The Medical Appeal Panel's decision
26After recounting the medical evidence, at [47] to [50] and [55] to [59] the Appeal Panel stated as follows:
47. The Panel is not convinced that the subsequent retinal detachment and giant retinal tear were caused by the trauma on 28 January 2009. We note that Dr Murugesan at one point thought that the impact with the door had caused a traumatic cataract, and may have been the cause of the retinal detachment. However the contemporaneous notes of Dr Saks make both possibilities unlikely. The blow to the eye caused a corneal abrasion and mild uveitis, which had resolved within five days. The cataract was already present. Nonetheless, we note the view of Dr Chang, expressed above, that the cataract was likely to have progressed more quickly following the blow to the right eye.
48. S 16 1987 Act provides relevantly: -
(1) If an injury consists in the aggravation, acceleration, exacerbation or deterioration of a disease...(Emphasis added).
49. It can be seen that Dr Chang's opinion was that the blow on 28 January 2009 accelerated the progress of the cataract. We are satisfied that the condition of the appellant was one of a person suffering from a disease process: (as to disease, see Favelle Mort Ltd v Murray [1976] HCA 13; (1976) 133 CLR 580 per Barwick CJ at [15]. See also the discussion in Zickar v MGH Plastic Industries Pty Ltd [1996] HCA 31; (1996) 187 CLR 310; (1996) 140 ALR 156; (1996) 71 ALJR 32).
50. It can thus be seen that if we were satisfied that the treatment undergone by way of surgery on 29 and 30 June 2009 was necessitated as a result of the acceleration of the progress of the posterior polar cataract caused by the blow to the eye on 28 January 2009, then the appellant would have established an entitlement pursuant to s.16.
...
55. This causal link was described by Dr Michael Delaney in his report of 28 March 2011. He pointed out some factual errors in the opinion of Dr Duke, and then said (ARD 4): -
....the need for cataract surgery was caused or exacerbated by the injury at work and this operation [that of 30 June 2009] and its complications caused or exacerbated the retinal detachment.
56. However, on a close analysis of the evidence we are unable, with respect, to agree. The critical evidence is that of Dr Saks, in two respects. Firstly, Dr Saks found the right eye injury to be minor, following the injury of 28 January. He found a small superficial corneal abrasion, a mild conjunctival injection and only a few cells in the anterior chamber. Fortunately, due to his protective eye shield, this was all that occurred. The eye healed in a few days. If the injury had been severe enough to cause damage to his lens, the corneal damage and surrounding eye damage would have been much more significant.
57. Secondly, Dr Saks diagnosed right advanced cataract with markedly reduced vision of 6/36 partly, which was pre-existing. He did not say this was traumatic in nature and commented that he expected it would require operation in the future.
58. Dr Chang did not have the benefit of Dr Saks's findings when he gave his opinion. Although his opinion in his report of 28 June 2011, as extracted above, made a causal connection, in his earlier report of 1 December 2010 he made an important qualification to that opinion. At ARD 9 Dr Chang said: -
...If the blow to the right eye was substantial this may have caused the cataract to progress more quickly...
59. For the reasons given, we find that the blow to the eye itself was not substantial, and thus the underlying condition of Dr Chang's opinion has not been satisfied."
27The plaintiff submitted that the Appeal Panel's decision is invalid for jurisdictional error because the Appeal Panel asked itself the wrong question and misconceived its function under ss 322(1) and 328 of the Act by attempting to determine whether the plaintiff's permanent impairment was caused by the work injury. According to the plaintiff, that issue was the function of an arbitrator which had been determined by the arbitrator's decision on 21 November 2011 and was not capable of referral to an AMS under s 321 of the Act or of an appeal to the Appeal Panel under s 327. Hence, the plaintiff says that the Appeal Panel failed to ask itself the proper question that question being what was the degree of permanent impairment resulting from the injury.
