists a disease or an injury simpliciter by citing from the decision of the plurality in Military Rehabilitation and Compensation Commission v May (2016) 257 CLR 468 at [50]-[53]:
First, does the evidence amount, relevantly, to something that can be described as an “ailment”, being a physical or mental ailment, disorder, defect or morbid condition? Second, if so, was that state contributed to in a material degree by the employee’s employment by the Commonwealth?
If the answer to both those questions is “Yes”, there is a “disease” within para (a) of the definition of “injury”. Of course, in some cases, the answer to those questions may be admitted. That is, the employee may admit that the answer to the first question, or both the first and the second questions, is “No”.
If there is not a “disease” within para (a) of the definition of “injury”, the tribunal of fact next inquires whether there is an “injury (other than a disease)” within para (b). The third question is – does the evidence demonstrate the existence of a physical or mental “injury” (in the primary sense of that word)? Generally, that will be determined by asking whether the employee has suffered something that can be described as a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state. However, that judicial language is not to be construed or applied as if it were the words of a statute defining a necessary condition for the existence of an “injury (other than a disease)”. The language of judgments should not “be applied literally to facts without further consideration of what is conveyed by the reasoning” in the cases from which it is derived, or without regard to the text and scheme of the Act.
If there be an “injury” in the primary sense of the word, the next question is – did that injury arise out of, or in the course of, the employee’s employment by the Commonwealth? If that question is answered “Yes”, there is an “injury (other than a disease)” within para (b) of the definition of “injury” in s 4(1) of the Act. In some circumstances, if the answer is “No”, it may be necessary to ask whether the case is one involving aggravation of an injury. That question does not arise in this appeal.
(b)The definition of an “ailment” in s 4(1) was discussed by Drummond J in Comcare v Mooi (1996) 69 FCR 439 at 442-3:
By s 4, the term “injury” means physical or mental injury other than disease, while the term “disease” means any physical or mental ailment, disorder, defect or morbid condition. The expression “ailment” is used in s 4 of the Act as a synonym for the term “disease”. It is apparent, from the exhaustive meaning given by s 4 to the term “ailment”, and from the ordinary meaning of that word – “a morbid affection of the body or mind; indisposition: a slight ailment” (The Macquarie Dictionary) - that that term is intended to cover the whole range of physical and mental illnesses from major to minor ones.
(c)Vo and Comcare [2005] AATA 773 where Senior Member Constance (now Deputy President Constance) and Member Miller discussed the meaning of an “ailment”, at [54]:
The definition of “ailment” is very broad... The terms “ailment” and “morbid condition” both connote a condition of disease in their ordinary meanings apart from their use as part of the definition of “disease” in the Act. In context the words “disorder” and “defect” should be interpreted accordingly. The definition of “ailment” in section 4 is somewhat circular as it includes the word “ailment” within its own definition. The Macquarie Dictionary (Revised Third Edition) definition of “ailment” includes “a morbid affection of the body or mind” and “morbid” includes “affected by, proceeding from, or characteristic of disease.”
(d)In Military Rehabilitation and Compensation Commission v May at [45]-[49], French CJ, Kiefel, Nettle and Gordon JJ (the plurality), considered the meaning of “injury” (other than a disease), citing from the judgment of Gleeson CJ and Kirby J in Kennedy Cleaning Services Pty Ltd v Petkoska (2000) 200 CLR 286 and said;
“Injury” in para (b) is used in its “primary” sense. As Gleeson CJ and Kirby J explained in Kennedy Cleaning Services Pty Ltd v Petkoska, if “something ... can be described as a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state, it may qualify for characterisation as an ‘injury’ in the primary sense of that word”.
That physiological change or disturbance of the normal physiological state may be internal or external to the body of the employee. It may be, for example, the breaking of a limb, the breaking of an artery, the detachment of a piece of the lining of an artery, the rupture of an arterial wall or a lesion to the brain. Each would be described as an “injury” in the primary sense
However, as the Full Court correctly held, “suddenness” is not necessary for there to be an “injury” in the primary sense. A physiological change might be “sudden and ascertainable”. A physiological change might be “dramatic”. The employee’s condition might be a “disturbance of the normal physiological state”. That an “injury” in the primary sense can arise, and can be described, in a variety of ways does not mean that “suddenness” is irrelevant. As the Full Court said, “suddenness” is often useful where there is a need to distinguish a physiological change from the natural progress of an underlying (and in one sense, closely related) disease (as occurred in Zickar v MGH Plastic Industries Pty Ltd and Kennedy Cleaning). But it is the physiological change – the nature and incidents of that change – that remains central (emphasis added)
That an “injury” in the primary sense can arise, and be described, in a variety of ways was recognised by Gleeson CJ and Kirby J in Kennedy Cleaning when their Honours stated:
“[C]onsideration [must] be given to the precise evidence, on a fact by fact basis, concerning the nature and incidents of the physiological change accepted at trial. If this evidence amounts, relevantly, to something that can be described as a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state, it may qualify for characterisation as an ‘injury’ in the primary sense of that word.” (emphasis added.)
It is against that background that the Act requires the tribunal of fact to give consideration to “the precise evidence, on a fact by fact basis,... accepted at trial” and then to ask certain questions in order to determine whether an employee is suffering a “disease” or an “injury (other than a disease)”.
Bumping incident on 30 January 2017
Ms Stancevska

Counsel for the Applicant submitted that Ms Stancevska gave thoughtful, measured and responsive answers to questions posed to her over five hearing days and through protracted cross-examination on a variety of issues. Counsel submitted that Ms Stancevska was not prone to giving dramatic or over-responsive answers; her answers were not self-serving and were forthright and credible
Counsel further submitted that Ms Stancevska presented as an uncomplicated and good-hearted person, who gave straightforward answers in her evidence, providing truthful answers even where her answers were not necessarily to her advantage within the setting of these proceedings.
Counsel submitted that Ms Stancevska’s answers to questions were invariably consistent with her witness statements and earlier answers, given that when she was asked the same, or similar questions numerous times and/or posed a number of different ways across her evidence, her answers were invariably consistent.
Counsel submitted the Tribunal could be confident in finding that Ms Stancevska’s evidence can be relied upon in coming to relevant findings of fact, including where her evidence is contrary to that of other lay witnesses, who have also given evidence before the Tribunal in these proceedings and that she was a witness of truth.
Counsel further submitted that the Tribunal had a very extended opportunity in which to assess Ms Stancevska’s credibility, through her prolonged period of giving evidence. Counsel submitted that the Tribunal should prefer Ms Stancevska’s evidence where it conflicts with that given by witnesses for the Respondent.
Counsel submitted that prior to October 2016, Ms Stancevska had not experienced any problems of note in relation to her interactions with Mr Smith, and she loved her job and considered that she was a dedicated and valuable contributor to NPA. Ms Stancevska had no idea what she had done to have Mr Smith treat her this way; it was near impossible for Ms Stancevska to avoid interactions with Mr Smith as they worked in the same area on the same shift roster, and she was distressed and disconcerted to find Mr Smith often observing her.
Counsel for Ms Stancevska contended that there was no dispute between the parties that there was a physical collision, namely a bumping incident, between Ms Stancevska and Mr Smith. However, Counsel noted that Ms Stancevska and Mr Smith gave separate accounts of what occurred, and those accounts do not align in various respects. Counsel submitted that this is not an unusual occurrence, in that it is to be expected that two accounts of the same incident are unlikely to be identical, that memory and mindset, inter alia, are relevant considerations for the Tribunal when it comes to make findings of fact.
