The assessment of damages
99 Since the plaintiff has succeeded against his employer and against the first defendant, it will be necessary to make assessments of damages under the regime provided for in the Workers Compensation Act 1987 and under the regime provided for in the Civil Liability Act 2002. Before proceeding to the assessments, it is necessary to review the evidence for the purpose of determining what injuries the plaintiff sustained, what disabilities have ensued and how they have affected his way of life.
100 No medical practitioner has been called to give evidence but many, many reports have been tendered in evidence, coming from a large number of doctors, some of whom have been treating doctors and some of whom have been qualified for the purposes of this case. I do not propose to review the medical evidence exhaustively but rather to focus on the reports of doctors where those reports have been referred to by counsel in their addresses.
101 I commence by summarising the plaintiff's evidence on the issue of damages.
102 The plaintiff was born on 18 July 1959, so that he was nearly forty-two years of age when the accident happened and he is presently nearly forty-eight years old. He is a single man. He did have a relationship with a woman in Bali. The relationship began in 1999 and the plaintiff believed that this relationship culminated in a ceremony of marriage in February 2003. However, the relationship broke up shortly after that ceremony and the plaintiff has since discovered that it was not a valid ceremony at all. Since then the plaintiff, apart from visits to Bali, has lived with his mother as a single person.
103 Prior to the accident, the plaintiff was a casual worker who took time off and travelled a great deal, mainly to Bali. He was a keen board rider and he also engaged in snow skiing.
104 The plaintiff experienced some health problems before the accident. He fractured a bone in his foot working at Garnock Engineering in 1980 and, after taking up employment on the waterfront in about 1991, he injured his knee, requiring a knee reconstruction procedure in 1995. Earlier in his lifetime he had also had some back problems. He fractured an ankle in 1998. Problems with the ribs and the lower back led to him having several myelograms and a discogram in the 1990s. He said that his knee was "playing up a bit" in 2005 and 2006.
105 In any event, he was working as a securer at the time of his accident and for years previously. I consider the work he was required to do in that capacity was reasonably strenuous.
106 The plaintiff said that on 13 July 2001 he injured his chest, his ribs and his back and there was also injury to his head. He is not clear whether he lost consciousness in the fall but he remembers being placed on a spinal board and in a neck brace before being lifted out of the hold of the the ship in a cage. He said he was terrified at the time. He was in Wollongong Hospital for thirty-three days.
107 At the time of discharge he said he was experiencing pain in his left shoulder. His problems persisted thereafter in the spine, the ribs and the chest.
108 The plaintiff said he has remained under the care of his local doctor, Dr Vickers, who he sees every ten or eleven days, and Dr Vickers prescribes medication for him.
109 The plaintiff said he underwent surgery on his spine in August 2003, the surgeon being Mr Sears. The surgery rendered the spine more stable.
110 Further surgery was considered to address instability in his rib cage, but eventually he decided not to undertake any procedure directed towards addressing that problem.
111 Apart from seeing Dr Vickers, the plaintiff has been seeing Dr Davidson, a specialist in pain management, and he also sees a psychologist, Ms Densley, and a psychiatrist, Mr Davies.
112 The plaintiff complained that he has trouble with his sleep and it is pain that wakes him up. There are ongoing problems in the areas earlier mentioned. The plaintiff suffers from depression.
113 The plaintiff said he cannot lift more than ten kilograms but he can walk for one to one-and-a-half hours at a time, and he does letterbox drops in his present work. He still visits Bali.
114 The plaintiff was off work following his fall until March 2002 when the fourth defendant offered him light duties. These were more or less of a clerical nature, and he attended work with the fourth defendant until January 2003. He said that he worked four hours per day up to six, and even seven, days per week. He felt able to continue and was distressed when his employer retrenched him. He has been on workers' compensation benefits ever since.
115 The plaintiff said he was fit to resume some work in the middle of 2004 after recovering from the fusion procedure which Mr Sears performed in August 2003. He found some part time work locally, working for an estate agent who is a friend. He is only working for eight hours per week.
116 The plaintiff said that his mother has looked after him and has assisted him in various respects. It will be necessary to consider this assistance more closely when considering the claim brought against the first defendant in the nature of a Griffiths v Kerkemeyer claim.
