Grant v Dateline Imports Pty Ltd (NSWPICPD 2022)

LINK TO DECISION

Key Takeaways

Evidence required to prove a consequential condition has been clarified in a Presidential decision. In certain circumstances the worker may have to provide evidence of diagnosis/pathology and evidence of tasks undertaken.

Brief Facts

The worker alleged a frank right arm injury and a consequential left arm injury. The worker alleged that the consequential left arm injury was due to using his left arm more often because of his accepted right arm injury. The worker also alleged that he developed CRPS as a result of the injury.

A lump sum claim under s66 of the Workers Compensation Act 1987 was made by the worker for both arms and CRPS. The insurer disputed the consequential left arm injury and disputed the CRPS.

At first instance the Principal Member Bamber of the Personal Injury Commission (PIC) determined the matter. She found the CRPS was a matter for a PIC appointed Medical Assessor. Regarding the consequential left arm allegation, she found against the worker due to insufficient evidence.

The worker appealed and the appeal was determined by Deputy President Wood.

Decision

The worker appealed PM Bamber’s conclusion that the worker had not provided sufficient evidence of diagnosis to prove a consequential left arm injury. DP Wood conceded that the case law had indicated that in most cases a diagnosis was not needed to prove a consequential injury, but that depended on the circumstances of the case. In the current case there were potential alternative causes: was the left arm injury caused by overusing the left arm because of the right arm injury or was the left arm injury due to CRPS? DP Wood agreed with PM Bamber’s conclusion that where there are other potential causes, the worker had the onus to provide further evidence to clarify the diagnosis.

PM Bamber also concluded that where there was an allegation of overuse, the worker had the onus to present evidence of the tasks undertaken and to present expert medical opinion as to whether the condition was caused by overuse. DP Wood agreed with this.

Implications

In a majority of consequential injury claims, workers do not have to provide evidence of diagnosis/pathology. However, if there are other potential causes of a consequential injury, workers may have to produce evidence regarding diagnosis/pathology.

Further, if the worker is alleging overuse of the consequential body part, the worker must provide evidence of the tasks undertaken and provide expert medical evidence linking the consequential condition to the overuse.