Counsel submitted that Ms Stancevska’s evidence was that she contemporaneously told others at the workplace about the bumping incident. This was:
(a)first to the colleague she was working with on the press that same day;
(b)second to NPA’s Health and Safety representative, Yvonne, who advised Ms Stancevska to report the incident to Human Resources;
(c)third to her then Floor Supervisor, Mark Kisielewski, who gave evidence confirming that this occurred;
(d)fourth, to the Foreman, Dean, who told Ms Stancevska to leave it with him but also advised Ms Stancevska to see Human Resources about the matter; and
(e)fifth to NPA’s Human Resources area and spoke with Human Resources staff member, Val Renton who also gave evidence confirming that this occurred.
Counsel submitted that Ms Stancevska’s account of the bumping incident, conveyed by her to numerous others on the very day of the incident, was indicative of her being highly aggrieved about the incident and Mr Smith’s treatment of her. Counsel submitted that Ms Stancevska’s viva voce recollections of the bumping incident were clear and consistent recollections.
Counsel submitted that Ms Stancevska was not hostile or angry toward Mr Smith but was trying to comprehend why he treated her the way he did. Counsel submitted that Ms Stancevska’s view of Mr Smith, after October 2016, was a fearful and somewhat confused one as she desperately tried to understand why Mr Smith was treating her badly.
Counsel for Ms Stancevska described the bumping incident in the following terms:
(a)as the doorway Mr Smith was passing through was really only large enough for a single person to move through, Ms Stancevska stood still and waited for Mr Smith to pass through;
(b)she avoided making direct eye contact with him because of the way he had been treating her;
(c)Ms Stancevska looked up just before Mr Smith made physical contact and she saw that he had put his shoulder down, as if to brace himself to make deliberate contact;
(d)Mr Smith made direct physical contact with her;
(e)the contact was a massive shock to her body that felt like being hit by a brick wall;
(f)contact was made with her nose and the right side of her head;
(g)her head reeled backwards due to the force of Mr Smith’s body with hers;
(h)she fell backwards towards a nearby wall but did not hit the wall;
(i)her right shoulder was immediately painful;
(j)Mr Smith didn’t stop after contact was made, or apologise, or say anything at all; and
(k)she was shocked and distressed by the incident.
Counsel submitted that following the incident, Ms Stancevska sought counsel from those she worked with, including a number of colleagues in senior positions and the Health & Safety representative. Ms Stancevska followed their advice and reported the matter to Human Resources the very day of the incident and continued working in her normal duties for the remainder of the week. Her right shoulder pain did not subside, there was bruising to her right shoulder, and it did not feel better, even when the bruising dissipated.
Counsel submitted that Ms Renton confirmed that Ms Stancevska complained to her that she was struck by Mr Smith on 30 January 2017 in the proximity of the turnstile exit from the Print Hall. Counsel submitted that Ms Stancevska’s evidence about her discussion was with Ms Renton that day was that she was in tears, her right shoulder was very sore, she touched and rubbed her right shoulder in Ms Renton’s presence because it was painful, and that Ms Renton told her to leave the matter with her, stating that she would review the CCTV footage of the bumping incident.
Counsel submitted it was abundantly clear that Ms Stancevska was highly distressed, aggrieved and in pain due to the bumping incident.
Counsel acknowledged that Ms Renton’s evidence was that she had reviewed the CCTV footage of the bumping incident and concluded that the contact between Ms Stancevksa and Mr Smith was minor and that neither person tried to avoid walking into the other. However, Counsel contended that Ms Stancevska was best placed to know and accurately describe the impact she actually experienced on that day.
In their final written submissions, Counsel for Ms Stancevska argued that whilst Ms Renton had concluded that neither party tried to avoid the other, she had failed to fairly take into account:
a. the fact that Ms Stancevska had previously, and relatively recently, reported that Mr Smith had verbally abused her, in circumstances where such abuse was entirely inappropriate and caused Ms Stancevska considerable distress;
b. that Mr Smith’s verbal abuse had occurred in circumstances where Ms Stancevska had done absolutely nothing wrong, she was simply appropriately responding to a printer’s request for assistance, which was a specified and essential responsibility identified in the Position Description for the role Ms Stancevska occupied;
c. that Ms Stancevska had reported Mr Smith’s misconduct (as was appropriate for her to do in all of the circumstances);
d. Ms Renton’s presumed view of the CCTV footage of the incident was likely to have been limited and insufficient to discount or rule out Ms Stancevska’s account of events; Ms Stancevska described in her evidence, and in her witness statements, that after the October 2016 verbal abuse incident “every time or almost every time that Smith came past me in the print hall he would have his head down when he passed me and I think this is because there are security cameras everywhere, but under his breath he would say things to me (or I thought they were said to me) such as “bitch”, “idiot” and “slut”.
f. the conduct described above is explicable as conduct designed to avoid detection.
g. Such conduct, it is submitted, is consistent with Mr Smith purposely colliding with Ms Stancevska and intentionally generating significant force to Ms Stancevska’s right shoulder and the right side of her face/ neck area, whilst simultaneously disguising that purpose. This would ensure the forceful contact did not appear to be overtly intentional.
h. The likelihood of Mr Smith disguising his aggressive and premeditated rough contact is not remote, in all of the circumstances.
i. Security cameras weren’t just located all around the workplace, they were very obvious and their existence was known to NPA employees given the valuable nature of the currency notes NPA produced.
j. That Ms Stancevska had advised Ms Renton that she had looked up moments before the forceful contact was made by Mr Smith and she saw that Mr Smith had lowered his shoulder in what she considered was Mr Smith deliberately bracing himself (rather than moving to avoid contact) and in that moment, the moment where Ms Stancevska realised that forceful contact with her was about to be made, it was too late for Ms Stancevska to do anything to avoid the impact.
k. As Ms Stancevska was leaving work on the day in October 2016 that Mr Smith had verbally abused her, Ms Stancevska’s on-floor supervisor, Warren, asked her what had happened earlier that day. This was because Warren had seen Ms Stancevska crying in the tearoom earlier. Ms Stancevska told Warren what had happened…
l. Ms Stancevska’s account that she was in pain immediately in her right shoulder;
m. That after the forceful contact was made Ms Stancevska looked toward Mr Smith but he kept walking forward without looking back, in circumstances where, if accidental contact had been made, it would be expected that Mr Smith would have stopped or said sorry, or checked to ensure Ms Stancevska was alright;
n. The fact that Ms Stancevska took steps to advise/report and follow up what had occurred with appropriate people in the workplace. This included an unnamed colleague Ms Stancevska was working with on the press that day, as well as Yvonne, the Health and Safety Representative, her floor supervisor, Mark Kisielewski who confirmed this in his evidence and his own witness statement, and NPA Foreman, Dean, who told Ms Stancevska to both leave it with him, and also to go to Human Resources. Ms Stancevska had now, she firmly believed, been intentionally physically abused in the workplace by Mr Smith, in addition to being repeatedly verbally abused by him. She felt unsafe and was in need of protection.
o. The fact that Ms Stancevska’s right shoulder was still so painful by Friday 3 February 2017 (after the Monday 30 January 2017 bumping incident) that Ms Stancevska attended the doctor. The doctor, Dr Vivek Patel, prescribed Voltaren 50mg tablets, an anti-inflammatory medication, and ice packs to treat Ms Stancevska’s painful shoulder. When Ms Stancevska saw Dr Patel she was recorded as being very stressed, having palpitations and having pain in her right shoulder.
