Victory for Child Sex Abuse Survivors

The High Court has delivered a decision that rings the bell on the appalling and disgraceful conduct of the Catholic Church in the way it deals with claims for damages of victims of child sexual abuse. The High Court’s decision serves as a salutary lesson to all institutions, including government departments, that they must reassess the way in which they respond to and deal with claims.

 

The victim, whose identity cannot be identified, brought proceedings in the Supreme Court of New South Wales against the Catholic church claiming that she had been raped by a Priest in 1968 when she was 14 years old.

 

The Catholic Church sought orders from the Supreme Court that the victim’s claim be permanently stayed – effectively meaning the case could not proceed – because the Church was not able to obtain a fair trial. It claimed that because the alleged perpetrator was dead and all other senior people within the Catholic Church with knowledge of the allegations were dead, it was unable to defend itself.

 

Justice Garling of the Supreme Court refused to stay the proceedings. He made the following points:

 

  1. A fair trial need not be a perfect trial.
  2. Child sexual abuse, of its nature, occurs in private and eyewitness evidence is rarely available.
  3. The Catholic Church was able to contradict the victim’s claims with its own documentary evidence.
  4. The Parliament had specifically abolished the Limitations Period relating to child sexual abuse claims.

 

The Catholic Church appealed to the NSW Court of Appeal. That Court, in effect sought to substitute its own discretionary reasoning power and granted the permanent stay.

 

The victim appealed to the High Court. The Justices of the High Court by majority decision determined that a permanent stay must be understood to be an absolute “last resort”. The High Court ruled that the NSW Court of Appeal got it wrong by seeking to substitute its own discretionary decision-making power. The High Court ruled that to grant a permanent stay does not involve an exercise of discretion but an application of a legal standard. The High Court ruled that the correct question in determining a stay is to ask whether a trial is so necessarily unfair or so unfairly and unjustifiably oppressive as to constitute an abuse of the Court’s procedures.

 

It remains to be seen whether the Catholic Church, and more broadly the many institutions who are responsible for the scourge of historical sexual abuse, take notice of the High Court.

 

If you have sustained an injury, Toby Tancred can help. He can provide you with legal advice, investigate your matter and represent you if you need to commence legal proceedings. Toby Tancred is a Law Society Personal Injury Accredited Specialist – one of only a handful in regional and rural NSW – and has been recognised by Doyle’s Guide as a Recommended Work Injury Compensation Lawyer for two years running. Doyle’s Guide has also named Toby Tancred Solicitor as a Recommended Asbestos & Dust Diseases Compensation Law Firm. More recently Toby Tancred has been awarded Leading Personal Injury Lawyer in Australia by Lawyer Monthly. Toby Tancred has the experience, knowledge and ability to help all injured people in difficult times.

Lets give older workers a fair go

Lets give older workers a fair go

It is often said that the advancement of a society is measured in the way it treats its elders. If that be so, at least the State of New South Wales has some work to do. Arguably the State of New South Wales is in breach of the United Nations 191 declaration for Older Persons that states, “older persons should have the opportunity to work or to have access to other income generating opportunities.”

 

In Australia a person is entitled to the Aged Pension when they reach 67.

 

A little known fact of the law in New South Wales is that a person’s entitlement to receive workers compensation ceases at age 67. As well, a person’s entitlement to claim damages for future economic loss is disregarded after they reach pension age – i.e. the age of 67.

 

This is enormously troublesome for workers who have every intention of working beyond age 67 but for sustaining a work injury.

 

I recently had the great privilege of representing a person who sustained injury in the workplace due to the negligence of her employer. Prior to her injury she had signed a contract with her employer demonstrating every intention that she would work until age 72. She sustained injury just before her 67th birthday. Her entitlements to workers compensation and damages for an injury that she did not ask to sustain and that was very clearly due to the negligence of her employer were severely curtailed.

 

I explained her predicament to her and she accepted my advice, but was disgusted that the law in New South Wales has not kept pace with the reality of society, that being that workers are being required to remain in the workplace beyond the age of 67.

