austlii:nsw/NSWPIC/2025/564
General information, not legal advice.
NSWPIC
2025-10-21
Original judgment source is linked above.
23 August 2024, being an acceleration, acceleration, exacerbation and deterioration of a disease in the course of his employment and the employment was a substantial contributing factor to the acceleration, acceleration, exacerbation and deterioration, pursuant to s 4(b)(ii) of the Workers Compensation Act 1987, and 2. compensation is not precluded by operation of s 254 and 261 of the .
(a) the Application to Resolve a Dispute and all attachments;
(b) the Reply and all attachments;
(c) Application to Lodge Additional Documents by worker and all attachments, and
(d) Application to Lodge Additional Documents by insurer and all attachments.
A brief statement is attached setting out the Commission's reasons for the determination.
31 January 2025 in relation to injury to the applicant's lumbar spine.
PROCEDURE BEFORE THE PERSONAL INJURY COMMISSION
(a) whether the applicant sustained injury to his cervical spine and right shoulder as a result of the nature and conditions of his employment with the respondent, with a deemed date of injury of 23 August 2024, being an acceleration, acceleration, exacerbation and deterioration of a disease in the course of his employment and the employment was a substantial contributing factor to the acceleration, acceleration, exacerbation and deterioration, pursuant to s 4(b)(ii) of the 1987 Act;
(b) whether compensation is precluded by operation of s 254 of the 1998 Act;
(c) whether compensation is precluded by operation of s 261 of the 1998 Act, and
(d) the extent and quantification of the applicant's entitlement to payment of permanent impairment compensation pursuant to s 66 of the 1987 Act.
(a) the ARD and all attachments;
(b) the Reply and all attachments;
(c) Application to Lodge Additional Documents (ALAD) by worker and all attachments, and
(d) ALAD by insurer and all attachments.
(a) he was fit prior to his employment with the respondent and there is no explanation for his cervical spine and right shoulder injuries besides his employment with the respondent;
(b) he worked for the respondent from May 20 December 2002 until
21 December 2023, as an attested General Duties Police Officer (police officer);
(c) he is awaiting medical discharge on account of post-traumatic stress disorder and a significant lumbar spine injury caused by his employment with the respondent which were the subject of separate proceedings before the Commission;
(d) he sustained injury to his cervical spine and right shoulder arising out of his heavy and repetitive duties as a police officer for over 21 years;
(e) in relation to the nature and conditions of his employment, the applicant detailed various physical requirements of his employment and physical traumas that he sustained in the course of performing his work duties as a police officer, which included:
(i) he was engaged in various rolling, wrestling, bending, twisting, lifting, holding, falling and high impact events;
(ii) he fell into things, onto things, over things and through things;
(iii) he was knocked over, tripped over, and has fallen over;
(iv) he assisted Ambulance Officers to lift persons out of motor vehicles, and helped carry persons, bodies and objects up and down steep embankments, slopes, stairs, narrow and tight spaces;
(v) he was involved in countless violent arrests and has been forced into awkward and twisting positions, all of which have progressively injured his cervical spine and right shoulder;
(vi) he has attended training programs and Defensive Tactics training exercises where he was required to play the role of both "attacker" and "victim" in exercises involving tackling, being tackles, dragging, being dragged, leg sweeping, being leg-swept, head-locking, being head-locked, and so on;
(vii) for the first twelve years or so of his employment, he was required as a condition of his employment to at all times wear his appointment belt which weighed approximately nine kilograms, including whilst travelling in a police vehicle, which required him to sit in a twisted position to accommodate his service revolver, often for two to three hours at a time;
(viii) from approximately 2014 onwards, he was required as a condition of his employment to often for the entirety of his shift, including whilst climbing on walls, fences, houses and buildings, wear a restrictive load bearing vest which weighed approximately nine kilograms, which put significant strain on his cervical spine and right shoulder;
(f) there was no specific event which led to his cervical spine and right shoulder symptoms, rather a plethora of incidents over the course of his over 21 years work as a police officer;
(g) his cervical spine and right shoulder symptoms came on over time;
(h) the cervical spine and right shoulder injuries, symptoms and restrictions are of such severity that they have had a severe profound impact on his life on a daily basis, although they are not as debilitating as his lumbar spine injury and post-traumatic stress disorder;
(i) he has self-managed his injuries through rest and by taking pain relief medication as required;
(j) he continues to experience:
(i) pain, stiffness and restriction of movement in his cervical spine;
(ii) pain, stiffness and restriction of movement in his right shoulder;
(iii) difficulty sleeping, driving, lifting and attending to inside and outside chores, and
(iv) he needs to take medications to manage his pain;
(k) he did not understand that he was required to report his cervical spine and right shoulder injuries within specific time frames and he was not previously aware of the requirements of ss 254 and 261 of the 1998 Act;
(l) in relation to his failure to notify the respondent of injury to his cervical spine and right shoulder at an earlier time:
(i) he admits that he made a mistake and was ignorant by not reporting the injuries;
(ii) he was "just trying to get on with things";
(iii) did not know now to report an injury that was not caused by one specific incident, but was a gradual worsening due to his heavy and repetitive duties as a police officer;
(iv) there is stigma for reporting injuries in the respondent;
(v) did not want to appear 'weak', or that he could not look out for his colleagues, and
(vi) he did not know how to put his hand up and say 'I am having some symptoms' without being made fun of;
(m) in relation to his failure to seek medical treatment for his cervical spine and right shoulder:
(i) he has a stoic nature;
(ii) he does not like to complain nor seek nor accept help unless he absolutely must;
(iii) he just tried to focus on his job and self-manage his symptoms;
(iv) he did not think that seeking treatment from his general practitioner would resolve his symptoms;
(v) he thinks that he just needs to put up with his symptoms;
(vi) his lumbar spine injury on 21 March 2023, and the subsequent treatment, including surgery, became a significant focus for him and his family;
(vii) his symptoms of post-traumatic stress disorder, and treatment which took years and is still ongoing, also became a focus, and
(viii) he thought that his cervical spine and right shoulder symptoms might resolve once he ceased to work for the applicant, but that has not occurred.