Counsel submitted that Ms Stancevska’s English is imperfect as it is not her native tongue, and this fact ought to be taken into consideration when reviewing medical records and reports. Additionally, Counsel submitted that when she attended doctors after the incident, Ms Stancevska was both physically and psychologically impacted and this further affected her ability to be specific and comprehensive.
Counsel submitted that Ms Stancevska attended Dr Patel’s on 3 February 2017 following the bumping incident and he noted that Ms Stancevska:
(a)was bumped by a person at work;
(b)was very stressed;
(c)was suffering from palpitations;
(d)was suffering from pain in her right shoulder; and,
(e)was advised to treat her right shoulder both with ice packs and Voltaren 50mg tablets.
Counsel submitted that irrespective of whether Mr Smith intentionally caused the bumping incident, as Ms Stancevska has surmised, there was no question that contact was made. Ms Stancevska has given consistent and credible evidence of the force of the contact made, the impact on her body from the forceful contact, and the pain and disability she has suffered following the bumping incident and her misstep resulting in a fall at the workplace in February 2017.
Comcare
The Respondent contended that Ms Stancevska did not suffer any injury as result of the bumping incident on 30 January 2017. They argued that the evidence did not suggest any diagnosed physiological changes or disturbance of her normal physiological state, and that complaint of pain does not in itself constitute the requisite change or disturbance to constitute physical injury.
The Respondent took the Tribunal to the plurality in Military Rehabilitation and Compensation Commission v May, which they submitted held that an “injury” is “something that can be described as the sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state” (at [52]). The Respondent submitted the High Court was concerned with an “injury” which was not a disease (ailment or aggravation of an ailment). A complaint “of being unwell” was held to be not sufficient to establish an injury simpliciter (which was not a “disease”) (at [61]). The Respondent submitted that a complaint of pain would fall into the same category.
The Respondent contended the plurality in May also held that the “nature and incidents of the physiological … change will determine whether there was an “injury” (other than a disease)” (at [62]), and that the evidence “where appropriate, …take into account common-sense inferences from a sequence of events”.
The Respondent contended that the evidence presented to the Tribunal of the bumping incident on 30 January 2017 where Ms Stancevska’s right shoulder came into contact with the right shoulder of Mr Smith, suggested a glancing blow and the absence of any resulting injuries for the purposes of the SRC Act.
The Respondent contended that Mr Smith’s evidence was that Ms Stancevska’s right shoulder came into contact with his right shoulder in the context that she moved into Mr Smith's path when exiting the Print Hall and stood in his way. They argued that this was contrary to Ms Stancevska’s allegation that Mr Smith forcefully thrust his shoulder against hers. The Respondent contended that Mr Smith explained the circumstances of the incident in examination in chief and did not resile from his evidence. The Respondent contended that Mr Smith explained how Ms Stancevska changed the path she was taking to the Print Hall and their shoulders bumped when he did not move out of her way.
The Respondent contended that Ms Stancevska evidence as to the occurrence of the bumping incident is conflicted and ought not be accepted. They argued that in her witness statement dated 12 September 2019 (in paragraph 29) she referred to the contact and feeling pain in her right shoulder, but she subsequently said that the contact was with her nose, right side of her head and right shoulder and that she "went backwards towards the wall nearby".
The Respondent contended that Ms Stancevska’s description of the bumping incident of "we slammed each other" did not attribute any fault to Mr Smith, as compared with the allegation in paragraphs 11- 12 of her further witness statement dated 1 July 2020, in which she alleged that she had been slammed into by Mr Smith resulting in contact with her nose, the right side of her head and her right shoulder with the effect of pushing her backwards.
The Respondent contended that Ms Renton (from Human Resources), who saw the Applicant and Mr Kisielewski (Manager) with Mr Smith on 13 February 2017, did not get the impression of anything serious having occurred. They argued that Ms Renton’s witness statement, dated 2 December 2020, corroborated the impression she gained of the absence of any significant injury; her statement described the incident as minor and in her oral evidence she said that if it was more serious, as suggested by Ms Stancevska, it would have led to disciplinary action. The Respondent argued that Ms Renton had seen the CCTV footage of the incident which confirmed her view of the contact being minor.
The Respondent contended that Ms Renton, in her oral evidence, described the bumping incident as if walking in a busy street "the kind of glancing blow, you might bump into a passing stranger…. It was that level of interactions". They argued Ms Renton said that she did not see anyone "being pushed backwards at all" and that the incident described by the Applicant would have led to "a much more formal process in terms of discussing with both of them what had happened….". They contended that from Ms Renton’s observations of the CCTV, she formed the view that Mr Smith did not brace himself nor collide with the Applicant's nose, head and shoulder and that the footage quality was extremely good.
The Respondent contended that Mr Mark Kisielewski, a floor manager, formed the impression after speaking to Ms Stancevska that she wanted an apology from Mr Smith. The Respondent argued therefore that she was not alleging significant contact between her shoulder and Mr Smith’s shoulder, nor had she suffered an injury. The Respondent contended that Mr Kisielewski did not gain any impression that Ms Stancevska was complaining of a serious event, and they noted paragraph 10 of his statement of evidence dated 22 December 2020, in which he states that from speaking to the Applicant he did not obtain an impression of heavy impact.
The Respondent contended that the Tribunal should accept that the impact was a glancing contact and unlikely to cause any injury. The Respondent contended that it was therefore more likely that Ms Stancevska was upset with Mr Smith not moving out of her way, rather than that the impact was severe and caused injury. The Respondent contended there was no suggestion made that Mr Smith was untruthful nor any motive advanced for him to say what he recalled. Therefore, they argued, his evidence should be accepted and if his evidence was accurate then it is also inconsistent with the evidence of the Applicant.
The Respondent submitted that the incident occurred on 30 January 2017 which was a Monday, and the Applicant did not see Dr Patek until 3 February 2017, which was a Friday. The Respondent submitted that Ms Stancevska had not explained why she waited about four days before seeing her medical practitioner if she had suffered an injury. Additionally, the Respondent alleged that her evidence was impacted by her perception of the incident in the context of her allegations that she was abused by Mr Smith in 2016. In answer to a question as to why the Applicant was in “a bad way” when she saw Dr Patel on 3 February 2017 the Applicant answered “…by having issues with the same colleague in 2016….by mentally, not capable of handling”. The Respondent argued the comment suggested that Ms Stancevska’s recollections of the bumping incident were influenced by the overall perception she had of Mr Smith and not that the Applicant suffered an injury to her right shoulder.
The Respondent submitted that Ms Stancevska continued to work after the incident, at the same work as before the bumping incident, without taking any time off or changes to her duties, nor did she seek to change her duties. She took two days off work after the fall on 6 February 2018.

The Respondent submitted that the evidence therefore suggests that the Applicant did not suffer any right shoulder injury simpliciter or, alternatively, if any injury was suffered, it was not significant and did not persist. Furthermore:
(a)Ms Stancevska ceased work for a couple of days after the fall on 6 February 2017. The concern, according to her evidence, was apparently being upset with Mr Smith, not as a result of an injury to the right shoulder. She suffered unrelated medical conditions later in 2017 and no complaint was made in respect of the right shoulder for about two months;
(b)The first reference to her right shoulder in her general practitioner’s clinical notes following 30 January 2017, is not until 1 May 2017, despite her attending the clinic for various other medical conditions. She attended on another medical practitioner on 27 April 2017 in respect of "painful posterior shoulder". The Applicant obtained healthcare imaging which disclosed "mild bursal full thickening only. Dr Lim recorded on examination "right shoulder-abduction and flexion …"”
(c)Ms Stancevska attended her general practitioner’s clinic on 12 February 2017 and made no complaint in respect of the right shoulder and it was another two and half months before she obtained x-ray material in respect of a shoulder complaint;
(d)a clinical note of 5 May 2017 records that the x-rays taken 27 April 2017 were "right shoulder normal". Despite subsequent entries in respect of other matters unrelated to the right shoulder, she complained of right shoulder pain on 22 June 2017 but not thereafter to the doctors at the practice even though the issue of wrist related pains was discussed on 17 October 2017. If any right shoulder injury was present, it is likely that it would have been raised at the time given complaints as to physical pains, or earlier;
(e)if Ms Stancevska had suffered an injury to the right shoulder on 30 January 2017, she would have manifested some objective abnormality e.g., imaging or medically confirmed objective signs; and
(f)Ms Stancevska did not make any employment related claims for compensation which included the right shoulder until the first 2018 claim following a cervical disc prolapse.
