Ground 4: whether the Tribunal made findings without evidence or inappropriate inferences
50 The key factual findings of the Tribunal on why it accepted that Mrs Reardon's hyperacusis was aggravated by her employment, and her workplace conditions, can be found at [53] of the Tribunal's reasons, which I have extracted at [13] above.
51 Comcare submits that these findings were either not supported by the evidence or involved inferences that were not reasonably open on the evidence.
52 However, its submissions are then couched in the language of "it is incorrect …", or it is "at least incomplete, to state" and what follows is, in my opinion, properly characterised as engagement with the Tribunal's fact-finding at a merits level, seeking to persuade the Court why the Tribunal's ultimate conclusions would have been different, if it had viewed the evidence through the lens Comcare submits was the better one.
53 The respondent's submissions answered these criticisms in the following way.
54 In relation to [53(c)] of the Tribunal's reasons, the respondent accurately pointed out that Mr Brennan did accept that workplace noises were capable of making the condition of hyperacusis worse (as the Tribunal found he did). The difference between Mr Brennan and Dr Sharman was the degree of impact that could be attributed to workplace noise. Mr Brennan put it at a much lesser degree. I return to this issue below.
55 In relation to the next seven factual findings at [53] of the Tribunal's reasons, and Comcare's criticism of them, the respondent submits:
The matters raised by the applicant in its submissions at paragraph 16(d) do not relate to the respondents "past history of noise exposure outside the workplace" and therefore the finding at 53(d) of the reasons is correct.
At paragraph 16(e) of its submissions the applicant appears to concede that the Tribunal's finding at 53(e) is correct. There was no diagnosis formal or otherwise of any condition that has caused the hyperacusis. At most Mr Brennan raised the possibility of an underlying condition such as endolymphatic hydrops. The absence of any diagnosed medical condition of the inner ear capable of explaining the condition is a fact which is capable of informing the Tribunal's ultimate conclusion that the employment was a significant contributor to the aggravation of the hyperacusis.
The applicant by its submissions at paragraph 16(f) again appears to concede that the Tribunal's finding at paragraph 53(f) was correct. The applicant's complaint appears to be with the ultimate conclusion reached by the Tribunal. In any event Mr Brennan did not give evidence that non-work related factors triggered Mrs Reardon's symptoms. To the contrary his evidence was on the whole consistent with employment triggering an aggravation of the hyperacusis.
The Tribunal's findings at 53(g) of the reasons is not a finding in respect of the respondent but a general observation as to whether hyperacusis can be worsened by workplace noise. This general finding accords with the evidence of Mr Brennan.
The applicant at paragraph 16(h) of its submissions appears to concede that the Tribunal's finding at 53(h) is correct. The applicant's complaint appears to be with the Tribunal's ultimate finding that the employment was a significant contributor to the aggravation of the hyperacusis. Mr Brennan's evidence as to the difficulties that the respondent experiences in everyday life relate to the time he saw her i.e. 15 May 2014 and when her hyperacusis was established.
The applicant by its submissions at paragraph 16(i) appears to accept that the finding of the Tribunal at 53(i) is correct. The applicant's complaint appears to be with the Tribunal's conclusion that the employment was a significant contributor to the aggravation of the hyperacusis. The Tribunal did not merely rely upon a temporal coincidence in order to make that finding.
Again the applicant by its submissions at paragraph 16(j) appears to accept that the Tribunal's finding at 53(j) is correct. The respondent repeats paragraph 41.
(Footnotes omitted.)
56 I accept the respondent's submissions. As I have noted above, what Comcare seeks to do is emphasise different evidence, in an attempt to contend that the Tribunal should not have found that the workplace noises and conditions aggravated Mrs Reardon's hyperacusis. That was the very matter consigned to the Tribunal as the merits reviewer.
57 In this context it is worthwhile extracting relevant aspects of Mr Brennan's reports which in my opinion bear out the respondent's submissions that Comcare's real quarrel is with the fact that the Tribunal did not entirely accept Mr Brennan's opinion and determine the review on that basis.
58 In his first report of 7 July 2014, having set out Mrs Reardon's hyperacusis and the testing he carried out, Mr Brennan then proceeded to answer 20 questions he was asked by Comcare.