Lisa Ann Gamlin, the applicant's wife, registered nurse
(a) she is qualified as a registered nurse and has worked as a registered nurse for the past twenty years;
(b) she has known the applicant since 2007, when he was already employed as a police officer;
(c) the applicant made general comments to her about physically arduous work that he undertook over the course of his work with the respondent;
(d) she observed the applicant having to hunch his neck and shoulders to get in and out of police vehicles whilst wearing his police uniform and load bearing appointment vest;
(e) she is not aware of any other explanation for symptoms in the applicant's cervical spine and right shoulder apart from his work with the respondent;
(f) from approximately 2014, she observed the applicant exhibit various physical signs of pain in his cervical spine and right shoulder;
(g) although he was generally stoic, from time to time, the applicant told her about pain in his neck and right shoulder;
(h) the applicant has a stoic nature and only attends a general practitioner if he absolutely needs to;
(i) since 2023, the applicant has been required to seek medical treatment in relation to his lumbar spine injury which resulted in him undergoing decompression surgery and his post-traumatic stress disorder, for which he was medically discharged from the respondent on 24 April 2025, following his last day of work on 21 December 2023;
(j) despite the applicant being diagnosed with post-traumatic stress disorder only in 2023, she observed him exhibiting psychological symptoms for many years prior;
(k) in her opinion, one of the reasons why the applicant did not report nor seek treatment for his cervical spine and right shoulder injuries is that his symptoms of post-traumatic stress disorder, which he had started to exhibit in the last years of his employment, were beginning to have a negative impact on his day-to-day functioning;
(l) in her opinion, it was not until the applicant was forced to stop working, first on account of his lumbar spine injury and then permanently due to his post-traumatic stress disorder, that the applicant realised that his cervical spine and right shoulder symptoms were not improving on their own;
(m) in her opinion, the applicant was just trying to survive through his last years of policing, and especially throughout 2023, his lumbar spine and post-traumatic stress disorder were his significant focuses, and following his surgery and some stabilisation of his post-traumatic stress disorder symptoms, he was finally able to take steps to further investigate his cervical spine and right shoulder symptoms.
(a) X-ray right shoulder showed: the shoulder is enlocated with a little loss of articular cartilage in the inferior portions of the joint and minor spurring on the inferior labrum; there are degenerative changes in the AC joint; there is a little sclerosis on the greater tuberosity at the site of rotator cuff insertion; and there are quite marked degenerative changes in the AC joint, and
(b) ultrasound right shoulder showed: tendinopathy changes and a little degenerative calcification of the subscapularis tendon; tendinopathy changes in the supraspinatus tendon and enthesopic irregularity at its insertion; mild restricted movement on abduction of the subacromial bursae but no restricted external rotation; and degenerative changes to the AC joint.
(a) CT Cervical Spine showed: cervical spondylosis and facet joint arthrosis and multi-level nerve root irritation.
(a) in about December 2014, Dr Wyatt referred the applicant to Michael Robinson, physiotherapist, for treatment of bilateral upper trapezius tension and cervical ROM restriction. In a report dated 11 December 2014, Mr Robinson noted that the applicant reported having increasing restriction and soreness bilaterally across the shoulders and neck for the last couple of weeks and Mr Robinson assessed that movement of the applicant's neck and upper trapezius was significantly restricted;
(b) on 28 May 2024, Dr Wyatt recorded that the applicant presented with bilateral shoulder stiffness and occasional pain, but reported that overall function was acceptable at present. Dr Wyatt recorded that the applicant had minor discomfort and no significant limitations in movement and that no further investigation was required at that time;
(c) on 12 February 2025, Dr Wyatt recorded that the applicant presented with right shoulder and neck pain which he reported he had experienced intermittently for some years, especially when reaching and raising the right arm and was sometimes painful in bed, however the pain was not of such a severity that analgesia was required. Dr Wyatt recorded that, on examination, the applicant's shoulder had pain and some reduced internal range of motion and the applicant's neck also had restricted movement. Dr Wyatt recorded that the symptoms were likely cervical in origin based on a positive neural tension test and referred the applicant for imaging;
(d) on 28 February 2025, Dr Wyatt recorded that the applicant reported shoulder pain with certain movements, however there were no significant findings on shoulder imaging. Dr Wyatt reported that the Cervical Spine CT showed low-grade degenerative changes and shoulder imaging showed no significant findings. Dr Wyatt recorded his impression of cervical spine degenerative changes causing referred shoulder pain, which should be managed by physiotherapy.