The Respondent argued that it was unlikely that Ms Stancevska suffered a right shoulder injury as a result of the bumping incident as contemplated by section 5A of the SRC Act, referring to Military Rehabilitation and Compensation Commission v May, as she continued working between 30 January 2017 and when she attended Dr Patel on 3 February 2018 who recorded in his clinical note that the Applicant was "bumped", the absence of a diagnosis by Dr Patel of any injury, nor identification of any change in pathology, and no subsequent complaints in respect of the right shoulder.
The Respondent argued that the Tribunal should be guided by Canute v Comcare (2006) 226 CLR 535 where the High Court said in the context of the pre-2013 definition of injury at [10]:
The definition of "injury" is expressed in terms of the resultant effect of an incident or ailment upon the employee's body.
The Respondent argued that Dr Patel did not diagnose any physiological change as result of the bumping incident nor did Dr Lim, and none was recorded in the clinical notes. Additionally, no such record appears in the note of Dr Ristevski on 7 February 2017 following the fall on 6 February 2017.
The Respondent argued that the Tribunal should be satisfied that no injury occurred on 30 January 2017 for the purposes of s 5A of the SRC Act, as there was no history of complaints to medical practitioners at the medical clinic Ms Stancevska attended in respect of the right shoulder following that date.
The Respondent argued that Dr Lim gave evidence based on Ms Stancevska’s retrospective complaints and said that contemporaneous clinical notes did not refer to any complaints related to the right shoulder following 30 January 2017 until she attended “on another practice” on 27 April 2017.
The Respondent argued that there was no evidence to support any alleged relationship between any wrist and neck complaints and the bumping incident. The Respondent took the Tribunal to numerous clinical notes and evidence. They referred to Dr Lim’s evidence that Dr Patel was a "careful and reliable medical practitioner" and would have recorded on 3 February 2017 any history of or current complaints if provided with that history, but none was provided. Dr Lim saw the Applicant on 12 February 2017 following the fall on 6 February 2017 and made no record of any neck or shoulder issues, none of any complaint related to her neck, arm or wrist pain. Similarly, there was no complaint in respect of any neck and arm pain, nor wrist pain on 26 May 2017 nor on 22 June 2017. On 1 May 2017, the Applicant was examined in respect of the right shoulder and the note recorded "right shoulder abduction in flexion? crepitus".
Fall on 6 February 2017
Ms Stancevska
Counsel submitted that on 2 February 2017, Ms Stancevska missed a step on the Nota Screen and fell hitting both of her knees on a mat which was covering the concrete floor. The Incident Report of that fall records that Ms Stancevska’s right knee and shoulder were sore, her right knee swelled up and an ice pack was applied to her right knee. Ms Stancevska’s evidence was that she fell more to the right side with outstretched arms.
Counsel submitted that this fall resulted in Ms Stancevska’s already injured and painful right shoulder becoming more painful.
Counsel for Ms Stancevska relied on the following medical evidence:
(a)On 7 February 2017, Dr Ristevski’s clinical note recorded injuries to Ms Stancevska’s right knee, right shoulder and right arm from a fall the previous day when she missed a step;
(b)an ultrasound of the right shoulder dated 27 April 2017 revealed mild bursal thickening; and
(c)an MRI report of the right shoulder was performed, and a report dated 15 May 2017 identified the presence of subchondral cysts at the posterior of the humeral aspect. These were considered likely to be degenerative.
Comcare
The Respondent contended that the Tribunal should infer that the fall was minor and did not result in any injury to Ms Stancevska’s right shoulder.
The Respondent accepted that Ms Stancevska fell down stairs and onto her knees on 6 February 2017 and that the incident report refers to "right knee and shoulder sore, the right knee swelled up”. The Respondent argued that apart from a certificate dated 28 May 2018 from Dr Ristevski stating that the Applicant presented on 7 February 2017 and that she missed a step on 6 February and fell "injuring her right knee and right shoulder and arm", nothing was said of any right shoulder injury as a result of the fall to any doctor until 2018. Further, they argue that no diagnosis of any injury appears to have been made nor is there any explanation of how the Applicant’s right shoulder was injured by falling on the right knee.
The Respondent argued the case law in Military Rehabilitation and Compensation Commission v May refers to the requirement of a diagnosed identifiable pathological change before the Tribunal is able to find an occurrence of an injury.
Alleged heavy/ repetitive work
Ms Stancevska
Counsel submitted that the Position Description for Ms Stancevska’s job at NPA identifies that: “This position is responsible for assisting printers in the printing process, especially with regard to preparing reams of substrate for the feeders on NPA’s print presses”. The Duties and Responsibilities in the Position Description identify the following:
• “Prepare reams of substrate for the feeders on NPA’s print presses (this includes lifting reams of substrate and fanning the substrate).
• Ensure all consumables required are available at the beginning of the job and are monitored to ensure adequate levels of stock are maintained for the duration of the job for their specific press.
• Perform data entry tasks as required.
• See attached Compliance obligations.
• Other duties as required by the company.”
Counsel submitted that Ms Stancevska’s role was that of an Operator, in which she worked in the Print Hall with “mostly” men and that the printing section of the workplace was very male dominated. At all relevant times of Ms Stancevska’s employment at NPA, there was both a morning and an afternoon shift with staff rotated between the shifts and each shift was staffed by permanent and casual employees.
Counsel contended that Ms Stancevska performed manual duties that were physically demanding and, in the course of her employment with NPA, she injured herself but continued working until she was not able to keep doing so, at which time NPA assessed her as being totally incapacitated.
Counsel for Ms Stancevksa submitted that the process of performing the task of ‘knocking up’ was the subject of much evidence before the Tribunal but Ms Stancevska had provided detailed evidence of how she carried out knocking up:
(a)the task was described as somewhat analogous to lining up the edges of a ream of photocopying paper before feeding it into a printer;
(b)however this analogy was limited in a number of respects as the NPA sheets which had to be ‘knocked up’ were made of polymer (otherwise referred to as substrate), were much larger than standard A4 photocopier sheets, and the printing processes progressively applied to the polymer sheets made the sheets sticky and thus made knocking up considerably more difficult and physically demanding;
(c)each polymer sheet passed through a variety of printing press machines obtaining a series of colour printing layers to reach their completed state. After each printing stage, the printed polymer sheets had to be knocked up again;
(d)the dimensions of the polymer sheets varied depending on the particular currency which was being printed;
(e)the number of polymer sheets knocked up at one time varied but was often more than 200 - 250 sheets. The more sheets knocked up together resulted in the handling of more weight;
(f)where sheets were particularly sticky, less sheets were knocked up together. When that occurred the knocking up process took longer;
(g)knocking up was a task that needed to be performed multiple times per shift so that the printing press being used could be continuously fed;
(h)ordinarily she knocked up on an air-assisted table but sometimes (around four weeks a year) had to use a wooden table without air assistance and which was not height adjustable. Air assistance helped to separate the sticky polymer sheets. It was much more difficult to perform knocking up on wooden tables;
(i)the polymer sheets to be knocked up were sometimes located above shoulder height and sometimes she was required to place them at shoulder height, such as when placing the polymer sheets on to boards in a pallet stack. This was because the pallet stack effectively grew and generally grew to a height above her own shoulder height. Such actions placed additional strain on her shoulders.
