The State of South Australia (in Right of the Department for Education) v Van Hattem (No 2) - [2020] SASCFC 45

Supreme Court of South Australia
(Full Court)
THE STATE OF SOUTH AUSTRALIA (IN RIGHT OF THE DEPARTMENT FOR EDUCATION) v VAN HATTEM (No 2)
[2020] SASCFC 45
Judgment of The Full Court
(The Honourable Chief Justice Kourakis, The Honourable Justice Parker and The Honourable Auxiliary Justice Tilmouth)
28 May 2020
WORKERS' COMPENSATION - ENTITLEMENT TO COMPENSATION - EMPLOYMENT RELATED INJURY, DISABILITY OR DISEASE - EMPLOYMENT SUBSTANTIAL OR SIGNIFICANT CONTRIBUTING FACTOR - TO INJURY
Appeal by the State of South Australia against a decision of the Full Bench of the South Australian Employment Tribunal dismissing an appeal against a finding of the trial Judge that the significant contributing cause of the respondent’s psychiatric injury was her employment as a primary school teacher. The Full Bench considered that it was not necessary to determine whether the trial Judge had correctly articulated the test in s 7(2)(b) of the Return to Work Act 2014 (SA). That is because the Full Bench considered that the Judge had found employment was the “only” significant contributing cause and the other causes were not significant.
The appellant contends that:
1. The Full Bench erred in that it did not correctly interpret the factual findings of the trial Judge. That error led the Full Bench mistakenly to find that it was not necessary to determine whether the Judge had correctly articulated and applied the test in s 7(2)(b).
2. The trial Judge erred in law by misapplying s 7(2)(b)(i) by concluding that for employment to be “the significant contributing cause” of a psychiatric injury, it was only required to be a greater or more significant contribution to the occurrence of the injury then the contribution from any other contributing cause.
The question of law raised by this appeal is the proper construction and application of s 7(2)(b)(i) and the requirement that employment be “the” significant contributing cause of a psychiatric injury in order to be compensable. The question is whether eligibility is restricted to those cases where employment is the “only” significant contributing cause of the psychiatric injury or whether eligibility extends to claims where employment is the “most” significant contributing cause of the injury.
Held, by Parker J (Kourakis CJ and Tilmouth AJ agreeing), dismissing the appeal:
1. Given that there are two possible interpretations, and having regard to the beneficial nature of the legislation, in the absence of clear words or an express statement of legislative intention, the more restrictive interpretation contended for by the appellant is rejected.
2. A psychiatric injury will be compensable under s 7(2)(b) if employment is the most significant or important contributing cause of the injury.
3. Where a worker contends that their employment has caused a psychiatric injury, the evaluative task referred to in South Australia v Roberts (2018) 130 SASR 274 of identifying whether employment is a significant cause of the injury must be taken further to identify the most important or influential of the contributing causes.
4. The trial Judge found that the respondent’s relationship difficulties with her husband and the cessation of Risperidone were contributing cases of her injury but that the only significant contributing cause was her employment. The Full Bench read the judgment as a whole and was entitled to make the findings that it did.
5. It is necessary to assess both employment and non-employment related causes in the aggregate so as to determine whether employment is the significant cause of the injury. As the trial Judge found that employment was the only significant cause of the respondent’s psychiatric injury, his Honour did not err in this respect.
Return to Work Act 2014 (SA) ss 7(2)(b)(i), referred to.
Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (2009) 239 CLR 27; Moloney v Motor Accident Commission (2013) 117 SASR 189; Owen v State of South Australia (1996) 66 SASR 251 at 256; SAS Trustee Corporation v Miles (2018) 265 CLR 137, applied.
Department for Education v Van Hattem [2019] SAET 193; South Australia v Roberts (2018) 130 SASR 274; Van Hattem v Department for Education and Child Development [2018] SAET 177, discussed.

WORDS AND PHRASES CONSIDERED/DEFINED
"the significant contributing cause"

THE STATE OF SOUTH AUSTRALIA (IN RIGHT OF THE DEPARTMENT FOR EDUCATION) v VAN HATTEM (No 2)
[2020] SASCFC 45
Full Court: Kourakis CJ, Parker J and Tilmouth AJ

KOURAKIS CJ: I would dismiss the appeal for the reasons given by Parker J. I add the following.
The requirement of s 7(2)(b) of the Return to Work Act 2014 (SA) (the RTW Act) that ‘employment was the significant contributing cause’ necessarily requires the identification of a cause which can be described as ‘the significant cause’. Only if employment is that significant cause, is the injury compensable. A psychiatric injury may have a number of causes which would individually qualify as ‘a significant cause’ within the meaning of that expression in s 7(2)(a) of the RTW Act. Nonetheless, s 7(2)(b) of the RTW Act requires the identification of that one of those causes which is, relative to the others, ‘the significant cause’. Ultimately, therefore, ‘the significant contributing cause’ is the most significant of the contributing causes.