Dr Alan Hopcroft, general surgeon (orthopaedics), qualified by the applicant
(a) stated that he examined the applicant on 5 August 2024;
(b) recorded a history of injury which included various physically demanding activities in the course of the applicant's work with the respondent, and that over the years the applicant has come to notice pain and restricted movement in his neck and shoulders, particularly on the right side, in addition to primary and ongoing major right-sided sciatic symptoms and injury to his lumbosacral spine, which resulted in right L4/5 and L5/S1 lateral recess decompression surgery on
29 February 2024;
(c) recorded that the applicant's symptoms included (amongst other symptoms):
(i) neck stiffness and soreness and restriction of movement, and
(ii) pain over his right lateral deltoid with some restriction in movement of his right shoulder, noting that the applicant is right-hand dominant;
(d) reported that, on examination, the applicant has (amongst other things):
(i) some terminal restriction in movement of his cervical spine in all directions but protraction and retraction are intact, and
(ii) at the right shoulder, abduction is limited in the terminal 40 degrees, flexion is limited in the terminal 40degrees but external rotation, internal rotation, adduction and extension are all unrestricted;
(e) diagnosed (amongst other things);
(i) osteoarthritic changes of his cervical spine, and
(ii) osteoarthritic changes of his right shoulder;
(f) expressed the opinion that the applicant's problems with his spine and limbs has arisen mainly from the entirety of his course of employment and by the nature and conditions of the duties required of him as a police officer undertaking general duties;
(g) assessed (amongst other things):
(i) a DRE Cervical Category II impairment of the applicant's neck with a WPI of 5%, and stated that "No subtraction from that impairment is required as he had no pre-existing problems with cervical spine function", and
(ii) an upper extremity impairment of his right shoulder of 5%, which converts to WPI of 3%.
(a) noted that he considered:
(i) the report of Dr Hyde-Page dated 6 November 2024, and
(ii) the X-ray and ultrasound right shoulder report dated
19 February 2025, and
(iii) the CT Cervical Spine report dated 20 February 2025;
(b) in relation to the X-ray and ultrasound right shoulder report dated
19 February 2025, noted a clinical history of painful arc and pain on abduction and a query of rotator cuff pathology, and stated that the important components of the imaging were:
(i) subscapularis - tendinopathy changes and a little degenerative calcification at the subscapularis tendon;
(ii) supraspinatus tendinopathy - changes in the tendon and enthescopic irregularity at its insertion, and
(iii) mild restricted movement on abduction of the patient's right shoulder;
(c) stated that those changes:
(i) are post-traumatic changes and, more specifically, "enthescopic irregularity at its insertion" of the supraspinatus occurs only with significant strain injuries to a shoulder in abduction;
(ii) are entirely consistent with the nature and conditions of the applicant's general policing duties as a police officer, including tackling, restraining, arresting and dragging offenders;
(d) in relation to the CT Cervical Spine report dated 20 February 2025, noted a clinical history of symptoms of right cervical radiculopathy in the C5/6 region and a query of nerve root improvement, and stated that the report shows:
(i) extensive post-traumatic changes of the applicant's cervical spine and facet joints specifically, in particular;
(ii) C/3: no central canal stenosis; subtle uncovertebral complex extending into the foramen right side with potential irritation of the nerve root within the foramen; no facet joint arthrosis;
(iii) C3/4: an uncovertebral complex that extends into both foramen; right sided foraminal nerve root compression and potential irritation on the left; no facet joint arthrosis;
(iv) C4/5: uncovertebral complex that extends into the right foramen with potential irritation of the nerve root right foramen; no facet joint arthrosis;
(v) C5/6: an uncovertebral complex that extends into both foramina;left sided foraminal nerve root compression; potential irritation on the right; minor bilateral facet joint arthrosis;
(vi) C6/7: an uncovertebral complex that extends into both foramen with bilateral foraminal nerve root compression, particularly left; indentation of the cord; minor right facet joint arthrosis;
(vii) C7/T1: no central canal stenosis.; foraminal narrowing bilaterally, potential irritation nerve root left foramen; no facet joint arthrosis;
(viii) comment: cervical spondylosis and facet joint arthrosis, multilevel nerve root irritation, and
(ix) clearly the applicant's underlying and significant cervical pathology recorded in Dr Hopcroft's report dated 5 August 2024 of neck stiffness and soreness and some restriction in movement;
(e) maintained the details, opinions and diagnosis which was expressed in his report dated 5 August 2024;
(f) expressed the opinion that the applicant's heavy and repetitive duties as a police officer were the substantial contributing factor to his diagnosed cervical spine and right shoulder pathology and injuries suffered;
(g) stated that as the applicant had no other cause for the changes confirmed radiologically and clinically, other than his work-related duties, it was in fact his work as a police officer over many years that caused and aggravated his radiologically-proven changes in the cervical spine and right shoulder;
(h) expressed the opinion that the applicant's duties as a police officer were the substantial contributing factor to the instigation and aggravation of the pathologies demonstrated in his report dated 5 August 2024, and
(i) on that basis, expressly disagreed with Dr Hyde-Page's opinions regarding causation of the applicant's cervical spine and right shoulder injuries and his impairment assessments.
Dr Murray Hyde-Page, orthopaedic surgeon, qualified by the respondent
(a) stated that he examined the applicant on 25 October 2023;
(b) recorded a history of injury that in the course of his work as a police officer, on
21 March 2023, he jolted his lower back when he fell as he engaged with an uncooperative person, and developed right-sided low back pain and shooting pain down the back of his right leg into the calf;
(c) diagnosed and acute lumbar back injury in the course of the applicant's work on 21 March 2023, being acute onset low back pain and right sided L5 sciatica where he has aggravated underlying longstanding degenerative disc disease of the lumbar spine, particularly at L4/5 where there is spinal canal stenosis and exit foraminal narrowing, and
(d) recommended that the applicant be assessed by a neurosurgeon with a view to either injections or surgical decompression.