59 In answer to the question "what is your diagnosis", Mr Brennan stated:
This patient suffers from a mild bilateral hearing impairment, tinnitus and excessive sensitivity to sound and noise.
60 There was no dispute that the "excessive sensitivity to sound and noise" is hyperacusis.
61 In this report Mr Brennan also wondered whether Mrs Reardon had an "underlying inner ear disorder" which might have caused her sensitivity to noise, but the Tribunal, as it was entitled to, found she did not have any such condition: see the Tribunal's reasons at [46]-[47].
62 In answer to one of the questions, Mr Brennan expressed the opinion that Mrs Reardon's "condition" (as he had described it and as I have set it out at [59] above) had been "aggravated by workplace factors to a minor degree".
63 In his further report dated 3 February 2015, in response to a request that he review and comment on, amongst other things, Dr Sharman's report, Mr Brennan said:
In regard to Dr Sharman's reports I agree there is certainly a work aggravation contributing to her complaint but I nevertheless remain concerned about the underlying cause for her hearing loss and tinnitus and am not convinced that this has a work related cause despite her level of distress with hyperacusis. I would have thought it reasonable for her to have a CT scan of the temporal bones to exclude any dehiscence of the superior semi-circular canals. I agree with both doctors that her prognosis appears poor.
64 Comcare submitted it was unclear whether Mr Brennan meant by this opinion that there was a work aggravation to Mrs Reardon's hyperacusis. It does not seem this was ever clarified in cross-examination. In my opinion it was open to the Tribunal to read Mr Brennan's opinion about aggravation (as opposed to cause) with the generality in which it was expressed, and to see it as extending to the hyperacusis.
65 Mr Brennan's oral evidence to the Tribunal was to a similar effect, as this exchange demonstrates:
What's your view then on whether Mrs Reardon's work or work environment has contributed in any way to the development of her tinnitus?---I think that her hearing loss and her tinnitus have got some other basis and I think that it's possible that work-related noise, which she has found unpleasant, would have aggravated the tinnitus to a - to a minor degree.
Moving to Mrs Reardon's hyperacusis, what's your view on whether her work environment has contributed to the onset of her hyperacusis?---Well, it's certainly an unusual event for hyperacusis to develop in a situation of more low-grade chronic irritation as opposed to an intense noise in the ear. But there are many causes for hyperacusis and sometimes it's known that a life stress can bring the hyperacusis to light and, as I've mentioned, many other factors. So I think it's likely that her capacity to tolerate noise in the work environment may have aggravated her hyperacusis to some degree.
When you say it has aggravated her hyperacusis is that distinct from having caused her hyperacusis? ---Yes. I - I think that the - the abnormal issue here is that she has a hearing loss and that I think if she has a hearing loss and tinnitus a very commonly associated symptom with it is sensitivity to noise and I think that it - that is, you know, something that she has with the hearing loss and if l think the hearing loss is not related to work I have to have a suspicion that her problems relate to a pre-existing ear complaint.
66 Elsewhere, Mr Brennan said in oral evidence he was "not inclined to significantly blame the work environment". It is fair to say, in my opinion, that it is often difficult to tell from Mr Brennan's evidence whether he is speaking about causation, or aggravation. Whichever it was at various times, it is also apparent that Mr Brennan took the view that Mrs Reardon had some underlying (but currently unidentified and undiagnosed) condition of her inner ear. At the end of his cross-examination by Mr Reardon is the following exchange:
Yes. Now, I think you've described in your evidence, and your reports generally, that you think the work factors are a minor aggravating contribution to her presentation?---Yes.
How do you assess that? Why do you say "minor" when I'm presented with a person who appears to have been rendered unable to continue in her job?---I'm talking about the contribution from the effect of the workplace, and whether it has really had a material adverse effect, and the way I see it is that she's likely to have an underlying clinical problem that would make her more sensitive to these events in the workplace than a normal person. So I suspect there's a fundamental abnormality. And it hasn't really been pursued. There has been an assumption made that it's just work noise, and work stress - work discomfort - work related problem that has escalated and caused, a, hearing loss, b, tinnitus, and c, hyperacusis, but I'm reluctant to make that decision when there's a pre-existing hearing loss.