PARKER J: This is an appeal by the State of South Australia[1] against a decision of the Full Bench of the South Australian Employment Tribunal (the SAET). The Full Bench dismissed an appeal against a finding that the significant contributing cause of the respondent’s psychiatric injury was her employment as a primary school teacher.
[1] In right of the Department for Education.
The appellant has advanced two grounds of appeal concerning the construction and application of s 7(2)(b)(i) of the Return to Work Act 2014 (SA) (the RTW Act). Permission to appeal was granted under s 68(2) of the South Australian Employment Tribunal Act 2014 (SA).
The legislative scheme
Section 7(1) of the RTW Act provides that the RTW Act applies to an injury “if (and only if) it arises from employment”. The phrase “arises from employment” must be read subject to s 7(2) which provides:
(2) Subject to this section, an injury arises from employment if—
(a) in the case of an injury other than a psychiatric injury—the injury arises out of or in the course of employment and the employment was a significant contributing cause of the injury; and
(b) in the case of a psychiatric injury—
(i) the psychiatric injury arises out of or in the course of employment and the employment was the significant contributing cause of the injury; …
…
Grounds of Appeal
Permission was granted to the appellant to amend its grounds of appeal to read as follows:
1. The Full Bench erred in law by misconstruing the learned trial Judge’s factual findings and holding that it was not necessary to determine whether the trial Judge had correctly articulated the test in s 7(2)(b). Contrary to the Full Bench’s conclusions (at [35]-[36]), the learned trial Judge did not find (i) that employment was the only significant contributing cause of the Respondent’s injury and (ii) that non-employment causes of the Respondent’s psychiatric injury were not significant contributing causes.
2. The learned trial Judge erred in law by misapplying s 7(2)(b)(i) of the [RTW Act] by concluding that for employment to be “the significant contributing cause” of a psychiatric injury, it was only required to be a greater or more significant contribution to the occurrence of that injury than the contribution from any other contributing cause.
Background
The respondent is employed in the entity now entitled the Department for Education. She has a history of mental health issues. In June 2013, she began experiencing hallucinations whilst teaching. In late June 2013, she was admitted to the Margaret Tobin Centre (MTC) following a psychotic episode. Between that time and early 2017 the respondent continued to have difficulties with her mental health. Factors contributing to those difficulties included relationship difficulties with her husband, the taking and ceasing of Risperidone,[2] and difficulties in her employment. In March 2017, the respondent experienced another psychotic episode and voluntarily admitted herself to the MTC. She was initially diagnosed with acute psychosis secondary to bipolar disorder and ceased working at that time.
[2] Anti-psychotic medication taken by the respondent between June 2013 and September 2016.
On 20 March 2017, the respondent claimed compensation under the RTW Act for the condition of adjustment disorder with depressed mood as diagnosed by her general practitioner. She stated that “violent and angry children had hurt her and others physically and mentally.” [3]
[3] Van Hattem v Department for Education and Child Development [2018] SAET 177 at [4].
On 6 June 2017, the appellant rejected the respondent’s claim on the basis that her psychiatric injury did not arise from her employment. That decision was founded upon on a report prepared by Associate Professor (AP) Abdul Khalid, a psychiatrist.
The SAET review by a single Judge/Deputy President
The respondent sought review by the SAET of the decision to reject her claim. Three medical experts, including AP Khalid, gave evidence. The other medical experts were Dr Allan Nelson, a consultant psychiatrist, who treated the respondent at the MTC in 2013 and again in 2017 and Dr Warwick Blakemore, also a psychiatrist, who assessed the respondent on 13 July 2017 at the request of her solicitor.
The evidence of AP Khalid
AP Khalid had provided four reports to the appellant. In his first report dated 11 May 2017 he diagnosed the respondent as suffering from schizophrenia with a differential diagnosis of schizoaffective disorder and bipolar disorder. He stated that these conditions were not work related.[4] AP Khalid had been asked by the respondent to advise whether the reduction and then cessation in the dosage of Risperidone taken by the respondent had contributed to the 2017 relapse of schizophrenia. He advised that there was always a high risk of relapse after ceasing anti-psychotic medication and a relapse may occur with or without stress. He further advised that the respondent’s employment was a contributing factor to her relapse but was not the significant contributing cause.
[4] Van Hattem v Department for Education and Child Development [2018] SAET 177 at [47].
In his report of 14 November 2017, AP Khalid stated that although the respondent’s work distress may have contributed to a relapse of her condition, the diagnosis of adjustment disorder with mixed anxiety and depressed mood had been made after she was discharged from the MTC. That advice from AP Khalid is linked to the view he had expressed in his earlier report dated 11 September 2017, where he had stated that if the condition of adjustment disorder with mixed anxiety and depressed mood had only been diagnosed following discharge from the MTC, he considered that this diagnosis could not be attributed to the respondent having ceased work on 7 March 2017.