(a) stated that he re-examined the applicant on 6 November 2024;
(b) recorded that since Dr Hyde-Page's initial report, the applicant underwent right L4/5 and L5/S1 lateral recess decompression surgery on 29 February 2024 and he was diagnosed with post-traumatic stress disorder in early 2024;
(c) recorded a reported history of injury that:
(i) he never had any specific injury to his neck, right shoulder and arm during his time as a police officer;
(ii) he never had any specific injury to his neck and right shoulder away from work;
(iii) in more recent years, he has developed some pain in his right upper arm where the deltoid muscle attaches and this occurs when he is abducting his arm;
(iv) other than that, he has no right arm pain;
(v) his shoulder joint itself has never been a problem, and
(vi) he has only ever had minor discomfort in his neck;
(d) on examination, reported that (amongst other things):
(i) the applicant had no discomfort and a full range of movement of his cervical spine, with no evidence of any muscle guarding or dysmetria, no radicular symptoms and no evidence of any radiculopathy in his upper limbs, and
(ii) the applicant has a full range of movement of his right shoulder in all directions equal to the left, there was no evidence of any rotator cuff impingement or tendinosis, he had some minor discomfort where the deltoid muscle attaches to his upper shaft of humerus but had normal strength, and there was no muscle wasting;
(e) diagnosed;
(i) no cervical spine injury nor cervical spine condition, noting that the applicant gave no history of any significant pain or discomfort, and he has never had an injury, and he had normal examination of his cervical spine and there is no evidence of radicular symptoms or radiculopathy, and
(ii) no right shoulder injury nor right shoulder condition, noting that the only finding in the right shoulder is some discomfort where the deltoid muscle attaches to the lateral side of the upper humerus, and this becomes uncomfortable when he abducts his arm to 90 degrees and the deltoid muscle contracts, which indicates some deltoid tendinosis, although the right shoulder itself is not involved;
(f) stated that:
(i) there is no evidence of any work injury to the applicant's cervical spine, noting that there is no diagnosis of the cervical spine, the applicant's neck pain is trivial and only occasional, there is no evidence nor indication that the neck pain that the applicant occasionally gets is work related and "He never suffered any injury to his cervical spine in the course of his work as a policeman", he does not need any treatment for his very minor neck symptoms and he needs no investigation;
(ii) there is no evidence of any work injury to the applicant's right shoulder, noting that although the applicant had a gradual onset of right upper arm pain, there is no evidence that the onset of the right upper arm pain is in any way related to his employment with the respondent "as he never suffered any injury and the nature of his work as a general duties policeman would not have cause him to develop this pain";
(g) assessed (amongst other things):
(i) a DRE Cervical Category I impairment of the applicant's neck with a WPI of 0%, and stated that the applicant had not suffered an injury to his neck, he has full range of movement with no muscle guarding or dysmetria and there are no radicular symptoms or radiculopathy, and
(ii) an upper extremity impairment of the right upper limb of 0%, and stated that the applicant had not suffered an injury to his right shoulder, with full range of movement in his right shoulder with no evidence of impingement or rotator cuff tendonitis.
(a) stated that:
(i) in his first report, he did not comment on the applicant's neck and shoulder condition in the first report and that the applicant did not give him any history of any injury or complaint;
(ii) in his second report, he concluded that the applicant had not suffered any significant injuries to his cervical spine and right shoulder in the course of his work as a police officer and that his examination was normal and he only had minimal symptoms;
(iii) since those reports, in February 2025 the applicant had undergone: an X-ray of his right shoulder which showed some AC joint arthritis and some minor osteoarthritic changes in the rest of the shoulder; an ultrasound of his right shoulder which showed some rotator cuff tendinopathy and some subacromial bursitis; and a CT scan of his cervical spine which showed cervical spondylosis and facet joint arthrosis with multilevel nerve root irritation;
(b) in relation to the applicant's neck:
(i) diagnosed chronic cervical spondylosis or degenerative disc disease of the cervical spine:
(ii) expressed the opinion that was an age-related condition unrelated to the applicant's employment as a police officer "where he never suffered any significant neck injury", and
(iii) expressed the opinion that it would likely have developed if the applicant had not been employed as a police officer over a twenty year period;
(c) in relation to the applicant's right shoulder:
(i) diagnosed some osteoarthritic and degenerative changes;
(ii) expressed the opinion that they are longstanding age-related degenerative changes unrelated to the applicant's duties as a police officer where there is no evidence of any acute injury or condition;
(iii) expressed the opinion that they would have developed irrespective of the applicant's employment as a police officer;
(d) stated that, working as a police officer, the applicant did multiple tasks and activities, and was not constantly putting strain through his neck and shoulders as someone might do when working in an abattoir or a factory and that the nature and conditions of the applicant's employment as a police officer in itself would not lead to him developing those conditions anyway;
(e) stated that there is no evidence of any specific event that could have caused the symptoms in the applicant's cervical spine and right shoulder;
(f) expressed the opinion that the applicant's employment as a police officer has not been a substantial contributing factor to either the onset or the neck and the right shoulder condition or any aggravation to the underlying degenerative condition, and
(g) noted that in his first report, there was no mention of any injury or condition affecting the applicant's cervical spine and right shoulder and there was never a mention of any specific injury to those body parts.
