Tredinnick and Comcare
[2007] AATA 1037
•31 January 2007
Administrative Appeals Tribunal
DECISION AND REASONS FOR DECISION [2007] AATA 1037
ADMINISTRATIVE APPEALS TRIBUNAL )
) No N2004/1443
GENERAL ADMINISTRATIVE DIVISION ) Re KELLIE TREDINNICK Applicant
And
COMCARE
Respondent
DECISION
Tribunal Robin Hunt, Senior Member and Dr J Campbell, Member Date 31 January 2007
Place Sydney
Decision The decision under review is affirmed. .....................[sgd]..........................
Robin Hunt
Senior Member
CATCHWORDS
COMPENSATION – continuing injury – delay between original injury and claim for secondary continuing injury – finding no permanent work related injury- no entitlement to compensation.
LEGISLATION
Safety, Rehabilitation and Compensation Act (Cth) 1988, ss 4, 14
REASONS FOR DECISION
31 January 2007 Robin Hunt, Senior Member and Dr J Campbell, Member summary
1. Ms Kellie Ray Tredinnick, the applicant, applied to the tribunal for review of a decision made by Comcare, the respondent. This decision affirmed a Comcare determination adverse to Ms Tredinnick’s claim for rehabilitation and compensation for injuries to her neck, back, legs, feet and hips, injuries Ms Tredinnick contends were sustained as a result of a lift accident that occurred in the course of her employment with Centrelink. After careful consideration of the evidence, we have found that Ms Tredinnick has not established her claim and affirm the decision under review. Our reasons are below.
Issues
2. The tribunal was asked to decide whether Ms Tredinnick is entitled to rehabilitation and compensation for injuries caused by a workplace lift accident. This question involves consideration of whether Ms Tredinnick suffers from injuries for the purposes of s 4 of the Safety, Rehabilitation and Compensation Act 1998 (the Act), to her lower back, neck and lower limbs, as well as a panic disorder. It further involves consideration of whether these complaints are continuing effects of the injury she sustained in the lift accident of 7 September 1995. If Mrs Tredinnick suffers from the effects of a work-related injury, the further question is whether she is entitled to compensation in respect of any injury pursuant to s 14 of the Act.
background – history of claim
3. Ms Tredinnick was born on 6 March 1970 and by the final day of hearing was aged 36 years. Ms Tredinnick commenced work as a file clerk with the Australian Public Service, with what was then the Department of Social Security, on 26 May 1986. She remained employed with the Department of Social Security through its various incarnations, most recently Centrelink, until accepting a voluntary redundancy in early 1999.
4. On 7 September 1995, Ms Tredinnick was involved in a lift accident when travelling between floors in the building where she worked for Centrelink. On 27 September of that year, Comcare accepted liability for “lower back strain (episode only)” resulting from “the sudden stop of lift on 6/9/95 [sic]”. Comcare accepted liability to pay compensation to Ms Tredinnick from 7 September 1995 until 6 October 1995.
5. Ms Tredinnick returned to work on full-time duties in September 1995. On 15 January 1999 she accepted a voluntary redundancy, although she gave evidence that her acceptance of this was coerced. She told the tribunal that a new supervisor had come to her team and shortly thereafter advised that she should accept a voluntary redundancy or face a termination of her employment. Ms Tredinnick said that the supervisor indicated:
I had a choice of taking a redundancy package or he would get me out on inefficiency grounds based on sickness and illness. So I took the redundancy.
6. On 15 August 2002, Ms Tredinnick lodged a further claim for rehabilitation and compensation in respect of injuries to her neck, back, legs, feet and hips. This was followed by a compensation claim to Comcare for permanent injury on 11 September 2002. The claim of 11 September, however, was not accompanied by an assessment of the degree of permanent impairment. Nonetheless, it was accompanied by a non-economic loss questionnaire. In this Ms Tredinnick assessed herself as:
§Pain – 4
§Suffering – 4
§Mobility – 2
§Social Relationships – 3
§Recreation and Leisure Activities – 3
§Other loss – 3
7. A determination by Comcare dated 29 July 2003 denied Ms Tredinnick’s claim, rejecting any liability for:
Lumbosacral (joint) (ligament) strain, neck sprain, panic disorder, unspecified injury to other sites also multiple (legs, feet and hips).