AP Khalid agreed in cross-examination that the respondent had not shown symptoms of schizophrenia when he examined her on 28 April 2017. He also agreed that she had a genetic vulnerability to a psychotic illness or disorder. He also accepted that if pressure was mounting on the respondent from the latter part of 2016 due to her aversion to a return to teaching, this stress may have precipitated the pre-existing psychiatric condition which had first occurred in 2013. However, he did not agree that this had occurred on the balance of probabilities because a psychiatric condition can relapse without any stress.
Most importantly, AP Khalid stated in evidence that the three factors which contributed to the respondent’s relapse were stress at school, stress at home and the reduced dosage of Risperidone. He weighted each factor evenly in terms of its relative contribution. He also said that he could not rule out the possibility that the stress which had caused the psychotic episode was also responsible for a depressive episode that the respondent had suffered after March 2017.
The evidence of Dr Nelson
Dr Nelson had treated the respondent at the MTC in 2013 and 2017. He stated that the respondent had experienced a psychological reaction to the situational difficulty she experienced in the classroom. He diagnosed an adjustment disorder with mixed anxiety and depressed mood on the background of a bipolar disorder, which at the time he had prepared his report was well controlled and not active. In the opinion of Dr Nelson, the most significant factor in the genesis of the respondent’s adjustment disorder was the stress associated with her work. He stated that people have different responses to stress but if they are overwhelmed by stress the result depends upon their genetic vulnerability. Some people may become depressed, others psychotic. Genetic vulnerability was a significant cause of a stress response of the type shown by the respondent.
It was suggested to Dr Nelson in cross-examination that difficulties she was having in her marital relationship rather than work was the foremost stressor suffered by the respondent. He responded that the history given to him was of significant stress at work and that that was the primary cause of the increased distress suffered by the respondent.
It was also suggested to Dr Nelson in cross-examination that the cause of the respondent’s increased stress and anxiety was the reduction in the dose of Risperidone. Dr Nelson stated that the respondent’s symptoms had settled and she was managing reasonably well with that medication until various events occurred at work. While Dr Nelson did not directly disagree with the view expressed by AP Khalid, that schizophrenia, schizoaffective disorder and bipolar disorder are not caused by employment related factors, he stated that employment factors could be significant in causing an episode of such an illness. Dr Nelson accepted that the respondent had a biological predisposition to suffering a major mental illness. He also agreed that the reduced dose of Risperidone was likely to have increased the chances of a relapse but stated that this occurred in the context of increased stress rather than because of the reduction in medication levels.
The evidence of Dr Blakemore
Dr Blakemore agreed that in 2013 and in March 2017, when the respondent was admitted to the MTC, she was experiencing psychotic symptoms. However, when he saw her in July 2017 her symptoms were not psychotic but those of an adjustment disorder. In his opinion, both sets of symptoms were precipitated by stress at work.
Dr Blakemore stated at one point in his evidence that it was possible, and at another point that it was probable, that the adverse comments made by the respondent to a counsellor about difficulties with her husband were the result of delusions she was experiencing. However, he also acknowledged in cross‑examination that he was not aware of some information that supported the existence of marital difficulties. In re-examination Dr Blakemore also agreed that the complaints made by the respondent about her husband were consistent with his lack of support and understanding of the problems she was having in the workplace. Dr Blakemore accepted that there was a possible link between the tapering off of the Risperidone dosage in mid-2016 and the emergence of psychotic symptoms in March 2017.
Consideration by the Judge
The Judge noted that s 7(2)(b) of the RTW Act requires that in the case of psychiatric injuries employment must be the significant contributing cause of the worker’s injury. In contrast, in the case of physical injuries, s 7(2)(a) only requires that employment be a significant contributing cause.[5]
[5] Van Hattem v Department for Education and Child Development [2018] SAET 177 at [89]-[91].
The Judge acknowledged that there can be multiple contributing causes in both psychiatric and non-psychiatric injuries.[6] His Honour stated that:
[93]…[F]or employment to be “the significant contributing cause” of a psychiatric injury, employment must have made a greater or more significant contribution to the occurrence of that injury than the contribution from any other contributing cause. I consider that the definite article indicates I have to be satisfied that employment is a more significant contributory cause than any other. It does not follow that employment has to be causally more significant than all the other contributing causes combined. If that were so, it would be more accurate to require employment to be the predominant contributing cause of an injury.
[6] Van Hattem v Department for Education and Child Development [2018] SAET 177 at [92].
His Honour considered that if employment was required to be the predominant cause, that word would have been used as it had been elsewhere in the RTW Act.[7]
[7] Van Hattem v Department for Education and Child Development [2018] SAET 177 at [93].
The Judge stated that he preferred the views of Dr Blakemore where they differed from those of AP Khalid and Dr Nelson. His Honour explained the basis for that conclusion which was based upon his observation of the witnesses as they gave evidence and their response to questions.