28The Appeal Panel made a jurisdictional error, the plaintiff further submitted, in assessing the degree of impairment resulting from the work injury solely by attributing the cause of the permanent impairment to a pre-existing condition rather than to the work injury. According to the plaintiff, the Appeal Panel was required to address pursuant to s 323(1), whether there was to be a deduction for any proportion of the impairment that was due to the pre-existing condition. It was also required to address pursuant to s 323(2), whether the assumption that the deduction is 10% of the impairment was met by asking whether the extent of a deduction would be difficult or costly to determine. The plaintiff submitted that the Appeal Panel failed to address either matter.
29In Haroun v Rail Corporation of NSW [2008] NSWCA 192, the Court of Appeal held that this was a matter for the Appeal Panel whether any permanent impairment "resulted from" the injury as found by an arbitrator. Handley AJA (McColl JA and McDougall J concurring) stated at [16] - [22]:
"16 ...The scheme for the settlement of compensation disputes established by the 1998 Act read with the Workers' Compensation Act 1987 (the 1987 Act) is to have factual and legal issues resolved by an Arbitrator subject to an appeal to a President or Deputy President, and to have certain medical issues decided by an AMS subject to appeal to a Panel.
17 Section 65(1) and (3) of the 1987 Act provides that in the event of a dispute the degree of permanent impairment that results from an injury is to be assessed in accordance with Part 7 of the 1998 Act. This includes ss 321, 323, 326, 327 and 328.
18 Section 326(1) provides that a MAC 'is conclusively presumed to be correct ... in any proceedings before a Court or the Commission' as to (a) 'the degree of permanent impairment of the worker as a result of an injury' and (b) 'whether any proportion of permanent impairment is due to any previous injury or pre-existing condition.' This section also applies to a MAC issued by a Panel: s 328(5).
19 The scheme of the two Acts is to ensure that the degree of permanent impairment that results from an injury, and any contribution to the worker's total impairment that is due to an earlier injury or pre-existing condition are assessed under and in accordance with Part 7 of the 1998 Act and not otherwise.
20 If there is a medical dispute of a kind defined in s 326(1) of the 1998 Act, an Arbitrator has no jurisdiction to decide it, but "may refer it for assessment" by an AMS: s 321(1). That section confers a power which an Arbitrator is bound to exercise in a proper case in aid of the private rights of the parties: Julius v Lord Bishop of Oxford (1885) App Cas 214, 235, 243, 244.
21 Since the Arbitrator had no jurisdiction to decide the medical dispute he, referred had no jurisdiction to make findings which were binding on the AMS or the Appeal Panel. The finding of a person without jurisdiction cannot bind the person or persons with jurisdiction, and cannot even be persuasive.
22 Section 350(1) of the 1998 Act provides that 'Except as otherwise provided by this Act' a decision of the Commission [which includes an Arbitrator] 'is final and binding on the parties and is not subject to ... review'. This section did not make the consent findings of the Arbitrator binding on the parties because the Act otherwise provides. A MAC which is conclusively presumed to be correct under s 326(1) trumps any inconsistent findings by an Arbitrator and such findings are neither final nor binding on the parties."
30The plaintiff says that the injury the Appeal Panel had to consider was the permanent impairment resulting from the exacerbation of the pre-existing cataract caused by the blow to the right eye. The Appeal Panel then had to consider what proportion of the permanent impairment was due to a pre-existing condition and make the appropriate deduction.
31It is for the arbitrator to decide the legal and factual issues. The arbitrator found that the plaintiff had suffered an injury to his eye on 28 January 2009 and Carter Holt was liable for that injury. In Wikaira v Registrar of the Workers Compensation Commission of NSW [2005] NSWSC 954, Malpass AsJ held that once the fact of an injury had been established by an arbitrator, it was for the AMS to determine the degree of permanent impairment resulting from the injury. The Appeal Panel accepted that the plaintiff had suffered an injury to his right eye on 28 January 2009.