(a) the applicant now presses only injury to the applicant's cervical spine and right shoulder pursuant to s 4(b)(ii) of the 1987 Act;
(b) as a police officer, the applicant was exempt from 2012 amendments to the
1987 Act and that the 1987 Act prior to the 2012 amendments applies to her claims for workers compensation: accordingly, the test to be applied pursuant to
s 4(b)(ii) of the 1987 Act is whether the employment was the substantial contributing factor;
(c) the test to be applied in determining whether there is injury pursuant to s 4(b)(ii) of the 1987 Act is that set out by the High Court in Federal Broom Co Pty Ltd v Semlitch [1964] HCA 34; (1964) 110 CLR 626;
(d) the imaging demonstrates that the applicant had a degenerative condition of his cervical spine and right shoulder;
(e) the cervical spine and right shoulder injuries which are the subject of the present claim were not major injuries and did not cause the applicant any major incapacity, in comparison to other injuries that he suffered, in particular the lumbar spine injury and post-traumatic stress disorder which resulted in the applicant's incapacity to work from 21 December 2023;
(f) in relation to the date of injury, the applicant does not rely on any incapacity relevant to the alleged injuries, and the deemed date of injury would be a deemed date of making of the claim for compensation on 23 August 2024;
(g) there is contemporaneous evidence that the applicant did complain of neck and right shoulder issues on two occasions, in December 2014 (applicant's ALAD 183) and on 28 May 2024 (applicant's ALAD 80), prior to making the present claim for compensation on 23 August 2024;
(h) the evidence of the applicant and his wife should be accepted;
(i) the applicant provided evidence of the physically arduous nature of his work and an explanation for the delay in reporting his symptoms;
(j) the applicant's wife corroborated the applicant's evidence in relation to his neck and right shoulder symptoms and that the applicant is not a person who complains about physical ailments;
(k) the applicant's evidence is that he found Dr Hopcroft's examination of him to be particularly thorough;
(l) the applicant's evidence is that Dr Hyde Page may be confused about the history of injury because he believed that, although he did not sustain any specific significant injury to his cervical spine or right shoulder, his over twenty years of work as a police officer including wrestles, training, lifting, carrying and more has caused injury to his cervical spine and right shoulder;
(m) Dr Hyde Page's opinion that there was no evidence of onset of right shoulder pain related to the employment does not fit with the statement evidence and the contemporaneous evidence;
(n) Further, Dr Hyde Page's opinion was not based on a full appreciation of the nature of the work that the applicant performed as a police officer, including wearing a heavy appointments belt, training and repetitively getting in and out of a police vehicle;
(o) Dr Hyde Page did not properly consider the evidence and his opinion is unfounded;
(p) the Commission should prefer and accept the opinion of Dr Hopcroft, and
(q) on that basis, the Commission should be satisfied that the applicant has established injury pursuant to s 4(b)(ii) of the 1987 Act and the matter should be referred to a Medical Assessor.
(a) the injuries to the applicant's neck and right shoulder which are the basis of this claim are different to what was recorded in treating medical records in 2014, which involved the right bicep;
(b) the evidence of the applicant's wife should be given little weight on the basis that she did not directly observe the applicant performing his work, and her evidence is self-serving and of little probative value;
(c) the applicant's evidence of progressive injury to his neck and right shoulder is not probative and should be afforded no weight because: the applicant did not state when he noticed any neck or right shoulder symptoms or the circumstances of such symptoms; there is no contemporaneous evidence apart from the clinical record in 2014 and it did not evidence the relationship between the symptoms and the applicant's work; and the applicant made no complaint of injury until after the claim for compensation was framed;
(d) there is little evidence of the nature and conditions of the applicant's employment, although the respondent accepts that the applicant's employment did involve significant physical elements;
(e) there is no evidence of work injury to the applicant's neck and right shoulder prior to the applicant's legal claim being considered and Dr Hopcroft was briefed in relation to other injuries;
(f) from 2024, there is contemporaneous evidence of both Dr Hopcroft and Dr Hyde Page that the applicant had pain over the right lateral deltoid, which is the large muscle over the front of the shoulder;
(g) Dr Hyde Page's initial report did not make any mention of the applicant's neck and right shoulder, because the applicant had not told anyone about thand by inference because neck and right shoulder symptoms did not exist at that time;
(h) Dr Hyde Page's second report was based on an examination of the applicant's neck and right shoulder and it recorded a reported history which did not include any particular causative event or events. Dr Hyde Page did record a reported history of development of pain in the applicant's right upper arm where the deltoid muscle attaches, and only ever minor discomfort in the applicant's neck. On examination, Dr Hyde Page found no abnormality in the applicants neck and right shoulder and concluded that the applicant did not sustain any work injury;
(i) Dr Page's final report stated the basis for his opinion that the applicant did not sustain any work injury to his neck and right shoulder;
(j) only Dr Hyde Page performed a clinical examination of the applicant's neck, and he concluded that there was no evidence of abnormality of both the applicant's neck and right shoulder;
(k) Dr Hopcroft's first report is of little probative value because: Dr Hopcroft did not examine the applicant's neck nor consider radiology of the neck; and Dr Hopcroft did not relate the applicant's symptoms with his work;
(l) Dr Hopcroft's second report is of little probative value because: Dr Hopcroft did not examine the applicant again and did not examine the applicant's neck; Dr Hopcroft did consider the radiology however he did not say how the radiology supports the clinical finding in the first report of pain in the right deltoid and restriction of movement of the right shoulder; the applicant did not offer a history of trauma sustained to those body parts; there was limited basis for Dr Hopcroft to accept the conclusion of osteoarthritic changes; and Dr Hopcroft did not give any real insight as to the basis for his conclusion that osteoarthritic changes were caused by the nature and conditions of the applicant's employment;
(m) based on the evidence, it is possible to conclude that the onset of neck and right shoulder symptoms did not occur until after the applicant ceased to work for the respondent;
(n) there is now evidence of a latent degenerative disease condition prior to the alleged date of injury;
(o) there is no evidence of a causal connection between neck and right shoulder symptoms and the applicant's work and no evidence that it was made symptomatic by the nature and conditions of the applicant's work with the respondent;
(p) there is no contemporaneous evidence of symptoms of the applicant's neck and right shoulder;
(q) there is no evidence of any symptoms of the applicant's neck and right shoulder after he ceased work with the respondent and prior to the investigation of compensation in relation to other injuries;
(r) if there is no evidence of incapacity, then there is no issue with ss 254 and 261 of the 1998 Act, and
(s) the Commission should not be satisfied that the applicant has established injury pursuant to s 4(b)(ii) of the 1987 Act and the matter should be referred to a Medical Assessor.
