Cossa v Victorian Workcover Authority [2026] VCC 26

1. The defendant does not dispute the plaintiff sustained very nasty injuries to her left elbow, right forearm and wrist and accepted ongoing significant symptoms - pain and restrictions - in the right hand and wrist in particular, conceding that it was open to conclude that those consequences meet the test of at least "very considerable" to this plaintiff and in the range of all possible impairments.[2]
2. The defendant contests whether the plaintiff's spinal injury is a serious injury.[3] And further the defendant contests the extent of the plaintiff's post-injury working capacity, specifically whether the plaintiff can work hours reflecting earnings no greater than 60 percent of her pre-injury earning capacity.[4]

1. For the plaintiff to succeed in her application, she must satisfy the Court, on the balance of probabilities, that she sustained a "serious injury" within the meaning of the definition prescribed in s 325(1) of the Act, which provides that a serious injury means -

(a) permanent serious impairment or loss of a body function; or

1. Assessing whether the injury claimed is a "serious injury" is undertaken at the time the application is heard. Here, the plaintiff says the right wrist, left elbow, and spine injuries which form the subject of the application are each a serious injury because they constitute a permanent serious impairment or loss of a body function, and so the term "serious" is satisfied by reference to the consequences to the plaintiff of any impairment or loss of body function with respect to pain and suffering or loss of earning capacity, when judged by comparison with other cases in the range of possible impairments or losses of body function.[5]
2. Any impairment or loss of a body function or a disfigurement will not be serious for the purposes of s 335(2) of the Act unless the pain and suffering consequence is, when judged by comparison with other cases, in the range of possible impairments or losses of a body function, or disfigurements, as the case may be, fairly described as being more than significant or marked, and as being at least very considerable.[6]
3. Whether an injury is a "serious injury" within the meaning of s 325(1) of the Act is assessed by applying the "narrative test".[7] This involves a two-stage process.[8] The first requires assessing whether the nature and symptoms of the injury and the consequences of the injury are, subjectively for the plaintiff, "serious". The second requires a determination whether the injury as so assessed is objectively "serious", or, in the case of mental or behavioural disturbance or disorder, "severe" when compared with the range or "spectrum of comparable cases". As to any physical injuries, the second stage involves a consideration whether the injury is, when compared with other possible impairments, losses of body function, or disfigurements, at least "very considerable", and more than "significant or marked".[9]
4. Assessing the plaintiff's pain and suffering consequences resulting from an injury requires the Court to consider both the plaintiff's experience of pain in addition to the disabling effect of the pain on the plaintiff's physical capabilities and enjoyment of life.[10] In conducting this assessment it may be necessary to consider the intensity, frequency, and duration of the plaintiff's pain by reference to the plaintiff's account of the pain, what he or she does about the pain (for example medication, rest, seeking medical treatment), the medical opinions as to the extent and intensity of the plaintiff's pain, and what the objective evidence shows as to the disabling effect of the pain.[11] Assessing the extent or degree to which pain from a physical injury impacts the plaintiff's physical capacity and enjoyment of life includes considering the effect of pain on the plaintiff's sleep, mobility, cognitive functioning, capacity for self-care and self-management, performance of household and family duties, recreational activities, social activities, sex life, and enjoyment of life.[12] The disabling effects of pain may also be shown by considering whether the plaintiff has resumed employment and, whether work which the plaintiff enjoyed had been closed off.[13]
5. The weight ascribed to the plaintiff's subjective account of pain will in part depend on the Court's assessment of the plaintiff's credibility or reliability.[14] An assessment of credibility or reliability depends on the plaintiff's evidence, as well as the views expressed by examining medical practitioners and any opinions about the reliability of the plaintiff's accounts of their pain.[15]
6. An assessment of serious injury incurring a loss of earning capacity involves, firstly, consideration of whether the plaintiff satisfied the described narrative test. Secondly, assessing whether the plaintiff has suffered a loss of earning capacity of 40 percent or more as at the date of the hearing, and a permanent loss of earning capacity which produces a financial loss of 40 percent or more.[16] This may be done by determining the plaintiff's pre-injury earning capacity on a weekly basis, then calculating the amount that is 60 percent of that amount, and then determining whether the plaintiff has shown earning capacity no greater than 60 percent of that amount.[17] In some cases, it may be necessary for the Court to make some assessment of the financial value of the plaintiff's earning capacity lost in order to determine whether the injury's incurring loss of earning capacity satisfies the aforementioned 'at least very considerable' test.[18]
7. Because here the plaintiff contends her right wrist, left elbow, and spinal injuries are serious injuries resulting from the workplace incident these are not readily aggregated into a single body function and whether the plaintiff's injuries can be aggregated depends on identifying the impairment or loss of body function, rather than the physical injury. Here the bodily functions impacted are readily severable to right arm, left arm and spine and the plaintiff has not sought to aggregate her several injuries, instead her affidavits set out the pain and suffering consequences of each bodily function impairment.
8. Pursuant to s 335(3) of the Act, if the plaintiff establishes a serious injury because of the pain and suffering consequences, but not with respect to loss of earning capacity, she may only bring proceedings for the recovery of damages for pain and suffering. But if the plaintiff establishes that the injury is a serious injury and establishes the requisite permanent loss of earning capacity of 40 percent, she will be entitled to bring a claim for damages for both loss of earning capacity, and for pain and suffering damages.[19]

1. The plaintiff is 46 years of age having been born in May 1979, in Australia. She has a partner and currently lives in Ferntree Gully. She was aged 41 at the time of the incident.

1. The plaintiff attended and completed primary and secondary school in Australia. She also holds a Diploma of Travel and a Certificate III in Tourism.

1. In her first affidavit dated 22 October 2024 the plaintiff recalls having back pain during her teenage years and as a young adult.[20] In or about September 2019, the plaintiff says that she sustained an injury to her right elbow which required an X-Ray and ultrasound in October 2019 on referral of her General Practitioner at the time.[21]
2. The plaintiff deposed that in the period of November 2019 and January 2020, she attended an osteopath several times for treatment relating to the injury of her right elbow in September 2019 and for general right arm, shoulders, and neck treatment. The plaintiff deposed that she sought treatment from her General Practitioner, Dr Desmond Yeow, for that right elbow injury. The plaintiff says that the symptoms were temporary and resolved after treatment.[22] The plaintiff has no reported chronic health issues.

1. Prior to commencing work with Adairs Retail Group the plaintiff worked in Office Administration at Peregrine Adventures from 2002 to 2014.[23]
2. The plaintiff began working for Adairs Retail Group on 27 November 2014 in a full-time, permanent position in the Online Customer Service and Accounts Administration team.

1. On 11 June 2020 the plaintiff was working at her usual place of employment at 2 International Court Scoresby. She was in the process of moving her belongings to a new office building location and at the time of the injury, the plaintiff was carrying a box down a set of stairs.[24] While walking down the stairs, the plaintiff fell down several steps and onto the ground floor. She was taken by ambulance to Maroondah Hospital Emergency Department.[25]
2. While at Maroondah Hospital on 11 June 2020 the plaintiff underwent X-rays and was diagnosed with complex fractures of her right wrist and left elbow.[26] A plaster cast was applied to both the left and right arms. Later that day, the plaintiff was transferred and admitted to Knox Hospital under the care of orthopaedic surgeon Mr Kemble Wang.[27] On 13 June 2020, the plaintiff underwent surgery in her right wrist and left elbow involving a left radial head replacement, a ligamentous reconstruction of the left elbow, a right distal radius and ulna plate fixation, and right carpal tunnel release.[28] Upon discharge the plaintiff wore a sling on her left elbow and a right thermoplastic splint on her right wrist[29] and continued to receive treatment from Mr Wang.[30]
3. On 14 November 2020, Mr Wang performed several procedures including: metal removal for hardware impingement of the right wrist, right ulnar nerve release at the wrist for ulnar nerve neuropathic pain, and left elbow arthrotomy and contracture release for pain and stiffness.[31] After the surgery, Dr Wang completed nerve conductive studies on the plaintiff in light of reported persistent neuropathic pain in her right hand.[32] The plaintiff last sought treatment from Mr Wang on 10 May 2022 when she was referred to pain management services.[33]
4. On 20 June 2020,[34] the plaintiff was referred to Melbourne Hand Therapy by Dr Wang. The plaintiff sought physiotherapy treatment from Ms Haley Field, occupational therapist as well as Ms Terri Stanley-Clarke on a number of occasions, at times on a weekly basis, in the period between June 2020 - August 2021.[35] The plaintiff also received physiotherapy treatment from Mr Eric Coleman, on 14 April 2022.[36] The plaintiff deposes that since November 2025 she has "just re-engaged in hand therapy".[37]
5. In the period between 29 June 2020 and 08 February 2024, the plaintiff sought treatment from her GP Dr Yeow on several occasions in relation to the injuries sustained on 11 June 2020.[38] In the period from 22 June 2020 the medical records additionally reference attendances on a treating Dr Resha Abbas at Boronia Medical Centre.[39]
6. On 2 October 2020[40], Dr Yeow referred the plaintiff to see Ms Elizabeth Harding, a psychologist at Fernhill Clinic to receive counselling and psychotherapy in relation to the distress the workplace injury had since caused her. The plaintiff sought treatment from Ms Harding on 21 November 2020.[41] The plaintiff deposes that as of November 2025 she no longer sees a psychologist.[42]
7. On 29 June 2021[43], Mr Wang referred the plaintiff to Neurology Network Melbourne in relation to "ongoing nerve symptoms in the right hand". The plaintiff saw Dr Marco Fedi, neurologist, for treatment on 20 August 2021 and 29 September 2021 in relation to right sided sensory ulnar neuropathy.[44] The plaintiff deposes that on or about 20 August 2021 Dr Fedi advised her to start taking Amitriptyline (Endep) when required for nerve pain.[45] Dr Fedi referred the plaintiff for nerve conduction studies which were undertaken on 30 August 2021 at Neurology Network Melbourne.[46]
8. On 10 May 2022,[47] Dr Wang referred the plaintiff to Pain Specialists Australia for further treatment for residual ongoing pain in her right hand. The plaintiff received treatment from Dr Kui Hun (also known as Anthony) Njo, pain specialist, on a number of occasions between 16 June 2022 and 07 June 2024 in relation to ongoing pain in her right forearm, hand, shoulder muscle, and back.[48] On 16 June 2022 Dr Njo diagnosed the plaintiff with neuropathic pain in her right hand using the pain-DETECT score.[49] Dr Njo advised the plaintiff to try a titration dose of Gabapentin, for neuropathic pain, in October 2020, after having side effect issues with another pain medication Lyrica[50], although the plaintiff gave evidence she suffered from further side effects and ceased taking the Gabapentin in or around 2023.[51]
9. On 01 December 2022[52] the plaintiff underwent nerve block surgery to her right cervical spine at Linacre Private Hospital for her back pain, specifically Dr Djo recorded a "block - right C6,7,8 DRG/s - cervical - prone". On 14 April 2023 the plaintiff underwent a further operation with Dr Njo at Linacre Private Hospital, specifically, pulsed radiofrequency to the "right median, radial, musculocutaneous, medical cutaneous nerve of forearm nerves".[53] Dr Njo reports prescribing Tramadol and "usual follow up".[54] On 18 May 2023, Dr Njo operated on the plaintiff at Linacre Private Hospital, during which time the plaintiff was treated with "radiofrequency neurotomy - SIJ" (sacro-iliac joint) targeted at her lumbar spine.[55]
10. On 15 June 2023[56] the plaintiff underwent day surgery to her lumber spine at Linacre Private Hospital performed by Dr Djo performed surgery, specifically "unilateral radiofrequency neurotomy - SIJ" (sacro-iliac joint). The plaintiff was prescribed Tramadol post-operation.
11. In her second affidavit the plaintiff deposes that on 19 May 2025[57] she underwent day surgery under sedation performed by Dr Njo on her right arm. The plaintiff deposes that as of November 2025 she continues to see Dr Njo "from time to time".[58] The plaintiff deposes that she self-funds deep tissue massage on a weekly to fortnightly basis "to get [her] through the work week".[5] The plaintiff says she also has remedial massage.[59] The plaintiff says that since the injury she has used heat packs daily[60] as well as gloves for typing and working.[61]
12. Since the incident and injuries, the plaintiff has taken several prescribed medications. On assessment by Dr Njo on 16 June 2022 the plaintiff was taking Celebrex 100 mg twice a day for mechanical back pain, Panadol Rapid two times a day, Advil/Nurofen two tablets a day as needed, and Endep 10 mg at bedtime for neuropathic pain.[62] As at 11 November 2025 the plaintiff was prescribed Celebrex 100 mg twice a day as required, Endep 10 mg nightly, and Panadol and half a tablet of Panadeine Forte as needed by Dr Yeow.[63] On assessment by Dr Njo in October 2022, the plaintiff also started taking Effexor for nerve pain although noted this created issues with side effects.[64] As noted above, the plaintiff also took Endep for nerve pain as well as Gabapentin, although struggled with side effects while taking many of these medications. The plaintiff says she ceased taking the Gabapentin and Effexor in or around the middle of 2023.[65] The plaintiff deposes that as of November 2025, she continues to take Endep 10 mg nightly for nerve pain, as well as Nurofen and Panadol every day and Panadeine Forte when she is "beside herself"[66]. The plaintiff deposes in her second affidavit that she continues to take Celebrex as needed but feels she has "become immune" to it.[67]
13. Following the incident and injuries the plaintiff took approximately twelve months of leave from Adairs Retail Group.[68] She gradually returned to work on a part-time basis undertaking two hours a day, two days a week in the office. She then started doing four hours a week, undertaking "on and off modified duties and reduced hours".[69] The plaintiff then moved to work from home during which time she was able to increase her working hours to five hours a day, three days a week. In September 2023, the plaintiff resigned from Adairs Retail Group[70]. And commenced working on a part-time basis 15 hours a week in Office Administration at Hurtigruten, a travel company.[71]
14. The plaintiff says she commuted to and from Hurtigruten's Melbourne CBD office every working day[72], with some occasional flexibility to work at home.[73] But her preference is to work on site for her mental health and capacity to interact with people.[74] The plaintiff deposes in her first affidavit that in or around February 2025 she formally spoke to a team leader around reducing her working hours[75], although during cross-examination the plaintiff explained that she had "regular coaching sessions" with her team leader and she believes the team leader "knew well before that [she] was struggling" with her hours.[76] The plaintiff tendered her resignation in February 2025,[77] although following further conversations with a senior team leader she was able to reduce her working hours to a total of 15 hours a week: 5 hours a day, three days a week.[78] On 1 May 2025 the plaintiff obtained a Certificate of Capacity from her treating GP Dr Yeow which limited work capacity to "Tuesday, Wednesday, and Friday 5 hours each".[79] The plaintiff deposes that she does not intend to go back to full time work; that she struggles with 3 days and would like to reduce to 2 days per week.[80]

1. On 16 June 2020 the plaintiff lodged a WorkCover claim in respect of the right wrist and left elbow injuries sustained on 11 June 2020.[81] On 23 June 2020, CGU Workers Compensation advised by letter that the WorkCover claim had been accepted in respect of the plaintiff's left elbow and right hand.[82] The insurer continues to pay for reasonable medical expenses in respect of this injury.

