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Fowler v Workers' Compensation Regulator[2016] QIRC 48

Fowler v Workers' Compensation Regulator[2016] QIRC 48

QUEENSLAND INDUSTRIAL RELATIONS COMMISSION

CITATION:

Fowler v Workers' Compensation Regulator [2016] QIRC 048

PARTIES:

Fowler, Kristy

(Appellant)

v

Workers' Compensation Regulator

(Respondent)

CASE NO:

WC/2014/65

PROCEEDING:

Appeal against decision of the Workers' Compensation Regulator

DELIVERED ON:

28 April 2016

HEARING DATES:

HEARD AT:

30 June 2015, 1 July 2015

Brisbane

MEMBER:

Industrial Commissioner Neate

ORDERS:

  1. The appeal is dismissed.
  1. The decision of the Respondent of 7 February 2014 is confirmed.
  1. The Appellant is to pay the Respondent's costs of and incidental to this appeal to be agreed or, failing agreement, to be the subject of a further application to the Commission.

CATCHWORDS:

WORKERS' COMPENSATION - APPEAL AGAINST DECISION - fall at work - physical and psychological injury - claim accepted for all but one component of lower back injury - appeal only in relation to that component - precise description of the injury the subject of the appeal - whether the appellant sustained a tear to L5/S1 disc - nature of hearing de novo - onus of proof - standard of proof

CASES:

Workers' Compensation and Rehabilitation Act 2003, s 32, s 48, s 548, s 548A, s 549, s 558

Rossmuller v Q-COMP (C/2009/36) - Decision

Workcover Queensland v BHP (Qld) Workers' Compensation Unit (2002) 170 QGIG 142

Sutherland v Q‑COMP (2009) 190 QGIG 106

Theresa Helen Ward v Q-COMP (C/2011/39) - decision

Davidson v Blackwood [2014] ICQ 008

Q-COMP v Darren Bruce Parsons (2007) 185 QGIG 1

Coombes v Q-COMP (2007) 185 QGIG 331

Blackwood v Mana [2014] ICQ 027

Ramsay v Watson (1961) 108 CLR 642

Adelaide Stevedoring Company Ltd v Forst (1940) 64 CLR 538

Chattin v WorkCover Queensland (1999) 161 QGIG 531

Obstoj v Van de Loos (Unreported, Supreme Court of Queensland, Connolly J, 16 April 1987)

Holtman v Sampson [1985] 2 Qd R 472

Commissioner of Police v David Rea [2008] NSWCA 199

EMI (Australia) Limited v BES [1970] 2 NSWR 238; (1970) 44 WCR 114

Fernandez v Tubemakers of Australia Ltd [1975] 2 NSWLR 190

Monroe Australia v Campbell (1995) 65 SASR 16

Sotiroulis v Kosac (1978) 80 LSJS 112

Joyce v Yeomans [1981] 1 WLR 549, [1981] 2 All ER 21

State of Queensland (Queensland Health) v Q-Comp and Beverley Coyne (2003) 172 QGIG 1447

Qantas Airways Limited v Q-Comp (2006) 181 QGIG 301

Sydney South West Area Health Service v Stamoulis [2009] NSWCA 153

Seltsam Pty Ltd v McGuiness [2000] NSWCA 29; (2000) 49 NSWLR 262

Tabet v Gett [2010] HCA 12; (2010) 240 CLR 537

MacArthur v WorkCover Queensland [2001] QIC 21; (2001) 167 QGIG 100

Nilsson v Q-Comp (2008) 189 QGIG 523

APPEARANCES:

Mr M. Smith, Counsel instructed by MurphySchmidt for the Appellant

Mr S. Gray, Counsel directly instructed by the Respondent

Decision

  1. [1]
    Kristy Jane Fowler ("the Appellant") injured herself on 13 March 2010 when she slipped and fell on her buttocks at her place of employment, McDonald's in Gladstone.  She made an Application for Compensation dated 18 March 2010 (Exhibit 1) in which she referred to her injury in the "Tail bone area." 
  1. [2]
    In a Notice of Claim for Damages dated 23 November 2011 (Exhibit 2), the Appellant provided the following particulars of all injuries alleged to have been sustained because of the event:
  1. (a)
    Lower back:  Fracture S5 vertebral body, soft tissue lumbosacral strain, injury to sacro-iliac joints, coccydynia, tear of L5/S1 disc
  1. (b)
    Psychological: Adjustment disorder/depression.
  1. [3]
    The Appellant's Claim for Damages was accepted other than in relation to the tear of L5/S1 disc.
  1. [4]
    The appeal to the Queensland Industrial Relations Commission ("the Commission") is only in relation to the decision of the Workers' Compensation Regulator ("the Respondent") dated 3 February 2014 and sent to the Appellant on 7 February 2014 to reject her application for compensation for the reason that her L5/S1 disc tear did not arise out of, or in the course of, her employment and her employment was not a significant contributing factor in the development of the personal injury.

The issue

  1. [5]
    There is some dispute about the scope of the issue on appeal.  The Appellant submits that, consistently with her Notice of Appeal, she is entitled to compensation in relation to "a torn disc at either the L4/5 or L5/S1 level."  At the hearing, the Appellant's case was put on a broader basis that the issue in relation to the personal injury is whether there was:
  1. (a)
    an injury to a disc or discs;
  1. (b)
    a desiccated disc at L4/5; or
  1. (c)
    a tear of L5/S1.
  1. [6]
    The Respondent submits that the Appellant cannot now argue that she has sustained a torn disc at L4/5 because:
  1. (a)
    at its highest, an injury to her L4/5 disc is said to be a generalised musculoligamentous injury and/or soft tissue injury to the lumbosacral spine (L4/5);[1] and
  1. (b)
    it has been accepted that she sustained a musculoligamentous injury, and her claim for the injury described in those terms was not rejected by WorkCover and was not the subject of the review by the Respondent.

Hence the Commission only has to determine whether the Appellant has sustained a tear to the L5/S1 disc.