32In Elcheikh v Diamond Formwork (NSW) Pty Ltd (in liq) [2013] NSWSC 365, the arbitrator had determined that Mr Elcheikh had suffered a compensable injury as the result of his heavy work over a period of 10 years, for which the former employer was liable. The nature of that injury was an aggravation of a previously asymptomatic condition, not as a result of any particular, identifiable event. Schmidt J held at [125] that:
"The starting point of a medical assessment conducted under s 322 is that the impairment being assessed resulted from an injury suffered at work, Under s 323, the medical specialist is not called upon to determine whether the resulting impairment was contributed to by that work. The assessment proceeds on the basis that it did."
33The relevant injury in Elcheikh fell within the meaning of s 4(b)(ii) of the Workers Compensation Act. Although the Plaintiff in the current matter submitted that the arbitrator had determined that the Plaintiff suffered an injury under s 4b(ii), this was not in fact the case. Rather, the arbitrator made orders by consent that the Plaintiff suffered an injury to his right eye on 28 January 2009. This injury was a discrete blow to the eye, which fell within the meaning of s 4(a) of the Workers Compensation Act. Therefore there could be no inconsistency between the orders made by the arbitrator, and the finding of the AMS (and the Appeal Panel) that the work injury did not result in any permanent impairment. It appears that principle expressed by Schmidt J above, that it is not the function of the AMS to determine whether the impairment was contributed to by the worker's employment does not apply to the facts of this case.
34It was common ground between the parties that the retinal detachment was the result of complications from the cataract surgery in June 2009. There was no question of negligence in the medical treatment and it was accepted that the complications arising from the surgery led to the subsequent spontaneous retinal detachment.
35The Appeal Panel noted the opinion of Dr Chang who had conducted the surgery after the complications from the initial cataract surgery in June 2009. Dr Chang, at that time, was of the opinion that the cataract "was likely" to have progressed more quickly following the blow to the right eye. On 1 December 2010, Dr Chang stated in a letter to the plaintiff's solicitor, that "[I]f the blow to the right eye was substantial this may have caused the cataract to progress more quickly" (R Dabaneh Aff, 23 May 2013, Ex RD-1 p 45). The Appeal Panel acknowledged that if the surgery at the end of June 2009 to correct the retinal detachment and tear was necessitated as a result of the acceleration of the progress of the cataract caused by the blow to the eye, the plaintiff would have established an entitlement to compensation under s 16 of the Workers Compensation Act. However, the Appeal Panel came to the conclusion that the blow to the eye was not substantial and that the need for cataract surgery was not caused or exacerbated by the injury at work.
36The Appeal Panel was required to determine the extent of any permanent impairment that had resulted from the work injury of 28 January 2009. The correct question to be answered by the Medical Appeal Panel was whether loss of vision in the right eye because of the complications arising from the cataract surgery, was caused or materially contributed to by the accident. They determined that the blow to the eye itself was not substantial and did not cause the cataract to progress more quickly. The Appeal Panel then confirmed the decision in the second Medical Assessment Certificate, that the plaintiff has 0% WPI as a result of the injury. In doing so, the Appeal Panel did not stray from the principles set out in Wikaira v Registrar of the Workers Compensation Commission or Elcheikh v Diamond Formwork (NSW) Pty Ltd (in liq).
37It is my view that the Medical Appeal Panel posed and answered the correct question. This ground of the plaintiff's application for judicial review fails.
38As the Appeal Panel found that no permanent impairment resulted from the work injury, there was no need for it to consider a deduction for the pre-existing injury pursuant to s 323 of the Act. As a result, this ground of the plaintiff's application for judicial review also fails.