 

I would argue that experienced workers are a valuable resource and there is absolutely no reason why they would not be afforded the same protections as people under the age of 67.

 

As an injured worker you are entitled to be advised by Toby Tancred.  The Independent Review Office (IRO) can assist by providing funding for this legal advice.  IRO provides funding to approved Solicitors to investigate claims, provide advice to you as an injured worker, and deal with employers and insurers on your behalf.  Toby is an IRO Approved Lawyer.  Toby Tancred is a Law Society Personal Injury Accredited Specialist and has been recognised by Doyle’s Guide as a Recommended Work Injury Compensation Lawyer for two years running.  Doyle’s Guide has also named Toby Tancred Solicitor as a Recommended Asbestos & Dust Diseases Compensation Law Firm.  Toby Tancred has the experience, knowledge and ability to help all injured workers in difficult times.

 

 

 

Assessing damages when there is no actual loss

People who sustain personal injury as a result of the fault or negligence of a third party, are often left with disabilities that cause impairment of their earning capacity. Sometimes the extent of that impairment and the calculation of the resulting loss of income is difficult when the loss is not for example a simple question of comparing a person’s income before and after an accident and calculating the difference.

 

Damages for past and future loss of income are awarded as compensation for the effect of an accident on an injured person’s ability to earn income. The exercise involves assessment of lost earning capacity and not loss of earnings. Lost capacity and the economic consequences of that loss must be identified. What was earned by the injured person in the past may be a useful guide to what might be earned in the future but it does not always provide certain guidance.

 

Where it is clear that a person’s income-earning capacity has been reduced but its extent is difficult to assess, the absence of precise evidence will not necessarily result in non-recovery of damages. In this case a Court will often resort to an award of a “cushion” or a “buffer”, being a global amount of damages to compensate a person for likely future economic incapacity. The Court still has to grapple with what the future was likely to hold in terms of economic activity had the injury not occurred.

 

The Court of Appeal recently considered a claim for damages by a man who sustained injuries when he fell from his motorcycle while avoiding a collision with a vehicle. A Judge of the District Court awarded damages, that included an award as a buffer for future economic loss. The appeal turned primarily on the District Court’s allowances for economic loss and future care. The injured person had suffered several injuries before the motorcycle accident. These included a prior motorcycle accident and an underground mining accident. The nature and extent of the earlier injuries and disabilities, and their impact upon the injured person’s earning capacity were considered at length by the District Court Judge. The injured person had previously been able to work as a self-employed electrician, running his own business until 2012 but at the time of the hearing in the District Court he had not worked for two years. He relied on evidence that he had been unable to commence employment in landscaping, due to injuries he sustained in the accident. These issues fed into his claim for future economic loss.

 

The District Court Judge found that due to injuries and disabilities that existed prior to the motorcycle accident, the injured person would have retired between the age of 60 and 63 and awarded a modest buffer of $125,000. What the District Court Judge however failed to do was take account of his own finding that the injured person would have continued to seek sporadic electrical contract jobs which did not require heavy activity and lifting such as work of a domestic or minor commercial nature or may have undertaken some electrical inspector and limited supervision duties, and therefore, that he retained an earning capacity prior to the motorcycle accident.

 

The Court of Appeal set aside the judgment of the District Court and awarded further damages for economic loss. The Court of Appeal held that the District Court Judge had erred in his finding that the injured person would have ceased work early, around the age of 60 or 63 due to his pre-existing injuries. Rather, this was an issue to be established by the negligent party if it were capable of doing so. The Court of Appeal determined that in the absence of a finding that the Appellant would have retired early, damages should be assessed on the basis that the Appellant would work to the age of 67. In setting aside, the award of the District Court Judge, the Court of Appeal awarded further damages of $50,000.

 

 

Jamal v Workers Compensation Nominal Insurer [2023] NSWCA 4

In April 2014 Mr Khaled Jamal was seriously injured while working in a small family run Mediterranean grocery store in Auburn, Western Sydney. Khaled was a cousin of the sole director of the company, Ms Jamal. In contravention of its obligations, the company did not hold a workers compensation policy. Companies who pay less than $7500.00 per year in wages are “exempt employers” and are not required to hold workers compensation insurance. The argument was raised that the company was exempt on this basis, as it did not have any paid employees prior to Mr Khaled commencing work. The Court found the company was paying family members through a mix of cash payment and grocery stock. On the basis of the number of weekly hours worked by the family, it did not qualify as exempt, despite its lack of formal employee and payroll records.