67 As the respondent submitted, Mr Brennan's opinion as expressed did not necessarily mean Mrs Reardon's claim must fail. The question remained whether, even if a worker had an underlying condition or sensitivity, her employment had aggravated that condition. That was a question of fact for the Tribunal to determine, and as it said in its reasons at [55], it was not bound by Mr Brennan's characterisation of the effect of Mrs Reardon's employment on the aggravation of her hyperacusis. Nor, as it clearly implicitly recognised, was it bound by any other opinion expressed by Mr Brennan to reach any other particular factual conclusion on the questions the SRC Act reposed in the Tribunal.
68 It should be noted that the main alternative hypothesis advanced by Comcare before the Tribunal for the cause of Mrs Reardon's hearing problems was the fact that she had been in two car accidents where airbags had been deployed. That deployment was accompanied, Comcare contended, by significant noise levels that could have caused Mrs Reardon's hearing problems. The medical evidence did not support this hypothesis, and the Tribunal rejected it, at [28]-[29] of its reasons.
69 On this ground as put by Comcare, it is worth emphasising that the Tribunal had much more than medical evidence before it, and from its reasons, relied on much more than that as well. In the introductory paragraph to its findings, the Tribunal made the following general finding (at [39]):
The entirety of the evidence about the nature of the noise in Mrs Reardon's workplace prior to her incapacity, conveys a clear picture that there were many types of noises of varying volumes, some loud (such as the fire/evacuation alarms) and others equivalent to mere conversation (55 to 60 decibels). The evidence portrays a busy and quite noisy workplace.
70 At [13], the Tribunal had found:
On the basis of the evidence of all witnesses who gave evidence at the hearing, I am satisfied that the work environment where Mrs Reardon worked during 2011, 2012 and 2013 was noisy. It had various "call bells" which frequently made audible sound during the course of a working day. In addition, there were other sounds, general talking when taking calls, feedback from the headsets/phone calls, radios, and fire alarm and other bells at times, all of which Mrs Reardon was exposed to while at work.
71 In particular, the Tribunal was clearly persuaded by the evidence of Mrs Reardon herself. The respondent took the Court to the following parts of Mrs Reardon's evidence:
Could you tell the Tribunal what you mean when you use that phrase "head pressure"? Can you describe what that means to you?---What would be happening is when I used the headsets - and it was only ever when I was at work and when I had the headsets on my head and was talking on the phone. It felt like somebody had gone up to the side of my head and put their wrists into the side of my head and was squeezing it. That's what head pressure felt like.
So this is a symptom you say was only associated with the use of headsets, and when you say "talking on the phone", do you mean talking on the phone with a headset? Okay. And so it felt like a squeeze on your head. And the pressure: was it something that would go away once you stopped talking on the phone with a headset, once you took the headset off?---At the beginning it did. At the beginning it did go away when I started - when I would take the headsets off I no longer had the problem, but as time went on it would not go away; it would stay with me, and - - -
Okay. And did you ever experience that same symptom of head pressure other than when you were using the headset and phone? Okay. And so can we take it that you haven't been experiencing since you stopped working using that headset and telephone?---Now I get - the hyperacusis kicks in, and I get headaches more so than head pressure.
Okay?---The headaches are what I get now. It's a pain. I suppose sometimes it still feels like pressure, but it's more a pain.
But that's something distinct or different from what you had described as head pressure. We can safely make a distinction between what you had described as head pressure---?---In early days it was head pressure.
Yes?---And then it kept getting more head pressure, head pressure, head pain, pain, pain.
Okay?---So it just flowed on from head pressure to pain.
And when you say the pain, that's the pain associated with the hyperacusis with the exposure to sound, and that's something you experience with the hyperacusis when exposed to noise?---I experience the pain before my hyperacusis was diagnosed---
Yes?------ so it was the head pressure, and then head pressure turned to pain, and then pain - then I was diagnosed with hyperacusis, so - - -
Okay?---They all - yes .....
All right. I'm just trying - it's an important distinction for us to understand, if there's difference between what you're describing as head pressure, which is only associated with a headset, and pain that might be associated with hearing sound or headset.
Okay?---I've got pain as well.
Okay. Are head pressure and a pain associated with a headset? Yes?---Then it went onto head pain when I was on the headset, so it was actually physically painful for me to have them on my head.
Okay. And when you stopped using the headset - because you've not been working for some time. Is that correct? So I - we can assume you're not using a headset at all, so you're not experiencing the head pressure that you experienced with a headset?---No. It's more - it's just pain.....