While the decision maker was satisfied that Ms Tredinnick suffered lower back strain, neck pain and panic disorder, she was not satisfied that Ms Tredinnick suffered any injury to her legs, feet or hips. Moreover, the decision maker was not satisfied that the injuries to Ms Tredinnick were caused by or related to any work incident that would warrant a new claim. Subsequently, Ms Tredinnick’s claim was forwarded to the case officer in charge of her original claim. The case officer was requested to determine whether it would be possible to extend liability to cover Ms Tredinnick’s newly arising condition (secondary condition), her original condition being accepted as “lower back strain (episode only)”.
8. On 5 August 2003 Ms Tredinnick’s solicitors requested a reconsideration of the decision dated 29 July 2003. On 24 December 2003, Comcare affirmed the determination, stating:
The medical evidence provided is insufficient to suggest that the employee’s current ailments are related to the 1995 accident. Therefore I am not convinced that the various conditions currently suffered are attributable to the 1995 accident. I note that very little treatment was required at the time of the incident. Comcare’s records indicate that the employee resumed her normal duties following a three week absence…
9. The applicant then lodged with this tribunal a request for a review of the Comcare decision dated 24 December 2003.
evidence of Ms Tredinnick
10. Ms Tredinnick told the tribunal that she commenced working with the Commonwealth Public Service, in the Department of Social Security, in 1986. She told the tribunal that, on 7 September 1995:
I was going up in the lift with a number of other people and just short of hitting the second floor where we [Centrelink] were [located] – I was going to get off [on the second floor when] the lift started to fall – I… realised it was actually falling, not just shaking around, because it had done that a number of times – I just lent over and started banging the “Stop Lift” button. It didn’t stop. It just fell right down to the bottom of the basement.
11. Ms Tredinnick told the tribunal that the lift fell a little over 4 floors. She explained that it fell from just off the second floor, through the first floor, through the ground floor, through the first basement and to the second basement. On landing on the second basement, Ms Tredinnick said the lift “bounced back up”. Ms Tredinnick was unable to say how fast the lift fell, or how high it “bounced back up” on hitting the second basement. She said, however, that when the lift hit the floor of the second basement she was able to remain on her feet. By way of explanation she told the tribunal that as the lift had been falling she had been leaning against a wall trying to stop the lift by pressing the stop button.
12. Ms Tredinnick stated that after the initial shock of the accident, she noticed pain in her lower back. She said:
At that stage it was only just sort of lower back and sort of out into the right hip a small amount.
In giving evidence she also indicated that there was pain in her neck, describing the area as “the base of my skull” and pointing to this area and the centre of the back of her neck.
13. Ms Tredinnick told the tribunal that it took approximately 45 minutes for lift mechanics to free her and the other people trapped in the lift, none of whom worked for Centrelink. She said that there were approximately 6 other people in the lift, all of whom appeared to be new migrants attending a school that taught English as a second language. This school was also located in the building.
14. Before the lift accident, Ms Tredinnick told the tribunal that she had been involved in a car accident. She said that this had been some 9 years earlier, in 1986. Ms Tredinnick said that the accident, in which the car she was travelling in was hit from behind by another vehicle, caused her to suffer an injury to her lower back. She told the tribunal that from 1986 until 1992 she suffered lower back pain, describing the pain as being “medium”. She said that the pain seemed to improve when she was pregnant with her son, Aiden, who was born in April of 1992. Ms Tredinnick told the tribunal that she had taken approximately one month off work before she gave birth to Aiden and 7 weeks off after Aiden’s birth.
15. Ms Tredinnick said that, in the period between May 1995 and September 1995, she did not recall having any particular health complaints, other than a miscarriage suffered in April 1995.
