Workcover Queensland v Lau

WorkCover Queensland (the appellant) appealed a decision of the Queensland Court of Appeal which had overturned a decision of the Supreme Court of Queensland. The dispute concerned the interpretation of section 175(1) of the *Workers' Compensation and Rehabilitation Act 2003* (Qld) (the Act), which provides that a worker who has suffered a compensable injury is entitled to recover from the insurer all reasonable expenses of and incidental to the injury. The worker, Mr Lau (the respondent), had suffered a compensable injury and sought to recover the costs of a surgical procedure performed by a specialist surgeon. WorkCover had refused to pay for the surgery, arguing that it was not "reasonable" within the meaning of section 175(1) because the surgeon had not obtained prior approval from WorkCover before performing the procedure.

The central legal issue before the High Court was whether section 175(1) of the Act imposed a requirement for a worker to obtain prior approval from the insurer before incurring expenses for treatment, or whether the reasonableness of the expenses was to be assessed objectively, irrespective of whether prior approval had been sought. The High Court was required to determine the proper construction of the phrase "reasonable expenses of and incidental to the injury" in the context of the statutory scheme for workers' compensation in Queensland.

McHugh and Heydon JJ held that section 175(1) did not impose a requirement for prior approval. Their Honours reasoned that the language of the section focused on the objective reasonableness of the expenses themselves, not on the procedural steps taken by the worker. They noted that the Act provided other mechanisms for WorkCover to manage costs and dispute claims, such as the ability to require a worker to undergo a medical examination or to seek a second medical opinion. To read a prior approval requirement into section 175(1) would unduly fetter a worker's access to necessary medical treatment and would be inconsistent with the remedial purpose of the legislation. The appeal was dismissed.