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[2005] VSCA 33
Court of Appeal (Vic)
2005-02-25
ORMISTON, CHERNOV & PHILLIPS JJ.A.
Original judgment source is linked above.
"... whilst attending to one of the defective and newly installed oil pots, she slipped on some of the spilt oil. She did not fall to the ground but twisted and jarred her back."
Notwithstanding, the plaintiff concluded the shift on the Friday and worked again on the evening of Sunday 18 June. She attended Dr. Wilson, her general practitioner, on the Monday and he diagnosed a strain to the paravertebral muscles of her thoracic spine. She did not then return to work until November 2000, undergoing physiotherapy in the meantime.
"I feel that efforts should continue to be made to wean this lady off passive modalities and she should be continued to be pushed into a self-management program. I note that she has on occasions managed to return to work on modified duties and hours and efforts should continue to try to rehabilitate her into the workforce. I can perceive she will have difficulty in the long term with recurrent bending, lifting or twisting tasks and with tasks requiring stooped activities. She would also require work which did not require the lifting of heavy weights. She would also be best served by activities which allowed her to change posture regularly."
"8. She had a weekend's break, returning to work at the Sunday night shift. She was in great pain. Notwithstanding visits to doctors and physiotherapy, pain persisted, particularly in the right leg. Six months after the accident she returned to work. The pain did not cease and was exacerbated by the work. In January 2002 she stopped working. 9. From her evidence, it was clear that the pain has sadly eaten away at her pre-accident way of life."
The judge quoted from a letter to her from her employer and continued:-
"11. Her employment life has been characterised largely by unskilled activities. She is an untutored labourer. 12. he plaintiff is not work shy, indeed she gave a very clear indication by her actions she is desperate for work. Unfortunately, given the medical evidence her desperation may intensify."
"16. The plaintiff said in her evidence that she had to sit and then stand with significant regularity. 17. This confirms Dr. Wilson's report. It was patently apparent that she was very uncomfortable and this was not some dramatic feigning. She is pregnant again - unwittingly - and this may have exacerbated the pain in the way the previous pregnancy did. Then it was thought the birth would have provided relief. It didn't. It is fair to postulate that the pattern will be repeated."
"The medical evidence as contained in the reports presents some difficulties, especially with respect to the issue of the future prognosis".
And it was on that issue specifically that his Honour quoted from three of the medical reports, as already mentioned.
"There may be some permanent impairment, taking into account she has residual symptoms two years after injury".
Third came the extract from Dr. Davison's report (of 15 August 2000) about how the plaintiff presented at interview, followed (in paragraph [16]) by the judge's comment on the plaintiff's own evidence about her need to sit and stand "with significant regularity", and (in paragraph [17]) by the judge's finding as to her obvious discomfort, her current pregnancy, and the failure of the previous birth to provide relief (a paragraph already quoted above[47]). Nothing more is said on the matter until the final conclusion was expressed a little later, in paragraph [20].
"The crucial problem with these re-constructed potentialities is that they pay scant, if any, regard to the plaintiff's pain, her response to pain (up and down), to her capacity to enjoy the confidence of an employer who is aware of her limitations".
In view of the conclusion that immediately followed, in paragraph [20], his Honour must be taken to have dismissed the defendants' figures of what the plaintiff was "capable of earning" as unreliable on the ground just stated. But if so, it does not follow that the worker had established that she was unable to work in any employment whatsoever. His Honour did not otherwise canvass the possibility of rehabilitation or re-training. Anyway, it does not follow that, because the defendants' figures on capacity to earn were dismissed as they were, there was evidence of economic loss to the extent of the 40 per cent required by sub-s.(38)(e).
"20. I am satisfied that she [the plaintiff] will have a permanent, a very considerable and a marked injury and that she will be unable to stay in any employment because of that impairment. No employer will be attracted to someone who has to agitate herself with regularity."
It was agreed that in the first sentence, the reference to "a marked injury" was a slip: it should read "a marked impairment". But the conclusion that there was an impairment which was permanent was challenged, and, as we have said already, with justification. As to the balance of the conclusion, that the plaintiff "will be unable to stay in any employment because of that impairment", that too was properly challenged by counsel as insufficiently justified by the findings which preceded it.
"... when judged by comparison with other cases in the range of possible impairments ... [be] fairly described as being more than significant or marked, and as being at least very considerable".
The requirement in paragraph (e) that economic loss answer the 40 per cent threshold is expressed as "in addition to the requirements of paragraph (c) ..."; yet nowhere does his Honour address the critical question in terms of paragraph (c). Perhaps it was regarded as implicit in the consideration of economic loss: that if a plaintiff is unable to earn at all by reason of the impairment the impairment must be "more than significant or marked and ... at least very considerable", but if so, it should have been articulated more clearly, given the issues that s.134AB(38) raises so specifically for determination.