16. On cross examination Ms Tredinnick told the tribunal that the case history recorded by Dr Evans was not entirely correct. Dr Evans had noted, in a report of 14 September 1995, that Ms Tredinnick had previously been involved in a car accident which had caused her an injury resulting in pain to her lower back. Dr Evans recorded that this “went on for a couple of years but then resolved more or less completely”. Ms Tredinnick stated that she did not recall giving this history to Dr Evans. She stated that doing the washing had always caused her to have “flare-ups” with her lower back. She said that she had never denied having such problems with her lower back and agreed that she had a symptomatic back from time to time before 1995.
evidence of Mr tredinnick
17. Mr Tredinnick, the estranged husband of Ms Tredinnick, provided a statement, dated 16 October 2006, and gave oral evidence. In his statement he set out that, before the lift accident of September 1995, Ms Tredinnick had suffered a miscarriage. He recalled this as occurring in around June or July of 1995. He told the tribunal that a week after the miscarriage, in an effort to cheer her up, he took Ms Tredinnick on a ski trip to Thredbo. In his statement he said:
Kellie told me she’d never skied before. Although she was quite upset and depressed at having lost the baby and we spent a lot of time walking and talking, I recall that we spent about two days skiing. Kellie and I skied a number of difficult ski runs together including blue runs. Kellie did not show any sign of any pain or injury.
18. In his statement, Mr Tredinnick said that he had been the occupational health and safety officer at the time of the lift accident in September 1995. He said he recalled lift mechanics prising open the lift doors and freeing the trapped people inside. He described the people exiting the lift as looking “shaken up”. He stated: “Kellie appeared to be very shaken up and said to me that she was sore”. He went on to say he took Ms Tredinnick to see a female doctor, Dr Gerges.
19. Mr Tredinnick stated that, after the lift accident, his and Ms Tredinnick’s sex life deteriorated. In oral evidence before the tribunal he said that after the lift accident Ms Tredinnick “became more and more withdrawn” and lost interest in sex. In his statement Mr Tredinnick said that at this time he began to give her regular massages of her lower back as well as of her neck and shoulders. He said that he would do this each night, for as long as 2-3 hours. At the hearing he said that, whereas previously there had been a sexual component to the massages he’d given Ms Tredinnick, this was no longer the case after the lift incident. He also stated that at this time Ms Tredinnick began to seek regular chiropractic treatment.
Medical Evidence
20. Before us were a number of medical reports. In addition, two doctors gave oral evidence, Dr Hopcroft and Dr Prowse. The reports and oral evidence are discussed below.
Dr James K. Evans
21. Dr James K. Evans, orthopaedic surgeon, provided a report dated 14 September 1995. In this report he recorded that Ms Tredinnick had been involved in a motor vehicle accident some 10 years before her lift accident of September 1995. He stated that in October 1994:
…she had a recurrence of pain after she bent to pick up some washing. She was off work for about a week. At that time she had shooting pains to the left calf. These were lasting for just seconds. She had no continuous leg pains. The leg problem resolved in a couple of weeks and the back problem resolved over a couple of weeks and the leg over a couple of months.
22. In his report, Dr Evans opined that Ms Tredinnick had “a sprain only associated with her spondylolisthesis”. He reported that there was no evidence of disc prolapse and that there was “really no special treatment”. He stated “it is just a matter of time until she recovers”.
Dr T. Rogers
23. Dr T. Rogers, Commonwealth Medical Officer, provided a report dated 13 February 1996. In this, he noted Ms Tredinnick’s lift accident, recorded as occurring in August. In the report, however, Dr Rogers said nothing about the injury/ies incurred as a result of the lift accident. Dr Rogers noted Ms Tredinnick’s pregnancy and stated that she should be able to continue her duties as an AS03.
Dr Drew Dixon
24. Dr Drew Dixon, Orthopaedic Surgeon, provided two reports, both dated 11 May 2001. In his first report (T11, p20) he recorded that Ms Tredinnick had suffered a lower back injury while in a lift at her workplace. Dr Dixon took Ms Tredinnick’s patient history as:
This 31 year Clerical Officer sustained an injury to her lower back when a lift in which she was travelling at the Department of Social Security Building in Rockdale jerked on arrival on the second floor and then dropped down to the first floor jarring her lower back. She developed pain radiating to the right buttock. She had one week off work and returned to work for 3 years but left in January 1999. She had been reducing her workload to part time.
