The evidence before the trial judge
20 The trial judge carried out a careful analysis of the evidence, including the medical evidence, tendered at the trial. His Honour identified the fact that the respondent had on occasions said that he awoke in hospital and left on the second day, whereas, the hospital records indicate that he was seen at 18.30 by the Emergency Department and was ready for departure at 23.30 the same night. The respondent said when he awoke in hospital he felt strange and confused. His head was "very heavy", he had lacerations and bleeding from the scalp, and had no sensation and numbness in the left hip.
21 The respondent complained of headaches and problems with his hip region the day after the accident. The headache was said to radiate to the neck and back causing dizziness which prevented him from standing up. He developed pain in the low back. He gave evidence that his general practitioner, Dr Hanna, made a house call and gave him injections and medication.
22 In the month or two after the accident the respondent continued to see his general practitioner and was sent for x-rays of the neck and lumbar spine and a CT scan of the skull. He was placed into the care of Dr V Maniam, a trauma orthopaedic surgeon. He was also referred to Mr V Herrera, a psychologist, and Dr J P Sheehy, a neurologist. In his evidence the respondent complained that his condition has become worse over the years since the accident, his headaches, neck and back have all worsened and when his low back pain is bad, it affects his legs. He also indicated that he has problems with his right wrist and has difficulties with sleep.
23 The respondent stated that he had attempted to return to his normal work duties but that after two weeks he could not continue working. He gave evidence that he stopped working after the second of two episodes, the first being a fall after a dizzy attack, although at the time he was not doing any physical work, and the second being head, neck and back pain whilst rendering a wall, as a result of which he had been taken to a doctor by one of his workers.
24 He said that he had made efforts to work on other occasions but these had not proved successful. The trial judge records that the respondent stated that being unable to work, he now spends his time being preoccupied with his pain and feels depressed because he cannot be a good father to his children.
25 The respondent said that before the accident he helped his wife around the house including cleaning, heavy work and the gardening although he employed someone to mow the lawn. Since the accident he does nothing inside or outside the house, although he does care for his own personal hygiene. When he is in a lot of pain, he cannot shave. He gave evidence that he cannot drive for a long period of time although, if he is not in pain, he can drive normally. He said he had only had one speeding fine since the accident, although his traffic record discloses four speeding infringements between January 2000 and September 2002.
26 There was evidence at the trial that the respondent suffered a motor vehicle accident in November 1997. He gave evidence that he suffered no injury from that accident and he had not seen a doctor or had medications prescribed for neck or back pain.
27 The notes of his general practitioner, Dr Hanna, were tendered at the trial. They indicated that on 19 June 1997, which was before the earlier accident, the respondent was complaining of low back pain with a query as to whether he had a disc lesion. Between January 1998 and the date of the accident, the subject of this case, the respondent consulted Dr Hanna on several occasions for neck problems, with at least one visit in which he reported low back pain. The respondent suggested that these visits were probably for pain related to his work and general health problems and not to the previous accident.
28 The trial judge noted that the respondent's treating orthopaedic specialist, Dr Maniam, was given a history by the respondent which in certain respects does not accord with the evidence. In particular, the respondent exaggerated the nature of the accident and also the extent of his disability. In a report dated 19 April 2001, Dr Maniam found:
"At present, there seems to be a lack of motivation and loss of self esteem and these stem from the reactive anxiety depressive state, until these can be improved, I feel that Osman Ali may not be able to return to the workforce. Stemming from the injury there has been an affection on his enjoyment for the quality of life and also in pursuing his recreational sports. I informed him that his longevity will not be affected and in terms of premature retirement, I informed him, that with care and proper techniques that have been advised, he should be able to continue on the selected duties until retirement age.
He is able to carry out his day to day activities without any help. He is also able to do his minor maintenance work around his home. … ."
29 Because of his psychological difficulties the respondent's general practitioner referred him to the Metropolitan Psychological Centre of Sydney. He was assessed on 15 November 1999 and was diagnosed by Mr Herrera as having "an Adjustment Disorder with mixed emotions of depression and anxiety."
30 In his report Mr Herrera, stated:
"The emotional disturbance caused by the shock of the accident has not yet stabilised but it appears that the intensity of the symptoms are gradually decreasing. In the balance of probabilities, it is expected that if he accesses therapy, it will take four to six months for this condition to improve. The emotional disturbance caused by the consequence of the accident will depend on his physical progress through medical intervention. It is my opinion that as long as Mr Osman is suffering from pain and disability, his symptoms will persist."
31 A treatment program was recommended.
32 The respondent was also seen by a number of medical practitioners at the request of the appellant. Dr R Mellick, a consultant neurologist, reported on 16 December 2002:
"The history he provided included no pattern of symptoms which raised the likelihood of a specific neurological cause. The pattern of the symptoms was characterised by a diffuse generalised distribution with and by a description of symptoms which did not conform to a likely organic aetiology.
The findings on physical examination are in accord with the interpretation of the history, the physical examination revealing no abnormalities.
…
The clinical picture as it presents is one of a pattern of multiple chronic symptoms without any evidence that those symptoms arise as a result of an underlying physical disorder."
33 Dr J M Matheson, a consultant neurologist, also provided a report dated 26 August 2002, in which he said:
"Mr Osman sustained a scalp laceration which has healed. He has a little bit of glass impaction and it would be a little bit tender. It is a minor disability. He has sustained no other disability, there is nothing wrong with his ears. There is nothing wrong with him neurologically. He has not sustained any brain damage. There has been no injury to his spine. His symptoms he is producing just seem to be invented symptoms and vary from report to report. He is clearly not a true witness of his symptoms.