The Judge found that the injury sustained by the respondent was an adjustment disorder with depressed mood as diagnosed by Dr Blakemore. His Honour also found that the contributing causes of this injury were the respondent’s employment, her relationship difficulties with her husband and the reduction and eventual cessation of Risperidone.
The Judge found that the respondent’s relationship with her husband was not the significant contributing cause of her injury. His Honour accepted the evidence of Dr Blakemore that the contribution to her injury from relationship difficulties was less than the contribution from her employment.
The Judge also considered the relative contributions to the respondent’s injury of her employment and the cessation of Risperidone. His Honour noted that both Dr Nelson and Dr Blakemore considered it was a reasonable clinical decision to reduce the dose of Risperidone. That decision was made because the respondent appeared to be coping well at work and with life generally.
The Judge observed that even if the injury would not have occurred if the respondent had continued taking Risperidone, it did not necessarily follow that the cessation of this medication was the significant contributing cause of her injury. In that respect, his Honour found that the respondent would have continued to cope with work and life if not for the problems she had encountered with teaching in 2017. She had returned to classroom teaching in early 2016 having previously only taught drama after the 2013 psychotic episode. His Honour found that if the respondent had continued teaching drama rather than returning to classroom teaching she would not have sustained the injury. Her hypothesis, that the increased levels of stress associated with her return to classroom teaching and difficulties with some students had caused the injury, fitted with the facts.
The appeal to the Full Bench
The appellant appealed to the Full Bench and contended that the Judge had erred in the construction of s 7(2)(b)(i) by finding employment to be the “more significant contributory cause than any other”.[8]The appellant contended that the Judge had erred by finding that it is necessary to be satisfied that employment is a more significant contributory cause than any other cause. The appellant submitted that the requirement that employment to be the significant contributing cause of the injury can only be satisfied by aggregating significant employment contributing causes and significant non‑employment contributory causes. It is then necessary to determine if the aggregate of significant employment contributing causes predominates over the aggregate of significant non-employment contributing causes. The Judge was said to have erred by comparing significant employment contributing causes with each individual non-employment significant contributing cause.
[8] Department for Education v Van Hattem [2019] SAET 193 at [32].

The Full Bench considered that it was not necessary to determine whether the Judge had correctly articulated the test in s 7(2)(b). That is because the Full Bench considered that the Judge had found that employment was the only significant contributing cause and the other causes were not significant.[9]
[9] Department for Education v Van Hattem [2019] SAET 193 at [35]-[36].
While the appeal was dismissed for the reasons I have noted, the Full Bench cautioned against reading words into s 7(2)(b). The Full Bench suggested that the phrase “the significant contributing cause” means something more specific than “a significant contributing cause”. However, the Full Bench observed that the legislative direction may simply be to evaluate the facts to determine whether employment was in truth the important or influential contributing cause of the worker’s injury as stated by the Full Court in South Australia v Roberts.[10]
Submissions to the Full Court
[10] (2018) 130 SASR 274.
Ground 1
It is only necessary to make brief reference to the parties’ contentions about Ground 1. The central premise of the criticism of the Full Bench decision made by the appellant in Ground 1 is that it did not correctly interpret the factual findings made by the Judge. That led the Full Bench mistakenly to find that it was not necessary to determine whether the Judge had correctly articulated and applied the test in s 7(2)(b). The latter issue is the subject of Ground 2 and will determine the outcome of the appeal.
The respondent submits that the Judge made the necessary evaluative judgement as to what were the contributing causes of the respondent’s injury and what, if any, of those causes was significant. His Honour found that the relationship difficulties and the cessation of Risperidone were contributing causes but that employment was the only significant contributing cause. The Full Bench read the judgment as a whole and was entitled to make the findings that it did.
I have concluded at [72] below that the Judge found that employment was the only significant contributing cause of the respondent’s injury. I would therefore dismiss Ground 1.
Ground 2 - The appellant’s submissions
The appellant contends that the use of the definite article in s 7(2)(b)(i) makes it manifestly clear that a psychiatric injury will not be compensable where there were other significant contributing causes in addition to employment. Employment must be the only significant contributing cause.
The appellant submits that the Judge erred by finding that s 7(2)(b)(i) requires employment to be the most significant contributing cause. That interpretation departs from the text of the statute, whether s 7(2)(b)(i) is read in isolation or in the context of s 7(2)(a). Furthermore, the interpretation adopted by the Judge assumes that there will always be a contributing cause that can be characterised as the significant contributing cause. Such an approach merely requires that the cause that had the greatest individual effect must be identified. However, it is quite conceivable that a psychiatric injury may have multiple causes and no single cause may be important or influential. Under the interpretation adopted by the Judge, no more is required than the identification from those many contributing causes that which has had the greatest individual impact, even though that impact may be of little importance on either an absolute or objective basis, or when assessed relative to the combined weight of the other causes.