117 This brings me to a review of the medical evidence.
118 The discharge summary from Wollongong Hospital reveals that the plaintiff was admitted to that hospital on 13 July 2001 and was discharged on 14 August 2001. He was diagnosed whilst in hospital as having fractured ribs and also to have sustained a fracture of the spine at T7. Fractured scapulae were also detected. The discharge summary records that the plaintiff was treated conservatively.
119 There are two reports in evidence from Dr Vickers dated 28 June 2005 and 28 May 2007. Dr Vickers saw the plaintiff after he was discharged from hospital in August 2001, and on 28 June 2005 Dr Vickers reported that since August 2001 the plaintiff had required large doses of analgesics notwithstanding his treatment, including the spinal fusion. Dr Vickers noted in June 2005 ongoing physical and emotional problems. He reported:
"I believe Gary's physical impairments are real and are aggravated by physical activity such as lifting/prolonged sitting/standing."
120 In his more recent report of 28 May 2007 Dr Vickers recorded that he continued to see the plaintiff on a regular basis "for review, medication and counselling". Dr Vickers noted that the plaintiff had made little progress systematically or functionally and that he was periodically troubled with pain in the right chest wall and muscle spasm. He further noted that the plaintiff was suffering from sleep disturbance, anxiety and depression. However, Dr Vickers was not alone in indicating the possibility of improvement when the plaintiff's case is behind him:
"I believe Gary will be able to focus more on the future and dwell less on his injuries after his prolonged claim has been satisfactorily completed."
121 Mr Sears is a spinal neurosurgeon, and the plaintiff came under his care in February 2002. He noted that the T7 crush fracture also involved some compression of T8 and had created a thirty degree kyphotic deformity between T6 and T9. Mr Sears concluded that the site of the plaintiff's pain was below the level of the crush fracture and was probably due to spinal imbalance rather than the fracture itself. On 20 August 2003 Mr Sears performed "a posterior vertebrectomy at the T7 level to realign and stabilise his post traumatic kyphosis". On 31 October 2003 Mr Sears reported that the plaintiff recovered well from the operation, and on 22 March 2004 Mr Sears said he was optimistic that the plaintiff would be able to return to light physical work eventually. In the last of his reports, dated 10 June 2004, Mr Sears wrote:
"His thoracic fusion is almost certainly solid now. There is apparently residual soft tissue pain but I think the best thing for him now is to try to resume his previous activities in work and recreation. Ian Davidson would be the best person to advise on the overall effects of his injuries and his work capacity. From the point of view of the thoracic fracture and fusion, there is no need to place any specific restrictions on him now."
122 A number of reports have been tendered from Dr Davidson, the earliest of which is dated 19 November 2001. When the plaintiff saw Dr Davidson he was complaining of chest pain and pain in the sternum and the shoulders. He also complained that his sleep was disturbed when he was awakened by pain. Dr Davidson formed the opinion that the plaintiff had multiple musculoskeletal problems with some ongoing post traumatic stress systems. He considered that the plaintiff would benefit from a supervised exercise and hydrotherapy programme and that a TENS machine should be trialled. Dr Davison saw the plaintiff on a number of occasions in 2004, and he prepared a report for medico-legal purposes on 30 June 2005, from which I quote:
"He has had extensive treatment, initially an outpatient rehabilitation program, which involved hydrotherapy, exercise, a trial of alternate pain relieving modalities and support of a clinical psychologist for his persistent posttraumatic stress, depression and anxiety…
His main complaints of pain are still related to his right thoracic spine and chest wall at the site of his surgery and with the rib dislocation. He has minor intermittent symptoms at his right shoulder…"
123 Dr Davidson expressed this prognosis:
"Unfortunately Mr Corbett's progress is not good even with the hope for improvement in the management of his persisting depression and anxiety. His ongoing chronic pain problems have been resistant to a comprehensive rehabilitation programme over a prolonged period of time. I think it unlikely that he will achieve a significant functional improvement."
124 Finally, on 5 June 2007 Dr Davidson reported that he did not think that there were realistic rehabilitation interventions "likely to ameliorate Gary's situation". Dr Davidson noted that the plaintiff was continuing to see Dr Davies for his depression and that he was also continuing to have psychological support from a psychologist.