1. The plaintiff says, relevantly, that she experiences pain in her right wrist. She says in her first affidavit that she is in constant pain which varies in sensation and intensity from aching, to numbness, to pins and needles, to a stronger shooting pain. The plaintiff says she experiences altered sensations across her right fingers, hand, palm and forearm and a restricted range of motion in her right fist and fingers. She experiences fatigue in her right hand with increased use and finds her pain to be worse on workdays. The plaintiff experiences reduced dexterity and finds it hard to open things. She uses her right hand to use a mouse although finds typing for extended periods will inflate her symptoms. She says she takes medication for this right hand pain although struggles with side effects including nausea and vomiting with stronger analgesic medication.[83] The plaintiff also experiences reduced strength in her left arm although deposes it is not as bad as her right arm.[84] The plaintiff experiences some tightness, numbness and spasms in her right shoulder and deposes having multiple scars on her arms.[85]
2. The plaintiff says she can and does drive, although finds that driving for long periods of time exacerbates her pain. She experiences pain and numbness in her hand after gripping the steering wheel. She has trouble with tasks that require fine dexterity including putting petrol in her car or putting on earrings.[86]
3. The plaintiff says she finds herself in circumstances where her right hand becomes stuck in a claw shape and she must manually stretch her fingers back. The plaintiff experiences symptoms in times of very cold or very hot weather. She says her pain is regularly so intense that she is "distracted" and it impacts her ability to concentrate.[87]
4. The plaintiff says that she has problems with simple day-to-day things and finds it difficult to cut steak and meat due to her right wrist problems. She says that due to these issues, when she goes out for dinner, she tends to order things that require less strength to cut and, which can be eaten with a fork. The plaintiff says this means she has less satisfaction from dining out, which is one of her favourite past times. The plaintiff says that there have been several occasions during which she has picked up a glass or cutlery and dropped it, which she finds embarrassing and awkward. She says that since her injury she experiences "difficulty with cooking" and was unable to cook for about 12 months after the injury, although has returned to some cooking infrequently.[88]
5. The plaintiff says she now has difficulty with typing at work. She finds that her right fingers become increasingly numb when typing for longer periods and struggles to grip and use a mouse as the day wears on. The plaintiff has a prescription for Panadeine Forte and Tramadol although tries not to take these while working because they make her drowsy. The plaintiff describes that, because of her symptoms, she works slower than she used to. She gets less satisfaction out of her work because working causes her pain and she finds the second half of the workday particularly difficult. She often feels extreme anxiety trying to keep up with general life tasks and holding down a job.[89] The plaintiff deposes that she had difficulty finding work when she disclosed her injuries to prospective employers and felt guilty about disclosing her injuries to her current employer.[90]
6. The plaintiff says that before the injury she had no physical restriction in her ability to do housework or tend to the garden, but presently, due to her right arm restrictions, she is limited in her ability to do so. She says there are tasks which she is unable to now do, including lawn mowing and lifting heavy trays and pots. She says she finds it difficult to use garden implements for more than a short period or to do simple things like weeding. She tends to avoid tasks which involve force such as scrubbing bathrooms and toilets, vacuuming, mopping, hand washing garments although occasionally she will "give something a go". The plaintiff has sought assistance with these tasks from her mum and partner.[91]
7. The plaintiff says she has problems with sleep every night due to right hand and wrist pain and numbness. She says that this numbness runs down her right leg, into her right calf and foot. She finds it difficult to fall asleep because of pain and has taken Melatonin and Endep previously to help her sleep. The plaintiff regularly wakes up with what feels like a 'dead' right arm and right leg.[92]
8. The plaintiff says the restrictions in her right wrist have impacted on her relationship with her partner. She says that her constant pain is emotionally draining and she has less emotional space for friendships, has extreme anxiety, and prefers to be alone.[93] She says that although she still socialises and dines out, she now socialises less often. She finds pain impacts on her desire to want to socialise with others and prefers not to socialise as it makes her feel anxious.[94]
9. The plaintiff says that her right wrist injuries have impacted her ability to enjoy former hobbies including yoga, going to the gym, weightlifting, and small DIY projects. She says she can no longer participate in classes such as body pump because she struggles with heavy lifting. The plaintiff deposed that before the incident on 11 June 2020, she used to travel regularly overseas. In September 2024 the plaintiff travelled to Norway for just over 2 weeks for work with her partner. She says that she struggled to carry her luggage herself, and that towards the end of the trip it started getting colder which made her pain worse. The plaintiff says she found the September 2024 trip much less enjoyable than trips before her injury due to her pain and restrictions.[95]
10. The plaintiff says her injuries have made her feel less independent because she requires more assistance around the house. The plaintiff says that after she was injured, she was unable to brush her teeth, shower, dress or wipe herself after using the bathroom which she felt was "terribly humiliating". She says she has ongoing restriction in her right hand which limits her ability to wash and style her hair. She says that at the time of her first affidavit she was still dependent on her partner and her mum. The plaintiff says she used to be independent, but her restrictions have changed her inherent personality.[96]
11. In her second affidavit deposed 18 November 2025 the plaintiff says her pain, symptoms, and consequences set out in the first affidavit have remained the same save that her pain has become a bit worse. She says she has "declined slightly" because she was pushing herself to work full-time. The plaintiff deposes that her injury has put immense stress and pressure on her relationship. She says that because of predominantly right arm pain, she has little desire to have sex.[97] The plaintiff says that since the incident on 11 June 2020 she has lived with persistent and chronic pain and restrictions, predominantly in the right wrist and arm.[98]
12. The plaintiff attended a family wedding in Malaysia in 2025. During this time, the plaintiff did not feel she could safely do physical activities such as going to a water park because of a fear she might knock her arm and not be stable on amusement park rides. She says that she has a history of working in adventure travel for 14 years and participating in fun and adventure- but now feels so is "limited in things" - she feels useless.[99]

1. In her second affidavit the plaintiff describes the pain, symptoms, and consequences in relation to her lower back, neck, and pelvic area. She says that since the incident on 11 June 2020 she has suffered from chronic lower back and neck pain. The plaintiff finds it hard to sit for hours at a time because of her back and she tends to re-position herself at work every 90 minutes. When at home, the plaintiff lies on her side to relieve the pain. She finds static sitting looking at a computer gradually increases her neck pain because of the position involved. She deposes her back pain impacts on her quality of sleep.[100]
2. The plaintiff says she has restrictions in walking due to back pain. She does walk, and tries to do so regularly, but finds that her back pain increases after about 30 minutes. She finds heavier lifting and housework flares up her back and neck pain. She has intermittent but regular migraines. The plaintiff deposes that her right arm symptoms are her worse symptoms as compared to her chronic neck and back pain.[101]

1. In her second affidavit the plaintiff deposes that she has chronic left arm pain and problems. She finds it hard to fully straighten her left elbow. The plaintiff says that she generally experiences the same problems in her left arm as her right arm, although in her left arm to a lesser extent.[102]

1. Dr Yeow is the plaintiff's treating GP, providing ongoing care for the plaintiff at Mountain Gate Medical Centre in relation to the injuries she sustained on 11 June 2020. The plaintiff has been a patient of the clinic since 21 May 2018. Dr Yeow first saw the plaintiff in relation to injuries sustained to her left elbow and right wrist on 29 June 2020. Dr Yeow reports that following the surgeries performed on 13 June 2020, the plaintiff's arms were immobilised with splints and a sling.[103]
2. Dr Yeow has provided 3 treatment summaries dated 26 August 2021, 31 July 2023 and 01 May 2025,[104] as well as 2 reports dated 08 February 2024 and 11 November 2025.[105] Dr Yeow has managed the plaintiff's treatment for her injuries including referrals for MRI imaging, specialist referrals, a WorkSafe certificate of capacity, sleep management, and prescriptions.
3. On review of the plaintiff on 2 October 2020, Dr Yeow reports that the plaintiff felt ongoing pain in her right wrist, as well as a pins and needles sensation in her fingers. Dr Yeow reports the plaintiff had started to feel stressed and upset about the inconvenience caused by her injuries and he referred the plaintiff to see Ms Elizabeth Harding at Fernhill Clinic to receive counselling and psychotherapy in relation to an adjustment disorder with stress and depressive symptoms. Dr Yeow reports the plaintiff continued to see her surgeon Dr Kemble Wang, who recommended she see a neurologist for further assessment regarding paraesthesia and discomfort in her right wrist. Dr Yeow notes the plaintiff was seen and assessed by Dr Marco Fedi on 20 August 2021.[106]
4. In his first report dated 08 February 2024[107], Dr Yeow opines the diagnosis of the plaintiff's condition as including left elbow radial head fracture (surgically repaired); right wrist complex fracture (surgically repaired); right hand neuropathic pain (ongoing); low back pain and right sacroiliac joint pain (ongoing). Dr Yeow opines that on the balance of probabilities that the nature of the plaintiff's incident at work is a cause and continues to be a cause of the plaintiff's injuries. Dr Yeow says that the plaintiff suffers from right forearm, wrist and hand pain, associated with numbness and altered sensation in her fingers. He states that these symptoms did not improve with medications and this was affecting the plaintiff's ability to use her right hand in day-to-day activities. Dr Yeow describes these symptoms as "chronic" and ones which slowly affect her mental health and wellbeing. Dr Yeow says the plaintiff's injury has an organic basis. He opines that the plaintiff is at an "increased risk of developing degenerative changes in her right wrist and elbow" because of the injuries sustained. Dr Yeow says that it is "very likely" the plaintiff will develop osteoarthritis in her right wrist and left elbow joints in the future.[108]
5. As to restrictions in mobility caused by the plaintiff's injuries, Dr Yeow opines in his first report that the plaintiff experiences stiffness and reduced movement and flexibility of her right wrist and her left elbow to a lesser degree. He reports that pain and paraesthesia in the plaintiff's right wrist was at the time being managed by a pain specialist with radiofrequency treatments. Dr Yeow opines that the plaintiff's symptoms will likely be permanent and the identified restrictions are also permanent. He says that the plaintiff is not fit for unrestricted pre-injury duties.[109]
6. Dr Yeow reports that the plaintiff returned to work 4 months after the accident.[110] He reports that the plaintiff, at the time of the first report being prepared, was working 18 hours a week at Adairs. Dr Yeow reports that the plaintiff still gets discomfort and pain with jobs that required constant use of her right hand and is unable to carry any weight heavier than 5kg. Dr Yeow opines in his first report that the symptoms continue to affect the plaintiff every day. He reports that treatments received from pain specialist Dr Njo showed some benefit although temporary in nature.[111]
7. Dr Yeow opines that the plaintiff's neuropathic pain, paraesthesia and limitation of function in the plaintiff's right wrist and fingers is permanent. He reports that the prognosis of the plaintiff's condition is unclear. Dr Yeow reports there has been some improvement with treatments from the pain specialist, osteopath, and exercises, and that the plaintiff should continue these treatments.[112]
8. In his most recent 11 November 2025 report,[113] Dr Yeow diagnoses the plaintiff's condition as follows: left elbow radial head fracture (surgically repaired); right wrist complex fracture (surgically repaired); right hand neuropathic pain with recurrent flare ups (ongoing); low back pain and right sacroiliac joint pain (ongoing); associated symptoms; intermittent anxiety related to chronic pain and functional limitation. Dr Yeow opines that the work-related incident on 11 June 2020 is the cause and continues to be the cause of the above injuries. He says that the plaintiff is not fit to perform unrestricted pre-injury duties.
9. Dr Yeow reports the plaintiff continues to experience recurring low back pain and right sacroiliac joint discomfort, particularly aggravated by prolonged sitting, standing, bending, or lifting. He opines that these limitations significantly restrict her ability to perform roles that require physical exertion, repetitive movement, or sustained posture. Dr Yeow reports there is an "ongoing risk of aggravation and deterioration" with manual handling activities or prolonged static positions. Dr Yeow reports that having regard to the plaintiff's spinal injuries alone, the plaintiff has limited capacity for suitable employment on a permanent, reliable and consistent basis. He provides a further "clinical justification" for this statement to the effect that "reduced spinal mobility, persistent pain, and susceptibility to flare-ups make it unlikely [the plaintiff] could maintain reliable full-time work without risk of re-injury".[114]
10. Dr Yeow opines that, having regard to the plaintiff's left upper limb injuries alone, the plaintiff may have some limited functional capacity for light or sedentary duties. He provides a further clinical justification for this statement to the effect that "post-surgical changes and reduced range of motion restrict repetitive or heavy use of the left upper limb", which Dr Yeow reports limits the plaintiff's ability to perform manual or physically demanding work safely.[115]
11. Dr Yeow opines that having regard to the right upper limb injuries alone, the plaintiff has "minimal to no realistic capacity for suitable employment on a reliable and consistent basis". Dr Yeow says that the plaintiff's "right hand and forearm symptoms have recently worsened". He says the plaintiff reports a "flare-up" involving the right forearm, wrist, and three medial fingers. Dr Yeow reports that despite a recent radiofrequency ablation procedure, the plaintiff's symptoms "have not significantly improved". He notes that oral tablets such as Celebrex and Endep have provided minimal relief. Dr Yeow reports that the plaintiff's symptoms flare during work activities and the plaintiff continues to experience frustration with domestic tasks due to ongoing right-hand weakness. He reports a further clinical justification to the effect that "persistent neuropathic pain, sensory disturbance, and reduced functional control of the right hand significantly impair fine motor function and endurance". Dr Yeow opines that the plaintiff's symptoms with respect to the right upper limb "remain unpredictable and refractory to treatment" which makes "sustained or reliable work performance impractical" and increases the "risk of deterioration with repetitive upper-limb activity".[116]
12. Dr Yeow considers, having regard to the plaintiff's hip and sacroiliac joint pain alone, the plaintiff's capacity for suitable employment is substantially reduced. He reports that the plaintiff's pain is aggravated by prolonged walking, sitting, or standing. He says the plaintiff may tolerate short periods of light activity but would require frequent positional changes. He reports the plaintiff receives osteopathic treatment regularly to manage back and hip pain. Dr Yeow provides a clinical justification for the above assessment to the effect that "ongoing mechanical pain and reduced load tolerance" limit the plaintiff's ability to "sustain work requiring mobility or static postures". Dr Yeow notes "any increase in activity risks exacerbation" of the plaintiff's pain symptoms.[117]
13. Considering all injuries and functional limitations collectively, Dr Yeow opines that the plaintiff retains "limited residual capacity for sedentary duties" which would allow "flexible rest breaks, minimal upper-limb use, and frequent changes in posture". Dr Yeow reports the plaintiff, at the time of preparing the report, works 15 hours a week (3 days per week) and that this workload "aggravates her right upper-limb symptoms". Dr Yeow says the plaintiff reports difficulty performing household tasks and continues to drive a manual vehicle, which may place "additional strain on the affected upper limb". Dr Yeow reports the plaintiff requested a referral back to an occupational therapist and that she wishes to trial treatments such as paraffin wax therapy and dry needling.[118]
14. Dr Yeow estimates the plaintiff's sustainable work capacity as being up to "3-4 hours per day, 2-3 days a week, depending on symptom severity and flare ups". Dr Yeow provides a clinical justification for this estimate that the effect that, together, the plaintiff's chronic neuropathic pain, reduced right-hand function, limited spinal load tolerance, and susceptibility to symptom flare-ups significantly restrict her ability to perform duties requiring manual handling, repetitive upper limb use or sustained posture. He considers it likely that the plaintiff's residual incapacity will "continue permanently into the foreseeable future". Dr Yeow reports that the plaintiff's injuries are "longstanding, surgically treated, and have resulted in chronic pain and functional restriction despite appropriate and ongoing management". Dr Yeow considers that further significant improvement in the plaintiff's work capacity is unlikely.[119]
15. Overall, Dr Yeow's reports and treatment summaries show a consistent and longstanding pattern of multi‑site pain, functional limitation and restricted work capacity arising from the injuries sustained on 11 June 2020. Across multiple reports, he attributes the plaintiff's upper‑limb, spinal and psychological symptoms to that incident and considers the resulting impairments to be permanent. He opines that the plaintiff's right‑hand neuropathic pain in particular, remains refractory to treatment, unpredictable, and incompatible with reliable employment beyond very limited hours. Dr Yeow concludes that the plaintiff's residual work capacity is narrow, fluctuating and unlikely to improve, with ongoing risks of aggravation and deterioration.

