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  4. Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator - [2018] QIRC 49

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Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator[2018] QIRC 49

Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator[2018] QIRC 49

QUEENSLAND INDUSTRIAL RELATIONS COMMISSION

CITATION:

Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator [2018] QIRC 049

PARTIES:

Ellison, Shirley

(Appellant)

and

Ellison, Shirley (as the Executrix of the Estate of the late Eric Ellison)

(Appellant)

v

the Workers' Compensation Regulator

(Respondent)

CASE NOS:

WC/2016/89

WC/2016/90

PROCEEDING:

Appeals against decisions of the Workers' Compensation Regulator

DELIVERED ON:

23 April 2018

HEARING DATES:

13 and 14 February 2017

9 May 2017

9 and 10 November 2017

12 February 2018

MEMBER:

HEARD AT:

Industrial Commissioner Fisher

Brisbane

ORDERS:

WC/2016/89

  1. The appeal is dismissed.
  2. The decision of the Regulator is confirmed.
  3. The Appellant is to pay the costs of and incidental to the appeal.  Failing agreement, liberty to apply is granted.

WC/2016/90

  1. The appeal is allowed.
  2. The decision of the Regulator is set aside and substituted with another decision that the Application for Compensation No S14NG223520 is one for acceptance.
  3. The Regulator is to pay the costs of and incidental to the appeal.

CATCHWORDS:

WORKERS' COMPENSATION - APPEAL AGAINST DECISION - where application for dependency - where multiple health conditions - whether death resulted from an aggravation of the major depressive disorder - whether major depressive disorder in remission - where aggravation of major depressive disorder was one contributing factor to death - whether injury includes death from an aggravation of a psychiatric or psychological disorder

WORKERS' COMPENSATION - APPEAL AGAINST DECISION - where claimant suffered from a work related injury being pleural plaques - whether aggravation of psychiatric disorder -  whether employment was the major significant contributing factor to the aggravation of the personal injury being a major depressive disorder - whether anticipation of the results of a bronchoscopy was the major significant contributing factor to the aggravation of the major depressive disorder

LEGISLATION:

CASES:

Workers' Compensation Act 2003, s 32

Veronica Mary Omanski v Q-COMP (C/2012/34) - Decision http://www.qirc.qld.gov.au

Simon Blackwood (Workers’ Compensation Regulator) v Mahaffey [2016] ICQ 10

APPEARANCES:

Mr M. Grant-Taylor, QC instructed by vbr Lawyers for the Appellants.

Mr S. McLeod, Counsel directly instructed by the Workers' Compensation Regulator for the Respondent.

Reasons for Decision

  1. [1]
    Mr Ellison had a workers' compensation claim accepted by WorkCover Queensland on 25 June 2012.  Three further applications for workers' compensation were made in 2015.  Of relevance to these proceedings are the application concerning the dependency of Mrs Ellison and the application for major depressive disorder secondary to asbestos disease.  The decisions in these applications both in the first instance by Work Cover Queensland and on review by the Workers' Compensation Regulator were adverse to the Appellant.
  1. [2]
    Each decision of the Regulator was appealed to the Queensland Industrial Relations Commission.  The appeals were heard together.  Case No WC/2016/89 is the appeal against the dependency decision and Case No WC/2016/90 is the appeal against the decision on the second application.  The Regulator was of the view that were the appeal in relation to second application to be successful, the dependency application should be returned to the Regulator for determination.  In this regard its submissions only concerned WC/2016/90.  However, as the appeals unfolded, the determination to be made by the Commission was whether Mr Ellison's death was from an aggravation of his major depressive disorder, which is the issue to be determined in WC/2016/89, before dependency can be determined.  The submissions made by the Regulator in WC/2016/90 have been considered in determining the other appeal.
  1. [3]
    The hearing of the appeals commenced in February 2017 and was adjourned to allow the Psychiatrist called by the Regulator to consider health records which had not previously been disclosed to her or the Regulator.  The hearing was unable to be resumed until 12 months later due to unforeseen circumstances.

Brief Facts

  1. [4]
    From 2 February 1978 to 8 November 1979, the deceased was employed by James Hardie as a labourer at its asbestos factory at Meeandah, Brisbane.
  1. [5]
    On 25 June 2012, WorkCover Queensland accepted Mr Ellison's claim for "bilateral calcified pleural plaques and right upper zone pleuroparenchymal fibrotic changes".
  1. [6]
    Mr Ellison's General Practitioner was Dr Maria Belina, Helensvale Surgery who had referred him for opinion and treatment to Dr Rob Nickels, Respiratory Physician.  Dr Belina referred Mr Ellison to Dr Nickels again on 4 November 2014 because of ongoing weight loss.
  1. [7]
    Mr Ellison, in company with his wife, consulted Dr Nickels on 24 November 2014 who recommended a bronchoscopy be performed.
  1. [8]
    Mr Ellison underwent the bronchoscopy on 1 December 2014.
  1. [9]
    Mr Ellison was admitted to the Robina Hospital on 22 January 2015 and was transferred to the Carrara Health Centre in March.
  1. [10]
    On 19 March 2015, Mr Ellison made an application for compensation for major depressive episode secondary to asbestos disease.
  1. [11]
    Mr Ellison passed away on 22 March 2015.
  1. [12]
    Mrs Ellison as the Executrix of the Estate made an application for dependency on 21 September 2015.

WC/2016/90

  1. [13]
    This is the appeal against the first claim which was rejected by the Regulator although it has the later case number.  It must be determined before the dependency application.
  1. [14]
    The Appellant submits that WC90 only deals with whether Mr Ellison suffered an aggravation of a psychiatric disorder, viz., a major depressive disorder, pursuant to s 32(3)(ba) of the Workers' Complexation and Rehabilitation Act 2003.  Thus, the issue for determination in this appeal is whether employment was the major significant contributing factor to the aggravation of the personal injury being a major depressive disorder.
  1. [15]
    The Appellant contends that Mr Ellison sustained an aggravation to his major depressive disorder as a result of the bronchoscopy or in anticipation of those results.  That he sustained such an aggravation is supported by the notes of Dr Espenschied, Psychiatric Registrar of the Robina Hospital, dated 22 January 2015 and by Dr Gunn, the Psychiatrist retained by the Regulator.
  1. [16]
    The parties accept that Mr Ellison had a work related injury being the pleural plaques.  They also accept that Mr Ellison had suffered depression prior to the events of late 2014.
  1. [17]
    Mrs Ellison said that during that consultation with Dr Nickels on 24 November 2014 he intimated that Mr Ellison's respiratory test had declined and thought it was necessary to perform a bronchoscopy to ascertain whether the asbestosis had led to mesothelioma.  At the mention of the word "mesothelioma", Mrs Ellison said "there was a, sort of, deathly silence" and he did not say anything at all.[1]
  1. [18]
    The evidence of Dr Nickels does not establish that he mentioned the possibility of Mr Ellison's weight loss being caused by mesothelioma, although cancer was raised.  In his report dated 21 December 2015, Dr Nickels said he had a clear recollection of his discussions with Mr Ellison with his wife present.  While Dr Nickels focussed on diseases that could be treated, he also discussed:

"the possibility that this could represent an endobronchial cancer such as primary bronchogenic carcinoma, which is seen more frequently in patients with previous asbestos exposure.  That is, exposure to asbestos fibres increases the risk significantly of primary bronchogenic carcinoma.