(a) the absence of earlier radiological evidence of the alleged injuries is explained by the fact that the applicant's complaints in relation to his neck and right shoulder were fairly minor in comparison to his other injuries, and did not warrant earlier radiological investigation;
(b) the evidence of the applicant's wife is that the applicant did complain to her of such injuries is important and persuasive.
(a) means personal injury arising out of or in the course of employment,
(b) includes:
(i) a disease which is contracted by a worker in the course of employment and to which the employment was a contributing factor, and
(ii) the aggravation, acceleration, exacerbation or deterioration of any disease, where the employment was a contributing factor to the aggravation, acceleration, exacerbation or deterioration, and
(c) does not include (except in the case of a worker employed in or about a mine) a dust disease, as defined by the Workers' Compensation (Dust Diseases) Act 1942, or the aggravation, acceleration, exacerbation or deterioration of a dust disease, as so defined."
"The words have somewhat differing meanings: one may be more apt than another to describe the circumstances of a particular case: but their several meanings are not exclusive of one another. The question that each poses is, it seems to me, whether the disease has been made worse in the sense of more grave, more grievous or more serious in its effects upon the patient. To say that a man's sickness is worse or has deteriorated means in ordinary parlance, oddly enough, the same thing as saying that his health has deteriorated."[2]
"Moffitt J. was right, I think, in saying: 'There is an exacerbation of a disease where the experience of the disease by the patient is increased or intensified by an increase or intensifying of symptoms. The word is directed to the individual and the effect of the disease upon him rather than being concerned with the underlying mechanism'. Accordingly if salt be applied to an open wound, making the would [sic] no worse but causing it to smart as it had not smarted before, it is proper to say that there is an exacerbation of the wound."[3]
"16 Aggravation etc of diseases - employer liable, date of injury etc
(1) If an injury consists in the aggravation, acceleration, exacerbation or deterioration of a disease:
(a) the injury shall, for the purposes of this Act, be deemed to have happened:
(i) at the time of the worker's death or incapacity, or
(ii) if death or incapacity has not resulted from the injury - at the time the worker makes a claim for compensation with respect to the injury, and
(b) compensation is payable by the employer who last employed the worker in employment that was a substantial contributing factor to the aggravation, acceleration, exacerbation or deterioration.
(3) In this section, a reference to an injury includes a reference to a permanent impairment for which compensation is payable under Division 4 of Part 3.
Credibility of the evidence of the lay witnesses
Factual findings in relation to the nature and conditions of the applicant's employment
(a) the applicant gave evidence of the nature and conditions of his employment during his work for the respondent as a police officer from 20 May December 2002 until 21 December 2023, particularly in relation to the physically demanding nature of his training and work duties with the respondent, which included various rolling, wrestling, bending, twisting, lifting, holding, falling, high bodily impact events, Defensive Tactics training exercises, wearing an appointment belt and a restrictive load bearing vest, travelling in police vehicles and entering and exiting police vehicles;
the applicant stated that it was a plethora of incidents over the course of his work as a police officer, rather than any specific work event, which led to his cervical spine and right shoulder symptoms;
the applicant gave evidence that those various work activities progressively injured his cervical spine and right shoulder;
I give little weight to the evidence of the applicant's wife regarding the applicant's comments to her about physically arduous work on the basis that it was not her personal observation, except to the extent that she did personally observe the applicant having to hunch his neck and shoulders to enter and exit work vehicles whilst wearing the appointments belt and restrictive load bearing vest;
the applicant's evidence in relation to heavy physically demanding nature of his work with the respondent is consistent with the history that was recorded by Dr Alan Hopcroft;
however, Dr Hyde Page recorded a history that in his work as a police officer, the applicant did multiple tasks and activities and was not constantly putting strain though his neck and shoulders as someone might do when work in in an abbatoir or factory;
the respondent has not put on any evidence which challenges the applicant's evidence in relation to the nature and conditions of his employment with the respondent. In particular, there is no evidence which is inconsistent with the applicant's evidence regarding the physical demands of his training and work;
in any event, the respondent conceded that the applicant's work for the respondent did involve significant physical elements;
whilst the applicant did not detail the specific impacts alleged to his neck and right shoulder during his work and training as a police officer, considering his evidence as a whole, it is implicit in the applicant's evidence that he alleges that he sustained various traumas, stresses and strains to his neck and right shoulder in the various high bodily impact and strenuous activities that he engaged in during the course of his training and work as a police officer;
the activities described by the applicant, such as rolling, wrestling, bending, twisting, lifting, holding, falling, high bodily impact events, Defensive Tactics training exercises, wearing an appointment belt and a restrictive load bearing vest, travelling in police vehicles and entering and exiting police vehicles wearing the appointments belt and restrictive load bearing vest, are all significant physical activities. I consider that it is logical and likely that those activities would likely involve significant forceful impacts, strains, stresses or twisting of the body;
I consider that it is logical and likely that that traumas, impacts, stresses and strains to the neck and right shoulder would be sustained in the course of performing those activities described by the applicant, and
considering the evidence as a whole, I consider it logical and likely that during the course of his training and work with the respondent the applicant did engage in the physically demanding work and activities described by the applicant, and that from time to time in the course of such training and work, he did sustain forceful physical impacts, stresses and strains to the neck and shoulders in the course of performing their work.