1. Dr Wang is an orthopaedic surgeon who has prepared treatment summaries, operation records, and referral letters dated 15 September 2020, 27 October 2020, 28 October 2020, 14 November 2020, 05 January 2021, 29 June 2021, 10 May 2022,[120] as well as a medical report dated 10 February 2024.[121] Dr Wang first saw the plaintiff on 11 June 2020 on referral from Maroondah Hospital. In his report Dr Wang notes the plaintiff had sustained a workplace fall where she had sustained a "left elbow very comminuted radial head fracture, a right wrist very comminuted radius and ulna fracture".[122]
2. In his report dated 10 February 2024[123] Dr Wang reports he performed surgery on the plaintiff on 13 June 2020 in the form of an internal fixation of the right wrist radius and ulna internal fixation, right carpal tunnel release, and left elbow radial head replacement and ligament repair.
3. In the same report[124], Dr Wang reports he performed surgery on the plaintiff on 14 November 2020 in the form of right wrist removal for hardware impingement, right ulnar release at the wrist for ulnar nerve neuropathic pain, and left elbow arthrotomy and contracture release for pain and stiffness. Dr Wang reports that during the procedure, he found that her radial head replacement in the left elbow was stable with no loosening and no significant ligamentous instability. Following this surgery, Dr Wang reports that the plaintiff had persistent neuropathic pain in her right hand. He reports that the plaintiff underwent nerve conduction studies which showed no further areas amenable to decompression. Dr Wang reports that the plaintiff's left elbow "regained full range of motion".
4. Dr Wang last treated the plaintiff on 10 May 2022. On this date, Dr Wang referred the plaintiff to Pain Specialists Australia for neuropathic symptoms mainly relatable to the right hand seeking alternative pain management modalities.[125]
5. Dr Wang diagnosed the plaintiff's condition as follows:[126]
   • "Right wrist radius and ulnar fracture, with injury to the median and ulnar nerves. Treated with internal fixation and nerve decompression"
   • "Persistent neuropathic pain right hand and forearm"
   • "Right shoulder tightness"
   • "Left elbow comminuted radial head fracture, treated with radial head replacement"
6. In his report dated 10 February 2024,[127] Dr Wang opines that it is "very clear that the injuries documented above occurred at work". He reports that the neuropathic pain in the plaintiff's right forearm and hand is the result of the described condition. Dr Wang opines that the plaintiff's injuries sustained to her right forearm and her neuropathic pain "definitely has an organic basis as she had sensory changes and pain straight after injury". Dr Wang reports that this pain has "improved somewhat" with nerve decompression treatment but opines that part of the symptoms remain.
7. Dr Wang opines that there is a risk of "degenerative changes" in the right wrist due to a "comminuted intra-articular fracture". Dr Wang further explains that an "intra-articular fracture damages the cartilaginous surface of the joint and can lead to degenerative changes". Dr Wang opines there is also risk of "degenerative changes" in the left elbow due to a radial head replacement being implanted. He further explains that "any intra-articular fracture damages the cartilaginous surface of the joint" can lead to degenerative changes. Dr Wang further reports a risk of degenerative changes in the left elbow. Dr Wang opines this risk is because a radial head replacement has been implanted. He explains that the replacement "artificial joint surface is in contact with [the plaintiff's] native cartlagenous surface on the capitellum" which can "lead to earlier chondral wear and thus degenerative changes down the road".[128]
8. Dr Wang reports that it has been almost two years since he last saw the plaintiff for treatment. He notes that, at the time he last saw the plaintiff on 10 May 2022, she still had limited ability to use her right arm and the plaintiff described to him some ongoing difficulties with daily tasks. Dr Wang reports that on that occasion he "did not go into the details" about what "restrictions" the plaintiff was still on for work at the time and Dr Wang understood the plaintiff was receiving "ongoing COCs" (certificates of capacity) from other providers. Dr Wang reports that since he last saw the plaintiff for treatment, her neuropathic pain had persisted for about 2 years since time of injury with little further improvement. Dr Wang reports that based on the plaintiff's description of the pain, "one would assume there will be limited possible improvement into the foreseeable future". Dr Wang further reports that as of 10 May 2022 the plaintiff had persistent pain in her right arm and was therefore not fit for all pre-injury unrestricted duties.[129]
9. Dr Wang reports that when he last saw the plaintiff, she had: a reasonably well functioning left hand; a reasonable range of motion and strength in the right arm although with persistent neuropathic pain and reasonable mobility in the plaintiff's lower limbs. Dr Wang says he would "assume she has some capacity in the wage-earning workforce, even if not at the exact same level as pre-injury" and it would be "reasonable to assume she has some capacity for employment". Dr Wang reports the plaintiff as having neuropathic pain but was able to engage in most tasks in daily living. Overall, Dr Wang reports that the above situation described may have changed since he last saw the plaintiff.[130]
10. Dr Wang reports that there is likely to be some ongoing neuropathic pain for the plaintiff in her right arm. He opines there will likely be some negative impact of her neuropathic pain on her sleep, domestic and recreational activities, and enjoyment of life. Dr Wang reports that such pain and its impacts on the plaintiff's life will likely be permanent as, at the time of last assessment, it had not resolved by 2 years post-injury.[131] He considers the prognosis for the plaintiff's left arm is good but the prognosis of ongoing neuropathic pain in the right arm is poor as it has shown itself to be persistent, with the prognosis for structural integrity of the right arm/wrist good.[132]
11. In summary, Dr Wang's reports record significant bilateral upper‑limb injuries from a June 2020 workplace fall, managed with surgeries on 13 June 2020 (right wrist fixation and carpal tunnel release; left radial head replacement and ligament repair) and 14 November 2020 (hardware removal, ulnar nerve release, and left elbow arthrotomy), with a good structural outcome in the left elbow but persistent neuropathic pain in the right hand and forearm. He considers the right‑sided neuropathic pain organic, refractory to further decompression, and likely permanent, with expected impacts on sleep, domestic and recreational activities. He identifies ongoing risk of degenerative changes in the right wrist and left elbow due to the intra‑articular nature of the fractures and the radial head prosthesis. As at his last review on 10 May 2022, he regarded the plaintiff as retaining some residual employment capacity, though reduced.

1. Dr Marco Fedi is a neurologist who has prepared reports dated 20 August 2021 and 29 September 2021.[133] Dr Yeow first referred the plaintiff to Neurology Network Melbourne on 29 June 2021 due to ongoing nerve symptoms in the right hand, both in the median and ulnar nerve regions.[134]
2. On 20 August 2021[135] Dr Fedi describes the plaintiff with a right side sensory ulnar neuropathy who has been complaining of increasing paraesthesia over the last few months. Dr Fedi reports the plaintiff had a "significant fall from the stairs" on 01 June from which she "developed bilateral complex fractures". Dr Fedi reports the plaintiff has been attending an occupational therapist on a weekly basis. He reports the plaintiff experiences "intermittent paraesthesias (sic) in the right hand" and has "noticed swelling in the volar aspect of her wrist, particularly after typing on a keyboard".
3. Dr Fedi conducted a neurological examination and reports as follows:
   • "Reduced sensation to pinprick and light touch in the ulnar distribution on the right side"
   • "Power was preserved"
   • "The remaining of the neurological examination was unremarkable"
4. On 20 August 2021[136] Dr Fedi arranged an "NCS", known as a nerve conduction study, for the plaintiff to assess the ulnar nerve. Dr Fedi reports he suggested a trial with amitriptyline (Endep) to the plaintiff.
5. On 29 September 2021[137] Dr Fedi saw the plaintiff for treatment via telehealth appointment. Dr Fedi reports the plaintiff "still complains of the same symptoms" raised in her previous appointment on 20 August 2021. Dr Fedi reports the plaintiff decided not to try the medication at this stage as she seeks "a more definitive treatment rather than a patch". Dr Fedi reports the NCS shows no evidence of neuropathy. Although, Dr Fedi further reports that this result "does not rule out the presence of small fibres neuropathy that could contribute to [the plaintiff's] symptoms" because "small nerve fibres studies have low sensitivity and specificity". Dr Fedi suggested the plaintiff continue with physical therapy and to consider a "brief course" of amitriptyline (Endep) should her symptoms worsen.
6. In summary, Dr Fedi reports show the plaintiff suffering persistent right‑hand paraesthesia in the ulnar distribution with intermittent swelling provoked by keyboard use, examination findings of reduced sensation but preserved power and otherwise unremarkable neurology, normal nerve conduction studies for large‑fibre neuropathy that do not exclude small‑fibre involvement, and a conservative management plan (ongoing therapy with a suggested trial of amitriptyline) that the plaintiff initially declined in favour of pursuing a more definitive treatment.