Counsel for Ms Stancevska submitted that her duties did not need to be categorised as duties constituting heavy manual work to cause injury, as the SRC Act does not specify any such requirement.
In any event, Counsel submitted that it is uncontroversial to state that Ms Stancevska’s duties were both physically demanding and often highly repetitive and that Ms Stancevska had been performing those specific, and often highly repetitive, work duties, including ‘knocking up’, since moving from the Finishing Department to the Print Hall in November 2015.
Counsel submitted that Ms Stancevska’s injuries had developed slowly over time as a result of the nature of the work she performed and that the work-related contributions to the development of these injuries across Ms Stancevska’s entire employment period are relevant, following the case of Smith v Comcare [2013] FCAFC 65 at [37]-[38] which found that “… the Tribunal correctly approached the issue of aggravation by looking at the whole period form 1977 to 2008”.
Counsel submitted that throughout Ms Stancevska’s employment in the Print Hall she had worked at a pace that allowed the press machines to continue their run. Counsel submitted that throughout her entire employment with NPA, Ms Stancevska performed repetitive movements with her hands, wrists and shoulders, including that often her shoulders were used for prolonged movements whilst simultaneously leaning.
Counsel referred to the report of Professor Marshall of 7 June 2018 which provided the opinion that:
(a)Ms Stancevska’s cervical spine/neck injury and right shoulder injury have not resolved;
(b)a causal condition existed between her cervical spine and right shoulder condition to her employment
(c)Ms Stancevska’s claimed condition were primary injuries to her cervical spine with aggravation of cervical spondylosis with radiculopathy and primary right shoulder strain injury, with worsening symptoms which continue as a result of the injury;
(d)Ms Stancevska’s employment contributes to aggravation of her pre-existing spondylosis;
(e)non-employment factors were not relevant to her claimed condition;
(f)the symptoms of Ms Stancevska’s primary injuries were worsening which continue;
(g)Ms Stancevska’s pre-existing spondylosis was aggravated by her employment duties;
(h)Ms Stancevska was not working because of her persisting symptoms and has no work capacity because of her existing symptoms;
(i)Ms Stancevska requires continuing physiotherapy for her neck, shoulder and wrist symptoms, weekly or twice weekly for a three-month period, accompanied by a gymnasium/ pool membership following which he hoped that self-maintenance strategies would be appropriate with the possibility that, depending upon progress, Ms Stancevska would return to suitable duties; and,
(j)ideally, Ms Stancevska may have a capacity to perform light duties in the future.
Counsel submitted that NPA terminated Ms Stancevska’s employment by letter dated 8 August 2019, with effect that same day. NPA stated it decided to terminate Ms Stancevska’s employment on the basis of her inability to perform her permanent position of Print Hall Operator, they considered it unlikely that she would ever be fit for her permanent position of Print Hall Operator and claimed there were no adjustments or accommodations that would help her perform that role.
Comcare
The Respondent submitted that there was no good evidence, lay or medical, of a causal relationship between Ms Stancevska’s work activities and any of her claimed injuries; the right shoulder, cervical disc prolapse with radiculopathy, and wrists or aggravations of the wrists complaints.
The Respondent submitted that the evidence did not support Ms Stancevska’s submission that she undertook repetitive/heavy work, nor that her work generally over her period of employment resulted in any claimed injury. The Respondent argued that the clinical notes of Ms Stancevska’s medical consultations did not refer to any heavy/repetitive work, nor that such work contributed to any medical condition. Ms Stancevska had not complained to the medical practitioners at her clinic of any injury occasioned by work e.g., that particular work activities were occasioning pains or restrictions. The Respondent submitted, by way of example, the entry of 17 October 2017 which refers to "pain and numbness of bilateral wrists/hands the last few months" and while it notes "repetitive wrist movements with her job" it also records "no hx of trauma". Similarly, the entries on 20 October and 22 October 2017, which refer to hands, 28 January 2018 which refers to right arm paraesthesia, and chronic right shoulder pain, and 29 January 2018 which refers to a history of shoulder and neck pain, make no reference to work-related pain.
The Respondent contended that if Ms Stancevska believed work activities caused pain, she would have told her general practitioners. The Respondent submitted that Ms Stancevska told the medical practitioner at the clinic on 15 February 2018 that she had had lower back pain after heavy lifting at her old job in 2013. The Respondent contended that the Tribunal should therefore infer that until 29 January 2018 the Applicant did not blame work for any pains she had. Noting by comparison that Ms Stancevska had referred to pain in the right shoulder as a result of the incident on 30 January 2017.
The Respondent contended that it was not until 1 March 2018 that Ms Stancevska retrospectively attributed right arm paraesthesia in January 2018 to heavy lifting at work. The Respondent contended it was significant that no contemporaneous attribution to work was made. Similarly, the Respondent noted the osteopath of 25 January 2017 recorded that Ms Stancevska had wrists/hands pains "from heavy lifting... on 16 January 2018".
The Respondent submitted the Tribunal should accept and prefer Mr Kisielewski’s, evidence that the work undertaken by a print assistant was not unduly strenuous, contrary to the impression sought to be conveyed by Ms Stancevska. The Respondent submitted that this was also borne out by the photographs of the workplace provided to the Tribunal.
The Respondent submitted that Mr Kisielewski’s evidence was also corroborated by Mr Nichols, whose evidence was that Ms Stancevska worked on the "Nota screen press", in January 2018. The Respondent submitted the Tribunal should accept Mr Nichols’ evidence from his 2 December 2020 statement that:
(a)the "Nota screen press" was one of the "easiest machines to work on and did not involve any heavy lifting work" and
(b)with the Nota screen press, lifting was mainly the handling of the sheets, which he did not consider to be heavy and took no longer than half hour per batch and the associated work was light.
The Respondent submitted that during cross-examination, Mr Nichols:
(a)did not depart from his evidence in any significant manner;
(b)noted other machines Ms Stancevska worked on did not involve heavy lifting;
(c)the use of pallet jacks and the lifting of pallets onto the jacks, he did not find the pallets too heavy and did not recall any complaints about lifting of pallets;
(d)the work of printer’s assistants was not demanding or easy but intermediate; and
(e)that other than a couple of cuts and lacerations over 14 years, no other injuries occurred in the Print Hall.
The Respondent submitted that Ms Stancevska’s evidence in cross-examination corroborated the general impression conveyed by Mr Kisielewski and Mr Nichols of the nature of the work as not particularly strenuous. That the work:
(a)was relatively light but with a considerable repetitive element in respect of the ‘knocking up’;
(b)included variations so as to reduce the repetitive element;
(c)when it involved "pushing of the large sheets of machine paper" the Applicant acknowledged that this was undertaken by the use of pallets and jacks, that some of the jacks carrying pallets were electrically operated;
(d)in respect of the pressure when using the non-electric jacks after Ms Stancevska referred to it as being heavy when pulled, she stated "like, you can feel it. I'm not sure"; with pushing/pulling taking "maybe two or three minutes" and then stopping for a time but it was easier once rolling’
(e)when asked whether putting the pallet back on the wheels was light, Ms Stancevska stated "Not that light to push it. It’s still you put pressure on it."