  1. [7]
    Neither party referred to or relied on judicial decisions or decisions of the Commission to support their submissions.  The resolution of this issue, however, is potentially significant, particularly if the Commission is not satisfied that the Appellant suffered a tear to her L5/S1 disc as a consequence of the work related event.
  1. [8]
    Nature of the hearing of the appeal: The relevant legislative provisions provide the starting point in deciding the nature of the hearing in relation to the appeal.  In summary, the Act provides that:
  1. (a)
    a claimant, worker or employer aggrieved by a review decision may appeal to an appeal body against the decision of the Regulator (ss 548, 549); and
  1. (b)
    for this purpose, the Commission is an appeal body (ss 548A(1)).
  1. [9]
    In deciding an appeal, the appeal body may -
  1. (a)
    confirm the decision; or
  1. (b)
    vary the decision; or
  1. (c)
    set aside the decision and substitute another decision; or
  1. (d)
    set aside the decision and return the matter to the respondent with the directions the appeal body considers appropriate (s 558(1)).
  1. [10]
    If the appeal body acts under s 558(1)(b) or (c), the decision is taken to be the decision of the insurer (s 558(2)).
  1. [11]
    There are numerous decisions of the Commission and the Industrial Court in relation to the nature of an appeal in cases such as the present case.  It is not necessary to set them out here.  An appeal against the decision of the Regulator is by way of a hearing de novo. It is not a review of the reasons for decision of the Regulator.
  1. [12]
    The Commission considers the evidence and submissions provided to it by the parties, rather than reviewing the material before the Regulator.  Indeed it is usually the case that the Commission has evidence that was not available to the Regulator.  The Regulator proceeds primarily on the papers, that is, on material put before it.  Sometimes documents that are tendered in the appeal proceedings were not before the Regulator.  Sometimes documents that were considered by the Regulator are not tendered in evidence to the Commission.  The Commission decides the appeal by reference to evidence admitted and submissions made in the hearing.
  1. [13]
    Although, in that sense, the hearing is conducted on a de novo basis, the starting point is that it is an appeal from a decision of the Regulator.  Without that decision, there would be no proceedings in the Commission.  The Commission's jurisdiction is attracted by the making of an appeal against the Regulator's decision in accordance with the Act.  As noted above, the appeal body may do one of four things in deciding an appeal, but each potential outcome relates to "the decision" against which the appeal is made.  If, for example, the appeal is unsuccessful, and the Commission confirms the decision, the Regulator's decision will stand.  In that sense, the status quo is the decision of the Regulator.[2]
  1. [14]
    In essence, the Commission proceeds afresh in relation to the evidence concerning the subject of the appeal.  That does not mean that the subject of the appeal is or might be enlarged by the way in which the hearing of the appeal is conducted.
  1. [15]
    For those reasons, I approach the resolution of the appeal by considering what was the decision of the Regulator that gave rise to the appeal.
  1. [16]
    It is clear from the reasons for that decision that:
  1. (a)
    WorkCover rejected the Appellant's L5/S1 disc tear, and it was that decision that she sought to be reviewed;
  1. (b)
    submissions in support of her application for review asserted that the Appellant suffered a desiccated disc at L4/5;
  1. (c)
    the review officer stated she would not be considering the L4/5 condition for the purpose of this review and her role was to determine whether the Appellant suffered a tear to her L5/S1 as claimed in her notice of claim for damages dated 23 November 2011;
  1. (d)
    having confined her consideration to whether the Appellant sustained a L5/S1 injury, the review officer determined that the Appellant sustained a personal injury, namely a L5/S1 disc tear, but her injury did not arise out of or in the course of her employment and her employment was not a significant contributing factor to the development of that injury.
  1. [17]
    It is the decision in relation to the Appellant's L5/S1 disc tear which is the subject of the appeal.

Definition of injury

  1. [18]
    The issue in this appeal is to be resolved by reference to the definition of "injury" in s 32(1) of the Workers' Compensation and Rehabilitation Act 2003 ("the Act") which, at the time of the Appellant's injury, provided:

"(1) An injury is a personal injury arising out of, or in the course of, employment if the employment is a significant contributing factor to the injury."

  1. [19]
    The Appellant bears the onus of proof on the balance of probabilities.  Having regard to the definition of injury for the appeal to succeed the Appellant must satisfy the Commission that:
  1. (a)
    as at 13 March 2010, she was a "worker" as defined in s 11 of the Act;
  1. (b)
    she suffered a personal injury;
  1. (c)
    the injury arose out of, or in the course of, her employment; and
  1. (d)
    her employment was a significant contributing factor to the injury.
  1. [20]
    The Respondent concedes that the Appellant was a worker and that she injured herself in the course of her employment on 13 March 2010.  Consequently, the only issues to be decided in this case are whether:
  1. (a)
    the Appellant suffered a tear to her L5/S1 disc;
  1. (b)
    the injury arose out of, or in the course of, her employment; and
  1. (c)
    her employment was a significant contributing factor to that injury.

 Medical opinion evidence - an overview

  1. [21]
    The resolution of the issue involves considering expert medical evidence called by each party.  The Appellant relies on the written and oral evidence of:
  1. (a)
    Dr Kim Bulwinkel, an orthopaedic surgeon;
  1. (b)
    Dr Allan Cook, a specialist orthopaedic consultant;
  1. (c)
    Dr Sandeep Joshi, a medical practitioner at Central Queensland Medical Imaging; and
  1. (d)
    Dr Symon McCallum, a pain medicine specialist.
  1. [22]
    The Respondent relies on the written and oral evidence of:
  1. (a)
    Dr Robert Labrom, a consultant orthopaedic spinal surgeon; and
  1. (b)
    Dr Gregory Day, a spine surgeon.
  1. [23]
    Medical opinion evidence was given about:
  1. (a)
    the nature of the injury suffered by the Appellant; and
  1. (b)
    whether the injury was caused by the Appellant's fall in the workplace.
  1. [24]
    The question of whether a worker has sustained an injury arising out of, or in the course of employment, and whether employment is a significant contributing factor to the injury is a question of mixed law and fact.[3]  It is a matter for the Commission to decide on the basis of evidence.[4]  In reaching that determination, emphasis is ordinarily placed on the opinions of medical practitioners.[5]  However, before expert medical evidence can be of value, the facts on which it is founded must be proved by admissible evidence.[6]
  1. [25]
    The Appellant contends that the Commission should be satisfied that she suffered a desiccation of her L4/5 disc or, if the Commission is not so satisfied, that she suffered a tear of her L5/S1 disc.  The evidence from the medical experts is summarised below.
  1. [26]
    Given my conclusion that the appeal relates only to whether the Appellant has suffered a tear to her L5/S1 disc, the focus must be on so much of the medical opinion evidence as relates to that issue.  However, some of the evidence in relation to the Appellant's L4/5 disc might have a bearing (at least for comparative or contextual purposes) in deciding whether she suffered a tear to her L5/S1 disc and whether that tear was caused by her fall in the workplace.