25. Dr Dixon reported that, on examining Ms Tredinnick, he found she had stiffness of the lumbar segment with forward flexion to her knees and with a slow recovery. He said there was a palpable step at the lumbo-sacral junction and her extension was reduced by one quarter and her lateral flexion by one third. Dr Dixon also reported that Ms Tredinnick exhibited tenderness in the right buttock and that her straight leg raise on the right was 60 degrees. He said there was no gross neurological deficit in either of Ms Tredinnick’s lower limbs, but said that heel walking was painful in the right buttock and that there was no limp on toe walking. He also stated that X-ray’s of Ms Tredinnick’s lumbar spine with functional views indicate an L5/S1 spondylolisthesis with PARS defects. He stated that they show “gross narrowing of the L5/S1 discs space on flexion”. On extension he said the views of the spondylolisthetic slip were grade one. On flexion view the slip was grade 11.
26. Dr Dixon diagnosed Ms Tredinnick with “symptomatic spondylolisthesis”, which he reported as being asymptomatic before the lift accident. He said:
[Ms Tredinnick] has residual low back pain secondary to asymptomatic grade 1/11 spondylolisthesis with facet arthralgia on the right and right buttock sciatica. There also appears to be a component of piriformis syndrome.
27. Dr Dixon stated that, in his opinion, Ms Tredinnick was a candidate for lumbar stabilisation with internal fixation. He stated that no further improvement of her condition was likely and that her prognosis for returning to fulltime clerical activity was guarded.
28. In his second report of the 11 May 2001 (T 11, p22) Dr Dixon stated that Ms Tredinnick had lost efficient use of her lumbar spine of 20% of the back as a whole, and that this loss was permanent. With regards to her lower limbs he stated:
The assessed efficient loss of use of her right lower limb due to her buttock sciatica and limitation of straight leg raise on the right is 10% at and above the knee and this is permanent.
29. Dr Dixon did not comment on any relationship between Ms Tredinnick’s symptoms to the workplace lift accident of 1995.
Dr Seham Gerges
30. Dr Seham Gerges furnished a report dated 18 April 2005. This set out that Ms Tredinnick had been a patient of hers since August 1995. In the report, Dr Gerges stated that, on 7 September 1995, Ms Tredinnick attended her surgery with back and left hip pain. He also noted that Ms Tredinnick was involved in a car accident many years previously. She relayed that since that time Ms Tredinnick had suffered low back pain as well as some pain in the cervico-thoracic spine.
31. Dr Gerges reported that, on examination, Ms Tredinnick exhibited limited movement in her back and tenderness on palpation. She stated, however, that she had no neurological signs and reported she had:
§Spasms of the para-spinal collar muscles;
§Restricted movements of the cervical spine; and
§Tenderness all over the cervical spine.
32. Dr Gerges added that Ms Tredinnick had developed:
…persistent symptoms referrable to a cervical strain as well as low lumbar back, strain, with nerve root irritation affecting the upper limbs.
33. Dr Gerges made no comment on whether Ms Tredinnick’s condition was attributable to the lift accident of September 1995. She stated that she was unable to comment on her prognosis on account of not having seen her since October 1998.
Roger D. Knowles
34. Mr Roger D. Knowles, a chiropractor, furnished a report dated 18 April 2005. In this, he set out that Ms Tredinnick “complained of neck pain of three days duration”. He stated that “the only significant trauma disclosed was a motor vehicle accident in 1986”.
35. Mr Knowles reported that he treated Ms Tredinnick by adjustment of spinal segments on a number of occasions. He stated:
Mrs Tredinnick received significant relief of symptoms she experienced in the majority of instances in which she sought care.
36. Mr Knowles also reported that, based on his experience, Ms Tredinnick will require “long-term regular maintenance care”.
Mr Paul J. Firmstone
37. Mr Paul J. Firmstone, chiropractor and osteopath, provided a report dated 22 March 2005. In this, he related that Ms Tredinnick had been a patient at his clinic from 4 October 1990 until 16 November 1998. He said she had a history of low back pain, neck pain and headaches from approximately 1996 resulting from a motor vehicle accident. He went on to state:
Kellie presented to the clinic on 16th September 1995 complaining of bilateral neck and upper thoracic spinal pain and left low back pain referring down to the lateral calf. She stated that she was in a lift accident at the Department of Social Securities Rockdale where the lift suddenly dropped, falling several floors.
38. Mr Firmstone observed on initial examination that Ms Tredinnick displayed:
Spinal motion restrictions… at L5S1 in left sidebending and rotation to the right, at T8-11 in left sidebending and rotation to the right, at T1,2 in extension, at C6,7, in left sidebending and left P-A rotation and at C1,2 in paravertebral muscles adjacent to these spinal restrictions.