39In the alternative, the plaintiff submitted that even if the Appeal Panel did act within jurisdiction in determining whether the permanent impairment was caused by the work injury, it made a non-jurisdictional error of law on the face of the record by:
(1) Incorrectly assuming that the blow to the right eye on 28 January 2009 was the work injury when as a matter of law the work injury for the purposes of ss 4, 9A and 16 of the Act was the exacerbation or aggravation of the plaintiff's existing cataract condition in the right eye;
(2) Misapplying the test of causation in asking whether the permanent impairment was caused directly by the frank injury from the blow to the right eye on 28 January 2009, instead of asking whether the permanent impairment was caused by the exacerbation or aggravation of the existing cataract condition.
40In written submissions to the Registrar in respect of the appeal against the second assessment of the AMS Dr Anderson, the plaintiff stated:
"1. There is no dispute that the worker suffered injury by way of frank trauma to the right eye in an incident on 28 January 2009.
2. The incident is not in dispute. Injury to the right eye is not in dispute. The question before the Workers Compensation Commission was whether the trauma to the eye on 28 January 2009 caused or contributed to the exacerbation or aggravation of a pre-existing condition necessitating the need for surgery. If that is affirmative, then any complications in that surgery (ie loss of vision) is part of the compensable injury." (R Dabaneh Aff, 23 May 2013, Ex RD-1 p 329)
41Carter Holt submitted that the arbitrator made no finding that the nature of the plaintiff's injury on 28 January 2009 was an aggravation of a disease to which the employment was a substantial contributing factor. The only consent determination made by the arbitrator was that "the Plaintiff suffered injury on 28 January 2009 to his right eye and the First Defendant has liability in respect to injury." The plaintiff's written submissions to the Registrar seem to be in agreement with Carter Holt's submission as to the arbitrator's decision.
42In my view, the plaintiff's assertion in the hearing before me, that the work injury as determined by the arbitrator was the exacerbation or aggravation of the existing cataract condition, is not correct. The words of the consent order are clear. The parties agreed that the referral was for an injury to the right eye. Had the parties agreed that the injury was an "exacerbation of pre existing cataract, necessitating surgery" this would have been reflected in the consent orders. Even if the parties had agreed that the injury was an exacerbation to the pre-existing cataract rather than the frank injury to the right eye that occurred on 28 January 2009, it may have been beyond the arbitrator's powers as it would have been a determination of a medical issue (see Haroun at [16]). The Appeal Panel did not make an incorrect assumption and made no non-jurisdictional error on the face of the record in this regard.
43In relation to the second submission, that the Appeal Panel misapplied the test of causation, it was common ground that the retinal detachment and tear were caused by complications from the cataract surgery. Pursuant to s 326(1) of the Act an assessment in a Medical Assessment Certificate is conclusively presumed to be correct, including whether any proportion of permanent impairment is due to any previous injury or pre-existing condition or abnormality. A dispute between a claimant and the person on whom a claim is made in relation to the degree of permanent impairment due to an injury, and what proportion of that permanent impairment is due to a pre-existing condition, is a "medical dispute" pursuant to s 319 of the Act.
44The Appeal Panel answered the question posed in the plaintiff's submissions to the Registrar where they said at [47]: "The Panel is not convinced that the subsequent retinal detachment and giant retinal tear were caused by the trauma on 28 January 2009." The Appeal Panel goes on to say at [49] - [50] that they "are satisfied that the condition of the appellant was one of a person suffering a disease process... It can thus be seen that if we were satisfied that the treatment undergone by way of surgery... was necessitated as a result of the acceleration of the progress of the ... cataract caused by the blow to the eye on 28 January 2009, then the appellant would have established an entitlement pursuant to s 16." (My emphasis added.)
45The Appeal Panel was not so satisfied. They did not misapply the test of causation. The Appeal Panel did not make a non-jurisdictional error of law on the face of the record.
46The result is that the application for judicial review fails. The summons filed on 16 April is dismissed. Costs are discretionary.
47Costs are discretionary. Costs usually follow the event. The plaintiff is to pay the first defendant's costs as agreed or assessed.