Medical opinion evidence - the evidence of each doctor

  1. [27]
    Because some doctors considered the reports and opinions of others, it is appropriate to review the evidence of the doctors in chronological order by reference to when they first examined the Appellant or were otherwise engaged in relation to her claim.
  1. [28]
    Dr Kim Bulwinkel:  Dr Bulwinkel examined the Appellant on a number of occasions from 2 September 2010 onwards.  The Appellant consulted him first some months after her fall because her problems were not resolving.  Much of his time and effort was spent trying to establish the principal location of her pain and attempting various types of management.  He viewed MRIs and CT scans of the Appellant. 
  1. [29]
    Dr Bulwinkel gave oral evidence that the MRI of 7 September 2011 showed that the Appellant's lumbosacral spine was generally healthy.  His written notes on 25 November 2010 describe the images on the 2010 MRI as "essentially normal" except at the L4/5 and L5/S1, where some early changes from loss of disc hydration were apparent.
  1. [30]
    In relation to L4/5, Dr Bulwinkel gave evidence that the L4/5 had started to lose disc hydration.  He stated that people lose water from discs with age and that this is a serial, cumulative process.  The condition is regarded as normal degeneration.  Dr Bulwinkel noted that the L4/5 is the part of the spine that is most injured and subject to injury, particularly a compression type of injury involving axial force.  The L5/S1 can also contribute to that injury pattern.
  1. [31]
    Dr Bulwinkel gave evidence that:
  1. (a)
    L4/5 is the level that is most likely to be injured by normal daily activities, including flexion forward when a person is lifting abnormally, because it is the one where there is the greatest amount of twist under load;
  1. (b)
    L5/S1 is much better supported by ligaments from the lateral spine and is less likely to be injured by rotational forces, but more likely to be injured by an axial force (i.e. a compression type of injury).
  1. [32]
    Dr Bulwinkel described the L5/S1 as more protected than the L4/5.  The L5/S1 disc showed "a little bit of internal disturbance of structure."  More importantly, he noted that there was a posterior rim lesion (i.e. horizontal tear) at the Appellant's L5/S1, evident from a little bright signal, which is "pretty much always associated with trauma to a disc."  The Appellant's fall and the axial injury could have been the initiating disruptive force.
  1. [33]
    Dr Bulwinkel agreed that the loss of disc hydration is consistent with ageing.  The degenerative process is a progressive, serial, and cumulative trauma that occurs with the activities of daily living.  However, in the absence of a pre-injury MRI for the Appellant, Dr Bulwinkel could not say with confidence whether the condition was commenced by the Appellant's fall or by ageing.
  1. [34]
    When asked whether the Appellant's employment was a significant contributing factor to the loss of water or desiccation of her L4/5 disc, Dr Bulwinkel said that it "could have been" and that he did not know of any other forces or stresses she had applied to it.  In particular, he stated that he had tried to locate the source of the Appellant's pain, and had eliminated some potential sources.  By that process he had formed the view that a significant contributor to her residual pain was discogenic at L4/L5 or L5/S1, or both.  That was his conclusion, however qualified.
  1. [35]
    The fall that the Appellant described to Dr Bulwinkel was severe enough to produce an S5 fracture.  In his opinion:

"That has to be a pretty decent sort of axial force.  Some of that force would have been dissipated in the fracture, some of it would have to be dissipated within the disc structure and the low lumbar spine."  (T1: 17)

  1. [36]
    After he expressed his opinion that, on the balance of probabilities, there was a cause and effect relationship between the fall and the L4/5 condition, he was asked specifically whether it will be the same for the L5/S1.  Dr Bulwinkel said:

"Very much so and in fact the L5-S1 posterior with disc lesion is very characteristic of the type of injury produced - disc wall injury that will occur with an axial force."  (T1: 17)

  1. [37]
    In his opinion, the fact that there is a remote lesion at L5/S1 means there has been a significant force applied to the bottom lumbar back or spine.  The presence of that lesion made him "lean a little bit towards the fact that the disc above may well have been injured as well."  Having gone through the diagnostic process with the Appellant to eliminate various sources of pain, referred pains from disc wall injury "had to go up the list a bit."  What he saw on the films in 2011 was "consistent with that residual pain."  He could not explain it any other way than to say that discs were "not behaving normally after this event."  The Appellant gave no history of particular problems before the event.  Consequently, he could not come to any other conclusion than that "the axial forces started the processes in the disc wall. …  I don't know what else it could be."  (T1: 21)
  1. [38]
    Dr Gregory Day: Dr Day examined the Appellant on 25 March 2011 in response to a request by WorkCover Queensland for an Independent Medical Examination and Report.  In his report dated 25 March 2011 (Exhibit 7), Dr Day noted a series of radiology reports.  The CT scans on 1 April and 4 May 2010, demonstrated respectively a displaced fracture of the fifth sacral segment and healing of the sacral fracture.  According to Dr Day, the MRI of 31 August 2010 demonstrated a "minimal tear in the posterior aspect of the L5/S1 disc which looked to be within normal limits."  (T2: 2-3)
  1. [39]
    In his oral evidence, he explained that people up to about 24 years of age should have a normal lumbar spine.  After 24 there are age-related changes, which initially would be minimal degeneration within the lumbar disc or perhaps a minimal tear in a disc.  They are part of the ageing process.  The most common levels for early disc degeneration are L4/5 and L5/S1.  The Appellant was 30 years of age.  Dr Day observed that "it sounds as though there's minor degenerative change in the bottom two disks, which is what happens, you know, when you reach age 30, I guess."  (T2: 5)
  1. [40]
    Dr Day gave evidence that a tear of a disc is quite different from a bulge.  A small degenerative tear can be "just from ageing."  An acute tear will appear on an MRI as a white spot, which some experts consider is linked to low back pain.  An old tear will be an off white, grey colour.  So it is possible to determine the age of a tear from an MRI.  A tear can remain a tear for months or years.  When it increases in width (e.g. following a second injury) it could become a bulge, which can then become a disc protrusion.
  1. [41]
    Dr Day did not agree that if an axial force applied to the spine was sufficient to cause an injury to the L5/S1 disc it could also be sufficient to cause an injury to L4/5.  He stated that normally the force applied goes across the path of least resistance.  So it is rare (though not impossible) to have a two level disc problem.[7]  A force sufficient to cause a fracture of the sacrum, would not cause an injury to the L5/S1 disc.  Rather, the next weak point is at T12 and L1.
  1. [42]
    He diagnosed all work-related conditions as "Fracture of the 5th sacral segment.  There may be pain resulting from pre-existing degenerative change in both sacro-iliac joints."  Later in the report he wrote that it was "likely that the heavy fall on to the tail bone fractured the distal sacrum."
  1. [43]
    When asked whether he could express an opinion as to whether that fall caused a tear in the L5/S1 disc, Dr Day said that was an "interesting question."  He answered from first principles.  In summary:
  1. (a)
    there is a natural lordosis (or inward curving) in the lumbar spine as it goes to join the thoracic spine;
  1. (b)
    post-menopausal females who have a significant fall (like that experienced by the Appellant) could have a minor crush fracture of the T12 or L1;[8]
  1. (c)
    to get a tear in a disc it would be necessary to crush the inner part of the disc, and usually that would be seen on an MRI;
  1. (d)
    the usual mechanism of tearing a disc is a rotation of the trunk, with the trunk in a loaded position (e.g., lifting a weight from perhaps half a metre away and twisting at the same time);
  1. (e)
    thus it is less likely that a fall on the sacrum (as experienced by the Appellant) would result in an injury to the L5/S1 disc;
  1. (f)
    given the MRI report on the status of the Appellant's L5/S1 disc, it would be "less likely" that the tear would be the result of trauma.
  1. [44]
    In cross-examination, Dr Day agreed that there can be post-traumatic degenerative change, and that one can never exclude trauma.
  1. [45]
    Dr Sandeep Joshi: Dr Joshi provided the following written report on an MRI of the Appellant's lumbar spine conducted on 7 September 2011 (Exhibit 5).