It was clear to myself, Eric and his wife that if a cancer was found, it would almost certainly not be curable given his very poor performance status and ill health, as surgical intervention would clearly not be possible, given his physiological status.  I therefore focussed more on the potentially reversible causes of his weight loss, which could be treated reasonably easily with antibiotic or anti-fungal therapy, rather than the potential causes of lung cancer, although Eric and his wife were certainly clear that this was also a possibility."[2]

  1. [19]
    The bronchoscopy took place on 1 December 2014.  According to Mrs Ellison, all that they were told about the results was the "washing was okay".  On the drive home in the car, Mr Ellison said, "[t]his is one battle I'm not going to win, Shirl."[3]
  1. [20]
    Dr Belina's medical records note that she advised Mr Ellison on 8 December 2014 that he had "depression and would need antidepressants to help with this problem … also discussed re results of bronchoscopy."[4]
  1. [21]
    A follow up appointment with Dr Nickels was scheduled for 27 January 2015.  In the time between the bronchoscopy and the next appointment, Mrs Ellison said her husband was very quiet, had taken to his bed and was losing even more weight.  His weight "plummeted."[5]
  1. [22]
    Mr Ellison was admitted to the Robina Hospital on 22 January 2015.  The notes made by Dr Espenschied, Psychiatric Registrar, on Mr Ellison's admission record under the heading of "history of presenting complaint" that Mr Ellison suffered:

"-  major deterioration in mental and physical state since Nov 2014 - dramatic weight loss, become (sic) bed bound.

  • - trigger appears to have been anticipation of bronchoscopy results on 01/12/2014 - Mr and Mrs Ellison understand that asbestosis 'nearly always progresses to mesothelioma after 6-8 yrs' so they were expecting bad news; the bronchoscopy was clear, but the psychological trauma appears to have triggered the depression."[6]
  1. [23]
    Dr Espenschied also notes that Mr Ellison had been engaged socially prior to November 2014 but now reports a "major drop in function and motivation".  He also "reports depressed mood (3/10) most of the time, with frequent crying, sobbing."
  1. [24]
    In her report of 26 May 2015 to the Appellant's lawyers, Dr Belina wrote:

"I have been looking after Eric Ellison as a patient frm (sic) 1 November 2012 until January 2015.  I agree that Eric's Major depression was triggered when he was awaiting the result of his bronchoscopy done in November 2104.  The bronchoscopy was organized by Dr Rob Nickels, who has been looking after him with regards to Asbestosis.  He believed that he was dying of Cancer secondary to Asbestosis, despite my attempts to exclude this."[7]

  1. [25]
    Dr David Storor, Consultant Psychiatrist, prepared two reports for these proceedings at the request of the Appellant's Solicitors and gave oral evidence.  The first report, dated 17 August 2015, was in the form of a File Review.  Dr Storor had been provided with the report of Dr Belina as well as her records, a report of Dr Espenschied dated 22 January 2015 and the records of the Gold Coast Hospital.
  1. [26]
    Dr Storor noted Mr Ellison's various medical conditions, which relevantly included, depression, asbestosis, cognitive impairment, lung disease, dysphagia and weight loss.  He drew the following conclusions:
  • Mr Ellison suffered the onset of progressive cognitive impairment consistent with dementia sometime prior to 2008.
  • He also suffered from depression from around 2006.  This occurred in a setting of increasing cognitive impairment.  A depressive disorder is a known complication of dementia.
  • He suffered a severe exacerbation of depression in late 2014, coinciding with a bronchoscopy for evaluation of asbestos disease.
  • He had a history of dysphagia from at least 2008 onwards.  There was a history prior to 2008 of him having poor appetite and low weight.
  1. [27]
    Dr Storor diagnosed the following clinical disorders - Major Depressive Episode (in early remission at the time of death); Dementia, moderate severity, of unknown aetiology; and Alcohol Use Disorder (Remission).  He opined that "the bronchoscopy in 2014, was a significant factor in the onset of the exacerbation of his depression, but the other factors noted above also contributed."  The other factors included Mr Ellison's past history and family history of depression, his poor general health, dysphagia and chronic low weight.
  1. [28]
    Dr Storor's second report dated 4 July 2016 was based on the same documents provided for the preparation of the first report plus Dr Nickels' report.  Dr Storor stated there was no evidence that Mr Ellison was suffering from significant depression in the period immediately prior to undergoing the bronchoscopy in November 2014.  Rather, the source material demonstrated that Mr Ellison was in good mental health at that time.
  1. [29]
    He opined:

"In conclusion, the evidence available indicates that the major contributing factor to the development of Mr Ellison's Major Depressive Episode was his employment with the James Hardy (sic) Asbestos factory.  His work at the factory reportedly caused him to develop asbestos disease, and the presence of asbestos disease lead him to being referred for an (sic) bronchoscopy in November/December 2014.  Undertaking and awaiting the results of the bronchoscopy triggered the development of the Major depressive disorder."

  1. [30]
    Under cross-examination, Dr Storor confirmed his view that Mr Ellison's past history and family history of depression were significant predisposing factors in the development of the exacerbation of his depression in late 2014.[8]  Further, he had a range of health issues that were significant contributing factors.[9]
  1. [31]
    Dr Storor rejected the proposition that there was no one single major significant contributing factor which was causative of Mr Ellison's major depressive disorder.  He said:

"… it was the bronchoscopy and waiting for the results and the view that he formed about the diagnosis that caused the onset of his severe depression.  That was the major significant contributing factor to the onset of his severe depression."[10]

  1. [32]
    Dr Jennifer Gunn, Psychiatrist, was retained by the Regulator to provide an opinion on whether Mr Ellison's employment was the major significant contributing factor to the major depressive disorder and to comment on the reports of Dr Storor.  Dr Gunn provided reports dated 19 September 2016 and 30 January 2018 and gave oral evidence.
  1. [33]
    Dr Gunn's first report was detailed and commented on the medical records and other documents contained in the file provided by the Regulator.  In her first report, Dr Gunn "noted the early signs of depression in the general practitioners notes of 1st October 2013, with clear indication of increased anxiety as evidenced in panic episodes in 17 June 2014".  She opined "that is more likely than not that an episode of Major Depression commenced at the end of 2013."[11]  In the summary of her report, Dr Gunn opined:

"It is very clearly documented that any exacerbation of Major depressive disorder that arose secondary to a bronchoscopy in December 2014, went into full remission.  This was documented throughout the Gold Coast Hospital notes and again as an outpatient in 2015."