"[The plaintiff] rested at home, with some improvement in the pain, and returned to work on the following Tuesday, performing light duties. During the following weeks, although she still suffered from some pain in her back, her symptoms largely resolved and she was able to resume part-time normal duties."
The judge appears to have accepted the plaintiff's evidence that this return to merely part-time duties was in part due to pain and in part her pregnancy: see paragraph [30] of the reasons for judgment.
"38. None of the medical practitioners who either treated [the plaintiff] or examined her for medical/legal purposes considered that the injury which [the plaintiff] suffered on 17 February 2000 was of any particular significance. 51. The effect of the strain to the plaintiff's lower back on 17 February 2000 was negligible in comparison to the injury - and the consequent impairment of function to her lower back - which resulted from the incident of 5 May, 2000. 54. The preponderance of medical evidence supports the proposition that the impairment of the function of [the plaintiff's] lower back arose from the incident of 5 May, 2000. 58. It is more probable than not that the incident of [17] February, 2000 was a mere straining injury from which [the plaintiff] made a substantial recovery, and that her return to work on reduced hours was attributable to caution and to her pregnancy, rather than to persisting symptoms of injury."
This is consistent, we were told by counsel, with the way in which the plaintiff's case was presented below, minimising, as it were, the consequences of any injury on 17 February.
"As the assessment of serious injury includes aggravation of a pre-existing injury it is permissible to analyse the impairment to one body function caused by two injuries for the purpose of determining whether the second injury aggravated the first and, if it did, whether the resulting additional impairment amounts to a serious injury. In determining whether or not the plaintiff has suffered a serious injury I have analysed each injury to the lower back for the purpose of comparing the impairment immediately before and immediately after the second injury."
"However, although I am satisfied that the incident in May at work aggravated the Plaintiff's back condition, I am not satisfied that the additional impairment amounts to a serious injury."
"Most of the medical evidence dealt with the back injuries together without drawing a distinction between them for the purpose of assessing the plaintiff's medical condition."
Of course it does not follow because most of the medical evidence dealt with both of the back injuries together that the judge was unable to analyse each injury as she said she did. The judge was concerned with the consequences as to pain and suffering and as to economic loss and there her Honour had the benefit of other evidence (and importantly that of the plaintiff herself) and, the judge having concluded that the plaintiff did injure her back in February (albeit that she recovered at least in the main) and then injured her back a second time in May, the analysis described by the judge became possible on a consideration of the totality of the evidence.
"I am not satisfied that the consequences for the plaintiff with respect to pain and suffering satisfy the statutory definition of serious injury".
So far as we can tell, this conclusion encompassed all of the evidence about the pain and suffering experienced by the plaintiff following upon the incident in May, and indeed the plaintiff so submitted on appeal. Mr. Maxwell contended that the judge had assessed the plaintiff's pain and suffering according to all of the evidence and without attempting any division or deduction because there had been two incidents; and he sought to use this as a factor to support his argument that what was relevant under s.134AB was the ultimate impairment of the body function (in this case, the lower back), rather than the specific injury which occurred on 5 May.
"32. The Plaintiff, in her affidavit sworn on 13 November 2000, stated that prior to her injury she considered herself to be fit and well. She was able to look after the home by doing all the cooking, cleaning and washing, and was able to go out with her husband and friends to barbecues and parties, and take leisurely walks during the summer months along the local beaches and other places in the Geelong area. She is now restricted in what she does and has to be careful about the moment of time she spends lifting, standing and walking because doing too much of any of these causes an increase in her pain and causes a lot more trouble with her lower back. 33. From her evidence before the Court, however, a picture has emerged of a person who lives a generally normal existence with some back pain for which she sees a chiropractor. The Plaintiff is able, with some assistance, to bathe and look after her child and to do most of the housekeeping, drive a car and do the shopping. Video film showed the Plaintiff going about her life in a normal fashion with no signs of pain or restriction. She has the ability to squat, bend and strap her child in and carry the shopping. I accept that the videos are a general snapshot of the Plaintiff's life from 2000 to 2003, and shows a person who is leading a generally normal existence with some back pain. 34. Although she is left with a back condition that gives her pain on occasions and restricts some of her activities when judged by comparison with other cases in the range of possible impairments and losses of body functions her impairment cannot be fairly described as more than significant or marked or at least very considerable"
"Basically from then on I continued seeing Dr. Sachdev and followed his instructions to take medication and to have the type of treatment that I have already described".