Dr Kui Hung (Anthony) Njo, Pain Specialist Physician

1. Dr Anthony Njo is a pain specialist physician and anaesthetist at Pain Specialists Australia who provided a medical report dated 07 June 2024. Dr Wang referred the plaintiff to Pain Specialists Australia on 10 May 2022 for pain management and diagnoses.[138] Dr Njo first assessed the plaintiff on 16 June 2022. The plaintiff continued to see Dr Njo for treatment and referral on at least 15 occasions between 16 June 2022 and 21 July 2023.[139] As described above the plaintiff gave evidence that she continues to see Dr Njo from time to time and underwent surgery to her right arm at his direction in May 2025.
2. Dr Njo first assessed the plaintiff on 16 June 2022.[140] Dr Njo reports the plaintiff presented with "a history of chronic pain following an injury sustained at work". Dr Njo notes the right arm pain was neuropathic with a painDETECT score of 19/35. Dr Njo reports the plaintiff also experienced some right shoulder tightness and tenderness, as well as right-back mechanical pain. Dr Njo states that at the time of the first assessment the plaintiff was taking Endep 10 mg at bedtime, Celebrex 100 mg twice a day, Panadol Rapid two times a day and Advil/Nurofen two tablets a day as needed.
3. At the first assessment on 16 June 2022,[141] Dr Njo reports that on physical examination the plaintiff's upper limb motor power was preserved and sensation grossly preserved, except for reduced sensation over the right hand over all the median, ulnar, and radial distributions. On examination of the back, Dr Njo notes there was no neurological deficiency and over the lower limbs straight leg raise test was negative for both legs. Dr Njo reports there was a "3/6 positive test over the right SI joint examination".
4. Dr Njo reports the overall impression of the plaintiff at first assessment is as follows:[142]
   • "Right forearm and hand neuropathic pain after trauma"
   • "Right shoulder muscle tightness and spasm with neuropathic sensitisation"
   • "Right back pain, probably is the right sacroiliac joint pain with a differential diagnosis of discogenic pain"
5. Dr Njo recommended the plaintiff keep active and continue with physiotherapy. He further suggested the plaintiff take Gabapentin 100 mg at bedtime to be slowly titrated up to 200 mg twice a day. Dr Njo opines that failing any improvement with medication at that stage, the following treatments could be considered:
   • "A right C5/6 nerve root block"
   • "A right sacroiliac joint block"
   • "Radiofrequency if longer-term-pain relief were required"
   • "Neuromodulation, if all of the above were ineffective" [143]
6. Dr Njo reviewed the plaintiff for further assessment on 26 August 2022.[144] Dr Njo reported that the plaintiff increased her Gabapentin dosage to 900 mg a day since her last assessment, although found she had issues with side effects. Dr Njo reports that upon reducing the Gabapentin dosage to 600 mg a day, the plaintiff encountered less of these side effects. Dr Njo reports he introduced a venlafaxine (Effexor) prescription to be slowly titrated up to 75 mg daily to help with the pain. Dr Njo reports the plaintiff mentioned that her hip pain had worsened on increasing exercise, specifically more to the left side and spread towards the sacrum.
7. On 10 October 2022[145], Dr Njo saw the plaintiff for further treatment. Dr Njo reported that the plaintiff should cease taking the Effexor given the side effects experienced. The plaintiff told Dr Njo that bilateral gluteal pain and bilateral groin pain was severe, alongside significant left-sided lumbar spinal pain. Dr Njo reported that given the persistence of right-arm numbness a diagnostic block of nerve roots would be arranged. Dr Njo requested an MRI of the lumbosacral spine and both hips to "rule out any discogenic pain and any hip pathology", as well as a "bilateral SI joint injection to see whether the pain was coming from the SI joint".
8. On 18 November 2022[146], Dr Njo saw the plaintiff for MRI follow-up and treatment after the MRI was conducted on 17 November 2022. Dr Njo reported the MRI of the lumbosacral spine was normal, while the left hip showed "some changes over the trochanteric bursitis". Dr Njo opined the left hip trochanteric pain was still prominent and so requested a trochanteric bursitis steroid injection.
9. On 27 January 2023[147] the plaintiff saw Dr Njo for further treatment regarding the outcome of the bilateral SI joint injection. Dr Njo notes that the plaintiff reported "70% pain relief from the bilateral SI joint injection, making this a positive block".
10. On 7 February 2023[148], Dr Njo saw the plaintiff for treatment regarding the right C6/7/8 nerve root block performed on 01 December 2022.[149] Dr Njo reported that this procedure "did not relieve" the plaintiff's right-hand pain. Dr Njo arranged for a pulsed radiofrequency treatment over the right hand and forearm. He also discussed the option of "spinal cord stimulation in the event that the radiofrequency were (sic) unsuccessful". Dr Njo reported further that "sacroiliac joint denervation" was discussed with the plaintiff as an option "if the steroid injection effect were short-lived". Dr Njo performed a further physical examination and found "hyperalgesia and allodynia over the whole right hand and some parts of the wrist, no further than the bottom half of her right forearm". Dr Njo reported there was some tenderness over the plaintiff's upper arm and shoulder "which appeared more muscular in origin".
11. On 4 April 2023[150], Dr Njo performed a "bilateral SI joint radiofrequency denervation" to the right ulnar, median and musculocutaneous nerves. Dr Njo reports this was performed "given the results of the steroid injection had begun to wear off". As described above, on 18 May 2023, Dr Njo performed a "radiofrequency neurotomy - SIJ - unilateral" to the left side.[151]
12. On 30 May 2023[152], the plaintiff saw Dr Njo for further consultation post-nerve operations. Dr Njo reported the plaintiff's right neuropathic pain had been much improved although she was "still experiencing flare-ups when overdoing her exercises". Dr Njo notes the plaintiff did not experience an exacerbation of pain after the pulsed radiofrequency procedure. Dr Njo reports the plaintiff indicated the left hip was "still painful two weeks after the procedures", and he recommended the plaintiff engage with some exercise including short walks and stretching for her back.
13. On 21 July 2023[153], Dr Njo saw the plaintiff for further review post-operation. He reported that the "right forearm pain returned to some degree" and that the plaintiff had a "flare-up lasting four days" which she was able to manage with a heat pack and reduced activities. At the time of assessment on 21 July 2023, Dr Njo reported the plaintiff's right forearm pain was "now okay". He recommended repeating radiofrequency of the forearm with a high energy level and suggested that the plaintiff consider undergoing spinal cord stimulation.
14. On 7 June 2024 Dr Njo diagnosed the plaintiff's condition as follows:[154]
    • "Bilateral SI joint pain with positive bilateral intra-articular SI joint injection and partially helped by bilateral SI joint denervation"
    • "Left hand and distal forearm neuropathic pain resulting from previous injury and persists after surgery with positive response to pulsed radiofrequency of the nerve innervating the forearm and hand"
    • "Left trochanteric bursitis pending approval of left trochanteric injection"
15. Dr Njo reports that, to his knowledge, the plaintiff's pain conditions are "as a result of the injuries sustained at work in the fall down the flight of stairs" and the subsequent resulting surgery. Dr Njo reports that he "cannot predict" whether the plaintiff's condition will deteriorate or whether she is at risk of further degenerative change. Dr Njo reports the plaintiff's prognosis is "reasonably strong" noting the plaintiff's previous "good response to interventions".[155]
16. In summary, Dr Njo describes the plaintiff experiencing persistent neuropathic pain of the right forearm and hand following workplace trauma, with associated right‑shoulder muscle tightness, sacroiliac joint-related back pain and left trochanteric bursitis. His management included trials of Gabapentin and venlafaxine, diagnostic blocks and imaging, bilateral sacroiliac joint injections with approximately 70% relief followed by denervation, a pulsed radiofrequency procedure to the forearm/hand that improved symptoms, and consideration of repeat radiofrequency and spinal cord stimulation after a right C6-8 nerve root block proved ineffective. He attributes the pain conditions to the workplace fall and subsequent surgery, considers the prognosis "reasonably strong" given prior responses, but cannot predict deterioration. Dr Njo's report supports a pattern of fluctuating yet persistent neuropathic and sacroiliac joint pain under active specialist management with partial relief from interventions and ongoing need for multimodal strategies.

1. Ms Terri Stanley-Clarke is a physiotherapist at Melbourne Hand Therapy specialising in hand and upper limb rehabilitation. Dr Wang referred the plaintiff to Melbourne Hand Therapy on 20 June 2020. Ms Stanley-Clarke provided treating notes dated 5 July 2020.[156]
2. Ms Stanley-Clarke reports that at the time of assessment, the plaintiff's injuries to her right arm presented as follows:[157]
   • "Carpal tunnel release with residual numbness/pins and needles"
   • "Ulna fracture and subsequent ORIF"
   • "Radius fractures and subsequent ORIF"
   • "Ulna nerve injury with pain, altered sensation and weakness"
3. Ms Stanley-Clarke reports that at the time of assessment, the plaintiff's injuries to her left arm presented as follows:
   • "Radial head fracture which required radial head replacement"
   • "Elbow LCL ligament which was repaired"
4. Ms Stanley-Clarke reports that physiotherapy, at the time the report was prepared, was focusing on "pain management, soft tissue management, AROM both hand, wrist and left elbow, nerve sensitisation, and scar management". Ms Stanley-Clarke opines the plaintiff has limited function in both hands and requires a support person to attend appointments with her to help with "undressing and don/doffing both sling and splint". [158]
5. Ms Stanley-Clarke sought approval from CGU Workers Compensation for extended physiotherapy sessions for the plaintiff. Ms Stanley-Clarke opined that due to the plaintiff's extensive injuries at the time, it was difficult to appropriately address the plaintiff in a single standard physiotherapy session and sought approval from CGU for extended consultations to achieve the appropriate treatment.[159]
6. In short, Ms Stanley‑Clarke's report and her review treating notes from Melbourne Hand Therapy record extensive bilateral upper‑limb injuries managed surgically, with persistent right‑sided neuropathic symptoms and reduced function in both hands requiring assistance to attend and manage slings/splints. Physiotherapy was directed to pain and soft‑tissue management, active range of motion of the hands, wrists and left elbow, nerve desensitisation and scar care, and she sought CGU approval for extended sessions given the complexity of the presentation. Overall, her report supports the plaintiff's ongoing, structured rehabilitation needs and a materially limited functional capacity on cumulative consideration.

1. Ms Haley Field is an occupational therapist at Melbourne Hand Therapy who has provided a report dated 16 April 2024 after examining the plaintiff that day.[160] On examination, Ms Field diagnoses the plaintiff's injuries as "left radial head replacement and ulnar collateral ligament repair and right distal radius and ulnar styloid fracture with ORIF and open carpal tunnel release". Ms Field reports that the plaintiff has "ongoing pain, numbness and decreased function".[161]
2. Ms Field viewed a video of the incident as part of her assessment preparation and opines that there is "no doubt the incident occurred at work and that [the plaintiff's] injuries at the time and currently are a result of her employment". Ms Field considers that the plaintiff's injuries continue to be exacerbated by her employment, specifically the repetitive use of her upper limbs while undertaking computer and phone-based tasks.[162]
3. Ms Field reports the plaintiff has: a reduced range of motion in her right wrist as compared to her left wrist; reduced grip strength of 21kg/force in her left side; and 21kg/force in her right side (dominant) as compared to the age average 29kg/force for a female of the plaintiff's age. Ms Field reports the plaintiff has a reduced pinch strength force of 4kg/force in her right side and 5kg/force in her left side as compared to the age average of 6kg/force.[163]
4. Ms Field reports the plaintiff experiences "ongoing numbness and pain in her right hand" with a "heavy feeling and a feeling of disproportionate representation of her right hand" as compared to its state pre-injury. She notes the plaintiff reported a pain of 5-6 out of 10 at rest using the VAS pain scale and 8-10 out of 10 after function.[164] Ms Field reports that pain in the plaintiff's right hand has resulted in decreased function and difficulty sleeping. Ms Field reports the plaintiff needed to take medication to sleep but that this created issues with feeling "very sleepy and dysfunctional" in the mornings. Ms Field notes that the plaintiff reports if she does not take the medication for her sleep she manages between 2 and 3 hours of sleep per night.[165]
5. Ms Field opines that the plaintiff's injuries described, specifically to the right radius and ulnar fracture, left elbow, and right nerve damage, "certainly" have an organic basis. Ms Field reports the plaintiff's left elbow joint replacement is at an "increased risk of osteolysis, aseptic and either prosthetic or periprosthetic fracture". Ms Field is of the opinion that the wear and damage to the prosthesis over time may also result in pain, weakness, further complications and possible need for further surgery" for the plaintiff.[166]
6. Ms Field opines that the plaintiff's reduced range of motion in her right wrist and decreased bilateral grip and pinch strength will restrict the plaintiff in performing many of her daily activities. This includes performing housework, cooking, driving, gardening, writing for extended periods and yoga. Ms Field also considers the plaintiff is restricted in the kind of work she can perform, specifically that she is limited in the use of her upper limbs for repetitive tasks such as typing and writing. Ms Field reports the plaintiff would be unable to perform a profession "requiring upper limb physical tasks like lifting, carrying, cutting, use of power tools etc". Ms Field opines that given the "ongoing" presentation of the plaintiff's symptoms almost 4 years since the injury, these identified restrictions will be permanent.[167]
7. Ms Field notes that the plaintiff's injuries presently restrict many activities of daily living that she performed pre-injury. Ms Field reports the plaintiff, at the time of preparing the report, finds dressing difficult and struggles with fine motor control tasks such as putting on earrings, and other tasks including changing bed sheets and cooking are "not possible or difficult". The plaintiff told Ms Field that driving over 45 minutes causes pain and cramping in the hand. Furthermore, that the plaintiff can no longer lift bags of soil or pot plants despite enjoying gardening prior to her injury. Ms Field notes the plaintiff cannot write for long periods, cannot wash her car "all at once", and finds cleaning "very difficult". Ms Field notes that the plaintiff "previously enjoyed an active social life and now doesn't go out much" as well as being unable to continue weekly yoga classes. Ms Field opines these limitations will continue to impact the plaintiff permanently.[168]
8. Ms Field considers the plaintiff has capacity for suitable employment although does not believe the plaintiff is fit for unrestricted pre-injury duties due to her ongoing symptoms and restrictions. Ms Field reports that the plaintiff's "weakness and decreased range of motion" will require her to manage these symptoms "on a daily basis" restricting the type of work she can undertake.[169]
9. As to the plaintiff's potential residual capacity for suitable employment, Ms Field opines the appropriate days per week and hours per day would be "entirely dependent on the nature of the work". Ms Field observes that the plaintiff has "reduced strength, endurance, and range of motion which significantly reduces her ability to perform tasks in many workplaces". Ms Field opines that the plaintiff may still be suitably employed "under the right conditions and with ongoing support and rehabilitation", although not at pre-injury level. Ms Field reports that the plaintiff's reduced capacity for tasks will be permanent because she does not expect further improvement in the plaintiff's symptoms.[170] Ms Field does not expect the plaintiff's symptoms or limitations will improve given the plaintiff is "now almost 4 years post injury" and has had "numerous interventions from pain management with little improvement".[171]
10. In short compass, Ms Field considers that the plaintiff's bilateral upper‑limb injuries have resulted in persistent pain, numbness and reduced function, corroborated by decreased wrist range of motion and reduced grip/pinch strength on assessment. She considers causation clear and ongoing, with repetitive computer‑ and phone‑based tasks exacerbating symptoms. Functionally, the plaintiff is restricted across daily activities (including dressing, cooking, driving beyond 45 minutes, gardening, and prolonged writing) and is unsuited to roles requiring repetitive upper‑limb use or manual tasks. Ms Field concludes these limitations are permanent, though some suitable employment may be achievable under tailored conditions and ongoing support, but short of pre‑injury capacity.