 

In absence of a workers compensation policy, Mr Khaled commenced his workers compensation claim against the “Workers Compensation Nominal Insurer”. The Nominal Insurer is a statutory body that receives a percentage of all workers compensation payments and takes the place of Insurer in workers compensation matters when the company has failed to insure itself. The Nominal Insurer is in turn permitted to recover any compensation paid either from the company or from a “culpable director”, where recovery from the company is not possible. In this case, the company had ceased trading, therefore, the Nominal Insurer sought financial recovery of more than $250,000 from Ms Jamal as a “culpable director”.

 

The Workers Compensation Act sets out that if at the time an injury occurred the corporation failed to hold compulsory workers compensation insurance and the insurance would have covered the corporation for the liability, the director at the relevant time is a “culpable director”.

 

There are exceptions to this rule upon which Ms Jamal sought to rely. Primarily, that she was unaware that the corporation had no insurance, was not in the position to influence a decision to take out insurance or used all due diligence to prevent the corporation from breaching its obligations. The District Court dismissed these arguments at first instance, a decision that was upheld by the Supreme Court. Ms Jamal was ultimately held to be a culpable director and liable to repay the Nominal Insurer the full amount of workers compensation damages awarded to Mr Khaled, the employee.

 

The two key messages here are, firstly, that employers must have workers compensation insurance or run the risk of being personally liable. Secondly, injured workers have the safety net of the Nominal Insurer scheme, if their employer has not properly taken out workers compensation insurance.

Fair financial redress for abuse survivor

Fair financial redress for abuse survivor

A recent decision of Justice Cavanagh of the Supreme Court highlights that survivors of childhood sexual and physical abuse suffer horrific permanent injuries for which Courts are prepared to award considerable damages.

The identity of the survivor was suppressed under a non publication order. The survivor was a student at de la Salle College Revesby Heights in 1983 and 1984. He had the great misfortune of entering into the orbit of a sexual predator who committed sexual assaults on him as a year 11 year old boy.

The survivor never revealed what had happened to him until hearing and reading about many other victims who came forward to be heard during and after the Royal Commission into institutional responses to child sexual abuse.

While the assaults occurred in the early 1980s the Plaintiff did not file his Statement of Claim in the Supreme Court until March 2021. He was permitted to do that because, the NSW Government adopted the recommendation of the Royal commission that limitations periods for child sexual abuse be abolished.

Unfortunately the de la Salle Brothers made no admissions in response to the survivor’s claim and in fact denied that they were liable for the conduct of the sexual predator. The case was originally allocated a ten day hearing however it only proceeded for three days, no doubt because many of the legal arguments adopted by the Brothers proved to be unarguable.

Justice Cavanagh believed the survivor. His evidence was that his life had been irreparably ruined by the sexual assaults leading to drug addiction and considerable periods spent in custody.

To highlight the position adopted by the Brothers the following is an example of a question that was put to the survivor by their Senior Counsel:

“You’ve set out to do things in this case. The first is you’ve set out to blame every misstep in your life, every mistake – to blame every one of them upon abuse you say you suffered at the hands of (the predator); you’ve done that, haven’t you?

Hard to believe anyone could even think that let alone ask that question, right?

Justice Cavanagh awarded the survivor $300,000 for general damages and aggravated damages, interest on past damages, damages of over $650,000 for loss of income and future loss of earning capacity and considerable damages for loss of superannuation and future medical treatment all totalling in excess of $1.1 million. The Brothers were also ordered to pay the survivor’s legal costs.

In his reasons Justice Cavanagh said many things including the following:

“I accept that the emergence of so many people subject to historical sexual abuse and the Royal Commission brought it all flooding back to the plaintiff leading him to seek relief and compensation through legal representation.”

