Nagy v Arthur Tzaneros Discretionary Trust & Luke Webber Trust t/as Labour Power & Anor [2025] NSWPIC 609

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Key takeaways

In this decision, the Commission explored the role of a Member and a Medical Assessor in resolving disputes regarding the level of impairment of a consequential sleep condition. The Member found that a consequential sleep disorder can be multifactorial and may make a general finding on causation, which can then be referred to the Medical Assessor to determine the degree of permanent impairment.

Brief facts

The worker sustained a lumbar spine injury during his employment, which was deemed to have occurred on 5 April 2018.

The worker brought a claim for permanent impairment compensation pursuant to section 66 of the Workers Compensation Act 1987 including consequential conditions of aggravation of his pre-existing diabetes and a sleep disorder.

The worker alleged that his sleep disorder had arisen from four separate causes – weight gain, back pain, narcotic relief, and sleep disturbance from pain. He further submitted that once a finding of sleep disorder consequential to the work injury was made, its precise cause was a matter for the Medical Assessor.

The employer accepted that the worker had aggravated his diabetes as a result of the lumbar spine injury. However, the employer disputed that the worker had suffered weight gain causatively related to the lumbar spine injury and sought a Member decision on this issue.

Judgment

The Member was not persuaded that the worker’s lumbar spine injury caused weight gain which contributed to his consequential sleep disorder. However, the Member found a causal link between the sleep disorder and the lumbar spine injury through pain, the use of narcotic analgesia and sleeping in the supine position.

The Member concluded that his role was to make a general finding that the sleep disorder was caused by the injury. He determined that once this finding was made, the Medical Assessor was responsible for applying the American Medical Association Guides to the Evaluation of Permanent Impairment, Fifth Edition (AMA Guides) and the State Insurance Regulatory Authority (SIRA) Guidelines to assess any permanent impairment and/or deduction.

Implications 

This case highlights that the causes of a consequential sleep disorder can be multifactorial.

The Member’s role in these disputes is to make a finding as to whether there is a connection between the primary injury and the consequential sleep disorder. The worker is required to articulate the body system under which an assessment is to be made.

It is important for employers to be mindful of the body system under which an assessment will be made and consider whether the assessment has been properly conducted in accordance with the SIRA Guidelines for that body system. The Medical Assessor’s role is then to assess impairment that results from the workplace injury, including considering the contributing factors and their extent.