1. Dr Asaid prepared two reports dated 16 July 2025, and 15 November 2025[172] respectively. In his first report, Dr Asaid diagnoses the plaintiff's condition as follows:[173]
   • "Right distal radius and ulna fracture"
   • "Left radial head fracture"
   • "Soft tissue injury to the lower back"
2. Dr Asaid considers the nature of the plaintiff's employment with Adairs and the incident on 11 June 2020 is a cause and continues to be a cause in respect of the plaintiff's left upper limb, right upper limb, and spinal injuries.[174]
3. Dr Asaid opines that the plaintiff's injuries to her right upper limb and left upper limbs "certainly" have an organic basis. However, he considers it is "more difficult to conclude" that the plaintiff's lower back injury has an organic basis given the MRI lumbar spine performed on 16 November 2022 was reported as normal. Dr Asaid states that given the nature of the plaintiff's injuries and the surgery performed, the plaintiff is at an increased risk of developing arthritis in her right wrist and left elbow. Dr Asaid reports the plaintiff is likely to be restricted in engaging in activities such as "pushing, pulling, lifting, gripping, manual dexterity and the repetitive use of her upper limbs". Dr Asaid considers these restrictions are likely to persist for the foreseeable future.[175]
4. In respect of the plaintiff's work capacity, Dr Asaid opines that given the severity of the injuries sustained, he does not believe the plaintiff has the capacity to perform unrestricted pre-injury duties in a full-time role as an administration assistant in the customer service department at Adairs.[176] Dr Asaid refers to the plaintiff's employment with Hurtigruten in a part-time sales/administrative position to support his view the plaintiff has a residual capacity for suitable employment. Dr Asaid states that the "specific" number of days and hours which the plaintiff can work ought to be best assessed by an occupational physician. Dr Asaid considers the plaintiff's prognosis to be "guarded" and that she is likely to continue to experience some degree of pain and restriction in her activities for the foreseeable future.[177]
5. In his second report, Dr Asaid notes that solely given the severity of the plaintiff's right arm injury, he does not believe the plaintiff has capacity to perform unrestricted pre-injury duties in a full-time role as an administrative assistant and that such incapacity for full time work is likely to continue for the foreseeable future considering the plaintiff's organic right arm injury.[178]
6. Across the two reports, Dr Asaid diagnoses fractures to the right distal radius/ulna and left radial head with a soft‑tissue lower‑back injury, attributes the plaintiff's upper‑limb and spinal conditions to the 11 June 2020 incident, and considers the upper‑limb injuries to have an organic basis while noting the lower‑back complaint is less likely organic given a normal lumbar MRI. He anticipates increased risk of degenerative change (right wrist and left elbow) and enduring functional restrictions in pushing, pulling, lifting, gripping, manual dexterity and repetitive upper‑limb use. He opines the plaintiff cannot perform unrestricted pre‑injury full‑time duties but retains residual capacity for suitable part‑time employment, with a guarded prognosis. In his later report, he reiterates that the right‑arm injury alone will preclude a return to unrestricted full‑time administrative work for the foreseeable future.

1. Dr Awad prepared two reports dated 14 August 2025 and 18 November 2025[179] respectively. In her first report, Dr Awad diagnoses the plaintiff's injury as follows:[180]
   • "Left elbow comminuted radial head fracture"
   • "Right wrist comminuted radial and ulnar fracture"
   • "Aggravation of cervical spondylosis"
   • "Aggravation of lumbar spondylosis"
   • "Chronic pain"
   • "Adjustment disorder with depressed and anxious mood"
2. In her report dated 14 August 2025[181], Dr Awad opines that the plaintiff's "employment was a direct cause of her injuries and her ongoing sequelae". She agrees that the diagnosed injuries in the left arm, right arm, spine, hip and pelvis have an organic basis. Dr Awad states that the plaintiff is at increased risk of post-traumatic osteoarthritis in her upper limbs and the nature of her cervical and lumbar conditions are such that the plaintiff is likely to continue to experience degenerative changes.[182]
3. In respect of the plaintiff's work capacity Dr Awad states that the plaintiff has "no capacity for her pre-injury role" and further opines that there are "no workplace adjustments that would allow her to return to her full hours and full remit".[183] Dr Awad references the plaintiff's undertaking 15 hours part-time work a week which, in her opinion, affords the plaintiff structure, although Dr Awad also notes that "nevertheless the plaintiff retains partial incapacity secondary to her injuries". Dr Awad states that 15 hours is the "maximum amount of hours" the plaintiff can undertake. In her supplementary report dated 18 November 2025, Dr Awad clarifies that this 15-hour limit is "secondary to her partial incapacities when considered individually[184]. Dr Awad delineates the plaintiff's maximum capacity referable to each injury. Based on the cervical spine, upper right limb, left upper limb and lumbar spine injuries respectively, Dr Awad reports the plaintiff can maximally work 15 hours a week.
4. Dr Awad considers, based on the condition of the plaintiff's cervical spine, that she should be "permanently medically restricted" from a number of physical activities including pushing, pulling, lifting, carrying above 5 kilos, reaching forward, reaching overhead, prolonged fixed positions of her cervical spine and repetitive movements of her cervical spine, as well as exposure to "whole body vibration" for the foreseeable future. With respect to the plaintiff's right upper limb injury, Dr Awad states that the plaintiff should be permanently medically restricted from undertaking these physical activities, and specifically from carrying above 2 kilos, forceful bimanual movements and repetitive movements of her right upper limb for the foreseeable future. Dr Awad further redraws these conclusions also with respect to the injury sustained to the left upper limb. Based solely on the plaintiff's lumbar spine injury, Dr Awad opines the plaintiff should be permanently medically restricted from pushing, pulling, lifting, carrying above 10 kilos, prolonged sitting, prolonged standing, prolonged walking, climbing, working at heights, and exposure to whole body vibration for the foreseeable future. Dr Awad considers each of these injuries to amount to a permanent partial incapacity.[185]
5. In her first report, Dr Awad states that the plaintiff is likely to experience increased symptoms of pain secondary to development of post-traumatic osteoarthritis and as such her ability to maintain her current part-time role up to retirement age is questionable and, on the balance of probabilities, unlikely. Dr Awad opines the plaintiff is also likely to experience recurrent flares of pain that may impact her ability to work in a reliable and sustained manner. She states that these medical restrictions significantly disadvantage the plaintiff when comparing her employability in an open market against her peers who do not have the same restrictions. She considers the plaintiff's symptoms and functional incapacities stated will permanently prevent her from working full-time for the foreseeable future, as well as prevent her from working in any physical manual roles and impact her efficiency with a flow-on effect to the plaintiff's promotions and career progression.[186]
6. In respect of the Vocational Assessment Report dated 16 May 2022[187], which was made available to Dr Awad in preparing her first report, Dr Awad states that the plaintiff is able to do the roles identified by Work Able Consulting up to 15 hours per week, with the exception of Car Hire Assistant/Rental Clerk to the extent that such a role goes beyond the plaintiff's medical restrictions.[188]
7. Overall, Dr Awad's two reports conclude that the plaintiff's bilateral upper‑limb fractures and aggravations of cervical and lumbar spondylosis, with chronic pain and adjustment disorder, have an organic basis, are employment‑caused, and amount to permanent partial incapacities. She considers there should be enduring medical restrictions across lifting, carrying, pushing/pulling and cervical/lumbar postures, and limits the plaintiff's residual work capacity to about 15 hours per week - insufficient for any return to her pre‑injury role or unrestricted full‑time work. Dr Awad anticipates progressive degenerative change (including post‑traumatic osteoarthritis) and questions the plaintiff's ability to sustain reliable employment to retirement, noting that any suitable work would be confined to tailored part‑time duties within these restrictions.

1. Dr Hazem Akil is a neurosurgeon who prepared a report dated 11 September 2025.[189] In respect of the plaintiff's diagnosis, Dr Akil notes that the incident on 11 June 2020 is the direct cause of the aggravation of the plaintiff's underlying and current spinal conditions and symptoms. Dr Akil reports the plaintiff's ongoing symptoms of chronic neck and lower back pain are consistent with such a diagnosis although he is unable to comment on the plaintiff's arm and hip injuries given they fall outside his area of speciality.[190]
2. Dr Akil reports that due to the chronicity of the plaintiff's symptoms five years post-injury, as well as the only partial and largely temporary success of multiple treatments, he considers the plaintiff's prognosis for a complete recovery of her spinal conditions is poor. Dr Akil states the plaintiff's symptoms are likely to be permanent. And that the plaintiff is at risk of degenerative changes in her spine, which could lead to a long-term deterioration of her symptoms although notes the likelihood of such deterioration is difficult to quantify.[191]
3. Dr Akil considers the plaintiff's spinal injuries have a clear organic basis evidenced by the plaintiff's history, clinical examination findings and degenerative changes seen on MRI scans. Dr Akil reports the injury has likely accelerated the natural history of degenerative spondylosis in the plaintiff's cervical and lumbar spine. Dr Akil states the plaintiff is at an increased risk of further degenerative change, which could manifest as worsening pain, stiffness and potential development of radiculopathy or myelopathy, although the latter was not present at the time of assessment. Dr Akil opines that given the five-year history of the plaintiff experiencing chronic symptoms and failure to achieve lasting relief even despite extensive treatment, the plaintiff's functional restrictions in relation to her spine are considered permanent and are likely to persist indefinitely.[192]
4. Dr Akil states that the plaintiff is not fit for unrestricted pre-injury duties of full-time work as an accounts administrator due to her spinal conditions.[193] With respect to the plaintiff's spinal injuries alone, Dr Akil considers the plaintiff's capacity for suitable employment is significantly limited and that her current work schedule of 15 hours a week appears to be at the limit of her tolerance.[194] Dr Akil opines the plaintiff's chronic neck and back pain, coupled with restricted movement and pain on prolonged sitting together reduces her ability to reliably and consistently perform duties, particularly those that are sedentary and computer-based. Dr Akil notes the plaintiff has demonstrated a capacity for part-time work but opines it is unlikely that she could sustain full-time employment on a permanent and reliable basis due to her spinal symptoms. With respect to the plaintiff's left upper limb, right upper limb, and hip injuries alone however, Dr Akil notes he is unable to provide an opinion on the impact of these injuries on the plaintiff's work capacity as they related to areas outside of his neurosurgical expertise.[195] Dr Akil also opines that given the complexity of the plaintiff's injuries with respect to her spinal and severe upper limb conditions, a comprehensive opinion on her work capacity would be best provided following an assessment by an occupational physician.[196]
5. To sum up, Dr Akil opines that the 11 June 2020 incident directly aggravated the plaintiff's underlying cervical and lumbar spondylosis, producing chronic neck and low‑back pain consistent with an organic spinal diagnosis, and he expressly does not opine on upper‑limb or hip complaints as outside his specialty. He assesses the prognosis as poor, with symptoms likely permanent and an increased - though unquantified - risk of further degenerative change and potential radiculopathy or myelopathy. He considers the injury to have accelerated degenerative spondylosis, with permanent functional restrictions. On capacity, he concludes the plaintiff is not fit for unrestricted pre‑injury full‑time administrative work; her current 15 hours per week is near her tolerance, with reliable full‑time employment unlikely, and he recommends an occupational physician for a comprehensive work‑capacity assessment.

Mr Richard Pennington, Orthopaedic and Upper Limb Surgeon

1. Mr Richard Pennington is an orthopaedic and upper limb surgeon who prepared a report dated 23 October 2025.[197] Mr Pennington diagnoses the plaintiff's injuries as follows:[198]
   • "Left elbow radial fracture and lateral ulna collateral ligament avulsion"
   • "Right distal radius and ulna fracture with distal ulna dislocation"
   • "Neuropathic pain right hand/upper limb"
   • "Non-specific sacroiliac joint/pelvic pain"
2. Mr Pennington reported the plaintiff continues to suffer ongoing pain and there is significant ongoing symptomology, particularly on the right side. Mr Pennington states that the left side is "comparatively well-compensated and recovered", noting there is secondary pain in the cervical spine and right shoulder girdle which he opines is likely compensatory. Mr Pennington reports the plaintiff experiences sacroiliac (SI) joint and pelvic pain following the injury and surgery, which is aggravated by activity and prolonged sitting. Mr Pennington considers "this is likely to degeneration and/or subsequent deconditioning with a 20kg weight gain". Mr Pennington states that the plaintiff is capable of the part time hours she is currently doing at Hurtigruten. He opines the plaintiff should be physically able to increase these hours with a shorter commute. In respect of the plaintiff's prognosis, Mr Pennington opines that the plaintiff has "objectively" had an excellent outcome in terms of range of movement and function given the complex nature of her fractures, although does not expect any further significant improvement. He reports that the plaintiff's ongoing nerve symptoms in the right upper limb may be due to small nerve fibre injury but there is "no objective evidence of this" and the injury itself is unlikely to change. Mr Pennington reports that the nature of the plaintiff's medical condition includes neuropathic pain in the right hand, left elbow post-traumatic stiffness, and no condition affecting the spine.[199]
3. Mr Pennington reports the plaintiff experience tenderness over the right trapezius but no tenderness over the spinous processes was elicited on examination. He reports cervical foraminal compression testing was negative and there were no unphysiological findings. Mr Pennington notes deep tendon reflexes were grossly normal and symmetrical.[200] With respect to neurovascular examination, Mr Pennington states that the plaintiff experienced "different" sensation in the index, middle, and ring fingers over the right hand as compared to the left. He notes that the plaintiff's sensation over the palm has reportedly never returned. He reports no hyper-reactivity and no signs of complex regional pain syndrome in either limb, although some tenderness over the elbow with grinding on rotation. Mr Pennington states no areas of tenderness on the wrists or hands. He notes a subjectively weaker grip on the right side. With respect to the lumbar spine, Mr Pennington notes no pain elicited on movement and no joint tenderness.[201]
4. Mr Pennington does not agree there was a medical basis for the plaintiff to reduce her working hours to 15 hours a week as she was working full-time.
5. In short, Mr Pennington diagnoses bilateral upper‑limb fractures with persistent right‑sided neuropathic pain and non‑specific sacroiliac/pelvic symptoms, records an objectively excellent structural outcome - particularly on the left - with no expectation of further significant improvement, and finds no spinal condition on examination. He attributes the sacroiliac/pelvic complaints to degenerative change and deconditioning (including a 20 kg weight gain), notes largely normal and symmetrical neurology with no complex regional pain syndrome, and considers the right‑hand sensory disturbance possibly small‑fibre in origin but unsupported by objective evidence. Functionally, he opines the plaintiff is capable of her current part‑time work and should be able to increase hours with a shorter commute, and he does not accept a medical basis for reducing her to 15 hours per week.
6. It should be noted that Mr Pennington's report appears to have been prepared without the benefit of any information from the plaintiff's treating general practitioner Dr Yeow including Dr Yeow's certification of modified hours of work for the plaintiff.[202] Nor is the report internally consistent since on the one hand he accepts a current work capacity of 15 which might increase if combined with a shorter commute, but absent a shorter commute, Mr Pennington does not explain why he not agree there was a medical basis for the plaintiff to reduce her working hours to 15 hours a week as she was working full-time. Presumably the impact of the length of the plaintiff's commute on the plaintiff's impairment is a factor in assessing her hours of work capacity.