  1. [34]
    Under cross-examination, Dr Gunn agreed with Dr Espenschied's note of 22 January 2015 that the "Trigger appears to have been anticipation of bronchoscopy results on 01/12/2014".[12]  Although Dr Gunn disagreed that Mr Ellison's depressive disorder was aggravated because that expression meant that it did not go into remission, she accepted that his condition had been exacerbated, because in her view, the depression had gone into remission.[13]  Dr Gunn also agreed that the major significant contributing factor to the exacerbation of Mr Ellison's pre-existing major depressive disorder was the anticipation of the results of the bronchoscopy.
  1. [35]
    In light of that concession, Counsel for the Appellant submitted:

"So the chain of events is:  exposure to asbestos;  development of signs and symptoms not inconsistent with problems caused by the asbestos;  diagnosis of asbestos related disease in the form of the pleural plaque, a definite diagnosis of that, so he definitely has an asbestos caused disorder;  followed by deterioration in the condition;  followed by the recommendation for the bronchoscopy, in part to exclude malignancy brought about by exposure to asbestos followed by the aggravation of the major depressive disorder attributable to his anticipation of the results of the bronchoscopy.  In that fashion, in my respectful submission, the relevant causal chain of events is demonstrated, the last of them being the trigger, as the term - being the term that Dr Espenschied adopts, and which Dr Gunn now agrees with."[14]

  1. [36]
    The Appellant therefore argues that this chain of events is sufficient to dispose of WC/2016/90 because it establishes that employment was the major significant contributing factor to the aggravation.[15]
  1. [37]
    Although medically there may be a distinction between an "exacerbation" and an "aggravation", the decision of Hall P in Omanski v Q-COMP, makes clear that there is no such distinction under the Act because the definition of "aggravation" in Schedule 6 to the Act is inclusive and can carry the meaning of "exacerbate".[16] 
  1. [38]
    As noted earlier, the parties agree that Mr Ellison had pleural plaques which was an accepted injury under the Act.  He also suffered from a major depressive disorder prior to the events of late 2014.  Drs Belina, Espenschied, Storor and Gunn agree that Mr Ellison suffered a further depressive disorder in late 2014.  The Commission is satisfied that this was an aggravation of his previous depressive disorder.  Further, the aggravation was caused by the anticipation of the results of the bronchoscopy which was conducted to exclude various conditions including other work related conditions.  In the circumstances the Commission accepts that employment was the major significant contributing factor to the aggravation of the personal injury, being the depressive disorder.

Orders

  1. The appeal is allowed.
  2. The decision of the Regulator is set aside and substituted with another decision that the Application for Compensation No S14NG223520 is one for acceptance.
  3. The Regulator is to pay the costs of and incidental to the appeal. 

WC/2016/89

  1. [39]
    The difference between the parties in this appeal is whether Mr Ellison's death was from an aggravation of his major depressive disorder.  Key factors in the position of the Regulator are Dr Gunn's opinions that Mr Ellison's depressive disorder went into remission in February 2015 and that he had an eating disorder.
  1. [40]
    It is common ground between Drs Storor and Gunn that in addition to having pleural plaques, Mr Ellison suffered from multiple health conditions including depression, dementia, cognitive impairment, dysphagia and weight loss.  To resolve the difference in professional opinions, it is necessary to refer to the medical records of the Robina Hospital and Dr Belina and as well as her evidence and that of Drs Gunn and Storor.
  1. [41]
    Mr Ellison attended on Dr Belina on 20 November 2014 because of ongoing weight loss and not eating.  His loss of weight caused her to refer him to Dr Nickels who recommended the bronchoscopy.
  1. [42]
    Dr Belina's notes of 8 January 2015 record that Mr Ellison is "not eating, sleeping all the time, waiting to die, emotional and sobbing++ wants to die."  The weights recorded in Dr Belina's notes show that he had lost 6.7 kg since the consultation on 20 October 2014.
  1. [43]
    Mr Ellison was admitted to the Robina Hospital on 22 January 2015 after being referred by Dr Belina to the Older Persons Mental Health Unit of the Gold Coast Hospital and Health Service.  The notes of the OPMHU made on 22 January following a home visit on 21 January show that Dr Belina referred Mr Ellison because she had "concerns about severe depression, weight loss and anhedonia."[17]
  1. [44]
    Part of the history taken by Dr Espenschied during the home visit was set out in the decision concerning WC/2016/90 and is not repeated.  However, this history is also relevant:

"- he feels that there is nothing worthwhile in his life currently, and everyday he 'prays that he will die'; he states that he hasn't got the energy to suicide, and that it doesn't fit with his value system, but he certainly wants to die as soon as possible

-He denies that he is refusing food in an effort to hasten his death

-reports feeling completely hopeless about his situation; and is resigned to the idea that he is imminently near death, when in fact his doctor has reassured him that he is not; …

-it is unclear whether Mr Ellison's belief that he is dying is a nihilistic delusion, or an understandable interpretation of his deteriorating physical health; his wife also believes he is dying imminently from his lung condition - I have assured her that this is not the case, and that his current state is reversible."[18]

  1. [45]
    Her notes also reference Mr Ellison's weight loss and his minimal oral intake.
  1. [46]
    Under the heading "Impression", Dr Espenschied states, "severe major depressive episode with severe appetite disturbance, leading to malnutrition and physical compromise, leading the patient to believe he is dying of his asbestosis when this is in fact stable;  high risk further deterioration and death if remains untreated;  suicide risk and aggression risk appear low."[19]  (It is important to note that while Dr Belina and Dr Espenschied referred to asbestosis and it is also noted on the Death Certificate, Mr Ellison did not have this disease.)  Dr Espenschied admitted Mr Ellison for re-feeding and noted the need for naso‑gastric feeding and "monitoring for re-feeding syndrome."[20]
  1. [47]
    Dr Espenschied's notes for January record an improvement in Mr Ellison's mood.  The "impression" she recorded on 27 January was:

"improvement in mood likely a response to being told he is not in fact dying from asbestosis at present; also possible early response to antidepressant and to improved nutritional status."[21]

  1. [48]
    Her note of 29 January is in the same vein, recording her impression as "significant improvement in mental state, with early sign of resolution of depressive symptoms".[22]  The review of Mr Ellison was undertaken by the Consultant Geriatric Psychiatrist, Dr Atkins, with Dr Espenschied, as was the review conducted the following day.  The record of 30 January, continues to note the improvement in Mr Ellison's condition.  Dr Espenschied notes state "likely dementia with superimposed major depressive episode for the last three months, now resolving" and "both dementia and depression are likely to have contributed to weight loss; need to rule out physical causes."[23]
  1. [49]
    Dr Espenschied also recorded her discussion with the dietitian who reports that Mr Ellison:

"makes a pretence of eating and makes excuses as to why he hasn't eaten; slightly deceptive (eg:  moving food around plate but actually eating very little of it, he is also very fussy with food and rigid in what he will eat; has pulled out NG tube more than one once - states it was an accident); suspects this might resolve as BMI climbs above 14."[24]

  1. [50]
    On 2 February, Dr Teo, Resident Medical Officer, noted:

"Dietician and Nurses report Pt to have psychological eating issues

-deliberately removing NG tube multiple times, but claiming it accidentally fell

out

-not finishing meals, but maintains an agreeable attitude that he will eat

-***advise psych. to please review this behaviour***."[25]

  1. [51]
    Mrs Ellison described Mr Ellison's condition.  He was swiping at the intravenous tube "almost as if he was swatting at a fly, you know, go away, sort of thing".[26]  He was frail and communicated little with her.  She would write a word on a pad and if he agreed, he would give her a signal.  On occasion, while in the Robina Hospital and "when he thought he had mesothelioma as a result of that bronchoscopy",[27] he told her that he wanted to go to sleep and not wake up.[28] 
  1. [52]
    When it was put to Dr Gunn that it was a contradiction for Mr Ellison to have an agreeable attitude to eating yet pull out his naso-gastric tubes, she explained that this behaviour was consistent with people who have eating disorders and he had a long standing eating problem.[29]  It was further put to Dr Gunn that Mr Ellison's behaviour was also consistent with someone who is depressed and wants to die by starvation.  She responded that Mr Ellison had also said he was not going to starve himself as it was against his morals.  She reiterated her view that he had a long standing eating problem.[30]
  1. [53]
    On 3 February, Dr Teo noted that Mr Ellison had been reviewed by the Psychiatric Registrar and Social Worker that afternoon and recorded, "Pt continues to be agreeable and voices that he is no longer depressed and much improved.  However, wife believes PT is not himself and putting up a good front."[31]  Dr Gunn agreed that the information from Mrs Ellison should be considered "if it was a well voiced opinion" and it put "a huge question mark" over the history Mr Ellison was providing.[32]
  1. [54]
    Mr Ellison was reviewed by the Psychiatric Registrar, Dr Arunachalam (recorded in the notes as Dr Arul, which is the name used hereafter), on 13 February.  The notes record that Mr Ellison reported "ongoing stability of his mood and rated as 7/10 … acknowledges that he stopped eating as a method to 'way out and be dead'."[33]  Dr Gunn agreed under cross-examination that Mr Ellison's statement on admission that he was not eating to hasten his death conflicted with this comment then made, but she was unable to resolve it.[34] 
  1. [55]
    The notes continued, "Eric denied ongoing suicidal or self-harm thoughts… Eric appeared positive and hopeful about future."  The diagnosis was stated to be "MDD into remission."[35] 
  1. [56]
    On 19 February, Dr Arul again reviewed Mr Ellison and noted team concerns that "Eric was hiding food under his bed sheet and nappies and giving it away to his wife."  When Mr Ellison was asked about this he denied hiding his food, saying he forgot to eat.[36]  Dr Gunn agreed that hiding food was not consistent behaviour with a person seeking to co-operate but it was common for a person with an eating disorder.[37]
  1. [57]
    Dr Arul had a telephone conversation with Mrs Ellison on 23 February.  His "Impression and Recommendation" is:

"Eric has shown significant improvement of his mental state and does not require inpatient treatment at this stage.  The community team will continue to monitor him on discharge.  From the history gathered so far, there is no evidence (of) eating disorder.  The poor eating pattern he demonstrates at present are (sic) simply the part of his normal rigid eating pattern that he has maintained for many years of life that were not related to an eating disorder.  It may be possible that cognitive decline is making his eating pattern more fussy and more difficult (having no flexibility in his thinking) to manage."[38]