The appellant also submits that, consistently with the approach of the Full Court in Roberts, the use of “significant” in s 7(2)(b)(i) requires an evaluative judgment as to whether employment is the important or influential cause of a psychiatric injury. It necessarily follows that cases will occur where no single contributing cause can be identified as the significant contributing cause. That may be because no one cause can be identified as “significant” or because more than one cause may be found to be “significant”. In the latter instance, the use by the Parliament of the definite article demonstrates its intention that where employment is only one of several significant contributing causes to a psychiatric injury, that injury will not be compensable.
The appellant submits that the Judge erred by simply asking which of the contributing causes had the greatest individual effect. His Honour failed to undertake the required evaluative judgment. Rather than undertaking an evaluative judgment, the Judge engaged in a mere comparative judgment and weighed, on the one hand, employment as a contributing cause against, on the other hand, each other non-employment contributing cause. The adoption of that comparative judgment approach would only accord with the statute if words are read into s 7(2)(b)(i) so that it becomes:
… the most significant contributing cause of all identified contributing causes.
The reading of those words into the statute departs significantly from the plain meaning of the text.
A further criticism made by the appellant of the approach adopted by the Judge is that his Honour adopted a test that compares causes at different levels of abstraction on either side of the equation. The basis for that criticism is that the Judge considered employment as a contributing cause and then compared that to each separate non-employment contributing cause.
The appellant further develops that submission by noting that expert evidence may identify some causes that may properly be attributed to employment and others which are not. In the appellant’s submission, s 7(2)(b) does not require that one or other of the employment related causes must be the significant cause. The test is directed at the level of employment. By way of further example, the appellant observes that in a given case a psychiatric injury may have been caused by bullying at work and also other unsafe work practices. It would be necessary to consider those causes in combination in evaluating whether employment is the significant contributing cause of the injury.
The appellant further submits that there are two possible approaches that are consistent with the text of s 7(2)(b)(i) and that do not require words to be read into the statute. The first such approach requires a comparison to be made between employment as a contributing cause on the one hand, and non‑employment related causes on the other hand. Both categories of cause are assessed on a collective basis which ensures that the comparison is made between two sets of different causes at the same level of abstraction. However, the adoption of this construction depends upon an assumption that there will always be a contributing cause that can be identified as “the” significant contributing cause.
The appellant submits that such an approach is not supported by s 7(2)(b)(i) and is also inconsistent with the recognition in s 7(2)(a) that an injury may have multiple significant contributing causes. A further criticism made by the appellant is that this interpretation does not allow for the possibility that while employment may be the more significant contributing cause, non-employment causes may also be significant. Thus, similarly to the approach adopted by the Judge, this construction eschews the required evaluative judgment of the various putative causes of an injury.
The second possible construction of s 7(2)(b)(i) advanced by the appellant is that the legislature has intended that there simply be an evaluative judgment of whether employment is the significant contributing cause. That approach is consistent with the interpretation of s 7(2)(a) adopted by the Full Court in Roberts. This approach recognises the possibility that, in some instances, an evaluative judgment will find that there is no significant contributing cause of a worker’s psychiatric injury. Such a situation will arise where employment is a contributing cause but there are also other contributing causes and no one cause is of particular importance.
The appellant also contends that under this second construction an evaluative judgment may indicate that there are several significant contributing causes that include employment. Because of the use of the definite article in s 7(2)(b)(i), such a result will preclude a finding that employment is the significant contributing cause of the injury.
The appellant contends that this second construction of s 7(2)(b)(i) avoids reading the word “most” into the provision. This interpretation is also said to require that the evaluation of causes occur at the same level of abstraction rather than at different levels. The appellant also submits that this second construction properly recognises the difference between s 7(2)(a) and s 7(2)(b). The legislation does not provide a basis to infer that there will always be a contributing cause that can be identified as the significant contributing cause.
The appellant submits that this second construction is the only coherent construction, having regard to the text, context and purpose of the provision. Employment can only be identified as the significant contributing cause of an injury if it is causally significant on an evaluative judgment as explained by the Full Court in Roberts, and the incidence and effect of other non-employment contributing causes, whether individually or in aggregate, is not such as to deny that employment is the only significant contributing cause.
Ground 2 - The respondent’s submissions
The respondent does not take issue with many of the contentions advanced by the appellant. In particular, the respondent agrees that the interpretation of s 7(2)(b)(i) must be approached consistently with the judgment of this Court in Roberts. However, the respondent submits that the Judge correctly applied Roberts. In particular, the respondent submits that the Judge did not read the phrase “the significant contributing cause” as requiring employment to be the most significant contributing cause. To the contrary, the Judge found that there was only one significant contributing cause. His Honour did not simply ask which of the contributing causes had the greatest individual impact, nor did he compare causes at different levels of abstraction. When his Honour’s judgment is read as a whole, it is clear that he undertook the evaluative process referred to in Roberts and applied the results of that evaluation as required by s 7(2)(b)(i).