Dr Joseph Slesenger, Specialist Occupational Physician

1. Dr Slesenger is a specialist occupational physician who provided a report dated 29 October 2025. Dr Slesenger diagnoses the plaintiff's injuries as follows:[203]
   • "Left elbow radial head fracture"
   • "Residual left elbow pain together with restricted range of movements"
   • "Right wrist distal radial fracture with ulnar dislocation"
   • "Chronic right wrist pain"
   • "Lumbar spine soft tissue injury"
   • "Aggravation of degenerative disease of the lumbar spine"
   • "Chronic lower back pain with radiating features"
   • "Right hip soft tissue injury"
   • "Chronic right hip pain"
2. Dr Slesenger further opines the plaintiff presents with a psychological impairment although notes this is outside his area of expertise.[204] Dr Slesenger states that there is a significant non-physical element to the plaintiff's presentation. In making such an assessment, he refers to the following:[205]
   • "Improved range of cervical spinal movements upon distraction"
   • "Absence of wasting around the right shoulder despite the weakness and restricted range of movements identified"
   • "Improved range of hip and thorascolumbosacral spinal movements upon distraction"
   • "Inconsistent seated to spine straight leg raise test"
   • "Absence of wasting in the right hand despite the severe weakness and restricted range of movements identified"
3. Dr Slesenger opines that based on the plaintiff's residual upper limb, lumbar spine as well as bilateral hip impairment she could return to work with modified duties and restrictions. These modifications include no pushing, pulling, carrying, or lifting over 10kg on an occasional basis and 5kg on a repetitive basis; avoiding forceful gripping, pushing and pulling; avoiding repetitive bending and twisting; avoiding prolonged static postures, and avoiding exposure to whole body vibration. Dr Slesenger reports that with these restrictions the plaintiff could remain at work sustaining pre-injury hours.[206]
4. As to the plaintiff's prognosis, Dr Slesenger reports the plaintiff is at risk of developing degenerative disease in the right wrist and left elbow although notes this risk should be "quantified by a relevant expert". Dr Slesenger also considers that as there is a non-physical element to the plaintiff's presentation there are accordingly opportunities for improvement in her symptoms. Dr Slesenger reports concern with respect to the plaintiff's mental health issues and presentation. Dr Slesenger refers to "inconsistencies" and notes the plaintiff does not appear to have sought additional advice about her physical or mental health issues despite the significant reduction in occupational capacity. He reports there may be a "behavioural element" to her presentation. Dr Slesenger opines the plaintiff would benefit from review of her mental health issues and that these should be addressed by a relevant expert.[207]
5. In summary, Dr Slesenger identifies multi‑site injuries - including left radial head fracture with residual elbow pain and restriction, right distal radial fracture with ulnar dislocation and chronic wrist pain, lumbar soft‑tissue injury with aggravated degenerative change, and right‑hip soft‑tissue injury - resulting in ongoing upper‑limb, spinal and hip symptoms. He identifies a significant non‑physical/psychological component, noting distraction‑improved ranges of motion, inconsistent straight‑leg‑raise, and the absence of muscular wasting despite reported weakness, and recommends specialist review of mental health issues. He opines the plaintiff can sustain pre‑injury hours in modified duties with restrictions on lifting (≤10 kg occasional, ≤5 kg repetitive), forceful gripping/pushing/pulling, repetitive bending/twisting, prolonged static postures, and exposure to whole‑body vibration. The prognosis includes a risk of degenerative change in the right wrist and left elbow (to be quantified by a relevant expert), with potential for symptom improvement given the non‑physical elements of the presentation.
6. It should be noted that, like that of Mr Pennington, Dr Slesenger's report appears to have been prepared without the benefit of any information from the plaintiff's treating general practitioner Dr Yeow[208] including Dr Yeow's certification of modified hours of work. He is also the only orthopaedic surgeon to have suggested the existence of some non-physical element to the plaintiff's presentation. In that respect his report appears to be an outlier.

1. A vocational assessment report was prepared by Work Able Consulting on 16 May 2022.[209] The report initially summarises the plaintiff's history of injury, the plaintiff's diagnosis per the WorkCover Certificate of Capacity dated 29 March 2022, prognosis, as well as medication, and current and future treatment. In terms of medical restrictions, the report refers to the WorkCover Certificate which provides that the plaintiff has the following restrictions:

"4 hours per day; Tuesday and Thursday; Rest breaks as needed - 10,20,10 minutes breaks throughout the day. Can use injured hand/arm with modification. Can lift with modification"[210]

1. In its report, Work Able Consulting notes that the plaintiff says, as at the time of preparing the report, she has returned to work with her pre-injury employer (4.5 hours each Tuesday and Thursday working from home) completing data entry. The report provides a basic summary of the plaintiff's vocational history from 1998-2022, as well as relevant education, license, and certificates.[211]
2. Based on the plaintiff's reported employment and educational history, Work Able Consulting identified several transferable skills including, knowledge of administrative and clerical procedures; knowledge of patient privacy and confidentiality practices; intermediate level computer skills; customer service skills; data entry skills; ability to follow direction.[212]
3. The plaintiff indicated an interest in the following vocations to Work Able Consulting which are recommended as possible full-time options instead of her part-time employment hours, pending final medical approval:[213]
   • Help Line Operator
   • Travel Consultant/Guide
   • Sales Representative
   • Trainer
   • Traffic Controller
4. Work Able Consulting identified several suitable employment options in line with the medical restrictions outlined in order of priority:
   1. Call Centre Operator
      1. ANZSCO: 541112
      2. $1,1960/week (before tax)
   2. Car Hire Assistant/Rental Clerk
      1. ANZSCO: 621912
      2. $1,128/week (before tax)
   3. Travel Consultant
      1. ANZSCO: 451612
      2. $1,318/week (before tax)
   4. Support Coordinator (e.g. NDIS)
      1. ANZSCO: 411712
      2. $1,328/week (before tax)
   5. Data Entry Operator
      1. ANZSCO: 532111
      2. $1,035/week (before tax)
5. The vocational assessment report is dated 16 May 2022, having been prepared more than three and half years ago. Accordingly, it does not consider the current medical restrictions on the plaintiff's capacity as set out in the various medical reports discussed earlier. Nor does the assessment consider the most recent certificate of capacity prepared by Dr Yeow on 1 May 2025 restricting the plaintiff's working hours. The assessment is therefore of limited probative value.

1. In summary, for the plaintiff it was submitted that:

(a) The plaintiff was injured at work on 11 June 2020 during which time she sustained a serious injury to her right wrist, left elbow, and spine and continues to experience ongoing and significant symptoms.

(b) The plaintiff's injuries are diagnosed by medical experts as including a left elbow radial head fracture; right wrist complex fracture; right hand neuropathic pain; low back pain and right sacroiliac joint pain.

(c) The plaintiff has, in her five-year journey since 11 June 2020, been treated by her GP Dr Yeow, her orthopaedic surgeon Mr Wang and pain specialist Mr Njo which the medical reports corroborate.

(d) The plaintiff's treaters indicate there is a risk the plaintiff will develop degenerative changes in her right wrist and left elbow.

(e) The pain and suffering consequences include loss of function, reduced daily activity and physical activity, impaired sleep, loss of hobbies, and impairment on personal relationships.

(f) The medical evidence supports the assertion that the plaintiff's injuries have resulted in a permanent loss of work capacity beyond 15 hours; reduction from full-time hours to 15 hours was under the guidance of her GP Dr Yeow, and he estimates the plaintiff's sustainable capacity is up to 2 to 4 hours per day for 2 to 3 days per week depending on the severity of symptoms and flareups.

(g) The plaintiff has said that she presently works 15 hours a week, albeit with some discrepancy with a couple of hours between the plaintiff's evidence and the report of Dr Yeow.[214]

(h) The plaintiff's memory is that she did not work beyond 15 hours a week in the period between 2021 - 2023 following the injury; there was medical advice given to her as to this capacity in those two years and there is no evidence this was not the case.

(i) The plaintiff's current earning capacity in her role at Hurtigruten, including bonuses, puts her under the threshold of a post-injury 60% earning capacity, as compared to pre-injury.

(j) There has been no evidence put on by the defendant to challenge the plaintiff's difficulty working 15 hours.

(k) The plaintiff has a clean history; she was a hard-working employee before this and none of the treating practitioners beyond Dr Slezenger attack her credit or reliability in any way; and her evidence should be accepted.

(l) The reports prepared by the plaintiff's General Practitioner Dr Yeow should be given most weight in terms of medical opinion; Dr Yeow is intimately familiar with the plaintiff's condition, seeing her monthly for a period of over five years, the plaintiff is supported in this will by Dr Yeow's evidence.

1. In summary, for the defendant it was submitted that:

(a) The defendant accepts the plaintiff had an injury to the left elbow, right elbow, and right wrist.

(b) The defendant contests whether the plaintiff's injury to her spine constitutes a serious injury in and of itself; the plaintiff's injuries cannot be aggregated.

(c) The defendant accepts the plaintiff has ongoing pain and restrictions, to an extent, in the right hand and right wrist, although it would be open to the court to find that those consequences are at least very considerable to the plaintiff.

(d) The defendant further contests whether the threshold of an at least very considerable injury is met with respect to the left elbow.

(e) The defendant does not contest the plaintiff having some impaired work capacity post-injury. The defendant accepts that, even including the average value of monthly bonuses, the plaintiff is currently just under the 60% of pre-injury earning capacity threshold.

(f) The defendant disputes the precise extent of the plaintiff's current impaired work capacity; the plaintiff has demonstrated a capacity to work more than the 15 hours she works presently; there is little to support her reduction from full-time to 15 hours at Hurtigruten; the plaintiff has previously demonstrated a capacity in a full-time administrative position for some 20 months or thereabouts post-injury.

(g) The defendant says the medico-legal report of Dr Slesenger is to be preferred over Dr Awad in respect of the limit on the plaintiff's post-injury work capacity.

1. The medical evidence provided by both parties indicates the possibility of a spectrum of injuries proceeding the plaintiff's fall on 11 June 2020, although, as the plaintiff indicated at hearing, the present application is confined to physical injuries sustained to the right wrist, left elbow, and spine.
2. There is no dispute, and I accept the plaintiff sustained an injury to the right wrist, and left elbow. The contest concerns the extent and consequences of the injury and whether it meets the statutory threshold.
3. The plaintiff has, since 11 June 2020, undergone a number of significant surgeries to her right wrist and left elbow. I accept the diagnosis of the plaintiff's condition as including a left elbow radial head fracture; right wrist radial fracture; right hand neuropathic pain, as indicated in the medical reports provided by both parties, including Dr Yeow, Dr Wang, Ms Stanley-Clarke, Dr Slesenger, and Mr Pennington. I accept Dr Njo's diagnosis of the plaintiff's condition with respect to right forearm and hand neuropathic pain. Dr Yeow's reports relevantly indicated that the injuries to the plaintiff's right wrist and left elbow particularly continue to incur significant pain and consequences for the plaintiff, despite numerous surgical interventions and physical treatment pathways. Together the medical evidence indicates that the plaintiff continues to suffer ongoing and significant pain and restricted mobility in both the left elbow and right arm despite these injuries occurring more than five years ago.
4. The defendant's contention, which I accept, is that the plaintiff's injury to the spine does not, in and of itself, amount to a serious injury. The plaintiff, at the time of hearing, made little to no submissions with respect to the extent and consequences of the spinal injury despite relying upon this injury in her application. The plaintiff has, undoubtedly, undergone several nerve-related procedures to her lumbar spine and sacroiliac joints since the injury on 11 June 2020. However, the MRI conducted on the hips, lumbar spine and anterior pelvis on 17 November 2022 showed no significant abnormality, with only some changes of trochanteric bursitis. The X-Rays conducted on 18 March 2021 to the lumbar spine and pelvis indicates a mild to moderate lumbar scoliosis concave to the right. The cervical spine MRI conducted on 28 August 2025 reported no abnormalities to the right hip.
5. Together, the radiology indicates mild bursitis or lumbar scoliosis, however there is limited evidence to support a definitive conclusion as to an organic basis of a serious injury referable to the workplace incident on 11 June 2020. Dr Slezenger reports a soft tissue injury to the lumbar spine because of the workplace fall. Dr Awad notes aggravation of cervical and lumbar spine injuries, and indeed Dr Yeow reports a diagnosis of low back pain. However, I am not satisfied the medical evidence otherwise indicates an organic basis for an at least very considerable injury to the cervical and/or lumbar spine related to the 11 June 2020 incident.
6. There are references to "aggravation" of spondylosis (age-related wear of the spine) in the medical reports from Dr Awad and Dr Akil with respect to a diagnosis of the plaintiff's alleged spine injury. Here, the medical evidence would seem to point towards, at best, an aggravation of otherwise age-related spinal degradation rather than a serious injury in and of itself with an organic basis referable to the workplace incident. I accept the opinion of the plaintiff's medicolegal expert Dr Asaid that it would be difficult to conclude the plaintiff's lower back injury has an organic basis. Moreover, the paucity of supportive medical evidence about an incident related serious spinal injury is consistent with the plaintiff's evidence about her injury related pain and suffering consequence. Any spinal injury pain and suffering consequences barely rates a mention in the plaintiff's first affidavit. And though some consequences are referenced in her second affidavit, though doubtless significant to the applicant the consequence cited are not objectively a least very considerable. Based on the above I accept the defendant's submission that the plaintiff's spinal injury complaint does not meet the 'at least very considerable' threshold on a pain and suffering basis.
7. The plaintiff's impairment of a bodily function is to the plaintiff's right and left arm constituted respectively by the injury to her right wrist, and left elbow.