  1. [58]
    Dr Arul developed a plan for Mr Ellison.  He notes that he discussed the "above" with Dr Atkins who was happy with the plan.
  1. [59]
    On 20 February, Dr Arul recorded his impression of Mr Ellison as having a stable mental state.[39]
  1. [60]
    Around this time a nursing home placement was discussed with Mr and Mrs Ellison.[40]
  1. [61]
    The medical notes for 3 March record Mr Ellison as being "bright and reactive" and "sitting up in bed eating custard."[41]
  1. [62]
    Dr Arul reviewed Mr Ellison on 12 March.  He noted that Mr Ellison reported his mood as "good" and in relation to his appetite stated "I am eating better than before, even the quantity".  He also notes that "there was evidence of disappointment regarding NH* placement, however able to understand that his care needs are high at present and the medical team has looked at best outcome for Eric.  Eric appears reassured."  (*Nursing Home)  Dr Arul recorded his impression of Mr Ellison as the major depressive disorder being in remission.[42]  On the same date but in a separate entry, Dr Teo recorded that Mr Ellison is no longer depressed.[43]  Mr Ellison's "manipulative tendencies" were also noted.
  1. [63]
    A Registered Nurse recorded in the notes of 14 March that Mr Ellison was "alert and oriented" but "observed to be low in mood and reluctant to communicate with nursing staff at times."[44]  When asked whether this was consistent with a person whose depression was in remission, Dr Gunn remarked that he may have been having a bad day and it was being suggested that the Commission accept a nurse's observation rather than a doctor's record.[45]
  1. [64]
    Similar entries about Mr Ellison being alert and oriented were made by Registered Nurses on 15, 16 and 17 March.[46]
  1. [65]
    Mr Ellison was reviewed by the Palliative Care Consultant on 16 March.  The assessment made at this review includes the comments "lying in bed looking comfortable.  Says he has no pain.  No other sig symptoms and stated he was 'content with himself'" and "told us he was dying and was not afraid or fearful.  Realises he cannot go home to wife and may need NHP.  Seemed to be OK with this (when we saw him)."[47]
  1. [66]
    A record made on 16 March by an Enrolled Nurse, after the Palliative Care assessment, is that the patient "kept stating that he id (sic) dying and they shouldn't prolong him from dying by giving AB's* and other medications."[48] (*antibiotics)
  1. [67]
    Although Mrs Ellison said her husband was transferred to the Carrara Health Centre on 9 March, the medical records suggest a later admission, on 17 March.[49]  Mrs Ellison described that on visiting her husband there it would often take some time before he recognised her.  He would lift his arms towards his face, which she interpreted as "I'm still here" but "he did not want to be."[50]
  1. [68]
    Nursing records of 18, 19 and 20 March show that Mr Ellison was very anxious.[51] The record of 19 March also notes that the "patient reports he is dying."[52]
  1. [69]
    The Dietitian's notes for 19 March record that supplementation was ceased as it caused the patient further anxiety and he had had no oral intake since admission.[53]  On the same day, the Registrar noted that Mr Ellison was a "palliative patient, still refusing oral intake and refusing medications",[54] although some nursing notes record limited oral intake.[55]  Later that day the Rehabilitation Physician had extensive discussions with Mr Ellison and his family.  The notes show "Psychiatric input throught (sic) the admission.  Apparently the depression has improved" and "Current issue is SOB* and anxiety." (*shortness of breath)  The plan was to hold off placement in a nursing home to see how the week unfolded.[56]
  1. [70]
    Mr Ellison was reported to have "nil distress" during the morning shift of 21 March.[57]  The following evening, the Registered Nurse reported that Mr Ellison was moving around the bed - observed to look uncomfortable, holding his head intermittently."[58]  Mr Ellison passed away later that night.
  1. [71]
    Dr Gunn was cross-examined on her opinion that she could not confirm Mr Ellison died as a result of a major depressive disorder.  It was her opinion that there were multiple factors involved and referred to his eating disorder, dysphagia, dementia and pneumonia whilst in hospital and the medication being withdrawn.  His major depression went into remission but the eating disorder did not.  In her view, even absent the depressive disorder, weight loss would continue.[59]
  1. [72]
    In her report of 19 September 2016, Dr Gunn said:

"It is my opinion that Mr Ellison had an Eating Disorder Not Otherwise Specified that was longstanding that had already been resulting in a progressive loss of weight over the years.  I do note that even after diagnosis of the benign pleural plaques his weight had increased, then subsequently continued to decrease slowly, however this may related (sic) to other factors including the Eating Disorder and the progressive Dementia.  I note that Mr Ellison was re-feed (sic) as an inpatient at the Gold Coast Hospital through January and February 2015."[60]

  1. [73]
    Her report of 30 January 2018 confirmed that her opinion remained unchanged.  She could not find any direct evidence to link a major depressive disorder with Mr Ellison's death.
  1. [74]
    Dr Gunn noted that Mr Ellison had lost 10 kg from October 2013 to November 2014, which was prior to the bronchoscopy.  She referred to the Hospital weight charts which show his weight fluctuated and said they showed that Mr Ellison was re-fed on admission to a weight that was near that of November 2014.  He then maintained that weight even after the naso-gastric tube was removed and for several weeks.[61]
  1. [75]
    Dr Gunn also noted that Mrs Ellison organised a new Will on 19 March and no issues about unsoundness of mind or major depression were voiced.  In addition, Acute Resuscitation Plans were activated on February and March where, on each occasion, it is recorded the patient had capacity to consent or refuse medical treatment.  Further, in the first Plan, Dr Gunn noted that it was documented that there was no evidence that the major depressive illness was colouring his decision making or capacity regarding him not being resuscitated.
  1. [76]
    As noted earlier, Dr Storor has a different opinion about the contribution of Mr Ellison's major depressive disorder to his death.  In oral evidence, Dr Storor indicated that when he wrote his first report he had not had the opportunity to read Mrs Ellison's Statutory Declaration.  (This document is not in evidence.)  In that Mrs Ellison notes that she believed her husband was putting on a front during his time in hospital and remained depressed.  (This was consistent with Mrs Ellison's oral evidence.)  With that information, Dr Storor reconsidered his opinion that Mr Ellison's depression was in full remission.  He said, weighing it up, it was likely that Mr Ellison was still suffering a significant degree of depression.  The "tipping point" seemed to be when it was decided due to his physical compromise as a result of the effects of depression that he could not go back home and would have to go to a nursing home that he really lost the will to live.[62]
  1. [77]
    Dr Storor did not accept that Mr Ellison had an eating disorder that could be described as a psychiatric disorder.  He had chronic low weight attributable to medical factors from 2008 onwards but the acceleration in his weight loss in that period of a year or so prior to the severe depressive episode was, on the balance of probabilities, due to the effects of depression.[63]
  1. [78]
    Dr Storor acknowledged that his view expressed in his first and second reports was that Mr Ellison had a number of physical health problems that were significant contributing factors.[64]  He suffered a severe depressive episode which led to a profound loss of appetite, physical compromise and malnourishment.  The depression appeared to be resolving and the treating team thought it was in early remission, but by this stage his state had become so severely compromised by the depressive illness, that he had effectively reached the point of no return and succumbed from the effects of the severe depressive illness on his physical health.[65]
  1. [79]
    The collateral information from Mrs Ellison by way of her statutory declaration caused him to reflect on the notes and review his opinion.  He considered it unlikely the depression had gone into full remission.  He still had depressive symptoms, had some recovery then slipped back and succumbed through physical compromise and malnutrition.  "Either way", the major depressive episode was still the major significant contributing factor to his death.[66]