39. Mr Firmstone described Ms Tredinnick’s primary condition as:
…acute synovitis and capsulitis of L5S1, T1,2 and C6,7 facet joints with associated muscle spasm of the posterior paravertebral muscles.
40. Mr Firmstone did not comment on whether Ms Tredinnick’s symptoms were attributable to the lift accident of September 1995.
Dr M. Girgis
41. Dr M Girgis provided a report dated 27 March 2005. In this, he reported that the L3/4, L4/5 and L5/S1 discs have a normal appearance without annulus bulge, focal herniation or compression of the thecal sac or nerve roots. He stated that wide bilateral pars interarticularis defects of L5 were present, causing Grade 1 spondylolisthesis at the lumbosacral level. In the report, Dr Girgis opined that:
These defects appear chronic with sclerosis at their margins. There is no resultant bony stenosis of the central canal. There is moderate foraminal stenosis at the lumbosacral level and the L5 nerve roots at the foraminal level impinge on the posterolateral margin of S1 but no nerve root compression or displacement is seen.
42. Dr Girgis gave his opinion that Ms Tredinnick’s complaints were a consequence of the car accident she was involved in 1986, aggravated by the later lift accident of September 1995. Dr Girgis stated:
[Ms Tredinnick] suffered injury to her back and neck as a result of a car accident in 1986 and further injury of similar nature when she was involved in an elevator fall whilst at work in 1995… It would appear the elevator incident had caused increased symptoms of back/neck pain and possibly triggered her anxiety disorder.
43. Dr Girgis also stated that he was unable to comment on Ms Tredinnick’s fitness for work. He noted, however, that on account of her previous long history of continued back and neck pain, he would feel it unlikely that she could perform full time duties as an administrative assistant.
Mr John F. Thompson
44. Mr John F. Thompson, a chiropractor, provided a report dated 28 April 2005. In this, he stated that Ms Tredinnick suffered “spinal involvement” of the upper and lower neck as well as lower back. He reported that her treatment consisted:
…primarily of spinal adjustments (in lay terms, specific spinal manipulations) to various areas of the spine…
45. In Mr Thompson’s opinion, Ms Tredinnick’s condition was such that she will require ongoing treatment on a long term basis.
Dr Alan G. Hopcroft
46. Dr Alan G. Hopcroft, general surgeon (orthopaedics), gave oral evidence to the tribunal as well as providing three reports dated 12 October 2005, 3 April 2006 and 19 September 2006. In his report of 12 October 2005, he opined that Ms Tredinnick has a pre-existent bilateral pars intercolaris defect. He also stated that she:
…has suffered from a destabilisation of her spondylolisthetic defect of the L5/S1 pars interarticularis level bilaterally in the work related elevator crash of 7/09/95.
In oral evidence Dr Hopcroft told the tribunal that a pre-existent bilateral pars defect is:
… 95% of the time a congenital pre-existing defect. In stabilising part of the bone between the body of the vertebra and the arch of the back and when that occurs it is sometimes asymptomatic for a person’s lifetime.
47. In his report of 12 October 2005, Dr Hopcroft opined that Ms Tredinnick had jarred her cervical spine in the lift accident. He stated:
…although she continues to have some low grade neck pain [she] has suffered no major structural abnormalities at that site in so far as the radiological investigations level of accuracy define.
48. In oral evidence, Dr Hopcroft expanded on this, telling the tribunal:
Sometimes the spondylolisthetic defects or the pas…defect on xray is simply picked up routinely on x-ray to the back for other injuries. But when a defect is discovered and symptoms date from a particular injury and you have no reason to deny those symptoms and they have been consistent and require regular treatment, that suggests that the injury caused movement at the pas defect legion and that it became unstable, certainly as the patient moves. Instead of having a rock solid L5 vertebra you have movement at the site that is defective and that movement then causes accumulated change…
49. When questioned by tribunal member, Dr Campbell, Dr Hopcroft confirmed that he believed Ms Tredinnick had a congenital condition of spondylolisthesis and then in 1986 had a car accident which caused some symptoms which were intermittent – “spondylolisthesis grade 1”. Ms Tredinnick was then involved in the workplace lift accident of 1995, and this caused her to come closer to a grade 2 spondylolisthesis, that is, “having constant lower back pain and symptoms radiating to her buttocks and legs”. Dr Hopcroft told the tribunal that, in his opinion, it is unlikely that Ms Tredinnick’s stage 2 progression was simply a normal outcome of the original injury sustained in the car accident in 1986. Dr Hopcroft said:
I believe that the injury of ’87 [sic – should be 1986] would have shown progression to a stage 2 by 1995 if it had in fact been of that severity and type. But she hadn’t reached stage 2 or grade 2 by 1995 but from 1995 the deterioration has been slowly continuous.