125 Dr Davies reported to the fourth defendant's insurer on 10 September 2005 that he had been seeing the plaintiff on referral from Dr Vickers. At that point of time he had seen the plaintiff three times. Dr Davies diagnosed "chronic pain disorder associated with both psychological factors and a general medical condition and the prognosis at this point is for only slow change." Dr Davies noted that the plaintiff was only working eight hours per week at the time of the report. He considered that the plaintiff had not reached his full potential for psychological recovery and that "with stability of his psychiatric state he should be able to progressively increase" his working hours.
126 Dr Horsley saw the plaintiff at the request of the plaintiff's solicitors on 9 March 2006 and prepared his report the same day. Dr Horsley's area of practice is that of occupational health, rehabilitation and counselling. The view of the doctor at the time of furnishing the report was that the plaintiff was working at capacity whilst then working only eight hours per week. It was the doctor's view that the plaintiff's options for reemployment would be extremely limited if he lost the position in the real estate office.
127 Ms Densley reported in an undated response to a letter from the plaintiff's solicitors that the plaintiff first consulted her in November 2001. Ms Densley said that the plaintiff consulted her approximately thirty times, complaining of a variety of psychological symptoms. Ms Densley opined that the plaintiff was suffering from a post traumatic stress disorder and, when asked, declined to express a view as to the plaintiff's capacity for work. Ms Densley expressed some optimism as to the plaintiff's prognosis:
"Mr Corbett's PTSD has persisted for 4 years, despite both medication and psychological treatment, which is not a good prognostic indicator. I believe that the ongoing legal matters and treatment delays may have aggravated his psychological state. Mr Corbett has become entrenched in matters regarding his compensation case and many perceived injustices (e.g. such as an extensive delay in approval for his operation, being on the cusp of changes in the WC legislation). I believe that once settlement takes place this may enable Mr Corbett to refocus his energies in a more constructive manner. I would expect that his level of anxiety, stress and depressive symptoms would be likely to reduce, even if he does not fully recover."
128 Amongst the medical reports tendered by the first defendant were reports from Associate Professor Dan dated 19 June 2003 and 20 October 2004. Dr Dan concluded in the later of those two reports that the plaintiff appeared to be "highly anxious" and "to be somewhat depressed" with "some paranoiac ideation". The report continued:
"As a consequence of his psychological state he is focused on the discomforts which inevitably must accompany major surgery such as he has undergone. The significant benefit of having a very stable spine does not appear to have made an impact upon his assessment of his own disability. Notwithstanding that, I think that he has had an excellent outcome from the spinal stabilisation."
129 Dr Lovell furnished two reports tendered in the interests of the defendants. These reports are dated 19 June 2003 and 25 October 2004. Dr Lovell thought that the plaintiff was suffering from an adjustment disorder with depressed mood secondary to chronic pain. Dr Lovell wrote:
"His complaints are reasonable, given the extent of surgical intervention. He is unlikely to benefit from antidepressant medications. There is no impairment in his ability to concentrate and, generally, psychological factors do not interfere with his work capacity, although fatigue and the side effects of the narcotic analgesics may impact on work performance."
130 The most recent reports tendered in the interests of the defendants were those of Dr Wilcox dated 29 March 2006 and of Dr Schutz dated 28 May 2007.
131 Dr Wilcox wrote on 29 March 2006:
"Although Mr Corbett now says that he has been experiencing low back pain since the thoracic spine operation the contemporary documentation failed to confirm this factor. Indeed when he saw Dr Burke on 05/10/2004 i.e. 14 months post-operative Mr Corbett not only specifically said that he had sustained no lower back or lower limb injuries in the accident but he had had no pain in the lower back recently. In addition, he stated that 'the lower back has been stiff and painful since the 1980's.'
The present clinical examination found no objective abnormal signs. There was some limitation in movement but this was stated to be because of other factors. The limited rotation has nothing to do with his lower back as most of this takes place through the upper lumbar spine and the thoracic spine. The minor muscle wasting of the right quadriceps accords with the previous knee reconstruction and has nothing to do with the events of 13/07/2001. It is reasonable to conclude that any low back symptoms that he may be experiencing are the product of degenerative change and have no connection with the 2001 accident.