1. The defendant raised a brief issue in closing submissions with respect to the reliability of the witness.[215] Although raising no issues as to credibility, the defendant submitted that the plaintiff was somewhat unreliable as a witness with respect to the evidence she gave during cross-examination about her hours of work because she was said to have given long, detailed, and exculpatory explanations when asked simple questions by counsel. I do not agree that the way the plaintiff answered questions reflects negatively on her reliability.
2. I consider the plaintiff presented as an honest and truthful witness. Her account in her written and oral evidence as well as the various histories she has given to medical practitioners has been consistent. I do not consider that she has exaggerated her symptoms nor the consequences she experiences arising from her injuries, nor has any practitioner suggested that she does. At its highest Dr Slesenger suggested that nonphysical elements to the plaintiff's presentation suggested that in his opinion the plaintiff could return to work working preinjury hours - subject of course to the restrictions identified. But as earlier noted Dr Slesenger's observations about the existence of nonphysical elements is not shared by the orthopaedic surgeons who treated or examined the plaintiff. True it is that Mr Pennington considers that there was no medical basis for the plaintiff to reduce her hours to 15 per week, but that opinion is based on one examination of the plaintiff and without the benefit of any substantive document from the plaintiff's general practitioner. And there is no other material to suggest the plaintiff was being untruthful as to her evidence or that her account is unreliable. Considering the whole of the evidence, the plaintiff's conduct and demeanour in court and the accounts she has given medical and health professionals, the fact the plaintiff may perhaps have, at times, elongated descriptions of her evidence on cross examination, provides no sound basis to question the plaintiff's reliability.

1. The preponderance of the medical evidence recounted earlier strongly suggests the injury to the plaintiff's right wrist, involving neuropathic pain and multiple fractures, is permanent, long term and incurs pain and suffering which continues to impact the plaintiff daily. The plaintiff has undergone several significant surgeries to repair and reconstruct the right distal radius and nervous system. Although nerve treatments from pain specialist Dr Njo appear to have provided temporary relief, the plaintiff's right wrist neuropathic pain has not subsided significantly. Dr Yeow opines the neuropathic pain, paraesthesia, and limitation of function in the plaintiff's right wrist is permanent. Dr Wang also indicated in his report of 2024, the effect of the plaintiff's pain on her life would be likely permanent as it has not resolved in the several years post injury, and Dr Asaid arrives at the same conclusions. The evidence of Ms Field also indicates the ongoing presentation of symptoms to the plaintiff's right wrist support the conclusion there is permanent damage despite attempted physio rehabilitation. Mr Pennington reports he does not expect any further significant improvement to the plaintiff's symptoms. The exception is in Dr Slesenger's report. Given the otherwise overwhelming medical evidence to the contrary provided by every other treating practitioner, I do not accept Dr Slesenger's assessment of the permanency of the plaintiff's injuries, and I consider the injuries to the right wrist continue to impact the plaintiff on a significant level and show no significant likelihood of improvement into the future. The impairment is therefore permanent.

1. The medical evidence provided with respect to the left elbow fracture and its ongoing symptoms and consequences also strongly supports the existence of a permanent and long-term impairment. The plaintiff underwent multiple significant surgeries to the left elbow to repair a very complex left elbow fracture and ligament repair. Even though perhaps less significant than the right wrist symptoms, the injury to the left elbow and its consequences carry a present and ongoing risk of long-term degradation and pain for the plaintiff on a day-to-day basis. Mr Wang notes the plaintiff initially recovered well from surgery and it would seem the fracture itself has healed well, and this healing process is indicated in the radiology evidence. However, post-surgery medical evidence, particularly that prepared by Dr Asaid, Dr Yeow, and Ms Field, would seem to suggest the plaintiff has continued to experience pain and discomfort in her left elbow which has not subsided despite rehabilitative and significant analgesia-based efforts. The fact the plaintiff continues to report ongoing and significant stiffness, pain, and discomfort in her left elbow more than five years post-surgery is, according to Dr Wang, indicative of the fact the injuries are long-standing and have resulted in chronic pain and functional restriction despite long-term management. Based on the medical evidence described I consider the impairment of the plaintiff's left elbow to be permanent.

What was the plaintiff's pre-injury earning capacity?

1. The plaintiff's statement of calculations[216] shows her pre-injury earnings at Adairs Retail Group, inclusive of the first aid allowance, was $1146.77 per week as a base salary. Sixty percent of this figure is $688.06. The defendant does not contest these figures and I accept them.

What was the plaintiff's after-injury earning capacity?

1. The contest between parties is the degree and extent of the plaintiff's capacity for work post-injury. I accept the plaintiff has a capacity to engage in work post-injury, having regard to the medical evidence and the plaintiff has shown a capacity to work post-injury at Adairs and Hurtigruten.
2. Since her injury, the plaintiff has tried a range of working hours and conditions during her cumulative return to work. Presently, the plaintiff works 15 hours a week at Hurtigruten, 5 hours a day over 3 days, and this has been the case since February 2025. The circumstances in which the plaintiff came to work these reduced hours including giving notice of resignation when she was told initially by her team leader that she could not reduce her hours of work are canvassed in the plaintiff's second affidavit and are earlier discussed. These circumstances need not be re-canvassed here. In May 2025, the plaintiff obtained a certificate of capacity from Dr Yeow approving these reduced hours, with Dr Yeow indicating support for reduced hours to part time work. In the period in which the plaintiff worked full-time, between 2023 and 2025, Dr Njo continued to treat the plaintiff on several occasions for chronic and unabated pain in her right wrist. In July 2025 and November 2025 respectively, Dr Asaid opines that given the severity of the plaintiff's injuries she does not have the capacity to perform unrestricted duties in a full-time role as an administrative assistant, and particularly with respect to the right wrist injury.
3. Dr Awad noted in her 14 August 2025 report that the plaintiff currently in employment was undertaking part-time work 15 hours per week and she considered that this is likely to represent the maximum number of hours that the plaintiff could undertake.[217] And unlike the opinions of Dr Slezenger and Mr Pennington, Dr Awad had the benefit of the extensive reports and histories from all of the plaintiff's treaters including Dr Yeow.[218] In her 18 November 2025 report Dr Awad clarifies that considered separately the plaintiff's right upper limb injury means that she can "maximally worked 15 hours per week" and considering the plaintiff's left upper limb injury the plaintiff can work "maximally 15 hours per week".[219]
4. In his most recent report of 11 November 2025, the plaintiff's general practitioner Dr Yeow notes that although the plaintiff currently works 15 hours per week across three days, he considers that a sustainable capacity for the plaintiff is closer to 3 to 4 hours per day across 2 to 3 days. Dr Yeow's opinion is not just given by chance. Instead, he sets out his clinical justification. Dr Yeow considers the estimated sustainable capacity is justified on clinical grounds because the plaintiff's chronic neuropathic pain, reduced right hand function, limited spinal load tolerance and susceptibility to symptom flareups significantly restrict the plaintiff's ability to perform duties requiring manual handling, repetitive upper limb use or sustained posture. And this incapacity will continue permanently into the foreseeable future.[220]
5. Looking at each of the left and right upper limb injuries separately, Dr Yeow considered:

(a) In respect of the plaintiff's left upper limb injury that:

(i) the plaintiff "has residual stiffness and discomfort in the left elbow, especially with repetitive reaching, lifting, or carrying tasks;

(ii) activities involving sustained elbow flexion or forceful gripping may worsen pain;

(iii) the plaintiff has some limited functional capacity for light or sedentary duties;

(iv) post-surgical changes and reduced range of motion restrict repetitive or heavy use of the left upper limb, limiting her ability to perform manual or physically demanding work safely; and

(b) In respect of the plaintiff's left upper limb injury that:

(i) The plaintiff has minimal to no realistic capacity for suitable employment on a reliable and consistent basis;

(ii) her right hand and forearm symptoms have recently worsened;

(iii) she reports a flare-up involving the right forearm, wrist, and medial three fingers, with pain described as numbing, electrical, and prickly in nature;

(iv) she experiences weakness in the hand and fingers and reports a sensation that "the arm does not belong to her";

(v) she currently works part-time (approximately 15 hours per week over 3 days) in administrative and sales duties, which require significant typing.

(vi) due to neuropathic symptoms, she types primarily using two fingers on the right hand;

(vii) symptoms frequently flare during work activities.

1. I prefer these opinions as to the plaintiff's work capacity to those expressed by Dr Slesenger because they are grounded in significant exposure to the plaintiff by her treaters.
2. During cross-examination the defendant put to the plaintiff that her actual capacity for work at presents stands greater than the 15 hours, and that the plaintiff has a current post-injury capacity for full time work given her period of doing so for some 22 months between 2023 and 2025.[221] The plaintiff did not agree, nor do I.
3. I accept the plaintiff has, in the several years since her surgery, at some points worked full time although I do not believe this shows she is entirely medically capable of doing so at present and into the future based on the evidence of ongoing pain, flare-ups, and discomfort presented particularly by Dr Njo and Dr Wang. The plaintiff explained that she has, at times, tried to work more than what she believes she is capable of in an attempt to demonstrate her worth as an employee.[222] The plaintiff also gave evidence to the effect that she was struggling with the 15 hours at Hurtigruten, and wished to potentially reduce her working hours further if manageable from an operational standpoint.[223] The described evidence provided by treating medical practitioners and the plaintiff herself on examination would together indicate the plaintiff has a post-capacity to engage in the present part-time work hours of 15 hours a week.
4. I do not accept the submission that because the plaintiff may have, at some time, engaged in full-time work, she is properly medically capable of doing so at present, particularly given the significant symptoms and challenges full-time work created for the plaintiff. Nor do I accept any suggestion that the plaintiff has somehow manufactured a 15 hour per week work capacity so as to show the requisite degree of reduction in her earning capacity. From my observations, the plaintiff presented as a diligent and honest worker. She disclosed her injuries to her current employer and tried to manage while suffering to maintain full-time employment. When this became too much the plaintiff raised the prospect of part-time hours and when she was initially told that this was not possible, the plaintiff did not seek to manufacture any claim, instead she gave notice of her resignation. This is not the conduct of a person who would seek to manufacture circumstances for her advantage. Rather this is conduct of an honest person whose physical needs could not be accommodated and so she tended her resignation. Fortuitously both for the plaintiff and her current employer, a hard-working and diligent employee was not lost, and reduced hours were accommodated.
5. Ultimately, Dr Yeow certified the plaintiff as having a capacity for suitable employment on an ongoing basis working five hours per day across each of three days with designated breaks. There is no basis to suggest that Dr Yeow's certification is manufactured or otherwise does not represent a valid medical assessment. Indeed, as noted earlier, Dr Yeow more recently considered that even 15 hours per week might not be sustainable.
6. In the circumstances I accept that the plaintiff's work capacity is limited to no more than 15 hours per week and that that will remain the case into the foreseeable future.
7. The positions identified in the vocational assessment[224] identify administrative and clerical work, in which the plaintiff demonstrates having prior work experience. On a 15 hours a week schedule, these occupations carry per week earnings as follows: Call Centre Operation $472 per week; Car Hire Assistant/Rental Clerk $445.20 per week; Travel Consultant $520.20 per week; Support Co-ordinator NDIS $524.25 per week and Data Entry Operator $408.60 per week.[225] Notwithstanding the plaintiff presently work for a travel company Hurtigruten, each of these vocations the plaintiff would be earning less than the 60% threshold of $688.06. The wage rates attached to the roles are as at May 2022. Each role would be covered by a modern award made by the Fair Work Commission and annual wage increases awarded pursuant to the Commission's annual wage review would be passed on. Applying the outcome of the annual wage review - 5.2% (2022), 3.75% (2023), 3.75% (2024) and 3.5% (2025) - in the period since passed on a compound basis taking the highest wage rate being that for the support coordinator NDIS the weekly wage rate would be $612.01.
8. The plaintiff's current 15 hours a week equates to a base salary, including an average of bonuses taken in September, October and November of 2025, is $634.71.[226] Where bonuses are comparatively higher, as they were in the August-October 2025 period, taking an average of these months' bonus and the base salary equates to a base salary of $681.16.[227] The plaintiff deposes to her bonus in October 2025 most reflecting the 'average', which when added to a base salary, equates to $612.66 a week.[228] Even taking the bonus at its highest, with 15 hours worked per week, the plaintiff's weekly earnings currently remain under the 60% reduction in the plaintiff's earnings threshold.
9. To achieve at least 60 percent of the plaintiff's pre-injury agreed earnings, without bonuses, the plaintiff would need to work at least 20 hours a week. Considering the possibility of a bonus, for example an average bonus being $87.65,[229] the plaintiff would need to increase to a minimum of 18 hours. There also remains the possibility of a larger weekly bonus (maximum recorded at $139.95 in September 2025),[230] in which case the plaintiff would only need to work one more hour a week to exceed at least 60 percent of her pre-injury agreed earnings. However, bonuses fluctuate. For reasons earlier outlined, the plaintiff appears to be maximising her work capacity at 15 hours a week, and, on the available medical evidence, she does not have capacity to work more hours. I am therefore persuaded that the plaintiff has capacity to work 15 hours a week and no more and that this is likely for the foreseeable future. Any alteration to her working hours is, according to Dr Yeow, likely to result in a decrease in hours further eroding the plaintiff's earning capacity. Considering her current earnings and factoring in an average for variable bonus discussed above, I consider the plaintiffs earning capacity holds to be less than 60 percent of the agreed pre-earnings amount. Accordingly, I consider the plaintiff has suffered a loss of earning capacity of 40% or more as at the date of the hearing and given the plaintiff's likely future work capacity, she has sustained a permanent loss of earning capacity which produces a financial loss of 40% or more.