Regrettably, and sadly I am presently representing over 100 survivors of child sex abuse. It is however my great privilege and honour to do this and to be able to hopefully help, in some small way, these people restore something of their damaged lives. It is not an exaggeration to say there was an epidemic of sexual predation on children in the periods leading right up until the Royal Commission. The Royal Commission gave a voice to survivors and gave many of them both the knowledge and courage to pursue their legal rights. Survivors of historical child sex abuse should feel no shame. Organisations such as the de la Salle Brothers, no doubt assisted by legal advice, continue to deny these claims and put survivors through the legal process. This is a scourge and the antithesis of what many of these institutions say they stand for.

So many survivors say they never thought anyone would believe them.

I believe you.

If you or a family member feel that you were the victim of sexual abuse as a child please contact me for a confidential discussion about your legal rights. My team and I will help you.

Defence of Necessity

Defence of Necessity

I recently had the privilege of representing the driver of a motor vehicle that had collided with the fence at the Orange Court House, in turn causing damage to State Government property. The State of New South Wales sought significant costs associated with the repair of the fence based on an allegation of negligent driving. The driver was at the time, being aggressively pursued by another vehicle as it travelled down Byng Street towards the Orange Police Station. Inside the other vehicle were four assailants who had verbally threatened the driver and followed him at high speed to prevent him report them to local Police. During the course of the pursuit a large metal object was thrown from the vehicle, striking the driver, forcing him to lose control of the vehicle and the collision into the Court House fence. Having sustained serious injuries as a result of the incident, insult was added to injury when some three years later the driver was notified of the State’s intent to recover financial damages from him for the necessary repairs to the Court House. It was then that the driver sought advice and assistance from me.

I relied upon the common law defence of “necessity” to defend my client in this claim. The necessity defence operates to absolve liability of a defendant both at criminal and civil law. The principle is that a person should not be liable for actions, that although ordinarily would constitute negligence, when the act occurs in response to a perilous situation.

In Leishman v Thomas the Court stated, “a man is not to be charged with negligence if his not being the creator of the crisis or emergency which has arisen, finds himself forced with a situation which requires immediate action of some sort and if in the so called “agony of the moment” he makes an error of judgment and takes a step which wiser counsels and more careful though would have suggested was unwise”..

The defence has been successfully raised even in situations where the so-called negligent act, deemed necessary by the defendant at the time, is later in the cold light of day and with hindsight reasoning objectively determined not to have been necessary, to wit “the agony of the moment”.

Rather appropriately capturing the circumstances of the driver who crashed into the Orange Court House fence, the Court in Southport Corporation v Esso Petroleum noted “the safety of human lives belongs to a different scale of values from the safety of property. The two are beyond comparisons and the necessity for saving life has at all times been considered a proper ground for inflicting such damage as may be necessary upon another’s property”.

I was able to successfully argue the necessity defence and ultimately force the State to withdraw its claim and make a contribution toward my client’s modest legal costs.

 

 

Experience Wins every time

An AFL Grand Final is an experience of a lifetime. The atmosphere is electric, and you leave in no doubt that you have been to a major event. The recent Grand Final between Geelong and Sydney was a non-event on the field, with Geelong absolutely destroying the Swans. Pundits were predicting the Swans would run away with the game because Geelong was too old and too slow, but how wrong they were. And how quickly and easily people are prepared to overlook experience and everything that it brings.

 

One player stood out – Joel Selwood. There is nothing he has not achieved in the game on the field, but it was his performance off the field that was truly inspiring. From carrying the child of his good mate through the banner at the start of the game, to his grace and respect in his post-match speech, handing his footy boots to the child who presented him with his premiership medal, greeting a supporter with genuine affection and shared joy, advising his younger team mates to go easy on the alcohol during the celebrations, right through to a backhanded crack at the Geelong critics during their Monday celebrations – nothing like returning serve to those who want to criticise you from the safety of a keyboard.

 

Joel Selwood – you are a true legend of a man.