The respondent notes that, in accordance with Roberts, the word “significant” must be read as meaning important or influential. When that meaning is applied, the phrase “the significant contributing cause” provides sufficient flexibility to enable a decision maker to decide cases where there may be more than one potentially significant contributing cause. If an evaluative judgment shows that, of the significant contributing causes, one is potentially the important or influential cause, then that will be “the significant contributing cause”. However, the respondent acknowledges that in some cases there may be no cause that is significant.
The respondent further submits that where two constructions of beneficial workers compensation legislation are possible, the established principle of applying the construction which is favourable to the worker should be adopted.
Ground 2 - Consideration
It is apparent that the only distinction between the operation of s 7(2)(a) and s 7(2)(b)(i) of the RTW Act arises from the substitution of “the” for “a”. Therefore, most of the conclusions I reached in Roberts (with Blue J agreeing) about s 7(2)(a) are also relevant to s 7(2)(b)(i).
The focus of my judgment in Roberts was on the words “a significant contributing cause”. In the present case, the issue is what is meant by the requirement that employment be “the significant contributing cause of the injury”.
I held in Roberts that, in the context of s 7(2)(a), the word “significant” meant important or influential. Thus, employment would be a significant cause of an injury if it is an important or influential cause. In deciding that issue the decision maker must undertake an evaluative judgment to identify the significant causes of the worker’s injury. The need to identify causes and then assess whether employment was a significant cause of the injury required that close attention be given to the facts and circumstances surrounding the employment of the worker. In making the necessary evaluative judgment, a “but for” test cannot be the sole determinant. However, such a test may sometimes assist.
I also held in Roberts that, because of the use of the indefinite article “a”, it is only necessary under s 7(2)(a) that employment be one of the significant contributing causes. Employment need not be the only significant cause or the most significant contributing cause. Provided that employment was one of the significant causes of a non-psychiatric injury, it will be compensable under s 7(2)(a) regardless of whether there were other significant contributing causes.
Clearly, the use of the definite article “the” to qualify the phrase “significant contributing cause” in s 7(2)(b)(i) is intended to impose a stricter test upon eligibility for compensation for psychiatric injuries than that found in s 7(2)(a). The question is whether eligibility is restricted to those cases where employment is the only significant cause of the psychiatric injury or whether eligibility extends to claims where employment is the most significant cause of the injury.
In answering that question, the starting point is the text considered in light of the context and the purpose of the provision.[11] Where the text permits more than one meaning, the choice between meanings may depend upon the relative coherence of each meaning with the scheme of the statute and its identified objects and policies.[12]
[11] Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (2009) 239 CLR 27 at [47] (Hayne, Heydon, Crennan and Kiefel JJ); SAS Trustee Corporation v Miles (2018) 265 CLR 137 at [20] (Kiefel CJ, Bell and Nettle JJ).
[12] SAS Trustee Corporation v Miles (2018) 265 CLR 137.
If the interpretation of s 7(2)(b)(i) suggested by the appellant is correct, a psychiatric injury will only be compensable if the worker can establish that their employment was the only significant cause of their injury. It is commonplace that experienced psychiatrists cannot identify with certainty a specific cause for a psychiatric injury. The nature of such injuries, as this case exemplifies, is that they will frequently have a number of possible causes. The likely result under the interpretation favoured by the appellant, is that workers suffering from psychiatric injuries will face grave difficulties in establishing that their injury is compensable. The question is whether that was the legislative intention underlying the enactment of s 7(2)(b)(i).
The objects of the RTW Act are stated in s 3. Section 3(1) states that the object is “to establish a scheme that supports workers who suffer injuries at work and that has as its primary objective to provide early intervention in respect of claims, so as to ensure that action is taken to support workers” in the manner enumerated in the following four paragraphs. Those four paragraphs refer to realising the health benefits of work, recovering from injury, returning to work and being restored to the community when return to work is not possible.
Other objectives appear in s 3(2) of the RTW Act. These include that injured workers receive high quality service, are treated with dignity and are supported financially. A further objective is to ensure that employers’ costs are contained within reasonable limits so as to minimise the effect of injuries on business and to reduce the overall social and economic cost of work injuries to the State and to the community. However, paragraph (c) of s 3(2) states that one of the other objectives is to provide a reasonable balance between the interests of workers and the interests of employers. Consistently with that latter objective, s 3(3) directs that a person exercising judicial, quasi-judicial or administrative powers must interpret the Act in light of its objects and objectives without bias towards the interests of employers on the one hand or workers on the other.
While the Court must have regard to the preceding objects and objectives when interpreting the RTW Act, I do not consider that they provide any assistance with the present question of statutory interpretation, particularly when considered in light of s 3(2)(c) and the exhortation in s 3(3) to adopt an even‑handed approach.