"... I was off work for about 2 weeks initially at the direction of Dr. Sachdev. I commenced working about 2 hours per day after that, and then 3 hours and eventually 4 hours per day in the laundry on light duties doing light folding work, but I was struggling to keep up those hours and I had days off here and there. I have already described what happened to me on the 14th April, 2000. I think I was off for about one month at that stage before going back to work about 2 hours per day for a couple of months. My boss wanted me to do more hours, but I was finding it difficult to stand for more than 20 minutes or so before the pain increased. Eventually the pain I was having and the severity of it saw me stopping work altogether in about January 2001. I have not been able to return to work since then."
The plaintiff's case was that she was now altogether unemployable.
"19. In this case the CT scan reported no abnormality. The MRI report referred to minor degenerative changes in the L5/S1 disc. Appearances were otherwise within normal limits. These findings are consistent with Mr. Klug's view that the Plaintiff suffered a minor abnormality of the L5/S1 disc. I accept the opinion of Mr. Klug, expressed in his second report dated 7th August 2003, and his evidence that, on the scale of injuries that he has seen over the years in his practice, from a purely physical point of view the injury is of a relatively mild degree. I find that there is support for Mr. Klug's diagnosis in the notes and reports of the Plaintiff's treating doctor, Dr. Sachdev. 20. In Dr. Sachdev's report of 16th October 2001, he expresses the view that `the Plaintiff seems to have a deeply entrenched chronic pain syndrome. She has attended a psychologist and also tendered a pain management clinic for management, but has not reported any significant benefit. The symptoms will eventually resolve, but it is very difficult to say how long it is going to take'. 21. In his report of 1st December 2000 Mr. Muir, a pain specialist, described the Plaintiff `as appearing mildly depressed and exhibiting multiple pain behaviours'. Mr Wood, a rheumatologist, stated in his report of 16 May 2001 that `there are clearly a number of examination findings that suggest a functional component. Perhaps there is a psychological basis to the severity of her pain and of course the other possibility would be a deliberate exaggeration. I cannot explain her pain and examination findings, however, on the basis of a physical injury or condition.'"
"26. In this case I accept the medical opinion that the injury to the Plaintiff's back, although permanent, is an injury of a relatively moderate degree. Although I accept the sincerity of the Plaintiff in her description of her back symptoms, I also accept that the Plaintiff is, as Mr. Sachdev described, `entrenched in a chronic pain syndrome'. This is a case which incorporates psychological and/or psychiatric symptoms which I cannot take into account in assessing whether or not the Plaintiff's impairment comes within the definition of a serious injury as defined in 134AB(37)(a)."
Thus, the judge accepted that the plaintiff had suffered injury to her back, though of "a relatively moderate degree", this no doubt reflecting her Honour's earlier acceptance of Mr. Klug's oral evidence that "from the purely physical point of view, the injury would be of a relatively mild degree"[55]. Significantly, her Honour also accepted the existence of psychological and/or psychiatric symptoms which, by virtue of s.134AB(38)(h), had to be excluded from account when considering "serious injury" as defined in paragraph (a) of the definition in sub-s.(37). And before us, the defendants pointed not only to the functional overlay to which the judge referred, but also to the degenerative condition to which Mr Klug had referred.
"35. I accept the majority medical opinion that the Plaintiff is capable of performing light physical work that does not involve heavy lifting or forceful pushing or pulling activities. Further, I accept that the Plaintiff has the physical capacity, if not the motivation, to perform work of the nature mentioned in a Vocational Assessment prepared by Heron Assist. The jobs identified as being suitable for the Plaintiff are real jobs that exist in the market place. The onus is on the Plaintiff to prove an inability to undertake "suitable employment", alternative or further or additional employment. Taking into account the criteria set out in section 5 of the Act I am not satisfied that she has discharged this onus."
We agree, with respect, in this conclusion. On appeal the plaintiff contended that though Heron Assist had purported to identify other jobs for her, the medical evidence was not such as "to enable the court to determine the suitability of such employment"[59]. But that cannot advance the plaintiff's case, for the onus in that regard lies on her: s.134AB(19)(b).
"27. In her affidavit of 16 April 2002, the Plaintiff alleged that her life had been affected in many ways since suffering her injury. Her ability to do her housework properly has been affected. She still does housework but needs help from her husband and children. Her ability to do gardening has been affected. She used to be an active member of the Croatian community and attend dances which she cannot do any longer. In her evidence to the Court she claimed that she could no longer work because of the pain she suffered in her back after sitting or standing for 15 to 20 minutes. 28. On good days, however, the Plaintiff goes about her life in a normal fashion. She does the cooking, washing and housework. She can drive to the shopping centre and carry bags of shopping around. She is doing unpaid work for a couple of hours a week at the St John of God Hospital and hopes to increase her hours. The Plaintiff's treating Doctor encouraged her to be active and to return to work. After carefully considering all the evidence in this case I am not satisfied that the consequences to the Plaintiff of the impairment or loss of function of her back with respect to pain and suffering when judged in comparison with other cases in the range of possible impairments may be fairly described as more than significant or marked and as at least very considerable."