I saw no evidence here of any psychological disability and no reason why an accident like this should produce such. My impression was that Mr Osman was contriving symptoms for the purpose of gain. There is no disability in relation to this accident at this stage. He could be pursuing full time work if he chose to. He requires no further treatment."
34 He was also seen by Dr J Seymour, an ear, nose and throat specialist, who found in relation to reported earache that there was no otological condition but that it could be referred pain from his neck. Dr Seymour found in his report of 27 June 2002 that:
"… the applicant is fit to resume his normal range of duties now, with the exception of any occupation which required climbing to heights, piloting aircraft, lying on his back for long periods, or any occupation which required quick and repetitive movements of his head."
35 The respondent was also seen by Dr J P Maguire, a consultant psychiatrist, who diagnosed an adjustment disorder with mixed emotional features. He concluded in his report of 15 November 2000 that:
"I cannot diagnose a current psychiatric or psychological 'disorder' that would prevent [him] [sic] from working or leading a normal life. On that basis I cannot diagnose a 'permanent impairment' to his emotional state."
36 Mr G Haralambous, a clinical psychologist, believed that the respondent was exaggerating his problems. He expressed the opinion in his report dated 2 July 2001 that:
"Mr Osman has not suffered any identifiable cerebral damage whatsoever and on objective psychological testing demonstrates, rather, a pattern of responses that appears more consistent with malingering than a genuine psychological or cognitive disorder."
37 Having analysed the medical evidence, the trial judge turned to his conclusions which he expressed as follows:
"This does not mean, however, that the plaintiff has not significantly exaggerated his evidence as to his present and past condition and work capacity. In these respects the evidence shows that the plaintiff was an unreliable witness. All of the inconsistencies between his evidence and the objective facts related to these matters. For example, the plaintiff denied that he had ever seen a doctor prior to the accident for his neck and back, yet the clinical notes of Dr Hanna showed that he had for some time seen Dr Hanna for these matters. He stated that, in effect, he was unconscious until he woke up in hospital, whereas this was contrary to the ambulance and hospital reports, including the plaintiff's Glasgow Coma Scale readings, and his conversations with the ambulance officers. He exaggerated his condition both in relation to when he was in hospital and later: he stated that he had difficulty walking, including when he left hospital, yet the hospital notes state the contrary. He sought to paint the picture of a person afflicted with severe disabilities where the video evidence, though admittedly capturing only a brief time, showed a person able to move, walk, and perform normal activities in an apparently unrestricted manner, such that he was bound to concede in cross-examination that he 'was flying' on that occasion. He exaggerated the severity of the accident and his condition to most of the doctors he attended, including that his vehicle was hit by a semi-trailer, and that he was unconscious until 3.00am whereas he was discharged before that at 11.30 pm. There were significant contradictions between his complaints and the objective medical evidence. As conceded by the plaintiff in submissions, the plaintiff must have worked more than two weeks after his accident having regard to his tax returns, and his evidence was partly unreliable. However, having regard to the evidence as a whole, I am satisfied that this was due only because of an attempt to exaggerate his condition and work capacity. Consequently, though in these respects the plaintiff clearly exaggerated his evidence, which must therefore be regarded as unreliable, I accept his evidence relating to the manner in which the load on the utility was secured and the collision, which was supported by other evidence.
The medical evidence supports the view that the accident did not cause any brain injury or vestibular or hearing impairments, and that the plaintiff's headaches and dizziness are non-specific and benign in origin. Similarly, the evidence of the plaintiff's emotional and psychological evidence is that the plaintiff suffered an adjustment disorder with mixed emotional features, which however does not, according to Dr Maguire, amount to a permanent impairment to his emotional state and would not prevent him from working or leading a normal life. With respect to the plaintiff's emotional condition, I prefer the views of Dr Maguire and Mr Haralambous, which are consistent with the plaintiff's behaviour, demeanour, and the evidence as a whole, rather than that of Mr Herrera whose opinion was not only inconsistent with the evidence as a whole but was based on subjective impressions including the plaintiff's self reporting.
There is, however, evidence that the plaintiff has some on-going injury to the cervical and lumbar spine. In this respect I prefer the opinions of his treating doctors, Dr Hanna, and, in particular Dr Maniam, who found that the plaintiff suffered a musculo ligamentous strain to the cervical spine, with aggravation of underlying degenerative disease, and an intervertebral disc protrusion at L4/5 and a minor disc bridge at L5/S1. Though there is evidence of prior neck and back problems, the subject accident has materially contributed to these injuries, but, as Dr Maniam states, the reason for the plaintiff not returning to work stems mainly from the psychogenic element rather than orthopaedic injuries, and the plaintiff will be capable of returning to selected work, avoiding repetitive bending and heavy lifting, including cement rendering activity on a casual basis.
The plaintiff, of course, suffered the laceration to the right parieto occipital region and soft tissue injuries to the left shoulder and a ligament strain to the left thumb."
38 It is apparent that although his Honour was sceptical about the respondent's reported emotional and psychological problems, preferring the views expressed in the reports of Dr Maguire and Mr Haralambous which were tendered by the respondent, rather than Mr Herrera's opinion, his Honour nevertheless found that the respondent had suffered ongoing injury to his cervical and lumbar spine as a result of the accident in 1999. Recognising that there was evidence of prior neck and back problems, his Honour was nevertheless satisfied that the accident had materially contributed to those injuries to the extent found by Dr Maniam.