50. In his first report Dr Hopcroft stated that in his professional opinion, Ms Tredinnick has a permanent loss of efficient use of her back of 15%, permanent loss of efficient use of her right leg at or above the knee of 10% and permanent loss of efficient use of her left leg at or above the knee of 10%. He stated that in his opinion, due to the pre-existent L5/S1 spondylolisthetic defect, she lost one third of her impairment assessment, leaving her with a permanent impairment arising from the work related injury of 10% affecting her lumbosacral spine.
51. In his next report of 3 April 2006, Dr Hopcroft updated his assessment of Ms Tredinnick’s permanent impairment. In this report he opined that, based on the guidelines applicable to a Comcare compensation client, Ms Tredinnick:
§ [Has] ongoing and significant sciatica and by way of reference to Table 9.5 of the Comcare Guides the patient has a whole person impairment of 10%.
§ Regarding her cervical spine, she has a whole person impairment of 0%; and
§ Regarding her thoracolumbar spine, she has a whole person impairment of 5%.
Dr Hopcroft, in consequence, assessed Ms Tredinnick as having an overall whole person assessment of 15%.
52. In his final report, dated 19 September 2006, Dr Hopcroft noted that he had not taken account of the fact that Ms Tredinnick had suffered a motor vehicle accident and, as a result of that accident, suffered some low back pain and sciatica before the lift fall of 1995. Taking this into account, he said that “a one tenth subtraction from her whole person impairment” should be made. Following this, he stated that Ms Tredinnick has an overall impairment of 14%.
Dr Michael Prowse
53. Dr Prowse, a rheumatologist/physician and senior lecturer at the University of New South Wales’ School of Rural Health, provided two reports, dated 5 July 2005 and 8 September 2005. In his report of 5 July, he found that Ms Tredinnick had a satisfactory range of neck movement and no spinal tenderness. He stated that, on examination, she had satisfactory lumbar spine movements. He said that a neurological assessment of her upper and lower limbs proved normal. Dr Prowse found Ms Tredinnick’s hip movements were normal, but noted they were mildly tender around the right greater trochanter. Dr Prowse stated that he felt unable to give a diagnosis as he did not have any x-rays before him.
54. In his next report of 8 September 2005, Dr Prowse noted that he had reviewed Ms Tredinnick’s x-rays and other reports and updated his earlier assessment of her condition. In this next report Dr Prowse stated:
X-ray of lumbar spine September ’98 shows a Grade 1 L5/S1 spondylolisthesis and bilateral pars defects and no disc height loss. I reviewed the films from September ’95 and there is no change and on those films there was again a spondylolisthesis and pars defects.
55. Dr Prowse went on to report that the x-ray of Ms Tredinnick’s pelvis was normal, as were the x-ray of her neck from September 1998 and the CT scan of her neck of 29 June 2000. In his second report Dr Prowse stated that the CT scan of Ms Tredinnick’s lumbar spine of 29 June 2000 shows:
…an L5/S1 Grade 1 anterior spondylolisthesis of <1cm and bilateral pars interarticularis defects and no disc protrusion…
56. In his final report, Dr Prowse assessed Ms Tredinnick as being a woman suffering chronic neck pain without radicular features, and with normal neurological assessment and x-ray reports. He stated that she has chronic low back pain and chronic right posterior pelvic pain. In his opinion, Dr Prowse said:
This may in part be related to the L5/S1 spondylolisthesis and pars defect but this was evident in the X-ray films from September ’95 and would be unlikely to be related to the elevator injury although it is possible that the pain was aggravated by the elevator fall.