"... in respect of personal injuries to both arms suffered during the course of her employment as a kitchen hand/cook with [the employer] on very frequent occasions between the 20th October 1999 and approximately 27th April 2001 in being required to perform unduly heavy lifting, twisting, straining and bending work, such injuries being caused by the negligence of [the employer]".
The particulars of injury given by the plaintiff mentioned both carpal tunnel syndrome affecting both right and left wrists and hands and, in respect of the right wrist, hand, forearm and elbow, reflex sympathetic dystrophy (which, we were told by counsel, also has the diagnostic labels of chronic pain syndrome, type 1, and regional pain syndrome). Amongst the doctors' reports, there was medical opinion that work was a significant contributing factor to carpal tunnel syndrome, but there was also medical opinion that it was not - although this difference of opinion seemed to lie rather in the general nature and aetiology of carpal tunnel syndrome than in the circumstances of the particular case.
"On 13 January 2000 she presented with right hand pain suggestive of carpal tunnel syndrome and was referred for a nerve conduction test that was performed on 7 March. The study confirmed right carpal tunnel syndrome and was consistent with very mild left carpal tunnel syndrome."
"She said that she had some soreness in her right hand which had increased over the previous twelve months. She stated that she had not suffered an injury at work, but she had first noticed the pain at work and therefore had put in a Workcare claim. The pain was a shooting pain in the dorsum of her right hand, and it also went over the index middle metacarpal region. This pain was worse with heavy lifting, and the stirring in which she had to do in her job as a cook. Associated with this was numbness in the index and middle finger tips of the right hand. She could not particularly recall when this happened, although it did occur at least daily. She also complained of pins and needles at night in her index and middle finger, and this tended to wake her up at night."
After describing the results of his examination of the plaintiff, Mr. Brown referred to the nerve conduction tests conducted on 7 March and added:
"My assessment of this lady's pain was that it was not entirely consistent with a carpal tunnel syndrome. Check x-rays were obtained, and these were found to be normal. I felt that she had the problem of a chronic pain syndrome, and had been referred to Jane Abbot for help [for] this."
"I had [it] for a while, but the treatment did not relieve the problems I was having in both hands which, by that stage, was a lot of pain in my right wrist and hand with pins and needles in my hand and fingers. I was suffering similar problems to my left hand, but they were not as severe."
Accordingly, in July or August 2000[60] the plaintiff returned to see Mr. Brown and on 14 September he operated on her right wrist in a procedure for right carpal tunnel release, performed upon her as a day patient. The surgeon thought the procedure successful. In his report of 12 March 2003, he said simply that the plaintiff "was reviewed post operatively without any particular problems".
"The diagnosis of Mrs. Gledhill's condition is therefore not totally clear. Although she did have a right carpal tunnel syndrome, she also had features of a chronic pain syndrome. In addition, her symptoms appeared at work and were made worse particularly with her heavy lifting at work and stirring pots at work. I felt that her work as a cook did contribute to this."
"15. Carpal tunnel syndrome is an evolving complaint, what Dr Blair-Holt described as an `over-use injury'. He said that it was very difficult to categorise the onset point, when symptoms commenced."
"24. I am satisfied, on the balance of probabilities, that the plaintiff's carpal tunnel syndrome was caused in large measure by the nature of the employment she undertook."
The plaintiff's work was then described from her own affidavit, which, his Honour said "was confirmed in viva voce evidence".
"29. I accept that carpal tunnel syndrome is marked by progressive symptoms. Thus it presents a difficulty for me in establishing the point at which it may be said to have evolved. In reaching a conclusion as to this, I have given considerable weight to the period of time during which full-time work was undertaken and continued, to the medical evidence, to the reports to Ms Galven to the employer, and the evidence of the plaintiff. The denouncement [an obvious mistyping of "denouement"] occurs when a firm diagnosis is made after nerve conduction tests. I am satisfied that the injury occurs after 1999. 30. Notwithstanding the defendant's submissions, I am satisfied that the plaintiff's injury is serious and she is most unlikely to obtain further employment and certainly not to an income level as predicated by the defendant."
[1] Hansard, Legislative Assembly, 13 April 2000, at p.1001.