Is the plaintiff permanently incapacitated for work?

1. For the reasons outlined below, I am persuaded the plaintiff has a permanent incapacity for full time work and based on her capacity for work the plaintiff has a permanent loss of earning capacity as at the date of the hearing which is greater than 40 percent of her pre-injury earning capacity whether measured against her current part time role or the alternative roles in the vocational assessment.

What are the impairment consequences for the plaintiff?

1. As earlier noted, the plaintiff reports experiencing pain in her right forearm, wrist and hand. She describes this as constant pain which varies between aching and numbness to shooting pain. She notes having better and worse days, with pain tending to be worse on workdays or when she exerts herself. The plaintiff experiences numbness and altered sensation in her fingers, hand and palm which worsens. She finds heavier lifting and, particularly, the repetitive or prolonged use of her right arm exacerbates her symptoms. The plaintiff finds her hands sometimes become stuck in a claw shape and has to manually stretch her fingers back. She finds the pain and related symptoms become worse in cold weather and very hot weather. The plaintiff reports taking several prescribed and over-the-counter analgesic medications for pain management, at various times, including Endep, Gabapentin, Panadeine Forte, Nurofen, Tramadol, Lyrica, and Advil, as well as Effexor in relation to mental health challenges, although she at times struggled with side effects with many of these medications. The plaintiff has taken several steps to attempt to reduce pain and discomfort temporarily. She regularly uses heat packs and self-funds remedial massage for pain management, and wears gloves for mobility.
2. The plaintiff underwent several surgeries performed by Dr Wang in relation to the right wrist and associated nerve pain. Dr Njo provided significant and ongoing treatment in relation to ongoing right wrist nerve pain between 2022 and 2023. Dr Asaid notes the plaintiff, who was assessed in July 2025**,** continues to experience some degree of pain and restriction in her activities by reason of her right wrist and left elbow injuries for the foreseeable future some 5 years after the original injury. I accept this evidence and the submission that the plaintiff continues to suffer significant pain and restrictions currently, particularly so with respect to the right wrist and related nerve issues. Dr Yeow has provided ongoing treatment as the plaintiff's general practitioner for several years and his reports demonstrate a chronic and continuing history of treatment for pain in the years following the original workplace injury despite several rehabilitative referrals and intervention surgical procedures. Dr Wang has provided significant primary care for the plaintiff up to 2022 in respect of the right wrist, left elbow and related right wrist neuropathic pain. I accept Dr Wang's assessment of right forearm, left elbow, and neuropathic pain creating a risk of degenerative changes in both limbs. Dr Fedi's assessment indicates that he does not rule out the presence of small fibres neuropathy in the plaintiff's right wrist, which I accept given the ongoing history and indication of neuropathic pain separately and historically reported by Dr Njo. Additionally, Dr Wang referred the plaintiff for further rehabilitative treatment at Melbourne Hand Therapy considering the ongoing pain, numbness, and decreased function in her left elbow and right wrist and hand in 2020, which I accept demonstrates medical evidence of the plaintiff's described symptoms with respect to an ongoing feeling of numbness and 'dead' limbs.
3. In his report Dr Slesenger contends, and it was submitted in closing by the defendant, that the plaintiff's injuries have a significant non-physical element to them. Except for this statement, and as the defendant accepted in closing submissions, Dr Slesenger otherwise contends that based on the evidence presented the plaintiff has suffered injuries to her left elbow and right wrist. As earlier noted, Dr Slesenger's conclusion with respect to a non-physical element is at odds with other otherwise contradictory evidence presented by all other medical practitioners as to the organic basis and long-standing consequences of injuries to the right wrist and left elbow which restrict the plaintiff's capacity to varying degrees. None of the other medico-legal assessors arrive at that same conclusion and so I do not accept, nor does the preponderance of evidence support that the plaintiff's pain and mobility presentation is purely or even significantly non-physical in nature.

1. The plaintiff explains she has problems with sleep every night due to right hand and wrist pain and numbness. The plaintiff stated that she finds it difficult to fall asleep because of pain and notes she often wakes up in the night because of pain. She has tried a dosage of melatonin previously to assist with sleep, and reports waking up with the feeling of a 'dead' right arm and right leg. I accept this evidence.

1. For the reasons already discussed the plaintiff now has a limited work capacity, and the need to work part-time hours is the product of her ongoing pain. Her in ability to work full time or a greater array of part time hours will, in my assessment also impact the plaintiff's career prospects, though I note she is in a job she very much likes.

1. The plaintiff says she has a restricted range of movement and stiffness in her right wrist and fist. She reports having intermittent swelling in her right wrist, particularly after typing. She experiences fatigue in her right hand with increased use, as well as reduced dexterity finding it difficult to open things. I accept this evidence.

1. As earlier noted, the plaintiff describes that prior to the fall she did most of the cooking tasks and enjoyed dining out and trying new cuisines. She reports that since the fall she has had difficulty with cooking and couldn't do so for about 12 months. She sought help from her partner and mother at the time. She finds it difficult to do basic cooking tasks including chopping, lifting trays, and lifting pots from the stove and requires assistance. She reports sticking to simpler meals and cooks infrequently. The plaintiff states that she used to do most of the housework prior to her injury and used to plant, re-pot and dig in her garden as well as mow the lawn and plant a herb garden. She now reports finding it difficult to use garden implements for more than a short period. She can do some household tasks but struggles with things involving force including scrubbing bathrooms and mopping. She explains that because of her right arm restrictions she is limited in her ability to do the housework and seeks help from her mum and partner. She reports asking for her mother's help makes her feel given this is at times difficult, noting her father has a medical condition which also requires constant care. The plaintiff reports difficulty with activities that require fine manual dexterity and motor control including putting on earrings, brushing her hair, and putting petrol in her car.
2. The plaintiff states that her right arm injuries have impacted her ability to enjoy practising hobbies, including yoga, going to the gym, participating in body pump classes, and small DIY projects around the house.
3. The plaintiff reported that travel is a passion of hers although she did not travel overseas for a number of years. The plaintiff gave evidence that in September 2024 she travelled to Norway for a work trip for two weeks with her partner on a cruise, during which time she was trained on the travel packages that she would be selling to prospective clients seeking to go on the cruise. The plaintiff explained she struggled to carry her luggage while on the trip and enlisted the help of her partner.
4. The plaintiff reports she can and does drive although finds that driving for a longer period exacerbates her pain in the right wrist. She states that gripping the steering wheel causes increased sensations of numbness and gives her a sore hand. None of this evidence was challenged, and I accept it.

1. The plaintiff states that her injuries have had an ongoing impact on her relationship with her partner, particularly because of the restrictions in her right arm. She explains this has impacted her romantic relationship into more of a supportive friendship and has negatively impacted her sex life with her partner. The plaintiff describes that since her injuries she has been less social with friends because of the constant pain she is in. She reports that since the injury she has less emotional space for friendships and socialises less, preferring to be alone. I accept this evidence.

1. The plaintiff's experience of her pain is subjective, but it appears to me clear on the objective evidence that the plaintiff's experience of the pain associated with her right upper limb is very considerable judged by reference to her evidence, the severity and frequency of the pain, her reports to medical practitioners, the medicinal, surgical and therapeutic steps she has taken to relieve or resolve the pain, the medical assessments of her pain. Moreover, the disabling effects of the pain demonstrated in the evidence discussed above impacting the plaintiff's capacity for work, sleep, mobility her recreational and social activities, performance of her household functions and sex life as well as general enjoyment of life is also very considerable.
2. The same may be said in respect of the plaintiff's experience of pain associated with her left upper limb and the disabling effects of that pain.
3. The plaintiff reports experiencing significant and ongoing daily pain, numbness, and discomfort in her right wrist and left elbow. She describes the pain has affected many aspects of her daily life and has impacted her sleep, hobbies, personal relationships, household chores, and personal care. This pain has persisted since the workplace injury on 11 June 2020 despite multiple surgical interventions, significant attempts at pain management with analgesia, and ongoing physical rehabilitation. For the reasons I have outlined above I accept the plaintiff's injuries and associated impairment of her right wrist and related neuropathic pain therein, as well as of her left elbow, each meet the requisite threshold of being at least very considerable amounting to a serious injury.
4. The plaintiff's capacity to participate in aspects of daily life are marked, specifically in respect of physical exercise, fine dexterity tasks, manual handling, and have incurred consequences for the plaintiff's personal relationships. The plaintiff has undergone numerous surgeries, pain management operations and rehabilitative treatments for more than 5 years without any more than temporary alleviation of symptoms. While the plaintiff retains a capacity to work and to engage in some household and social activities, the breadth of evidence indicates this is only very limited as compared to her pre-injury ability. On the totality of the evidence, I accept that the plaintiff's impairment with respect to her right wrist and left elbow and the incurring pain and suffering consequences described above meets the "very considerable" test in s 325(2)(c) of the Act. When considered against a range of cases, including cases involving similar consequences such as pain requiring prescription medication, significant medical treatment, significant sleep deprivation and inability to work and socialise, the plaintiff's impairments plainly each satisfy the threshold.
5. Consequently, the plaintiff's impairment to her left elbow and right wrist, also including right wrist neuropathic pain, is sufficiently serious for the purposes of s 335(2) of the Act because the pain and suffering consequences described above, when judged in comparison with other cases, are similarly in the range of impairments to a body function, and may be fairly described as being more than significant or marked, and being at least very considerable.
6. As to the question whether the plaintiff's impairment of a body function is serious because of the loss of earning capacity consequence, for the reasons given earlier I accept the plaintiff has, by reason of the impairment to her right upper limb suffered a loss of earning capacity of 40% or more as at the date of the hearing and a permanent loss of earning capacity which produces a financial loss of 40% or more. I also consider the same is the result of her impairment of her left upper limb. The plaintiff has satisfied the additional statutory requirements.[231]
7. The plaintiff reports ongoing pain to her cervical and lumbar spine, which on the medical evidence, is most notably described as an aggravation of age-related degradation (spondylosis). Notwithstanding the effect this impairment has had on the plaintiff's day-to-day life, on the totality of medical evidence, I am not persuaded that the impairment, has a particularly referable organic basis to the workplace incident on 11 June 2020 nor does it, when compared with referable cases, meet the "very considerable" test encased in s 325(c) of the Act. As compared to the spectrum of cases and indeed to the plaintiff's the right wrist and left elbow injuries, which in and of themselves have undergone significant, ongoing, and multiple surgical interventions and treatments at first instance and in the years since, the plaintiff's spinal impairment falls short of the statutory threshold.
8. In the result, I am satisfied that both the pain and suffering consequence and the loss of earning capacity consequence, the result of the impairment to the plaintiff's right upper limb, when judged by comparison with other cases in the range of possible impairments are each fairly described as being at least very considerable. I am also satisfied that both the pain and suffering consequence and the loss of earning capacity consequence, the result of the impairment to the plaintiff's left upper limb, when judged by comparison with other cases in the range of possible impairments are each fairly described as being at least very considerable.
9. The application for leave to bring proceedings to recover damages for pain and suffering and loss of earning capacity in respect of the impairment of the plaintiff's right wrist and her left elbow is granted. The application in respect of the injury to the spine is refused.
10. I will hear the parties on costs.

[7] Humphries and Anor v Poljak [1992] VicRp 58; [1992] 2 VR 129

[8] Ibid; Transport Accident Commission v Katanas [2017] HCA 32; 262 CLR 550 at 555

[9] Humphries and Anor v Poljak [1992] VicRp 58; [1992] 2 VR 129 at 140

[10] Haden Engineering Pty Ltd v McKinnon [2010] VSCA 69; 31 VR 1

[13] Hawkins v DHL Express (Australia) Pty Ltd [2013] VSCA 26 at [63]

[14] Haden at [12], citing Dwyer v Calco Timbers Pty Ltd (No 2) [2008] VSCA 260 at [8]; Sejranovic v Berkeley Challenge Pty Ltd [2009] VSCA 108 at [171]; Sabanovic v Atco Controls Pty Ltd [2009] VSCA 143 at [142]- [145]

[15] Haden at [12] citing Sabanovic at [142]

[17] De Bono v Victorian Workcover Authority [2019] VSCA 85 at [50] - [57]

[19] W_oolworths Ltd v Warfe_ [2013] VSCA 22 at [75]

[20] Plaintiff Further Amended Court Book (PCB) 9 [8]

[23] Defendant Court Book (DCB) 41; T7 L7-9

[110] There is some inconsistency between this timeframe indication and that deposed by the plaintiff at PCB 10 [14] and at T7 L7-9 in which the plaintiff says she was off work for 12 months. It appears uncontroversial however that the plaintiff was off work for 12 months following the incident.

[125] PCB 88; PCB 90

[214] At T63 it was pointed out by counsel that at PCB 66 Dr Yeow reports the plaintiff working 18 hours though the plaintiff deposes at PCB 31 she worked 15 hours.