Section 7 is a fundamental element in the assessment of whether an injured worker is entitled to compensation. If an injured worker can satisfy the various tests laid down in s 7, they may be entitled to significant monetary compensation. Thus, the various elements of s 7, and in this instance s 7(2)(b)(i), are beneficial provisions. For that reason, to the extent that there is uncertainty as to the correct interpretation, the principles of statutory interpretation would ordinarily require that a liberal interpretation should be adopted in favour of an injured worker.[13] On the other hand, as I observed in Roberts, the enactment of s 7(2) when compared to the former provisions of s 30 and s 30A of the Workers Rehabilitation and Compensation Act 1985 (the WRC Act), is plainly intended to restrict eligibility. Those two countervailing considerations can be reconciled on the basis that there has been a tightening of eligibility but that does not go so far as to place an onerous barrier to eligibility for compensation upon workers suffering from psychiatric injuries.
[13] See D Pearce, Statutory Interpretation in Australia (LexisNexis Butterworths, 9^th ed, 2019) at 9.2 to 9.6 and the many cases discussed therein.
It is permissible to refer to the Second Reading speech so as to identify the mischief or purpose of disputed legislation.[14] Recourse may also be had to Ministerial statements made during debate at the Committee stage.[15]
[14] Owen v State of South Australia (1996) 66 SASR 251 at 256 (Cox J with Prior J agreeing at 257).
[15] Moloney v Motor Accident Commission (2013) 117 SASR 189 at [32]-[35] (Kourakis CJ) and, more particularly at [89]-[91] (White J).
There is nothing in the Second Reading Speech for the Return to Work Bill 2014 delivered by the Minister for Industrial Relations, the Hon John Rau MP, nor in the accompanying Explanation of Clauses, to indicate the limits intended to be placed by s 7(2)(b)(i) upon eligibility for compensation.[16] The Explanation of Clauses simply paraphrased the text of s 7(2)(b)(i).
[16] South Australia, Parliamentary Debates, House of Assembly, 6 August 2014, pp 1436 to 1472.
Nothing was said by the Minister in the House of Assembly during the debate at the Committee stage on the Return to Work Bill concerning the intended operation of s 7(2)(b)(i).[17]There was debate upon an amendment proposed by the Hon J A Darley MLC (an independent cross bencher) at the Committee stage in the Legislative Council that would have modified what is now s 7(2)(b)(i) so that it operated in the same manner as s 30A of the WRC Act.[18] During that debate Mr Darley stated that the Law Society had informed him that the provision as proposed by the Government appeared to require “that employment must have contributed more than any other causal factor to the psychiatric injury”. Thus, Mr Darley suggested the interpretation now advanced by the respondent, rather than the appellant. The Minister responsible for carriage of the Bill in the Legislative Council, the Hon I K Hunter MLC, spoke against the amendment but did not offer any comment on the interpretation advanced by Mr Darley. As the amendment was opposed by both the Government and the Opposition, it was defeated. Of course, the fact that Mr Hunter did not expressly disagree with the interpretation suggested by Mr Darley, does not constitute endorsement of that interpretation by the Government. Reference to Hansard merely establishes that the stricter qualification now contended for by the appellant was not advanced by the former Government during the Parliamentary debates. The only reference to the interpretation suggested by the respondent was made by Mr Darley. However, no reliance can be placed upon his suggestion as it was not endorsed by the Government as the proponent of the Bill.
[17] South Australia, Parliamentary Debates, House of Assembly, 23 September 2014, pp 1909 to 1917.
[18] The test would be effectively the same as that now applied under s 7(2)(a) in relation to non-psychiatric injuries.

Given that the fundamental task is to determine the meaning of the text, I turn to the dictionary definitions of the word “the”. Amongst several other meanings, the Online Macquarie Dictionary defines the word “the” to mean:
2a. used to mark a noun as indicating something well known or unique: the Alps; the earth; the Titanic.
4. used emphatically to mark a noun as indicating the best-known, most improved, or most important of its kind.
The Online Oxford English Dictionary provides, amongst others, the following definition of “the”:
3a. Before a noun denoting a thing or person that is unique or considered to be unique, or of which there is only one at a time (e.g. the sun, the earth, the sea, the sky, the air, the world, the universe, the Almighty, the Lord, the Saviour, the Devil, the Emperor, the Pope, the Net, the Web, etc.).
4. Before a noun denoting one of a class of persons, things, events, etc., used to indicate a particular instance that is most relevant in the context.
The first of the definitions quoted from each dictionary is consistent with the interpretation advocated by the appellant. The second such definition is in each instance consistent with the respondent’s contention. Thus, when viewed in isolation, the definitions do not assist in resolving the intended meaning of the text. However, the second definition from each dictionary does establish that, contrary to the appellant’s submission, the interpretation advocated by the respondent can be derived from the text of the statute without the need to read in the word “most”.