(f)In regard to lifting pallets, the Applicant explained that pallets were brought to the site by the "logistics people" with reams of paper, and when they were empty of paper they were stacked for putting away and lifted "at end of batch”. The Applicant said of this task "I could not do I will not do it, but I find it's not easy”; she estimated the pallets weighed 12 to 13 kg which was heavy but that she was capable of undertaking the work;
(g)in the period 2017-18 the bulk of her work was on the Nota screen and was not heavy so that she couldn't manage it, but there was pressure to put the pallet into the press; and
(h)the ’knocking up’ operation was not continual because when she concluded doing that work at the back of the machine, she proceeded to the front to help the printer.

For completeness, the Tribunal explored the contribution of Ms Stancevska’s employment at NPA on her claimed injuries. The evidence before the Tribunal described the work of NPA, which produces Australian bank notes. The process commences by printing on sheets of polymer substrate in NPA's printing hall using various printing plates, processes, machines and inks. Different sized sheets are used for each denomination and the number of banknotes printed on a sheet varies. The first printing process involves the background colours and patterns being printed onto both sides of the polymer sheets at the same time by simultaneous printing machines. Security features are then applied by another screen-printing process using an optically-variable ink. Portraits and narrative elements are printed next using intaglio printing machines. In this process, the ink is transferred to the sheets under great pressure using engraved metal plates. Separate print runs are required for each side of the sheet. Serial numbers are then added to the sheets using a letterpress printing process. A protective overcoating ink is then applied to the banknotes using an offset printing press. The notes are then embossed with a tactile feature to assist the vision-impaired community to identify different denominations.
Ms Stancevska’s evidence to the hearing was that she found the role of print assistant as hard and not easy. She described that she could cope with the role but was pushing herself to do so:
…that really all you're doing is knocking up, and you're knocking up stuff which is not as sticky as the OLOV stuff?‑‑‑It's a knocking up, and also like I said I was - I was their one permanent and always had a casual with me, so always actually the printer was asking me to put a new ink to the drum to make sure there is ink there, to pick up the (indistinct), two stack of (indistinct) on the - on the press, we take that off. So it's more I was involved helping with printer, because I was a permanent and I knew the job involved, and the casual he just started it. So I was more involved knocking up, plus helping printer on the front of them, on the press, because he didn't have help, he was by himself.
All right. I can put the proposition on the basis that none of this work is particularly hard, but if you want me to split it up. What I am suggesting to you is that there's a difference between something being physically hard and something that is just hard work in terms of having to go around and, you know, be busy and trying to meet deadlines or whatever. I am suggesting to you that the OLOV type work is not particularly hard?‑‑‑The part of the job running around and helping the printers, doing that for me was - I was active lady, I was (indistinct) 30 kilos less and I was no problem of running around and doing stuff. I love working, I love my job. But the main job was sitting on the back of the printer and knocking up and laying on the - on the table and working, I find that was for me hard, but I was capable to do it. If I couldn't do it then I'll leave the job and not do it, but for me I can't say it's a less - it's easy job and are done easy. Sorry, I can't say that.
No, but did you go and see someone within the employment place and say, "Look, I find this work too hard" - whether physically hard or whatever - - -?---It was hard, but like I said I was coping and doing it. So it was not like can't cope it, but I was pushing myself to cope it, so it was hard, because like I said some days my wrists were so sore, for the weekend to then get better for the Monday when I go back to work, but I was coping and working, and because I did love the job.
Mr Nichols’ evidence to the hearing was that the print assistant job, whilst not overly demanding, was not easy either. He described the role in detail:
What does or does did you from your experience see the assistant printer doing - aware of doing behind the machine when they were not knocking up? What kind of work and could you identify any work that involves doing anything by way of lifting?---So other than actually knocking up and loading the feeder, they would set the feeder away, so that means they would start the machine running with the various controls on the feeder head. They would take the pallet that the work had been on when they loaded it in to the front of the machine. They could take that by means of the pump truck, the lifter truck, down to the front of the machine. And also they would change over the actual delivery. So when the 10 reams were actually completed they would go down the front. One assistant - there’s two assistants on there and a printer. One assistant would go down the front and take the load out of the actual machine with a pallet lifter. It’s an automatic delivery so you just push a button on the console and it will come to the floor. Just wheel the pallet in, take it away and take it about 10 yards into a loading zone where another department comes and collects the actual product. Other tasks from the assistant would be (indistinct) printer.
…
Thank you?---So they decanter into a one-litre container for the other printer to clean. Also could assist the printer in cleaning the screen. The screen itself is very light because it’s made of nickel - very thin nickel. Yes, it’s very light and we also have a squeegee blade and holder that the assistant would sometimes help the printer clean. That’s fairly light as well. We have a cleaning trolley that they just place the items on and clean. Other than that, topping up the rag bin. Obviously when I say rags, they’re cleaning rags for cleaning the screen and the actual squeegee and squeegee holder. Assistant would top them rags up at all times just to make sure we don’t run out of any rags. Solvents bowls that I’ve covered. Starting and stopping the machine. Matter of controls - computer controls. Removing the actual pile and then just the worker (indistinct).
And you’ve got the moving of the trolleys, basically, when you remove the – well firstly, when you push the trolley into the machine for printing at the feeder end and – is that right?---Yes, so the work comes in, obviously (indistinct) lots, the first batch of the day, the printer and assistant, or the two assistants, have to retrieve that work from what we call a security vault, or it gets locked up overnight. That’s about 20 yards away from that machine. That’s only for the first batch of the actual day and then another department delivers at the back of the machine in a location bay, the next batches that are going to run through the machine, so they’re right next to the back of the machine. So the guys put that – and then put that onto a self-levelling pallet lifter, so it’s got an automatic eye, you can set it just so it comes at waist height each time. You take off 150, 100 sheets, whatever they’re comfortable with, slide that across onto the knock up bench, which is also adjustable, (indistinct) to help knock up the sheets and find the sheets and knock them up. And then place that onto the actual – what I class as the pre-loader, press pre-loader at the feeder, it has a self-levelling – it goes up and down so you can – obviously you’ll want it higher at the start when you’re starting to knock up and then you lower it down as you’re knocking up the (indistinct), just so it keeps it at a comfortable height.
Would you describe just overall the work in the print hall as – and for the print assistants, as demanding physically, you know, demanding? Not – just the whole job, you know?‑‑‑I wouldn’t say it’s over-demanding but I would say it’s easy neither, you know. I would say it’s intermediate. I’ve done the work, myself, not at Note Printing but at other printing businesses so, you know, I’ve been a printer all my life so when I started my apprenticeship I used to have to knock up and things like that, so but I was a lot younger then so – yes.
It makes a difference, doesn’t it?‑‑‑Yes, it does, yes. A lot lighter as well, fitter
The evidence indicates that the print assistant’s role is to assist the printer on the various printers in the Print Hall. Much was made of the fact that Ms Stancevska worked primarily on the Nota screen printer during 2017 – 2018 as this press was described as an easier machine to operate.
Ms Stancevska’s evidence to the heaving was:
With the NOTA - NOTA screen there’s not much to do involved with wash up and too much of end of the shift cleaning up. It’s more simply press. But the knocking up and the, you know, getting the pallets and bringing the substrate is similar like other presses.