(a) the applicant gave evidence that:
(i) his cervical spine and right shoulder injuries came on over time;
(ii) he self-managed his injuries through rest and by taking pain relief medication as required;
(iii) his cervical spine and right shoulder injuries were not as debilitating as his lumbar spine injury and post-traumatic stress disorder;
(iv) he has a stoic nature;
(v) he does not like to complain nor seek help unless he absolutely must;
(vi) he just tried to focus on his job and self-manage his symptoms;
(vii) he did not understand that he was required to report his cervical spine and right shoulder injuries within specific time frames and he was not previously aware of the requirements of ss 254 and 261 of the 1998 Act;
(viii) he admits that he made a mistake and was ignorant by not reporting the injuries;
(ix) he was "just trying to get on with things";
(x) he did not know now to report an injury that was not caused by one specific incident, but was a gradual worsening due to his heavy and repetitive duties as a police officer;
(xi) there is stigma for reporting injuries in the respondent;
(xii) did not want to appear 'weak' or that he could not look out for his colleagues, and
(xiii) he did not know how to put his hand up and say 'I am having some symptoms' without being made fun of;
(b) there is no independent and objective evidence of the respondent's workplace culture regarding the reporting of injuries;
(c) the respondent has not put on any evidence at all which challenges the applicant's evidence in relation to his perception of the respondent's culture of stigma for reporting injuries during the period of the applicant's employment, nor his understanding regarding reporting such injuries, and
(d) having regard to the matters set out above, I consider it logical and likely that the applicant, as a police officer employed by the respondent, particularly during the relevant time period, may have perceived a culture of stigma and not reporting physical impacts and relatively minor injuries where he was capable of continuing to work despite those impacts and injuries.
Evidence in relation to not obtaining medical treatment for injuries
(a) the applicant gave evidence that:
(i) his cervical spine and right shoulder injuries came on over time;
(ii) he self-managed his injuries through rest and by taking pain relief medication as required;
(iii) his cervical spine and right shoulder injuries were not as debilitating as his lumbar spine injury and post-traumatic stress disorder;
(iv) he has a stoic nature;
(v) he does not like to complain nor seek help unless he absolutely must;
(vi) he just tried to focus on his job and self-manage his symptoms;
(vii) he thinks that he needs to put up with his symptoms;
(viii) his lumbar spine injury on 21 March 2023, and the subsequent treatment, including surgery, became a significant focus for him and his family;
(ix) his symptoms of post-traumatic stress disorder, and treatment which took years and is still ongoing, also became a focus, and
(x) he thought his cervical spine and right shoulder symptoms might resolve once he ceased to work for the applicant, but that has not occurred;
(b) the evidence of the applicant's wife is that the applicant has a generally stoic nature and that his lumbar spine injury and post-traumatic stress disorder and symptoms were a significant focus for the applicant;
(c) there is no evidence that the applicant had any incapacity for work as a result of the cervical spine and right shoulder injuries nor that he took time off work for that reason;
(d) it is not disputed that the applicant had a significant lumbar spine injury and post-traumatic stress disorder and I consider that it is logical and likely that those injuries, which involved various treatment including lumbar spine surgery, would have been a significant focus for the applicant;
(e) the clinical records indicate that the applicant consulted his treating general practitioner, Dr Wyatt, in about December 2014 regarding bilateral upper trapezius restriction and cervical range of movement restriction. Dr Wyatt referred the applicant to physiotherapist, Michael Robinson, for physiotherapy treatment. Mr Robinson noted that the applicant reported having increasing restriction and soreness bilaterally across the shoulders and neck for the last couple of weeks and he assessed that the movement of the applicant's neck and upper trapezius was significantly restricted;
(f) there is no record of the applicant seeking medical treatment for cervical spine and right shoulder symptoms between December 2014 and when he consulted Dr Wyatt in May 2024 with reported bilateral shoulder stiffness, occasional pain but not significant limitations with overall function. Dr Wyatt's records indicate that subsequently, in February 2025, the applicant presented with right shoulder and neck pain, which he said had been present intermittently for some years prior. Significantly, Dr Wyatt noted on examination that the applicant's shoulder had pain and some reduced internal range of motion and the applicant's neck also had restricted movement, which Dr Wyatt considered was likely cervical in origin based on a positive neural tension test. Later in February 2025, Dr Wyatt recorded that shoulder imaging showed no significant findings however a Cervical Spine CT showed low-grade degenerative changes. Dr Wyatt then recorded his impression of cervical spine degenerative changes causing referred shoulder pain, which he considered should be managed by physiotherapy;
(g) I consider that it is logical and likely, and I accept, that the applicant's cervical spine and right shoulder injuries were not as debilitating as his lumbar spine injury and post-traumatic stress disorder and that those latter injuries were the primary focus for the applicant;
(h) having regard to the evidence as a whole, I consider it logical and likely, and I accept, that the applicant self-managed his cervical spine and right shoulder injuries, and
(i) in the circumstances, I consider it understandable that the applicant did not seek any other treatment for the cervical spine and right shoulder injuries from a medical practitioner or allied health practitioner, because he experienced them to be relatively minor injuries in comparison to his lumbar spine injury and post-traumatic disorder, he self-treated his cervical spine and right shoulder injuries and he continued to work despite those injuries.
