White v DM Ifield & L.B Ifield - [2024] NSWPIC 427

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	White v DM Ifield & L.B Ifield [2024] NSWPIC 427
APPLICANT:	Catherine White
RESPONDENT:	DM Ifield & L.B Ifield
MEMBER:	Cameron Burge
DATE OF DECISION:	8 August 2024
CATCHWORDS:	WORKERS COMPENSATION - Medical expenses claim; applicant suffered accepted injury and seeks an order the respondent pay costs of, and incidental to, radio frequency and PRP injections to lumbar spine; respondent argues the treatment is not reasonably necessary on two bases, namely, the proposed treatment will treat the applicant’s underlying pathology rather than the aggravation to it caused by the injury, and the proposed treatment is premature and should only be undertaken after the applicant has had pain management treatment; Held – the proposed treatment is reasonably necessary as a result of the injury; the respondent is ordered to pay the costs of, and incidental to, it.
DETERMINATIONS MADE:	The Commission determines: 1. The applicant suffered an injury to her lumbar spine in the course of her employment with the respondent on 11 January 2022. 2. As a result of the applicant’s injury, the treatment proposed by A/Prof Russo is reasonably necessary. 3. The respondent is to pay the costs of and incidental to the bilateral cluneal nerve pulsed radiofrequency and SIJ PRP injections, as recommended by A/Prof Russo.

STATEMENT OF REASONS

BACKGROUND

On 11 January 2022, Catherine White (the applicant) was working as a cleaner in the course of her employment with the respondents, DM Ifield and LB Ifield when she suffered a fall down some stairs at a client’s premises, falling backwards and landing on her back and tailbone.
There is no issue the applicant suffered an injury to her lower back in the fall at issue. She has also suffered accepted symptoms in the nature of urinary incontinence.
The applicant has consulted A/Prof Marc Russo, pain management specialist, who has recommended treatment by way of bilateral cluneal nerve pulsed radiofrequency and SIJ PRP injections to the applicant’s lumbar spine. The respondent denies liability for the treatment on the basis it is not reasonably necessary as a result of the applicant’s injury.

ISSUES FOR DETERMINATION

The parties agree that the only issue in dispute is whether the proposed treatment is reasonably necessary as a result of the applicant’s injury.

PROCEDURE BEFORE THE PERSONAL INJURY COMMISSION

I am satisfied that the parties to the dispute understand the nature of the application and the legal implications of any assertion made in the information supplied. I have used my best endeavours in attempting to bring the parties to the dispute to a settlement acceptable to all of them. I am satisfied that the parties have had sufficient opportunity to explore settlement and that they have been unable to reach an agreed resolution of the dispute.
The parties attended a hearing on 6 August 2024. At the hearing, the applicant was represented by Mr Stockley of counsel instructed by Mr Kasturi. The respondent was represented by Mr Gaitanis of counsel, instructed by Mr Gaudie.

EVIDENCE

Documentary evidence

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading White v DM Ifield & L.B Ifield

Details

AGLC: White v DM Ifield & L.B Ifield [2024] NSWPIC 427
Case: [2024] NSWPIC 427
Decision Date: 8 August 2024

CaseChat Overview and Summary

The applicant, White, filed a claim against the respondents DM Ifield and LB Ifield seeking compensation for medical expenses related to radio frequency and platelet-rich plasma (PRP) injections for their lumbar spine. White had suffered an accepted injury, and they sought an order that the respondents pay the costs of, and incidental to, the proposed treatment. The respondents argued against the claim on two grounds: firstly, that the treatment was not reasonably necessary as it would address the underlying pathology rather than the aggravation caused by the injury; and secondly, that the treatment was premature and should only be undertaken after the applicant had undergone pain management treatment. The court was required to decide whether the proposed treatment was reasonably necessary as a result of the injury.

In determining whether the treatment was reasonably necessary, the court considered the evidence and arguments presented by both parties. It was established that the proposed treatment was aimed at addressing the aggravation of the underlying pathology caused by the injury, rather than the pathology itself. The court found that the treatment was reasonably necessary because it was specifically aimed at managing the effects of the injury and not the underlying condition. Furthermore, the court did not accept the argument that the treatment was premature, as it found that there was no requirement for pain management treatment to be undertaken prior to the proposed treatment. Therefore, the court held that the proposed treatment was reasonably necessary as a result of the injury.

The court ordered the respondents to pay the costs of, and incidental to, the radio frequency and PRP injections for White’s lumbar spine. This decision recognises the need for appropriate medical treatment to address the aggravation of an injury, and highlights the importance of considering the specific circumstances of each case when determining the reasonableness of a proposed treatment. The court's decision reinforces the principle that an injured worker is entitled to receive the necessary medical treatment to manage the effects of their injury, and that the compensation provider must bear the costs of such treatment when it is deemed reasonably necessary.

Orders