[2] By Act No. 95/2003 s.3(8) the words "if employment of that nature was a significant contributing factor, and" were omitted as from 3 December 2003, but that was well after the injuries relied upon by the plaintiffs in these four cases.
[3] Contrast the position that existed when Hanrahan v. Davis [1997] 1 V.R. 285 was decided.
[4] Although the drafting of sub-s.(4) is not altogether clear.
[5] [2004] VSCA 55 at [16].
[8] See paragraph 2 above and compare s.135A(19).
[9] [1984] FCA 57; [1984] 1 F.C.R. 354 at 360.
[11] [2001] VSCA 148; [2001] 3 V.R. 644 at 651.
[13] The wording is derived directly from the majority judgment in Humphries v. Poljak [1992] VicRp 58; [1992] 2 V.R. 129 at 140.
[15] Including any physical consequences of the mental or behavioural disturbance or disorder: see sub-s.(38)(i).
[16] Wording which is again derived directly from the majority judgment in Humphries v. Poljak.
[17] Although paragraph (e) makes special provision for workers under 26 years of age and in Stojanovski the plaintiff was only 25 at the time of the incidents relied upon, that fact was not mentioned in argument. The special provision had no significance because the plaintiff abandoned on appeal any reliance upon economic loss.
[18] In Reprint Nos. 11, 12 and 13, the notation "(i)" intrudes at this point, apparently by a typesetter's error. It is ignored above.
[20] As pointed out in Humphries v. Poljak.
[21] Contrast the specific reference in sub-s.(38)(e)(ii) to the 40% loss of income "continuing permanently" and the absence of any such express reference in relation to pain and suffering.
[24] Compare Dodoro v. Knighting [2004] VSCA 217.
[26] [1998] 3 V.R. 833 at 841 per Brooking, J.A., at 858 per Phillips, J.A. and at 860 per Charles, J.A.
[29] On an appeal against the exercise of discretion it is not enough to differ in opinion as to the result; the exercise of the discretion below must be shown to have miscarried: for example, if the judge at first instance acts upon a wrong principle, allows extraneous or irrelevant matters to guide him, mistakes the facts or does not take into account some material consideration, or if the result is so unreasonable or so plainly unjust that the appellate court can infer relevant error though not otherwise identified specifically. Only then can the appellate court intervene: House v. R. 55 C.L.R. at 505.
[34] [1965] VicRp 41; [1965] V.R. 279 at 290.
[41] See further what was said in Mobilio by Brooking, J.A. at 836-7.
[42] Until the position was settled last December in Dodoro v. Knighting [2004] VSCA 217.
[43] See [2004] VSCA 217 at [1] per Winneke, P.
[45] The plaintiff herself so described the event in her affidavit of 1 August 2002.
[46] As to which see Richards v. Wylie [2000] VSCA 50; (2000) 1 V.R. 79 at 86 per Winneke, P.
[48] Mobilio v. Balliotis [1998] 3 V.R. 833 at 836.
[52] [1979] HCA 9; (1979) 142 C.L.R. 531 at 552.
[53] Contrast what was actually said by Crockett and Southwell, JJ. in Humphries v. Poljak [1992] VicRp 58; [1992] 2 V.R. 129 at 140 where it was the injury which was to be compared with other cases in a range of possible impairments or losses to see if it could be fairly described at least as `very considerable' etc, albeit by reference to consequences as to pain and suffering and economic loss.
[54] Although the plaintiff's Originating Motion speaks of suing the employer for injuries to back and spine occurring during the course of employment from 20 October 1999 to 6 January 2000, the Outline of Argument is focussed on the incident occurring on 6 January, and nothing more: see Plaintiff's Outline para. 32.
[56] Plaintiff's Outline of Argument paras.33-45, especially 39.
[57] Defendants' Outline of Argument, para. 16.
[59] Plaintiff's Outline of Argument para. 47.4
[60] In her affidavit the plaintiff said she went back to Mr. Brown on 10 July 2000 but Mr. Brown in his report said that she was reviewed on 4 August. The difference is of no consequence.
Barwon Spinners Pty Ltd
Podolak; St Laurence Community Services
"This effectively restores the task to be undertaken by a court of appeal to the principles established by Humphries v. Poljak [1992] VicRp 58; [1992] 2 VR 129 at 140. There the Court followed the dicta of the majority as stated by the Full Court of the High Court in Warren v. Coombes [1979] HCA 9; (1979) 142 C.L.R. 531 p.552, `the duty of the appellate court is to decide the case - the facts as well as the law - for itself. In doing so it must recognise the advantages enjoyed by the judge who conducted the trial'."