The construction of s 7(2)(b)(i) advanced by the respondent more tightly restricts the compensability of psychiatric injuries than the former s 30A of the WRC Act which merely required that employment be a substantial cause of a psychiatric injury. However, this construction does not restrict eligibility to the very substantial extent contended for by the appellant. Given that there are two possible interpretations, and having regard to the beneficial nature of the legislation, I consider that the legislature has used “the” in s 7(2)(b)(i) to indicate that a psychiatric injury will only be compensable if employment is the most significant or important cause of the injury. This interpretation does significantly restrict the compensability of psychiatric injuries in comparison to the former s 30A of the WRC Act but not to the extent submitted by the appellant. I also consider that this interpretation gives s 7(2)(a) and s 7(2)(b)(i) a coherent operation. In the absence of clear words or an express statement of legislative intention, and in accordance with the observation made at [56] above, I reject the more restrictive interpretation. Thus, where a worker contends that their employment has caused a psychiatric injury, the evaluative task referred to in Roberts of identifying whether employment is a significant cause of the injury must be taken further to identify the most important or influential of those causes.
For these reasons, I reject the contention by the appellant that a psychiatric injury will not be compensable unless employment is the only significant cause of that injury. I also reject the appellant’s contention that it is not correct for the decision maker to decide eligibility by determining which of several contributing significant causes had the greatest effect.
I turn to the appellant’s contention that the Judge erred by comparing the employment and each non-employment related cause of the respondent’s psychiatric injury at the same level of abstraction. In other words, the suggestion is that it is necessary to aggregate all employment related causes and weigh those against all non-employment related causes. The Judge is said to have erred by not adopting that approach.
I do not consider that the Judge erred in this way. His Honour found that the contributing causes of the injury were the respondent’s employment, her relationship difficulties with her husband and the reduction and eventual cessation of Risperidone. His Honour accepted the medical evidence that the respondent experienced increasing anxiety and stress because she continued to work and that led to a deterioration in the relationship with her husband in 2016 and 2017. His Honour specifically found that the respondent’s relationship with her husband was not the significant contributing cause of the injury. Moreover, the Judge also found that the relationship difficulties were, at least to some extent, caused by her employment.
It is correct that the Judge did not expressly find that the reduction in dosage and eventual cessation of Risperidone was not a significant contributing cause of the respondent’s injury. However, when the judgment is read as a whole, it is apparent that his Honour did reach such a conclusion. His Honour stated that even if it was the case that the psychiatric injury would not have occurred if the respondent had kept taking Risperidone, it did not necessarily follow that the cessation was the significant contributing cause of her injury. His Honour noted that Dr Nelson thought it appropriate to reduce the dosage and Dr Blakemore considered that to be a reasonable clinical decision. That decision was made by Dr Nelson because the respondent appeared, at the relevant time, to be coping well at work and with life generally. His Honour then expressly found that the respondent would have continued to cope if not for the problems she had encountered with teaching in 2017. The latter passage, in particular, makes clear that the Judge was satisfied that the cessation of Risperidone was not a significant contributing cause of the respondent’s injury.
I consider it quite clear that the Judge did not err in the manner suggested by the appellant in relation to the weighing of causes. His Honour was satisfied that there was only one significant contributing cause of the respondent’s injury, that being her employment.
While I have found that the Judge did not err in the weighing process, his Honour did hold that s 7(2)(b)(i) did not require that employment must be more significant than the combined effect of all other contributing causes. Nevertheless, as the appellant’s submission concerning the correct weighing process has potential implications for other cases, it is appropriate to consider the correctness of that submission.
The appellant acknowledged in its submissions that potentially the evidence in a particular case may establish that there is more than one employment related cause for a psychiatric injury. Thus, to adopt the example advanced by the appellant, a psychiatric injury may be caused by bullying and also by an inadequate management response to that conduct. In such a hypothetical case, there may also be one or more other significant contributing causes that are not related to employment.
In a case where there are several significant employment related causes for a psychiatric injury, I consider that s 7(2)(b)(i) clearly requires those causes to be assessed in the aggregate so as to determine whether employment is the significant cause of the injury. There is nothing in the provision to suggest that employment related causes should be assessed separately even if that were possible in a particular case. To the contrary, the clear focus of the provision is upon the extent to which the employment of the worker has caused their psychiatric injury. That necessarily requires the aggregation of employment related causes.
The question then arises as to whether there is any reason to assess non-employment related causes separately rather than in the aggregate. I cannot see any reason to do so. The object of the evaluative exercise required by s 7(2)(b)(i) is to determine whether employment is the significant cause of a psychiatric injury, in the sense of the most important or influential cause. Thus, I agree with the appellant that it is necessary to assess both employment and non-employment related causes in the aggregate. In other words, s 7(2)(b)(i) requires that employment must be more significant than the combined effect of all other contributing causes. However, as the Judge found that employment was the only significant cause of the respondent’s psychiatric injury, his Honour did not err in this respect.
I would dismiss Ground 2.
Conclusion
I would dismiss the appeal and confirm the decision of the Full Bench of the SAET.
TILMOUTH AJ: I agree with Parker J and with the additional observations of the Chief Justice.