"Clinical History: Recent disc injury.

Scan Protocol: Sagittal and axial T1 and T2.

Findings: Minimal scoliosis with convexity to the left is noted.  Lordosis and vertebral alignment is preserved. L4/5 disc appears desiccated and reveals preserved height.

No obvious disc herniation or canal/foraminal stenosis is seen.

No obvious annular tear is seen.

Vertebrae reveal preserved height and no obvious focal marrow signal abnormality is seen.

Pre-vertebral and paraspinal soft tissues reveal no significant abnormality.

Conus medullaris appears unremarkable.

CONCLUSION

Desiccated L4/5 disc.

No significant disc herniation.

No obvious annular tear."

  1. [46]
    In his oral evidence, Dr Joshi said that he had seen the MRI scans of 31 August 2010 and 7 September 2011.  Each showed a desiccation of the L4/5, that is, a small loss of water, which he estimated to be about 10-20 per cent.  He referred to that loss as "slight" and described it as within the normal limits for desiccation of a disc.  He described desiccation as a normal part of the disc ageing and, although such loss is more apparent in older age, the amount showing on the MRI here was normal for a person of the Appellant's age.
  1. [47]
    Dr Allan Cook:  Dr Cook examined the Appellant on 1 February 2012.  He also examined a range of medical records in relation to her, reports on CT and MRI scans, and reports of other doctors (including the report of Dr Day dated 25 March 2011). 
  1. [48]
    In his report dated 1 April 2012, Dr Cook wrote in relation to his examination of the Appellant's lumbosacral spine:

"Further examination revealed no report of localised tenderness in the upper or mid-region of the lumbar spine or over the paraspinal muscles on either side.  She did report localised tenderness in the mid-line posteriorly to palpation extending from L4 to S4-5 and over the region of both sacroiliac joints.  She reported pain being reproduced on stressing both sacroiliac joints.  Clinically her hip joints were intact and straight leg raising was in the region of 90 degrees on both sides and neurologically both lower limbs were intact." (Exhibit 4)

  1. [49]
    In that report, Dr Cook described following investigations:
  1. (a)
    a CT scan on 1 April 2010 confirmed the fracture of the S5 vertebrae in the distal sacrum;
  1. (b)
    a CT scan of the sacrum and coccyx on 4 May 2010 showed early healing of the fracture;
  1. (c)
    a CT scan of the sacrum on 23 August 2010 showed that the fracture of the S5 vertebra appeared to be united with some mild deformity, but no other abnormality was noted;
  1. (d)
    an MRI on 31 August 2010 showed a normal lumbar lordosis with intact vertebral bodies throughout the whole extent of the lumbar spine and only "very minimal desiccation" of the intervertebral disc at L4-5, whereas "all the other intervertebral discs appear to have normal hydration on the T2 weighted sequence" and "no posterior disc prolapse or prominence is noted at any level throughout the lumbar spine;"
  1. (e)
    a radio nuclear bone scan on 23 September 2010 showed "possible mild increased uptake in the sacroiliac joints" but the uptake through the rest of the hips, pelvis and spine appeared to be "within normal limits;"
  1. (f)
    an MRI scan on 7 September 2011 appeared to be "essentially the same" as the previous MRI scan, although "the desiccation at the L4-5 intervertebral disc appears to be a little worst (sic) but again there is no disc prolapse at any level."
  1. [50]
    Dr Cook's diagnosis was that the Appellant sustained the following injuries as a result of the incident on 13 March 2010:

"1. A fracture of the S5 vertebral body with displacement and some comminution.

  1.  Soft tissue injury to one or other or both of the sacroiliac joints.
  1.  Possible injury to the L4-5 intervertebral disc resulting in discogenic pain."

He felt that the diagnosis was consistent with the history as given to him by the Appellant.