 

For me the most striking feature of what unfolded on the field was that for all the pre-game confidence of the Swans youngsters and the experts, the Swans were seriously outgunned by a harder, more professional, more experienced and tougher team of men. Youthful exuberance and enthusiasm will get you so far, but on the big jobs on the big stage nothing beats experience. The Swans will be back, but this was not their time.

 

So here is where I compare myself to Joel Selwood and the Geelong Cats – or not!

 

The internet is full of incessant self praise, confidence, and outright misleading and deceptive conduct of some lawyers, mostly those with very little experience. Experience counts – in my case over 25 years of hard yards. Representing thousands of real people counts. Arguing hundreds of cases before Judges counts. Having long-standing professional relationships with a wide network of legal professionals, expert witnesses, and leading Barristers counts. Working harder than the next person, thinking about your clients’ cases when you are not at work, and genuinely hurting when people are confronted by injustice. This all counts. Having a genuine client first approach counts.

 

Lauding the work life balance, self praise about “resilience”, posting selfies on social media, blowing your trumpet about your success – all well and good – but none of that helps someone who needs help when they are in a hole. When the chips are down do you go with experience, hard work and a man for others, or someone with a great Linkedlin feed or Instagram page?

 

If you have experienced an injustice and you feel overwhelmed, then you can rely on my experience, my hard work, and my ability to fight for the result. Talk is cheap, action is what counts.

 

If you have sustained an injury, Toby Tancred can help.  He can provide you with legal advice, investigate your matter and represent you if you need to commence legal proceedings.  Toby Tancred is a Law Society Personal Injury Accredited Specialist – one of only a handful in regional and rural NSW – and has been recognised by Doyle’s Guide as a Recommended Work Injury Compensation Lawyer for two years running.  Doyle’s Guide has also named Toby Tancred Solicitor as a Recommended Asbestos & Dust Diseases Compensation Law Firm.  More recently Toby Tancred has been awarded Leading Personal Injury Lawyer in Australia by Lawyer Monthly. Toby Tancred has the experience, knowledge and ability to help all injured people in difficult times.

 

 

 

Medical Dispute with Icare and workers compensation Insurer

How long do I have to wait?

When you are an injured worker waiting for a decision from Icare and the workers compensation insurer relating to your medical treatment on your workers compensation claim can be painful and emotionally draining.  You know you need the treatment to assist your recovery, so why wont Icare and the workers compensation insurer help?

If your workers compensation claim has been accepted there is a range of treatment that Icare and the workers compensation insurer does not need to approve, including meeting with your GP, scans, some physiotherapy and some medication. Usually this is nowhere near enough to help your recovery if your work injury is serious.

Most treatment does require approval from Icare and the workers compensation insurer, for example regular physiotherapy, injections, surgery and inpatient psychiatric treatment.

Your GP, Specialist or treatment provider should send a written request for approval of the proposed treatment to Icare and the workers compensation insurer.  Icare and the workers compensation insurer must then make a decision regarding the treatment within three weeks of receiving the request.  In making its decision, Icare and the workers compensation insurer  will decide whether the proposed treatment relates to your work injury and is reasonably necessary.

It is very common for Icare and the workers compensation insurer to knock back an injured worker’s claim for medical expenses.  If Icare and the workers compensation insurer does this it MUST do it in writing. An injured worker will receive from Icare and the workers compensation insurer a section 78 Notice. This section 78 Notice MUST explain why Icare and the workers compensation insurer has knocked back your claim and MUST attach all evidence relied upon.

As soon as an injured worker receives a section 78 Notice you should contact Toby Tancred Solicitor.  For many years Toby Tancred has consistently been able to assist injured workers in their disputes with Icare and the workers compensation insurer particularly in relation to medical expenses. Some solicitors claim to have years of experience dealing with Icare and workers compensation insurers; in Orange and the Central West only Toby Tancred actually does. Runs on the board count.