57. In oral evidence, Dr Prowse agreed, when it was put to him, that one would expect to see significant broken bones if a person experienced a “free fall” of four floors in an elevator. Dr Prowse also told the tribunal that it was his opinion the lift accident did not lead to any ongoing injuries for Ms Tredinnick. He said:
Significant symptomatology before the accident, of the lift accident, September ’95, and she had ongoing symptomatology after the accident and there didn’t seem to be a major change in the pattern of symptomatology.
58. In regard to Dr Hopcroft’s opinion that Ms Tredinnick was suffering grade 1 spondylolisthesis before the lift accident and grade 2 as a result of the accident, Dr Prowse told the tribunal:
I saw films from 1998, which showed grade 1 L5/s1 spondylolisthesis and I saw films from September ’95 and that showed no change. I think if you have found various x-ray reports and talk about grade 1 and grade 1 to 2, … it is a subjective call… grade 1 is thought to be 1cm slip. It can be a projectional view somewhat where you might have subtle changes but I personally don’t believe there was any change between those films.
59. Dr Prowse said that “I haven’t seen any evidence for grade 2 spondylolisthesis on the films”. He added: “That is my interpretation and that is also the radiological reports that I had”.
Dr Phillip Brown
60. Dr Phillip Brown, consultant psychiatrist and psychologist, provided a report dated 4 April 2006. In this, he diagnosed Ms Tredinnick as having a pre-existing “undifferentiated somatoform disorder”, that being an irritable bowel syndrome. He said that this was a result of her psychological constitution and not her work accident. Dr Brown also reported that Ms Tredinnick had developed a “specific phobia of lifts” and has an “adjustment disorder”. He stated that her specific phobia of lifts is a result of the lift accident. He said, of her adjustment disorder, that the causes of this were most likely multi-factorial and varied with the salient stresses at the time.
consideration and conclusion
61. We have considered the many medical opinions before us and find that, on balance, there is no significant pathology to explain Ms Tredinnick’s symptomatology, or to link it to the lift accident of September 1995. We find Dr Prowse’s examination and consideration of Ms Tredinnick’s symptoms were based on a thorough examination and consideration and reading of x-rays. His opinion that Ms Tredinnick’s condition did not deteriorate as a result of the lift accident remained unchallenged under cross-examination and close questioning.
62. On the other hand, Dr Hopcroft’s diagnosis and opinion varied somewhat when pressed. We prefer to base our findings on the well reasoned opinion of Dr Prowse. In addition, while we took note of the opinions of other health professionals set out above, we have placed more weight on the prognoses and opinions of Dr Prowse as a specialist consultant.
63. We also note that Dr Gerges was unable to comment on the prognosis on account of not having seen Ms Tredinnick since October 1998. Dr Girgis, another practitioner, gave his opinion that Ms Tredinnick’s complaints were a consequence of the car accident she was involved in 1986, aggravated by the later lift accident of September 1995, but this opinion was qualified to the extent that Dr Girgis said the lift accident “appeared” to have aggravated her condition.
64. Dr Evans thought it was just a matter of time until Ms Tredinnick recovers. He expected the back problem would resolve over a couple of weeks and the leg over a couple of months.
65. While Ms Tredinnick may suffer pain, her condition is not attributable to the lift incident. As to her panic disorder or adjustment disorder, we agree with Dr Brown that the causes are most likely multi-factorial and varied with the salient stresses at the time.
66. On balance, we find the medical evidence is insufficient to support Ms Tredinnick’s claim that she suffers any permanent condition related to the 1995 accident. She does not continue to suffer from an injury as defined under s 4 of the Act. This means that Ms Tredinnick is not entitled to any compensation.
decision
67. The decision under review is affirmed.
I certify that the 67 preceding paragraphs are a true copy of the reasons for the decision herein of Robin Hunt, Senior Member and Dr J Campbell, Member.
Signed: ………[sgd]…….
AssociateDate/s of Hearing 22 February 2006, 24-25 October 2006
Date of Decision 31 January 2007
Counsel for the Applicant Ms S. Walsh
Solicitor for the Applicant Ms M. Snell
Counsel for the Respondent Mr Elliot
Solicitor for the Respondent Mr Pender
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