  1. [51]
    In his oral evidence, Dr Cook described the injury to the L4/5 disc as a musculoligamentous injury and/or a soft tissue injury.
  1. [52]
    Dr Cook also expressed the following opinions in his written report, some of which were confirmed or amplified in his oral evidence:
  1. (a)
    the CT scan carried out on 1 April 2010 "confirms a somewhat comminuted and displaced fracture of the vertebral body of S5 and this fracture also appears to extend into the sacrococcygeal joint," and subsequent CT scans in May and August 2010 confirmed that the fracture of the S5 vertebra had "progressed to bony union but with mild deformity;"
  1. (b)
    the MRI scan carried out on 31 August 2010 showed "essentially normal hydration of all the intervertebral discs throughout the lumbar spine with no posterior disc prolapse or prominence apart from what possibly is a very mild or minimal desiccation of the L4-5 intervertebral disc whereas all the other intervertebral discs have normal hydration on the T2 weighted sequence;"
  1. (c)
    Dr Cook stated that desiccation could be age-related or could occur after trauma or surgery, and that age related desiccation usually starts at the L5/S1 which carries the maximum load and pressure;
  1. (d)
    given that the MRI scan was carried out about 5 ½ months after the injury, there had been time for the very earliest changes of desiccation to develop secondary to injury to the L4/5 intervertebral disc;
  1. (e)
    the MRI scan carried out on 7 September 2011 (more than a year later) appeared to be unchanged when compared to the MRI scan of 31 August 2010, except that the desiccation of the L4/5 intervertebral disc "now seems to be a little worse whereas none of the other intervertebral discs show any change when these two scans are compared;"
  1. (f)
    Dr Cook "felt that it is more likely than not that [the Appellant] suffered a soft tissue injury and especially to the L4-5 intervertebral disc as a result of her fall" on 13 March 2010;
  1. (g)
    the two MRI scans show the "onset and progression of desiccation of the L4-5 intervertebral disc consistent with the degeneration secondary to injury," in other words, the desiccation got worse over the one-year interval and that was consistent with the Appellant suffering an injury involving a "very large force" sufficient to break the S5 vertebra;
  1. (h)
    if the L4-5 intervertebral disc desiccation was age-related, it would have already been present on the MRI scan carried out on 31 August 2010 and (because such degeneration occurs slowly) would not have progressed significantly over one year;
  1. (i)
    following a generalised musculoligamentous injury and/or soft tissue injury to the lumbosacral spine (L4-5), it is normally expected or anticipated that improvement can go on for up to two years post-injury, but any symptoms that are still present after two years would be considered permanent and unlikely to improve over time and, on that basis, the Appellant's condition could be considered to be "stable and static."
  1. [53]
    Dr Cook noted that a disc bulge was not the same as a disc tear, which is not normal.  A tear can be associated with degeneration.  The Appellant's L5/S1 looked perfectly intact and had no tear.  Consequently, Dr Cook disagreed with Dr Day's opinion that the MRI of 31 August 2010 demonstrated a "minimal tear in the posterior aspect of the L5/S1 disc which looked to be within normal limits."
  1. [54]
    On 4 August 2014, Dr Cook confirmed a record of a telephone discussion he had with Steve Herd of MurphySchmidt solicitors which included statements that:
  1. (a)
    it is more likely than not that the Appellant suffered a soft tissue injury, especially to the L4/5 intervertebral disc as a result of her fall on 13 March 2010; and
  1. (b)
    her fall was a significant contributing factor to the injury to her L4/5 intervertebral disc.
  1. [55]
    Dr Robert Labrom: Dr Labrom examined the Appellant on 8 March 2012.  He prepared a written report dated 26 March 2012 and a supplementary report dated 13 October 2014, which together were Exhibit 8.
  1. [56]
    On the MRI scan of 31 August 2010 Dr Labrom observed a "small bulging L5-S1 disc" which he described as within "normal limits," an expression which he explained in oral evidence meant that the bulge was physiologically acceptable or normal for a person of the Appellant's age.  In his written report he stated that the Appellant may also have some early lumbar disc bulging which is secondary to her poor abdominal musculature and general core muscle strength conditioning, and which also relates to other components that do not relate to her work-related activity or injury.
  1. [57]
    Dr Labrom noted that a disc bulge is different from a ruptured, or sequestrated, herniated type disc, and that it had no clinical relevance.  Although a tear cannot be normal, lots of degenerative discs have small annular tears that remain asymptomatic but can be detected on MRI scans.  The MRIs do not show a disc prolapse or herniation.  There was no evidence of a tear.
  1. [58]
    Dr Labrom gave oral evidence about degeneration which occurs after skeletal maturity (around 18 years of age).  Such degeneration can occur when a person is in their 20s or 30s.  It more commonly commences at L5/S1 or L4/5, and tends to go one before another up the spine unless affected by a traumatic event.
  1. [59]
    Much of his evidence concerned the L4/5 rather than L5/S1.  Dr Labrom disagreed with Dr Cook's opinion that there was musculoligamentous strain injury to L4/5 because, he explained, a disc is a shock absorber between two vertebrae.  Although muscle and ligament strain or sprain was very real and probable in this case, the fall would not cause desiccation of a disc.  In this case, the Appellant had fallen on her tailbone.  The sacrum at the end of the tailbone had fractured as that bone took the compressive load.  In his opinion, it is unlikely that the L4/5 would be injured by such a fall because the L4/5 is adjacent to the L5/S1.
  1. [60]
    Indeed, it was his "strong opinion" that there had been "no particular injury to that L4/5 disc."  The mechanism of injury would have had to have been significantly more forceful and probably with a rotational or twisting component.
  1. [61]
    He noted that the MRI of 7 September 2011 (which he could not confirm he had seen) showed a desiccated L4/5.  As far as he was aware, there was no significant difference at L4/5 (or L5/S1) shown on the two MRIs more than one year apart.  Such loss of water content, or dehydration, is part of the normal ageing processes.  In his opinion, a fall would not cause desiccation.  A fall might cause a rupture to a disc, a fracture or dislocation of the spinal column, a tear, prolapse or a herniation of disc material, but would not cause desiccation.  Water and collagen content is typically related to constitutional and age-related changes at a particular disc.
  1. [62]
    In cross-examination, Dr Labrom accepted that degeneration can be a result of external force.  More specifically, an axial force to fracture the S5 might lead to degeneration around the site of the fracture and possibly adjacent joints.  However, the spinal column is attached to the sacrum via the L5/S1.  The L4/5 sits above that.
  1. [63]
    In his opinion, the desiccation of the Appellant's L4/5 was consistent with the Appellant's age and was within normal limits.  It was not related to the incident on the 13 March 2010.
  1. [64]
    Dr Symon McCallum: Dr McCallum's report dated 30 November 2012 (Exhibit 3) was admitted into evidence by consent.  He was not called to give oral evidence. Dr McCallum wrote:

"I note the CT which is normal.  The MRI shows desiccated L4/5.  I note the SPECT scan which shows possible sacroiliac joint arthritis and a fracture at S5."

Assessing the medical opinion evidence

  1. [65]
    The approach:  In cases where there is an issue about whether to rely on expert medical opinion evidence, or to choose between the differing opinions, there is judicial authority for the following propositions:
  1. (a)
    the tribunal of fact can be assisted by expert medical opinion evidence, but must weigh and determine the probabilities as to the cause of an ailment or injury having regard to the whole of the evidence;[9]
  1. (b)
    the tribunal's duty is to find ultimate facts and, so far as it is reasonably possible to do so, to look not merely at the expertise of the expert witness, but to examine the substance of the opinion expressed and (where experts differ) to apply logic and common sense to the best of its ability in deciding which view is to be preferred or which parts of the evidence are to be accepted;[10]
  1. (c)
    only when medical science denies that there is a connection between, for example, certain events and a person's death can a judge not act as if there were a connection; but if medical science is prepared to say that it is a possible view, then the judge after examining the lay evidence can decide that it is probable;[11]
  1. (d)
    the issue will not be resolved by counting witnesses;[12]
  1. (e)
    the finding could be described as one based on the credibility of expert witnesses, having regard to such things as whether the witnesses display signs of partisanship in the witness box or lack of objectivity, and whether they make proper concessions to the viewpoint of the other side;[13]
  1. (f)
    distinctions may be drawn on the basis of demeanour (a limited ground where experts are under consideration); qualifications, impressiveness and cogency of reasoning and exposition of reasoning; preparation for, and application to, the problem in hand; and the extent to which the witness had a correct grasp of basic, objective facts relevant to the problem;[14] and
  1. (g)
    if it is open to the tribunal to prefer one body of evidence to the other on grounds fairly discerned, the tribunal should express its reasoned preference.[15]
  1. [66]
    The Appellant's written submissions referred to a number of other decisions which also support the propositions that:
  1. (a)
    the matter is essentially one of degree, and evidence of epidemiological studies is circumstantial evidence which may, alone, or in combination with other evidence, establish causation in a specific case;
  1. (b)
    the fact that experts do not infer causation on the balance of probabilities does not mean that a court may not, and a finding of causal connection may be made even when the expert evidence does not rise above the possible, the question being whether the evidence as a whole establishes causation on the balance of probabilities.[16]
  1. [67]
    In applying those propositions in the present case, it is also necessary to remember that these proceedings are conducted as a hearing de novo and the Appellant bears the onus of proof on the balance of probabilities.[17]
  1. [68]
    Although the onus to be discharged is on the balance of probabilities, the Commission must feel an actual persuasion before the alleged facts can be found to exist.  The mere possibility of an appellant suffering an injury on mere conjecture is not enough. Inference must be carefully distinguished from conjecture or speculation.  There can be no inference unless there are objective facts from which to infer the other facts which it is sought to establish.  It is not necessary, however, for an appellant to prove every fact or conclusion of fact upon which the issue depends.  Legitimate and reasonable inferences can be drawn.[18]
  1. [69]
    While there is room for intuitive reasoning when determining whether a worker has suffered an injury within the meaning of the Act, in the process of determining that question of fact, the Commission cannot substitute speculation for satisfaction on the balance of probabilities.[19]
  1. [70]
    Appellant's submissions:  The Appellant submits that if it is found that there is a tear to the L5/S1 disc and that this is the appropriate injury (or part of it), it is submitted that this injury cannot be normal.  All doctors have confirmed that anatomically speaking, a tear is not normal.  Dr Day has suggested that the tear is age related.  However, that is in contrast to the evidence of Dr Bulwinkel, and Dr Day had not reviewed the 7 September 2011 scan.
  1. [71]
    In the Appellant's submissions, the evidence of Dr Bulwinkel should be preferred because he is the treating orthopaedic surgeon, he has had the most involvement with the Appellant, and he had seen the most recent scan of 7 September 2011.
  1. [72]
    On the evidence before the Commission, given the preponderance of opinion from other medical specialists, the opinion expressed by Dr Labrom in relation to a "small bulging L5/S1 disc" cannot be correct.
  1. [73]
    Dr Bulwinkel also opined that, on the balance of probabilities, the injuries to the L4/5 and L5/S1 intervertebral discs were also caused by the axial force applied to the spine of the Appellant in the fall.
  1. [74]
    The Appellant submits that:
  1. (a)
    all of the evidence indicates that there has been a trauma and injury to at least one disc in her back;
  1. (b)
    the issue is whether or not the damage to the disc is within "normal limits;"
  1. (c)
    the preferred evidence was that, on the balance of probabilities, the condition of either or both of the discs was caused by the axial force that was applied to the spine;
  1. (d)
    the overwhelming evidence before the Commission is that her employment is a significant contributing factor to the injury she has sustained;