As an injured worker you are entitled to be advised by Toby Tancred.  The Independent Review Office (IRO) can assist by providing funding for this legal advice.  IRO provides funding to approved Solicitors to investigate claims, provide advice to you as an injured worker, and deal with employers and insurers on your behalf.  Toby is an IRO Approved Lawyer.  Toby Tancred is a Law Society Personal Injury Accredited Specialist and has been recognised by Doyle’s Guide as a Recommended Work Injury Compensation Lawyer for two years running.  Doyle’s Guide has also named Toby Tancred Solicitor as a Recommended Asbestos & Dust Diseases Compensation Law Firm.  Toby Tancred has the experience, knowledge and ability to help all injured workers in difficult times.

 

 

 

Case Summary – AA V PD 2022

Case Summary – AA V PD 2022

AA v PD [2022] NSWSC 1039

On 5 August 2022 the New South Wales Supreme Court handed down a decision concerning the historical sexual abuse of AA (a pseudonym) by Phillip Doyle in 1972, when AA was a 16-year-old boy. At the time of the abuse AA was employed by Doyle, at his cinema, the Mecca, in Kogarah. Although the conduct complained of constituted criminal offending, the Supreme Court proceedings sought monetary damages for the sexual abuse.

AA described his relationship with Doyle prior to the abuse as one where he and Doyle got on “exceptionally well” and he was treated like a “best mate”. Doyle frequently visited AA’s family home, spent time with his family, and often dropped AA home after his evening shifts at the cinema. On these occasions, Doyle would stop his car some distance away from AA’s home, talking with the then teenager for around ten minutes. On some of these occasions, Doyle would place his hand on AA’s thigh, causing him to feel “very uncomfortable”.

While working at the cinema, AA would change into his uniform prior to commencing a shift in the cinema changerooms. While AA changed, Doyle would frequently enter the changeroom and instigate conversation while he watched AA undress. Although no advances were made during these interactions, AA stated that this also caused him to feel quite uncomfortable. AA recounted Doyle owning a number of unique cars, one of which was raced at the Parramatta Speedway. AA recalled on several occasions visiting the speedway races with Doyle, as well as two or three other cinema employees, and a mechanic. It was after one of these trips that the sexual abuse is alleged to have occurred.

After returning from the speedway one evening, rather than dropping AA home, Doyle took the teenager to his unit in Cronulla. Shortly after arriving, Doyle took a shower, after which he emerged in the loungeroom, naked, and proceeded to dry himself with a towel. Doyle then suggested that AA take a shower, during which Doyle entered the shower still naked, and began to inappropriately touch AA. The teenager swiftly exited the shower as Doyle unsuccessfully tried to persuade him to engage in what Doyle was doing. AA never returned to work at the cinema following this incident.

Like so many cases of child sexual abuse, AA did not disclose the abuse committed upon him until 37 years after the fact. In 2009, having come across a local newspaper article detailing the arrest of Doyle for other historical cases of child sexual abuse, AA contacted the Police to make a statement. However, due to the distress caused by recounting his abuse,
AA was unable to complete his statement until 2018. AA subsequently commenced civil proceedings against Doyle in the Supreme Court in 2021. Doyle’s offending had in fact been so prolific, it was detailed in the 2017 Royal Commission into Institutional Response to Child Sexual Abuse.

On 5 August 2022 Justice Chen of the Supreme Court found in favour of AA, awarding $217,550.00 in damages. In reaching his decision that the abuse had occurred, on the balance of probabilities, His Honour considered a number of factors. Namely, the plaintiff’s contacting police of his own volition, the consistency of evidence given in his 2009 and 2018 police statements, evidence of the change room incidents and car conduct as precursors to the shower incident, and admissions made by Doyle in connection with separate criminal charges for the shower incident. These were all regraded as evidence supporting that the shower incident occurred in the manner described by the plaintiff.

As is standard procedure in sexual abuse cases, AA was assessed by a forensic psychiatrist, who diagnosed a psychiatric injury and mild alcohol use disorder stemming from the abuse. The symptoms, however, were categorised as “mild” and “intermittent” and AA who had successfully maintained steady ongoing employment over the course of his adult life was given a favourable prognosis. These factors weighed on the moderate award of damages which consisted of sums for general damages, a small amount for past economic loss and loss of superannuation, out of pocket expenses, and interest. By contrast to the $217,550 awarded to AA, another of Doyle’s victims was in February 2022 awarded $1.3 million for abuse committed upon him by Doyle.