Mr Nichols’ evidence to the heaving was:
So with a NOTA Screen every other process you have to knock it up quite well because it has an ink applied to it in the previous process so the substrate can be quite sticky. But on the notice screen it’s a bit different because the Opti-NOTA, the previous process puts the foil on the actual sheets which is not an ink, so that makes it non sticky. It separates the sheets with having the foil on it, so it’s a metallic foil, so it’s easier to – when I say it’s easier to knock up, that’s why I say it’s an easier machine, you don’t have to work the sheets as hard to put the (indistinct) in them.
The Respondent provided a risk assessment analysis for the Nota Protector machine which rated the overall physical demand of the print assistant on that machine as low to moderate.
The Respondent provided a job task analysis for the print assistant on the Orlof machine which rated the overall physical demand of the print assistant as “heavy”, describing the role:
The Print Assistant is responsible for the set-up, operation, cleaning and maintenance of the Orlof Machine; an electronic machine for making and printing bank notes. This involves;
• Quality Control: Inspecting printed sheets, entering data into computer
• Set Up of Orlof Machine (not assessed in this report)
• Operation, Cleaning and Maintenance of Machine:
o Moving equipment such as angles, boards, pallets and ink drums into and around work area using electric pallet jack (EPJ)
o Using a pallet turner to prepare boards for Orlof Machine
o Lifting, carrying, pushing and pulling equipment such as angles, boards, pallets and ink drums short distances to use in Orlof Machine
o Preparing completed stacks for transport by securing with strap and storing adjacent to work area
o Inspecting and monitoring Orlof Machine during operation, including
• Inspecting ink levels in inking unit
• Monitoring and replenishing ink drums in ink pump station
o Cleaning components of Orlof Machine. Completing mid and end of shift wash up.
o Replacing and maintaining components of Orlof Machine when required
o Replenishing consumables from storeroom external to Print Hall
And factors involved in the role as:
Standing on level linoleum flooring whilst operating Orlof Machine, on metal platform whilst working above machine, and on fatigue matting to conduct quality inspections at standing workstation.
Walking on level linoleum flooring within Print Hall and on Orlof Machine platform to access upper parts of the machine. Walking to logistics area in Print Hall to replenish equipment such as angles and boards (using EPJ) <lO0m. Walking to consumables storeroom outside Print Hall to replenish consumables <lO0m. Walking wiping cylinder on trolley to/from Orlof Machine <lO0m.
Sitting at computer workstation to enter data from quality inspections (approx. 4 times per shift, 5 mins per data entry) and to check emails.
Lifting metal angles and inserting between boards whilst machine is running (2.28kg each). Angles are lifted throughout shift from waist to shin to shoulder height as they make their way into the Orlof Machine. Several angles are often lifted together as they are stacked outside machine in preparation for use. Lifting boards (7.8kg each). Boards are lifted to shoulder height on to each completed stack and remaining boards removed out of machine at end of print (3 or less). Lifting pallets (9.4kg wood, 12.3kg plastic) into base of stack in machine. Lifting wiping blade (15.6kg) once per day when replacing blade. Lifting up to 2x20L (20kg each approx.) plastic containers to pour cleaning solution in to machine once per shift. Lifting small ink drums (20kg) from floor to knee height approx. once per day. Lifting light utensils when cleaning machine. Lifting blankets in to machine once per day. Lifting rag bundles.
Carrying wiping blade (15.6kg) 3 meters (approx.) to workbench to replace blade once daily. Carrying angles (2.28kg), boards (7.8kg) and small ink drums (20kg) small distances within work area (<1m). EPJs are used where possible to reduce carrying distances. Carrying consumables to work area (approx. 30m).
Pulling/pushing wiping cylinder on trolley (5.8kg force to pull) approx. 30m, every 3 days. Returning empty wiping cylinder upstairs, approx. 45m. Pulling/pushing to operate pallet turner, approx. 3-4 times per shift. Pulling/pushing EPJ to transport materials and equipment. Pushing angles to insert between boards when printing in operation. Pulling out retractable steps to reach higher areas of machine (e.g. inking unit). Pushing out empty large ink drums (150kg when full) from ink pump station.
Climbing stairs (6) with rail to access platform above Orlof machine. Climbing steps (up to 2) to inspect ink levels and for mid/end of shift wash up
Bending to inspect lower areas of machine (e.g. ink levels) and for cleaning of machine (e.g. pouring cleaning solution in to machine and maintenance.
Twisting may be required during inspection, cleaning and maintenance of machine. Twisting may occur when inserting angles between boards, replenishing equipment and manoeuvring EPJ.
Crouching/squatting required to reach lower areas of machine for inspection, cleaning and maintenance.
Reaching required to change blankets (once per day); the Print Assistant may need to reach forward to steady the blankets to assist the Printer. Reaching required to insert angles between boards, select printed sheets for inspection, secure stacks using straps, operate EPJs, clean machine components, etc.
Gripping handle of EPJ. Gripping pallet turner (3-4x day). Gripping handles of wiping blade to lift and carry (once per day). Gripping handle on exterior of Orlof machine to steady body whilst inserting angle (throughout shift}, gripping rail to climb stairs to access work platform above Orlof Machine. Handling small tools such as alien keys, scrapers and cleaning cloths/rags. Handling larger equipment such as angles, boards, pallets and ink drums.
Reaching at or above shoulder height to insert angles between boards whilst sheets are printing, to secure completed stacks with strap, and to access higher areas in Orlof Machine such as when inspecting ink levels and cleaning inking Shoulder Height unit. Reaching above shoulder height to pull down temporary bridge when accessing work platform above Orlof Machine (e.g. to change blankets). Reaching above shoulder height to obtain printed sheet for quality inspection.
The Tribunal, based on the evidence from the witnesses and the documentation about the role of the print assistant at NPA, concludes the work was physically demanding and repetitive. The Tribunal relied upon the evidence of Mr Nichols, who has worked as a printer all his life, that the work was not overly demanding but not light either and observed it had been easier to perform in his younger and fitter days. Mr Nichols also observed that the process of knocking up required you to work the sheets quite hard, particularly as ink has been applied in the previous process so the substrate can be quite sticky.
The Tribunal also notes Ms Stancevska’s evidence at the hearing on the various elements of her role were reflected in the description of the role contained in the job task analysis for the print assistant on the Orlof machine submitted by the Respondent. The role description included the requirement to reach above shoulder height to insert boards, pushing/pulling trolleys, moving around the machine, gripping etc. and rating the role as physically demanding. The Tribunal accepts the evidence that Ms Stancevska worked on the Nota screen for a period of time but does not accept the evidence that the work on the Nota printer was overall any easier.
The Tribunal had before it conflicting evidence on the impact of the work on Ms Stancevska’s claimed conditions, namely:
(a)Dr Haig’s evidence to the heaving was:
Again, there is no evidence that such work causes increased degeneration of - be it the cervical spine or the lumbar spine. These are essentially age related phenomenon
Now, can you say whether there was and/or is any injury in the shoulder, so to speak?---Well, to start at the beginning, I think the mechanism of that injury when someone bumped into her would be unlikely to cause any significant shoulder condition
Doctor, in your diagnosis and in relation to the question of work contribution, you simply say that both injuries - talking here about the two diagnoses, you’ve given one of prolapsed---No, there was no incident at work that caused the prolapsed disc. There were two incidents at work in early 2017. She didn’t develop symptoms of her prolapsed disc until early 2018.