and hence she has established her case to the requisite standard of proof and is entitled to succeed in the appeal.

  1. [75]
    Respondent's submissions:  In reply, the Respondent submits that the Appellant's claim must be rejected as there is no evidence supporting her claimed injury, that is, there is no evidence that the Appellant has sustained a tear of the L5/S1 disc as a result of the subject fall.  In support of that submission, the Respondent notes that:
  1. (a)
    Dr Bulwinkel expressed the view that the Appellant may have sustained an injury to her L5/S1 disc, although he did not describe that injury as being a "tear;"
  1. (b)
    Dr Bulwinkel said that the disks which have most pressure on them are the L4/5 and L5/S1, where most of the bending occurs;
  1. (c)
    Dr Day's view of the radiological evidence is that the MRI on 31 August 2010 demonstrated a minimal tear in the posterior aspect of the L5/S1 disc, which looked to be within normal limits;
  1. (d)
    Dr Day did not diagnose the Appellant as having sustained a tear of the L5/S1 disc as a result of the work incident and that opinion was not changed in the evidence that he gave;
  1. (e)
    Dr Day's evidence was that the Appellant suffered a fracture of the fifth sacral segment and that it is likely that the "heavy fall" on to her tail bone fractured the distal sacrum - a view that is not disputed in any of the evidence;
  1. (f)
    having reviewed 29 documents including the MRI scans which were the subject of the evidence before the Commission, Dr Labrom expressed the opinion that the MRI scan performed on 31 August 2010 confirms a small bulging L5/S1 disc which he thought was within normal limits;
  1. (g)
    Dr Labrom diagnosed an acute fracture of the fifth sacral segment and did not diagnose a tear of the L5/S1 disc;
  1. (h)
    Dr Labrom expressed the opinion that the Appellant has sustained an acute fracture of the fifth sacral segment in the subject accident - which opinion is not controversial;
  1. (i)
    Although he was an unimpressive witness, Dr Cook did not diagnose the Appellant as having sustained a tear of the L5/S1 disc - indeed he was adamant that she did not sustain an injury to her L5/S1 disc - and he did not accept that there was any abnormality shown, whether it was within normal limits or otherwise;
  1. (j)
    Dr Joshi gave evidence that both MRIs were normal;
  1. (k)
    Dr McCallum's opinion as a pain medicine specialist was that the Appellant had neuropathic pain persisting from a sacral fracture, which could still be sacroiliac joint related, and he did not diagnose the Appellant as having sustained a tear of the L5/S1 disc as a result of the work incident.
  1. [76]
    Further, the Respondent submits that any evidence that might be favourable for the Appellant proves no more than a possibility that there is some contribution from the event.  That is not sufficient to discharge the burden of proof that the Appellant carries.  Accordingly, her claim for that injury must be rejected.

Consideration and conclusion

  1. [77]
    As noted earlier, the only issues to be decided in this case are whether:
  1. (a)
    the Appellant suffered a tear to her L5/S1 disc;
  1. (b)
    if she suffered such a tear, the injury arose out of, or in the course of, her employment; and
  1. (c)
    her employment was a significant contributing factor to that injury.
  1. [78]
    Injury:  The evidence as to whether the Appellant suffered a tear at the L5/S1 is sparse.  It comprises:
  1. (a)
    Dr Bulwinkel's reference to a rim lesion (i.e. horizontal tear) at the Appellant's L5/S1 which showed a disturbance of structure, and which was evident from a little bright signal;
  1. (b)
    Dr Day's evidence that the MRI of 31 August 2010 demonstrated a "minimal tear in the posterior aspect of the L5/S1 disc which looked to be within normal limits" and which he described as minor degenerative change which is age related;
  1. (c)
    Dr Day's evidence that an acute tear would appear on an MRI as a white spot, which some experts consider is linked to low back pain.
  1. [79]
    In relation to that evidence, I note that the Dr Bulwinkel also described the images on the MRI of 7 September 2011 as "essentially normal" except at the L4/5 and L5/S1 where some early changes from loss of disc hydration were apparent.
  1. [80]
    On the other hand:
  1. (a)
    Dr Joshi saw "no obvious annular tear" on the MRI of 7 September 2011 and, although he referred to features of the L4/5 disc, he did not refer to the Appellant's L5/S1;
  1. (b)
    Dr Cook gave evidence that the Appellant's L5/S1 looked perfectly intact and had no tear (and he expressly disagreed with Dr Day's opinion);
  1. (c)
    Dr Labrom saw no evidence of a tear but observed a "small bulging L5/S1 disc" which he described as within normal limits for a person of the Appellant's age;
  1. (d)
    Dr McCallum's report made no reference to the Appellant's L5/S1.
  1. [81]
    Although Dr Bulwinkel has, by process of elimination, come to the view that a significant contributor to the Appellant's residual pain was discogenic at L4/L5 or L5/S1, or both, that does not establish that she has a tear at the L5/S1.
  1. [82]
    It seems unusual that suitably qualified doctors who saw an MRI would have missed seeing signs of a tear.  However, given the evidence of Dr Bulwinkel and Dr Day about how a tear is indicated on MRI imaging, I accept that there was MRI evidence of a tear.  I note that Dr Day described the tear as "minimal" and within normal limits.
  1. [83]
    Having considered that evidence I am satisfied on the balance of probabilities that the Appellant suffered a tear at the L5/S1.
  1. [84]
    Appellant's employment and injury:  Whether that injury arose out of, or in the course of the Appellant's employment, is to be answered by whether the injury arose out of her fall on 13 March 2010.  There are different medical opinions as to what might have caused the condition at the Appellant's L5/S1.
  1. [85]
    The bulk of the evidence was to the effect that the Appellant, at age 30, would be expected to have some disc degeneration.  The loss of some disc hydration usually commences in adulthood, and is a slow, progressive, serial, cumulative process that occurs with the activities of daily living.  Disc degeneration usually starts at L5/S1 and L4/5 and progresses up the spine.  Although such disc degeneration is usually age-related, it could occur after trauma or surgery.
  1. [86]
    The evidence in support of the Appellant's case was from Dr Bulwinkel that:
  1. (a)
    although the L5/S1 is more protected and much better supported (than the L4/5 level) and is less likely to be injured by rotational forces, it is more likely to be injured by an axial force (i.e., a compression type of injury);
  1. (b)
    a rim lesion at the Appellant's L5/S1 showed a disturbance of structure that is usually associated with trauma to a disc, hence the Appellant's fall and the axial injury could have been the initiating disruptive force;
  1. (c)
    the L5/S1 posterior with disc lesion is characteristic of the type of injury that will occur with an axial force, and the presence of such a lesion meant that there has been a significant force applied to the bottom lumbar back or spine.