Consideration

  1. [80]
    The two psychiatrists agree that Mr Ellison suffered from a number of health conditions but differed significantly over the contribution, if any, of Mr Ellison's major depressive disorder to his death.  Issues to be considered in reaching a conclusion include examination of the role played by other health conditions, Mr Ellison's eating problems, and whether the major depressive disorder went into remission (in part, in full or at all).
  1. [81]
    The medical records of the Robina Hospital were provided in two tranches.  Neither set was in chronological order making it difficult for the expert witnesses, the parties and the Commission to follow the care provided to Mr Ellison.
  1. [82]
    Other health conditions:  The medical records repeatedly show that Mr Ellison had multiple comorbidities.  The reports of Drs Gunn and Storor, based on the medical records, also refer to the many health conditions suffered by Mr Ellison.  In addition to pleural plaques, Mr Ellison had dementia, which is a progressive condition, he suffered pneumonia whilst in hospital and the records refer to his breathing difficulties.  His shortness of breath was impacting on Mr Ellison's life and activities in late 2014[67] and was particularly noted by the Rehabilitation Physician on 19 March 2015.  In addition, Mr Ellison suffered from dysphagia which meant that he had difficulty swallowing, solid food in particular.
  1. [83]
    Eating problems:  Dr Gunn referred in her report to several sources which identified that Mr Ellison had a long standing eating problem, including in June 2014 that Mr Ellison's BMI was 15 and the Dietitian noted Mr Ellison to be "severely malnourished with extensive muscle wasting."
  1. [84]
    According to Mrs Ellison's evidence, prior to 2008, Mr Ellison had not been a robust man and did not carry much weight.  However, he was fit and quite strong.[68]  By the second half of 2014 he was losing more weight.  During this time, Mr Ellison was consulting his General Practitioner, Dr Belina.
  1. [85]
    Dr Belina's oral evidence is that on 29 April 2014, she made a record of a consultation with Mr Ellison that "still no appetite" and she understood he had a problem with eating.  Her medical records note his continued weight loss from October to November 2014.
  1. [86]
    Dr Nickels also noted in his report of 21 December 2014 that Mr Ellison was "continuing to lose weight, further down by 7 kilograms in the preceding 12 months."  This weight loss preceded any discussion with Dr Nickels about its cause.  I also note that in evidence Mrs Ellison said that for approximately six weeks prior to consulting Dr Nickels, her husband's eating had deteriorated.[69]
  1. [87]
    Mr Ellison's dramatic weight loss was one of the reasons he was referred, and then admitted, to the Robina Hospital.
  1. [88]
    The Robina Hospital medical records of 23 February 2015 show Dr Arul had a discussion with Mr Ellison's GP.  The GP is recorded as saying that "Eric never showed signs or symptoms of eating disorder recently or in past.  Weight loss commenced around the diagnosis of Asbestosis".  Dr Arul also recorded the weights provided.  From 2010 to January 2015, Mr Ellison lost 20 kg.  The most significant weight loss (6 kg) was between October 2014 and January 2015.[70]
  1. [89]
    Dr Belina's records show that as at 8 January 2015, Mr Ellison weighed 40 kg.  The weight charts from the Robina Hospital[71] show Mr Ellison weighed 31.5 kg on 23 January (the day after admission) increasing to 36 kg on 25 January before declining significantly.  This and later dramatic fluctuations are aberrations, with the early ones possibly being due to faulty equipment.  The later significant declines such as that on 5 February are not considered to be reliable.  The weight recorded on that date shows a drop in weight of four and a half kilograms from the day before then returning to the previous weight the next day.  Another aberration occurs on 20 February where two significantly different weights are recorded.
  1. [90]
    Mr Ellison's significant weight loss caused the Robina Hospital to place Mr Ellison on enteral feeding to improve his physical state.  However, it is not entirely clear when Mr Ellison began this, although it was soon after Mr Ellison's admission.  It is also not clear when the tube was removed.  Dr Gunn noted the record which indicated that on 12 March the tube was no longer in place[72] and said his weight then stabilised.  Mrs Ellison said the tube was removed two or three weeks at most before Mr Ellison was moved to the Carrara Rehabilitation Centre which she believed to have occurred on 9 March.[73]  The weight chart for the period 2 to 17 March[74] shows little fluctuation in the recorded weight, although if the tube was removed on 12 March, his weight reduced by 1.4 kg on 16 March before increasing by 0.8 kg the following day.  No weights are recorded after this, including on death. 
  1. [91]
    I consider the weight charts confirm his weight gain while being fed enterally and his weight returned to approximately that of early January.  Even so, he remained significantly underweight. 
  1. [92]
    Mr Ellison reported to Dr Arul on 20 February that he had a poor appetite.  Further, this had been his pattern all his life, especially since retirement (at least in the last 20 years), although he could not identify any trigger since retirement.[75]  Under cross‑examination, Mrs Ellison said that during 2014, her husband would have three meals a day but small portions.  In the two months prior to the bronchoscopy his appetite deteriorated.[76]
  1. [93]
    While Mr Ellison's comment to Dr Arul on 12 March that he was "eating better than before, even the quantity" might have been (barely) true for 11 and 12 March, it deteriorated thereafter.  The Fluid and Food Consumption Charts for the period 11 to 17 March show that Mr Ellison had reverted to his usual eating habits - minimal food intake and some fluids.[77]  Dr Teo noted on 12 March that the Food Chart showed that Mr Ellison was consuming only fluids, not the solid foods.
  1. [94]
    The medical records for the period after Mr Ellison was transferred to the Carrara Health Centre (assuming it to be 17 March) show he was tolerating only a minimal intake of fluids and food.[78] 
  1. [95]
    Dr Storor disagreed with Dr Gunn that Mr Ellison had an eating disorder that could be classified as a psychiatric disorder.  He had problems with low weight since 2008 but that was due to poor dietary intake caused by medical factors.  The acceleration in his weight loss in the period of a year or so before the severe depressive episode was, he considered on the balance of probabilities, due to the effects of depression.[79]
  1. [96]
    It is unnecessary for me to determine whether Mr Ellison had an eating disorder that could be classified as a psychiatric disorder as opined by Dr Gunn and whether the weight loss coincided with the original diagnosis of pleural plaques.  The evidence establishes that Mr Ellison had long term eating problems and poor appetite which preceded the bronchoscopy for many years.  In WC/2016/90, I accepted that Mr Ellison suffered an aggravation of his depressive disorder and in this appeal accept that this aggravation contributed to his significant weight loss between November 2015 and January 2016.
  1. [97]
    The behaviours Mr Ellison engaged in during his hospital admission such as pulling out his naso-gastric feeding tube on multiple occasions and hiding food provoked considerable debate between the Appellant's Counsel and Dr Gunn.  These behaviours were considered by the Appellant to be evidence of Mr Ellison's wish to die because of the major depressive disorder whereas Dr Gunn considered them to be evidence of an eating disorder.