(b)Dr Khurana’s evidence to the heaving was:
So, doctor, you can’t rule out that her work has aggravated her condition, can you?---So on the probability I’d say during that period of time it has not. And the reason I say that is because in situations where work is now causing the problem structurally, physiologically, there should be some other data point that will show it to us, as opposed to someone just saying, you know, I had symptoms. Now, if it’s herself saying that, I would expect her to be telling people that, ‘I had symptoms, it started on January ‘18’ - remember, she didn’t even tell me that, but let’s say she did - she tell me, ‘Okay, doc, January 2018 something happened, I got these symptoms, then I continued to work for three months and I got much worse during that time.’ So I would hope that she would tell me that. But then I would also hope that there would be some information that we could correlate with that - that there is some worsening - and I’m just not aware of that.
(c)Dr Chehata’s evidence to the heaving was:
So I note that you refer to the continuation of work and doing those manual duties repetitively as her contribution. Do you say that that contribution only comes into play after those early 2017 incidents that she’s recorded, or not?---It’s almost impossible for me to be definitive in that. I think the idea of the repetitive use overhead and the development of the symptoms, just logically, if you’re doing the repetitive tasks with the level of the wrist, it’s not unreasonable to assume that there will be some component or development of carpal tunnel syndrome. I think it’s very different, and I am very aware of the studies that carpal tunnel syndrome occur spontaneously in middle-aged women without any precipitating events. But for me, when you’re given such a very specific role, and there’s repetition at the level of the wrist, that idea that - I mean, we are only very human. The idea of flexion and extension at the level of the wrist - the median nerve is running through a very tight canal. The idea that repetitive flexion and extension does not contribute is impossible.
Why do you say it’s impossible?---Well, because the - just the sheer idea - prior to many studies it’s almost - in medicine, it’s never none or never. It’s a grey zone. We don’t work in black and white. So the idea of trying to give a unique diagnosis specifically for someone individually, especially listening to the specifics of the job, I believe, is something that adds to the idea that the carpal tunnel syndrome at the very least can be aggravated. It makes physical sense.
….. You either are of two schools. You either believe that every single thing that occurs in your body almost is related to age, and we used to think of that in rotator cuff tendons, where every single time there was a tear of the rotator cuff, which is simply a tendon, a soft tissue, it was all age-related. There is no doubt as our knowledge increased, we operated more, we had further imaging, we find that that’s not the truth. There are elderly people that have intact rotator cuff tendons that fall and are traumatic in nature. That same concept is all I would suggest in terms of carpal tunnel syndrome, or in terms of cervical disc. There is a proportion of people that have constitutional carpal tunnel syndrome, but there is also undoubtedly a portion of people, due to the repetitive nature of literally - and I show you flexing and extending the wrists. The idea of repetition, it’s just a median nerve. It’s soft tissue. So the idea of someone definitively saying it’s impossible and it’s purely constitutional, that also doesn’t make sense. So rather than black and white, the idea of taking the middle ground is far - it makes more sense. So that would be my approach. And then obviously compounded by someone being hit, compounded - then a fall, you know, that concept, they just add weight to the idea, yes. I would accept there is a component from those injuries.
So it could turn out that this is – if in fact the tribunal forms the view that this was really a minor incident in terms of the impact of the shoulders, but that the applicant got terribly upset about this, this could be entirely a psychological condition? Well, it can be, for example, a jolt. It can just jolt the shoulder. So it doesn’t have to be – you know, it doesn’t have to be some massive traumatic event. It just – someone has to jolt the shoulder. So it doesn’t have to be some – like you don’t have to be hit in a rugby tackle to develop severe pain in pins and needles. That’s my only caveat for answering.
(d)Dr Aliashkevic’s evidence to the heaving was:
Do you say that employment generally has been a significant contributing factor to those conditions; being the degenerative condition of the cervical spine and the development of the right carpal tunnel syndrome?---Correct. Both of them.
you were uncertain of whether the stated injuries have contributed significantly?---Correct.
And why you say it’s employment-related?---Well, it’s a multi-factorial thing, and that involves sometimes it could be just the ageing process. We’re all getting older, and discs getting less elastic and less mobile.
Yes?---The second is probably some genetic factors as well. The work-related activities of this, the more you load your neck, the more you move your neck in different angles and static postures, it obviously aggravates and makes this degenerative process of the cervical spine faster. So I would say that, you know, assuming that she worked in the office, for example, and not in this printing job.
Yes?---Then she probably - she would have a good chance of not having this significant degeneration in her cervical spine, and maybe not having any pain in her neck or down her arms over many years.
And are there any particular movements or stressors in the work that you identified that you thought played a part in that aggravation?---I think it’s probably all of them. I couldn’t pinpoint any specific activity, but all in combination of them, they all seemed to me pretty significant stressors on her neck.
And in relation to the carpal tunnel syndrome development?---Yes.

The Tribunal is persuaded by the middle ground approach of Dr Chehata that:
There is a proportion of people that have constitutional carpal tunnel syndrome, but there is also undoubtedly a portion of people, due to the repetitive nature of literally - and I show you flexing and extending the wrists. The idea of repetition, it’s just a median nerve. It’s soft tissue. So the idea of someone definitively saying it’s impossible and it’s purely constitutional, that also doesn’t make sense. So rather than black and white, the idea of taking the middle ground is far - it makes more sense
And the evidence of Dr Aliashkevic who observed that age and genetics played a part in Ms Stancevska’s cervical spine condition but that the significant degeneration of her condition and related pain was work related:
The work-related activities of this, the more you load your neck, the more you move your neck in different angles and static postures, it obviously aggravates and makes this degenerative process of the cervical spine faster. So I would say that, you know, assuming that she worked in the office, for example, and not in this printing job.
Yes?---Then she probably - she would have a good chance of not having this significant degeneration in her cervical spine, and maybe not having any pain in her neck or down her arms over many years.
The Tribunal notes Bennett J’s explanation in Mellor v Australian Postal Corporation [2009] FCA 504 at [42]:
Further, Australia Post points out that the tribunal was referred to Tippett v Australian Postal Corporation [1998] FCA 335; (1998) 27 AAR 40, which inaccurately summarised the joint judgment of Evatt and Shepphard JJ in Beattie as stating that the injury will be aggravated if the experience of the injury is increased or intensified. In fact, their Honours said that 'it is enough to say that the pain brought on by work activity may constitute an aggravation’.
The Tribunal finds that Ms Stancevska’s claimed conditions were contributed to, to a degree that is substantially more than material, by her employment at NPA.
Conclusion
The Tribunal, having considered all the evidence before it, determines that Ms Stancevska is entitled to compensation for her claimed injuries of cervical spondylosis and carpal tunnel syndrome pursuant to section 14 of the SRC Act.
decision
The Tribunal sets aside the decision under review and in substitution decides that Ms Stancevska is entitled to compensation for her claimed injuries of cervical spondylosis and carpal tunnel syndrome pursuant to section 14 of the SRC Act.

I certify that the preceding 205 (two hundred and five) paragraphs are a true copy of the reasons for the decision herein of Ms A E Burke AO, Member

.....................[sgd]....................................
Associate
Dated: 12 January 2023

Date of hearing:
15-16 December 2020, 3-4 & 7-9 June 2021, 17 September 2021 and 20 September 2022

Counsel for the Applicant: Ms Cassie Serpell

Solicitors for the Respondent: Zaparas Lawyers

Counsel for the Respondent: Mr Joseph Lenczner

Solicitors for the Respondent: Moray & Agnew Lawyers

Date of hearing:	15-16 December 2020, 3-4 & 7-9 June 2021, 17 September 2021 and 20 September 2022
Counsel for the Applicant:	Ms Cassie Serpell
Solicitors for the Respondent:	Zaparas Lawyers
Counsel for the Respondent:	Mr Joseph Lenczner
Solicitors for the Respondent:	Moray & Agnew Lawyers