Dr Labrom also gave evidence that a fall might cause, among other things, a tear of disc material.

  1. [87]
    Dr Bulwinkel's opinion evidence was qualified because, in the absence of a pre-injury MRI for the Appellant, he could not say with confidence whether the condition was commenced by the Appellant's fall or by ageing.
  1. [88]
    On the other hand, Dr Day gave evidence that:
  1. (a)
    the minimal tear at L5/S1 was a minor degenerative change that was age‑related and looked to be within normal limits;
  1. (b)
    a force sufficient to cause a fracture of the sacrum would not cause an injury to the L5/S1 disc;
  1. (c)
    to get a tear in the disc it would be necessary to crush the inner part of the disc, and usually that would be seen on an MRI;
  1. (d)
    the usual mechanism of tearing a disc is a rotation of the trunk, with the trunk in a loaded position;
  1. (e)
    after a process of analysis working from first principles, it was less likely that a fall on the sacrum would result in an injury to the L5/S1 disc and, given the MRI report on the status of the Appellant's L5/S1 disc, it would be "less likely" that the tear would be the result of trauma.
  1. [89]
    Dr Labrom gave evidence (albeit in relation to the L4/5) that the mechanism of injury would have had to have been significantly more forceful and probably with a rotational or twisting component.  He also said that a lot of degenerative discs have small annular tears that remain detectable on an MRI scan and are completely asymptomatic.
  1. [90]
    Dr Cook gave evidence that a tear can be associated with degeneration.
  1. [91]
    Having considered that evidence, I am not satisfied that the state of the Appellant's L5/S1 arose out of or was caused by her fall on 13 March 2010.  In other words, she has not proved on the balance of probabilities that the tear to her L5/S1 disc arose out of, or in the course of, her employment.  Consequently, I do not have to consider whether her employment was a significant contributing factor to her injury.

 Orders

  1. [92]
    It follows from the conclusions that I have reached that:
  1. (a)
    the appeal is dismissed;
  1. (b)
    the decision of the Respondent of 7 February 2014 is confirmed; and
  1. (c)
    the Appellant is to pay the Respondent's costs of and incidental to this appeal to be agreed or, failing agreement, to be the subject of a further application to the Commission.
  1. [93]
    Order accordingly.

Footnotes

[1] See the evidence of Dr Cook at [51], [52](i).

[2] See Rossmuller v Q-COMP (C/2009/36) - Decision [2].

[3] Workcover Queensland v BHP (Qld) Workers' Compensation Unit (2002) 170 QGIG 142; Sutherland v Q‑COMP (2009) 190 QGIG 106, 110; Theresa Helen Ward v Q-COMP (C/2011/39) - decision , [3].

[4] Davidson v Blackwood [2014] ICQ 008, [17], [19] (Martin J).

[5] Q-COMP v Darren Bruce Parsons (2007) 185 QGIG 1, 3.

[6] Coombes v Q-COMP (2007) 185 QGIG 331, 334-5 (Edwards C); Blackwood v Mana [2014] ICQ 027, [13] (Martin J).

[7] He thought that 95% of the thousands of disc protrusions he had treated were single level.

[8] Known as a "grandma fracture."

[9] Ramsay v Watson (1961) 108 CLR 642, 645 (Dixon CJ, McTiernan, Kitto, Taylor and Windeyer JJ); see also Adelaide Stevedoring Company Ltd v Forst (1940) 64 CLR 538, 563-4 (Rich ACJ); Chattin v WorkCover Queensland (1999) 161 QGIG 531, 532-3 (Williams P), quoting Obstoj v Van de Loos (Unreported, Supreme Court of Queensland, Connolly J, 16 April 1987).

[10] Holtman v Sampson [1985] 2 Qd R 472, 474 (DM Campbell, Macrossan and Thomas JJ).

[11] Commissioner of Police v David Rea [2008] NSWCA 199, [8] (Handley AJA, with whom Allsop P and Johnson J agreed), quoting EMI (Australia) Limited v Bes (1970) 44 WCR 114, 119 (Herron CJ); see also Chattin v WorkCover Queensland (1999) 161 QGIG 531, 532 (Williams P), quoting Fernandez v Tubemakers of Australia Ltd [1975] 2 NSWLR 190, 199-200 (Mahoney JA).

[12] Monroe Australia v Campbell (1995) 65 SASR 16, 27 (Bollen J), quoting Sotiroulis v Kosac (1978) 80 LSJS 112 (Wells J).

[13] Holtman v Sampson [1985] 2 Qd R 472, 474 (DM Campbell, Macrossan and Thomas JJ), quoting Joyce v Yeomans [1981] 1 WLR 549, [1981] 2 All ER 21, 27, (Brandon LJ).

[14] Monroe Australia v Campbell (1995) 65 SASR 16, 27 (Bollen J), quoting Sotiroulis v Kosac (1978) 80 LSJS 112 (Wells J).

[15] Monroe Australia v Campbell (1995) 65 SASR 16, 27 (Bollen J), quoting Sotiroulis v Kosac (1978) 80 LSJS 112 (Wells J).

[16] Sydney South West Area Health Service v Stamoulis [2009] NSWCA 153, [137]-[139] (Ipp JA, with whom Beazley and Giles JJA agreed), citing Seltsam Pty Ltd v McGuiness [2000] NSWCA 29; (2000) 49 NSWLR 262; EMI Australia Ltd v BES [1970] 2 NSWR 238, 242; Fernandez v Tubemakers of Australia [1075] 2 NSWLR 190, 239-240.  See also Tabet v Gett [2010] HCA 12, (2010) 240 CLR 537, [111]-[113] (Kiefel J with whom Hayne, Crennan and Bell JJ agreed).