  1. [98]
    Further, Mr Ellison's later indications of being willing to cooperate with eating yet still engaging in the behaviours was considered by the Appellant to be evidence of his desire for his life to end but again Dr Gunn believed this to be evidence of an eating disorder.
  1. [99]
    Depressive disorder:  The first record showing the major depressive disorder went into remission is 13 February 2015.  Dr Storor ultimately concluded that it had not gone into full remission.  Based on the DSM criteria, the time frame was too short for full remission to have been achieved.[80]  In addition, having considered the collateral information from Mrs Ellison, the medical notes referring to Mr Ellison needing to be admitted into a nursing home and his objection to that, as well as his compromised physical state, he lost the will to live.  All of these factors led Dr Storor to decide that the depression never fully remitted notwithstanding the notes on file.[81]
  1. [100]
    In her first report, Dr Gunn wrote that the depression had been very clearly documented as going into full remission.  She was cross-examined at some length about this.  Dr Gunn took the view from the Robina Hospital records that Mr Ellison's depression had remitted.  She accepted that the records did not specify "full" or "partial" remission.  In the absence of that, Dr Gunn stated, "a remission is a remission", that is, remission leads to an acceptance of a full remission.[82]
  1. [101]
    It is true that the medical records show that Mr Ellison's mood fluctuated after the diagnosis was made of his depressive disorder being in remission.  Mrs Ellison believed her husband was putting on a front when he reported to the doctors an improved mood over late January/early February.  His advice to her that he wanted to go to sleep and not wake up is consistent with this, although this was not repeated to her when he was transferred to Carrara.[83]  However, her husband's gesture of raising his arms to his face while in the Carrara Health Centre was interpreted by her as indicating his disappointment with being alive. 
  1. [102]
    Although I accept Mrs Ellison's evidence is important collateral information, Mr Ellison voiced several times shortly before his passing that he was dying.  While this may be said to be evidence of his desire for his life to end, I note the medical records show he accepted his state as he reported to the Palliative Care Consultant on 16 March that he was "content with himself" and "told us he was dying and was not afraid or fearful."
  1. [103]
    There are reports of anxiety in the days following.  One report of anxiety followed a note that Mr Ellison was calling out and reassurance was given.  After this, the patient reported he was dying.  A cause of anxiety recorded in the notes is the supplementation.  Anxiety can be a symptom of depression but it can also occur for other reasons.  Given the range of issues affecting Mr Ellison at that time, the anxiety could be attributable to dementia or other challenges he was facing in his life.  In the absence of any cause noted by medical practitioners at this time, I am unable to be satisfied on the balance of probabilities that the anxiety was indicative of the depressive disorder reactivating.
  1. [104]
    I do not accept Dr Storor's opinion that the tipping point occurred when it was decided that due to his physical compromise, Mr Ellison would be unable to return home and would be permanently placed in a nursing home, with the result he lost the will to live.  The medical notes certainly record Mr Ellison's disappointment with the decision and his comments that he would run away.  However, they also show that he was prepared to evaluate this after the two weeks of respite.[84]  Further, he reported that evening his mood was good.[85]  Four days later, on 16 March, he informed the Palliative Care Consultant that he realised he may not go home and was "ok" with that.
  1. [105]
    I am prepared to accept that Mr Ellison's depression went into remission as determined by the Robina Hospital.  The Commission notes that the diagnosis of the major depressive disorder was made under the review of a Consultant Psychiatrist.  The medical records of the Robina Hospital are contemporaneous and there is merit in Dr Gunn's opinion that "the treating team's opinion, including a Consultant Psychiatrist who attended Mr Ellison, may carry significant weight on the diagnoses to be considered."[86]
  1. [106]
    That the Acute Resuscitation Plan of February included the note that there was no evidence the major depressive illness was colouring Mr Ellison's decision making or capacity.  This together with his capacity to make a new Will on 19 March are further indicators that his major depressive disorder was in remission.
  1. [107]
    Conclusion:  Mr Ellison had been losing weight for years and was physically compromised prior to the bronchoscopy.  However, the rate of weight loss increased, and his physical state worsened, as a result of the aggravation of his major depressive disorder while waiting for the results.  The increasing weight loss together with his depressive state caused him to be admitted to the Robina Hospital. 
  1. [108]
    His depression remitted in mid-February 2015.
  1. [109]
    As a result of being fed enterally, Mr Ellison's weight increased to that approximating his weight in early January 2015.  The enteral feeding was removed about 12 March 2015 and his weight then remained stable at least until 17 March, the last recorded weight in evidence.  Even so, he remained underweight. 
  1. [110]
    His high care needs resulting from his malnourishment and other health conditions caused the decision to be made to (ultimately) move him to a nursing home.  I have not accepted that in light of his physical compromise that the decision to move him to a nursing home caused the reactivation of his depression.  I consider his minimal intake after he was transferred to the Carrara Health Centre, awaiting placement, was a return to his earlier eating behaviours and was also caused by the dysphagia.  In this regard I accept Dr Gunn's opinion that weight loss would continue even were the depression not to be present.  His diminished intake would have further impacted on his physical state.
  1. [111]
    In WC/2016/90, I decided that employment was the major significant contributing factor to the aggravation of Mr Ellison's psychiatric disorder.  That aggravation was a significant contributing factor to his physical compromise, which ultimately, but not exclusively, caused his death.  The medical records chart his declining state and the multiple comorbidities present both at the time of admission and the week before his passing.  In my view his death was caused by multiple factors, including his physical compromise caused by the depressive disorder; his dysphagia, continued eating problems and poor appetite after his remission, which further weakened his physical state, together with his dementia and pleural plaques.
  1. [112]
    The question then is whether death was from an aggravation of the major depressive disorder.  The Commission was not addressed on how the legislation should be construed where death was from multiple health issues, one of which was an aggravation of psychiatric disorder where employment was the major significant contributing factor to that disorder.  Further, for this appeal, the Appellant relies on s 32(3)(f) of the Act.  It is useful to set out the relevant provisions of this section:

32 Meaning of injury

  1. (1)
    An injury is personal injury arising out of, or in the course of, employment if -
  1. (a)
    for an injury other than a psychiatric or psychological disorder - the employment is a significant contributing factor to the injury; or
  1. (b)
    for a psychiatric or psychological disorder - the employment is the major significant contributing factor to the injury.

...

  1. (3)
    Injury includes the following -
  1. (a)
    a disease contracted in the course of employment, whether at or away from the place of employment, if the employment is a significant contributing factor to the disease;
  1. (b)
    an aggravation of the following, if the aggravation arises out of, or in the course of, employment and the employment is a significant contributing factor to the aggravation -
  1. (i)
    a personal injury other than a psychiatric or psychological disorder;
  1. (ii)
    a disease;
  1. (iii)
    a medical condition other than a psychiatric or psychological disorder, if the condition becomes a personal injury or disease because of the aggravation;

(ba) an aggravation of a psychiatric or psychological disorder, if the aggravation arises out of, or in the course of, employment and the employment is the major significant contributing factor to the aggravation;

  1. (c)
    loss of hearing resulting in industrial deafness if the employment is a significant contributing factor to causing the loss of hearing;
  1. (d)
    death from injury arising out of, or in the course of, employment if the employment is a significant contributing factor to causing the injury;
  1. (e)
    death from a disease mentioned in paragraph (a), if the employment is a significant contributing factor to the disease;
  1. (f)
    death from an aggravation mentioned in paragraph (b), if the employment is a significant contributing factor to the aggravation.
  1. (4)
    For subsection (3)(b) and (ba), to remove any doubt, it is declared that an aggravation mentioned in the provision is an injury only to the extent of the effects of the aggravation.

…"

  1. [113]
    Section 32(3)(f) concerns an aggravation mentioned in paragraph (b), which concerns three types of injury but importantly excludes a psychiatric or psychological disorder.  These disorders are dealt with in another paragraph, paragraph (ba).  As psychiatric or psychological disorders are expressly considered separately from the types of injury covered by paragraph (b), paragraph (f) cannot be read to include psychiatric or psychological disorders.
  1. [114]
    Section 32(4) references both subsections (3)(b) and (3)(ba) and as such, deals with both an aggravation of all of the types of injury mentioned in paragraph (b) as well as psychiatric or psychological disorders which is the purview of subsection (3)(ba).  Section 32(4) immediately follows s 32(3)(f).  Because of its position in the section and the width of its coverage, it is difficult to accept that the non-inclusion of a provision for death from an aggravation of a psychiatric or psychological disorder was an oversight.  That said, I am aware that before the Act was amended to separate psychiatric or psychological disorders from other types of injury, death from an aggravation of such disorders would have been compensable if the employment is a significant contributing factor to the aggravation.
  1. [115]
    In Simon Blackwood (Workers’ Compensation Regulator) v Mahaffey,[87] Martin J held that that Act is beneficial legislation and discussed several cases which considered the meaning of the term.  He held:

"The approach described above is not without constraint. The interpretation adopted 'must be restrained within the confines of the actual language employed and what is fairly open on the words used'."[88]

And, further:

"It is only if more than one interpretation is available or there is uncertainty as to the meaning of the words that the beneficial interpretation approach arises."[89]

  1. [116]
    The opening words of s 32(3) are "Injury includes" followed by a list of specific types of injury, such as aggravation injuries, disease and death from those types of injury.  It could be argued that as the list of types of injuries is not exhaustive given the use of the word "includes", death from an aggravation of a psychiatric or psychological disorder where employment is a contributing factor is included.  Although this approach provides a beneficial interpretation, it strains the language of the Act for the reasons given in the paragraphs [113] and [114].

Orders

  1. The appeal is dismissed.
  2. The decision of the Regulator is confirmed.
  3. The Appellant is to pay the costs of and incidental to the appeal.  Failing agreement, liberty to apply is granted.

Footnotes

[1] T1-8.

[2] Ex 12.

[3] T1-8.

[4] Ex 9.

[5] T1-9.

[6] Ex 10, IP 422.

[7] Ex 3.

[8] T1-38.

[9] T1-39.

[10] T1-40.

[11] Ex 8, p 34.

[12] T2-21.

[13] T6-6.

[14] T6-47.

[15] T6-46, 47.

[16] Veronica Mary Omanski v Q-COMP (C/2012/34) - Decision http://www.qirc.qld.gov.au, [11].

[17] Ex 10, IP 419.

[18] Ex 10, IP 422,423.

[19] Ex 10, IP 424.

[20] Ibid.

[21] Ex 10, IP 427.

[22] Ex 10, IP 428.

[23] Ex 10, IP 430.

[24] Ibid.

[25] Ex 10, IP 379.

[26] T1-10.

[27] T1-14.

[28] T1-12.

[29] T2-33.

[30] T2-34

[31] Ex 10, IP 383.

[32] T2-35.

[33] Ex 10, RTI 19.

[34] T6-8.

[35] Ex 10, RTI 18.

[36] Ex 10, RTI 15, 16.

[37] T6-10.

[38] Ex 10, RTI 10.

[39] Ex 10, RTI 8.

[40] Ex 10, RTI 7.

[41] Ex 10, RTI 4.

[42] Ex 10, RTI 66, 67.

[43] Ex 10, RTI 58.

[44] Ex 10, RTI 70.

[45] T6-14.

[46] Ex 10, RTI 70, 71, 75.

[47] Ex 10, RTI 51, 52.

[48] Ex 10, RTI 83.

[49] Ex 10, RTI 33, 76 and 202.  It may have been that Mr Ellison had two weeks of respite care before being transferred to the CHC.

[50] T1-13.

[51] Ex 10, RTI 73, 76, 77.

[52] Ex 10, RTI 76.

[53] Ex 10, RTI 51.

[54] Ex 10, RTI 55.

[55] Ex 10, RTI 76.

[56] Ex 10, RTI 52.

[57] Ex 10, RTI 77.

[58] Ex 10, RTI 79.

[59] T6-18.

[60] Ex 8, p 34.

[61] T6-24.

[62] T1-34.

[63] T1-39, 40.

[64] T1-39.

[65] T1-41, 42.

[66] T1-42.

[67] T1-7.

[68] Ibid.

[69] T1-18.

[70] Ex 10, RTI 10.

[71] Ex 10, RTI 152, 153, 155.

[72] T6-19.

[73] T1-12.

[74] Ex 10, RTI 153, 155.

[75] Ex 10, RTI 15, 16.

[76] T1-15.

[77] Ex 10, RTI 162-169.

[78] Ex 10, RT1 55, 76, 78.

[79] T1-40.

[80] T1-34.

[81] Ibid.

[82] T2-5-7, T6-6.

[83] T1-14.

[84] Ex10, RTI 53.

[85] Ex 10, RTI 66, 67.

[86] Ex 8, p 29.

[87] Simon Blackwood (Workers’ Compensation Regulator) v Mahaffey [2016] ICQ 10.

[88] Ibid [42].

[89] Ibid [43].

Close

Editorial Notes

  • Published Case Name:

    Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator

  • Shortened Case Name:

    Ellison and Ellison (as the Executrix of the Estate of the late Eric Ellison) v Workers' Compensation Regulator

  • MNC:

    [2018] QIRC 49

  • Court:

    QIRC

  • Judge(s):

    Fisher IC

  • Date:

    23 Apr 2018

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
Workers' Compensation Regulator v Mahaffey [2016] ICQ 10
4 citations
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