Taking all the medical evidence into account Mr Corbett's main ongoing problem is abnormal pain/illness behaviour. If this could be eliminated and his attitude became one of healthy optimism he will be able to function much better. The fact that he did return to work on light duties relatively soon after the accident and before the major surgery must indicate that he could have been more rehabilitated into the workplace. Instead he says that he is only able to do eight hours a week delivering mail. This should not be accepted by his advisers. They would serve his lifestyle better by insisting that he is upgraded to increased hours in this or similar jobs. He will never be fit to return to his pre-injury duties but could be more productive if he had a positive attitude.
His advisers should encourage him to become much more active. Swimming is an excellent exercise in this respect. As there is nothing wrong with his lower limbs he should also be doing plenty of walking. It is doubtful whether any further treatment designed to alleviate symptoms caused by physical pathology is going to be of any assistance to him."
132 Dr Schutz reported on 28 May 2007 that the surgery had corrected the kyphosis to close to the normal. I do not propose to refer to the detail of the report addressing the various questions which were posed but from a reading of his report, I do not conclude that the doctor considered that the plaintiff's complaints were unreasonable. I do note in relation to the shoulders that Dr Schutz did not consider that there was any significant impairment in function referable to the accident. Dr Schutz did consider that it would be reasonable to provide for a domestic need of three hours per week.
133 When Mr Morris was cross examining the plaintiff, he put to him that he had not cooperated with the persons who conducted a functional capacity assessment in January 2005. The plaintiff denied that he had failed to cooperate. The cross examination was prompted by the content of reports from the Vocational Capacity Centre in January 2005. I refer to the report in particular of Ms Leaver, physiotherapist. In that report dated 31 January 2005, Ms Leaver noted that the plaintiff was not at all cooperative with the assessment and that he frequently refused tests "that were well within his expected capabilities and previously observed ability." Many inconsistencies were noted.
134 Ms Leaver wrote:
"In appropriate employment, Mr Corbett is capable of full time work. Although Mr Corbett has demonstrated his physical capacity for work and is presently working on a casual basis, his pain focussed presentation and anxious behaviour could be expected to present barriers to him obtaining work."
135 Not having seen Ms Leaver in the witness box and having regard to the plaintiff's denial in cross examination, it is difficult to evaluate what Ms Leaver has written.
136 It is apparent from the medical evidence reviewed that those who have treated and assessed the plaintiff do not all agree in their assessments. It is hardly surprising considering the number of doctors who have made assessments. Mr Sears and Associate Professor Dan said that the plaintiff had a good result from the fusion procedure but, on the other hand, Dr Davidson and Dr Vickers accept that there is persisting pain. The medical evidence as reviewed seems to lend support for the finding that there are psychological and emotional problems which compound any ongoing physical disabilities.
137 I consider that there was exaggeration of the plaintiff's Griffiths v Kerkemeyer claim, and the plaintiff certainly did not understate his ongoing complaints or his needs for help in the home environment. The latter needs were exaggerated. Nevertheless, I did not form the conclusion that the plaintiff was an untruthful witness who set out to give misleading evidence.
138 I find that the plaintiff sustained significant injuries in the fall, resulting in persisting pain and disability which in turn has been aggravated by his emotional disorder as variously described by Dr Lovell and by Dr Davies. Notwithstanding the content of the report of Dr Wilcox, the overall finding that I make from the totality of the medical evidence reviewed, is that the plaintiff has significant ongoing disabilities aggravated by his perception of them. The plaintiff's lifestyle has been seriously disrupted as has been his capacity for work. He will not be able to return to his pre-injury work in the future.
139 Nevertheless, there is room for improvement. The plaintiff's evidence was that he was worried about this litigation (T 70, T 129), and I consider that it is likely that there will be some improvement in the plaintiff's mental condition after the litigation is behind him. I am influenced in that conclusion by what Ms Densley said in the passage I referred to earlier and by what Dr Davies has said. I consider that the plaintiff will be able to improve in his lifestyle and in his work capacity after this case is behind him but that he will, nevertheless, be left with significant ongoing disability.
140 I will now proceed to the several assessments.