[17] Rossmuller v Q-COMP (C/2009/36) - decision http://www.qirc.qld.gov.au, [2]; State of Queensland (Queensland Health) v Q-Comp and Beverley Coyne (2003) 172 QGIG 1447; Qantas Airways Limited v QComp (2006) 181 QGIG 301.

[18] See MacArthur v WorkCover Queensland [2001] QIC 21; (2001) 167 QGIG 100, 101 (Hall P) and cases cited.

[19] Nilsson v Q-Comp (2008) 189 QGIG 523, 526 (Hall P).

Close

Editorial Notes

  • Published Case Name:

    Fowler v Workers' Compensation Regulator

  • Shortened Case Name:

    Fowler v Workers' Compensation Regulator

  • MNC:

    [2016] QIRC 48

  • Court:

    QIRC

  • Judge(s):

    Neate IC

  • Date:

    28 Apr 2016

Appeal Status

Please note, appeal data is presently unavailable for this judgment. This judgment may have been the subject of an appeal.

Cases Cited

Case NameFull CitationFrequency
Adelaide Stevedoring Co Ltd v Forst (1940) 64 CLR 538
2 citations
Jump To
Cite 1 - (1940) 64 CLR 538
Cite 2 - (1940) 64 CLR 538
Blackwood v Mana [2014] ICQ 27
2 citations
Jump To
Cite 1 - [2014] ICQ 27
Cite 2 - [2014] ICQ 27
Chattin v WorkCover Queensland (1999) 161 QGIG 531
3 citations
Jump To
Cite 1 - (1999) 161 QGIG 531
Cite 2 - (1999) 161 QGIG 531
Cite 3 - (1999) 161 QGIG 531
Commissioner of Police v David Rea (2008) NSWCA 199
2 citations
Jump To
Cite 1 - (2008) NSWCA 199
Cite 2 - (2008) NSWCA 199
Coombes v Q-Comp (2007) 185 QGIG 331
2 citations
Jump To
Cite 1 - (2007) 185 QGIG 331
Cite 2 - (2007) 185 QGIG 331
Davidson v Blackwood [2014] ICQ 8
2 citations
Jump To
Cite 1 - [2014] ICQ 8
Cite 2 - [2014] ICQ 8
EMI (Australia) Limited v Bes (1970) 44 WCR 114
2 citations
Jump To
Cite 1 - (1970) 44 WCR 114
Cite 2 - (1970) 44 WCR 114
EMI (Australia) Ltd -v- BES (1970) 2 NSWR 238
2 citations
Jump To
Cite 1 - (1970) 2 NSWR 238
Cite 2 - (1970) 2 NSWR 238
Fernandez v Tubemakers of Australia (1975) 2 NSWLR 190
2 citations
Jump To
Cite 1 - (1975) 2 NSWLR 190
Cite 2 - (1975) 2 NSWLR 190
Holtman v Sampson [1985] 2 Qd R 472
3 citations
Jump To
Cite 1 - [1985] 2 Qd R 472
Cite 2 - [1985] 2 Qd R 472
Cite 3 - [1985] 2 Qd R 472
Joyce v Yeomans [1981] 1 WLR 549
2 citations
Jump To
Cite 1 - [1981] 1 WLR 549
Cite 2 - [1981] 1 WLR 549
Joyce v Yeomans [1981] 2 All E.R. 21
2 citations
Jump To
Cite 1 - [1981] 2 All E.R. 21
Cite 2 - [1981] 2 All E.R. 21
MacArthur v WorkCover Queensland (2001) 167 QGIG 100
2 citations
Jump To
Cite 1 - (2001) 167 QGIG 100
Cite 2 - (2001) 167 QGIG 100
MacArthur v WorkCover Queensland [2001] QIC 21
2 citations
Jump To
Cite 1 - [2001] QIC 21
Cite 2 - [2001] QIC 21
Monroe Australia Pty Ltd v Campbell (1995) 65 SASR 16
4 citations
Jump To
Cite 1 - (1995) 65 SASR 16
Cite 2 - (1995) 65 SASR 16
Cite 3 - (1995) 65 SASR 16
Cite 4 - (1995) 65 SASR 16
Nilsson v Q-Comp (2008) 189 QGIG 523
2 citations
Jump To
Cite 1 - (2008) 189 QGIG 523
Cite 2 - (2008) 189 QGIG 523
Q-COMP v Parsons [2007] 185 QGIG 1
2 citations
Jump To
Cite 1 - [2007] 185 QGIG 1
Cite 2 - [2007] 185 QGIG 1
Qantas Airways Limited v Q-COMP (2006) 181 QGIG 301
2 citations
Jump To
Cite 1 - (2006) 181 QGIG 301
Cite 2 - (2006) 181 QGIG 301
Ramsay v Watson (1961) 108 CLR 642
2 citations
Jump To
Cite 1 - (1961) 108 CLR 642
Cite 2 - (1961) 108 CLR 642
Seltsam Pty Ltd v McGuiness [2000] NSWCA 29
2 citations
Jump To
Cite 1 - [2000] NSWCA 29
Cite 2 - [2000] NSWCA 29
Seltsam Pty Ltd v McGuiness (2000) 49 NSWLR 262
2 citations
Jump To
Cite 1 - (2000) 49 NSWLR 262
Cite 2 - (2000) 49 NSWLR 262
Sotiroulis v Kosac (1978) 80 LSJS 112
4 citations
Jump To
Cite 1 - (1978) 80 LSJS 112
Cite 2 - (1978) 80 LSJS 112
Cite 3 - (1978) 80 LSJS 112
Cite 4 - (1978) 80 LSJS 112
State of Queensland v Q-COMP and Beverley Coyne (2003) 172 QGIG 1447
2 citations
Jump To
Cite 1 - (2003) 172 QGIG 1447
Cite 2 - (2003) 172 QGIG 1447
Sutherland v Q-Comp (2009) 190 QGIG 106
2 citations
Jump To
Cite 1 - (2009) 190 QGIG 106
Cite 2 - (2009) 190 QGIG 106
Sydney South West Area Health Service v Stamoulis [2009] NSWCA 153
2 citations
Jump To
Cite 1 - [2009] NSWCA 153
Cite 2 - [2009] NSWCA 153
Tabet v Gett [2010] HCA 12
2 citations
Jump To
Cite 1 - [2010] HCA 12
Cite 2 - [2010] HCA 12
Tabet v Gett (2010) 240 CLR 537
2 citations
Jump To
Cite 1 - (2010) 240 CLR 537
Cite 2 - (2010) 240 CLR 537
Workcover Queensland v BHP (Qld) Workers' Compensation Unit (2002) 170 QGIG 142
2 citations
Jump To
Cite 1 - (2002) 170 QGIG 142
Cite 2 - (2002) 170 QGIG 142

Cases Citing

No judgments on Queensland Judgments cite this judgment.

1

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