These contrasting awards of damages highlight the varied outcomes in historical sexual abuse matters. Following the Royal Commission into Institutional Responses to Child Sexual Abuse in 2017, the statutory limitation period for bringing a claim in respect of childhood sexual abuse has been lifted. This means that anyone, of any age is now at liberty to commence proceedings for abuse suffered while they were a minor. Many of these matters are settled out of court, and Toby Tancred offers confidential and obligation free assessment of any potential claim for damages for sexual abuse.

But the treatment will help me recover!

The number of injured workers involved in disputes with icare and their employer regarding payment of medical treatment is on the increase.

Medical and related treatment includes treatment by a medical practitioner, dentist, physiotherapist, chiropractor, osteopath, masseur and speech therapist.  It is also defined to include the provision of crutches, glasses and other artificial aids (such as joint replacements), medications, domestic assistance and modification to an injured worker’s home or vehicle.

An employer must pay for any treatment if “it is reasonably necessary”. 

Icare guidelines state that the following are to be taken into account in determining whether medical treatment is “reasonably necessary”:

  • the appropriateness of the particular treatment
  • the availability of alternative treatment
  • the cost of the treatment
  • the actual or potential effectiveness of the treatment
  • the acceptance of the treatment by medical experts.

An injured worker’s treating medical practitioner will normally provide a report commenting on these factors.  For example, a treating Neurosurgeon, who has recommended an injured worker undergo back surgery, may be able to comment that the surgery is appropriate given the other treatment options the injured worker has explored to date, that he / she is willing to perform the surgery, provide a quote, provide an opinion as to the likelihood the surgery will be effective, and comment broadly on the surgery’s acceptance by medical experts as a suitable treatment for the injury.

If icare and the employer continue to dispute that treatment is “reasonably necessary”, proceedings can be commenced in the Personal Injury Commission.  It has been determined that the following five factors are relevant to the determination of whether medical treatment is reasonably necessary:

  1. Prima facie, if the treatment falls within the definition of medical treatment it is relevant medical treatment.  Broadly then, treatment is given by, or at the direction of, a medical practitioner and is such treatment;
  2. However, though falling within that ambit and thereby presumed reasonable, that presumption is rebuttable if it be shown that particular treatment afforded is not appropriate, is not competent to alleviate the effects of injury, then it is not relevant treatment for the purposes of the act;
  3. Any necessity for relevant treatment results from the injury where its purpose and potential effect is to alleviate the consequences of the injury;
  4. It is reasonably necessary that such treatment be afforded a worker if the Commission concludes, exercising prudence, sound judgment and good sense, that it is so.  That involves the Commission in deciding, on the facts as it shows them, that the particular treatment is essential to, should be afforded to, and should not before born, by the worker;
  5. In so doing the Commission will have regard to the medical opinion as to the relevance and appropriateness of the particular treatment, any available alternative treatment, the cost factor, the actual or potential effect of this of the treatment and its place in the usual medical armoury of treatments for the particular condition.

Commencing proceedings in the Personal Injury Commission is required when Insurer’s decline to pay for physiotherapy, medication, surgery, or other medical or related treatment.  Although unfortunate, this often occurs, despite evidence that an injured worker’s treating medical practitioner has recommended the treatment to achieve the best outcome for the worker.

As an injured worker you are entitled to be advised by Toby Tancred.  The Independent Review Office (IRO) can assist by providing funding for this legal advice.  IRO provides funding to approved Solicitors to investigate claims, provide advice to you as an injured worker, and deal with employers and insurers on your behalf.  Toby is an IRO Approved Lawyer.  Toby Tancred is a Law Society Personal Injury Accredited Specialist and has been recognised by Doyle’s Guide as a Recommended Work Injury Compensation Lawyer for two years running.  Doyle’s Guide has also named Toby Tancred Solicitor as a Recommended Asbestos & Dust Diseases Compensation Law Firm.  Toby Tancred has the experience, knowledge and ability to help all injured workers in difficult times.