So any pain you're experiencing now, if it's caused by anything, it's going to be caused by a noise you're exposed to at home or out in the street or wherever you happen to be, not from wearing a headset. Okay. Now, the pain you've just described that you experience when you're exposed to noise: does that go away after you're - after the noise has stopped, or - how do you experience that?---No. No, my hyperacusis builds up through the day, does not go away. It just compounds. So once my day starts my head usually gets worse. I grow confused. The pain increases. The tinnitus can get louder. It depends if I'm having a bad day or not.
That's all right. What do you describe as a bad day? What's a bad day for you?---Now, a bad day for me would be my dogs going off and barking, clanking the pots and pans as I'm cooking. It would be not stopping the microwave from beeping before I get to it, the washing machine beeping. All these things set me off if I'm not fast enough to get to the things before they all move or bark or whatever. That can - that can be a bad day.
…
I'm asking you whether you agree with that?---I have given so much evidence to show that my headaches came every time I put those headsets on my head, and that I was in pain, and that I told my employer time and time and time again, and I've got so much evidence to show that I told my employer I was in pain every time I put those headsets on my head.
So is it your evidence that you don't believe that your motor vehicle accident would have any connection or relationship to the onset of your hearing?---That's not true. I've already mentioned that I acknowledge that the motor vehicle - both motor vehicle accidents could have contributed sensitivity to my hearing, but l did not have hyperacusis in 2012. But by January 2013, I was suffering badly.
72 The Tribunal was obviously persuaded by Mrs Reardon's account. At [49]-[50] of its reasons, it stated:
The evidence of Mrs Reardon, is that her symptoms deteriorated and became worse when using the headsets at work and when exposed to the call bell and other noises in the workplace. I accept her evidence and am comforted in doing so because her complaints are corroborated to a degree by contemporaneous records created in the employment relationship.
Although Mrs Reardon also said that she experienced symptoms away from work, it was apparent from her evidence that the type and frequency of them, were greater in the workplace. She said words to the effect that "initially I had pressure in my head when using the headsets and then it became pain when using the headsets.
73 In May [2015] FCAFC 93; 322 ALR 330 at [212] the Full Court emphasised that the Tribunal's function does not require it to accept medical opinion on a conclusion which the empowering statute has given to it as fact-finder:
… neither the terms of s 4 of the SRC Act, nor the authorities, preclude an injury being established on the basis of an account by a claimant of the disturbances to her or his body or mind, without the necessity for a diagnosis of a recognised medical condition, or corroborating pathology or medical opinion. Whether or not the evidence of a claimant will be sufficient, if it is not supported, corroborated or confirmed by independent medical opinion or pathology, will be a matter for the Tribunal's satisfaction on the evidence in each particular case. The error in the Tribunal's reasoning process at [52] was to proceed on the basis that a claimant's account could never suffice to establish an injury.
74 This approach echoes observations of Brennan J in Repatriation Commission v O'Brien [1985] HCA 10; 155 CLR 422 at 441.
75 The determination of the question of causation, contribution or aggravation by employment for the purposes of the definition of "disease" is in my opinion not subject to any different approach in principle. It remains a determination for the merits reviewer on the evidence and material before it.
76 As to the importance of evidence from Mrs Reardon's co-workers, in the early part of its reasons (see [9]-[13]) the Tribunal set out the lay evidence before it, from Mrs Reardon herself and from her co-workers reaching the conclusion which I have set out at [70] above.
77 Comcare has not persuaded me that any of the findings the Tribunal has set out at [53] of its reasons were made without any probative basis in the evidence before it. What the Tribunal has done, as it was entitled to do as merits reviewer, is carefully assess all of the evidence before it, preferring some evidence over other parts (including deciding to accept Mrs Reardon's evidence about the aggravation of her condition at work), and not placing as much weight on Mr Brennan's evidence and other aspects of the evidence as Comcare contended it should. There is no legal error in the Tribunal taking that course.
78 As the respondent submitted, the Tribunal's finding at [54] of its reasons was a clear finding of worsening of the hyperacusis because of Mrs Reardon's employment (and, specifically, what she was asked to do in her role as an employee). This finding was obviously more than a finding of a temporal connection and is not attended by the legal errors suggested by Comcare on this appeal.