Consideration of evidence and findings in relation to injury to the applicant's cervical spine and right shoulder
(a) in December 2014, the applicant's treating general practitioner recorded that the applicant had restriction in range of movement of his cervical spine and referred the applicant to physiotherapist Michael Robinson for treatment of bilateral upper trapezius tension and cervical ROM restriction;
(b) on 11 December 2014, Mr Robinson, physiotherapist, reported that the applicant reported stated that he had increasing restriction and soreness bilaterally in his neck for the last couple of weeks. Mr Robinson then assessed that movement of the applicant's neck was significantly restricted;
(c) there is no treating medical evidence in relation to the applicant's neck symptoms until 12 February 2025, Dr Wyatt recorded that the applicant presented with neck and right shoulder pain which he reported he had experienced intermittently for some years, which was not of such a severity that analgesia was required. On examination, Dr Wyatt found that the applicant's neck also had restricted movement. Dr Wyatt recorded that the symptoms were likely cervical in origin based on a positive neural tension test and referred the applicant for imaging, and
(d) on 28 February 2025, Dr Wyatt recorded that the applicant reported that the Cervical Spine CT showed low-grade degenerative changes. Dr Wyatt recorded his impression of cervical spine degenerative changes causing referred shoulder pain, which should be managed by physiotherapy.
(a) in December 2014, the applicant's treating general practitioner recorded that the applicant had applicant had bilateral shoulder symptoms and referred the applicant to physiotherapist Michael Robinson for treatment of bilateral upper trapezius tension and cervical ROM restriction;
(b) on 11 December 2014, Mr Robinson, physiotherapist, reported that the applicant reported having increasing restriction and soreness bilaterally across the shoulders the last couple of weeks and Mr Robinson assessed that movement of the applicant's upper trapezius and neck was significantly restricted;
(c) having regard to the above evidence, I do not accept the submissions of Mr Stockley on behalf of the respondent that the injuries to the applicant's neck and right shoulder which are the basis of these proceedings are different to what was recorded in the treating medical records in 2014 which involved the right bicep;
(d) there is no treating medical evidence in relation to the applicant's shoulder symptoms until 28 May 2024, when Dr Wyatt recorded that the applicant reported bilateral shoulder stiffness and occasional pain which was not of such a severity that analgesia was required, and that overall function was acceptable at present. Dr Wyatt determined that no further investigation was required at that time;
(e) on 12 February 2025, Dr Wyatt recorded that the applicant presented with right shoulder that he said he had experienced intermittently for some years, but which did not require analgesia. On examination, Dr Wyatt found that the applicant's shoulder had pain and some reduced internal range of motion Dr Wyatt recorded that the symptoms were likely cervical in origin based on a positive neural tension test and referred the applicant for imaging, and
(f) on 28 February 2025, Dr Wyatt recorded that the applicant reported shoulder pain with certain movements, however there were no significant findings on shoulder imaging. Dr Wyatt reported that the Cervical Spine CT showed low-grade degenerative changes and shoulder imaging showed no significant findings. Dr Wyatt recorded his impression of cervical spine degenerative changes causing referred shoulder pain, which should be managed by physiotherapy.
(a) his opinion takes account of the applicant's evidence, which I accept, that he developed neck and shoulder symptoms over time and that that in the course of his training and work with the respondent, the applicant did regularly sustain forceful and damaging impacts, strains and stresses to his body from time to time, including to his cervical spine and right shoulder;
(b) whilst the applicant's work may not have put repetitive strain through his neck and shoulders as someone might do when working in an abattoir or a factory, I consider that his cervical spine and right shoulder symptoms are entirely consistent with forceful and damaging, impacts, strains and stresses that the applicant would likely have sustained to his body generally, and his cervical spine and right shoulder particularly, in performing his duties as a police officer, including tackling, restraining, arresting and dragging offenders;
(c) I do not accept the respondent's submission that only Dr Hyde Page performed a clinical examination of the applicant's neck. I consider that it is clear from Dr Hopcroft's report that he performed an examination of the applicant's cervical spine. Dr Hopcroft found neck stiffness and soreness and restriction of movement in addition to pain over the right lateral deltoid with some restriction in movement of the applicant's right shoulder;
(d) I do not accept that Dr Hopcroft did not give any real insight as to the basis for his conclusion that the applicant's cervical spine and right shoulder condition was aggravated or exacerbated by the nature and conditions of the applicant's employment;
(e) Dr Hopcroft's evidence is consistent with the radiological findings;
(f) Dr Hopcroft provided a detailed analysis of the radiological findings and an explanation for those findings, which appears to be logical and consistent with the applicant's reported history of injury;
(g) Dr Hopcroft's report appears to be a well-considered and careful analysis of relevant information and states with clarity his diagnoses and the basis for same;
(h) Dr Hopcroft's findings on examination of the applicant appear to be most consistent with the findings of the treating general practitioner and physiotherapist and the applicant's reported history;
(i) there is no evidence of any other injurious incident apart from underlying age-related degenerative change, and
(j) I note that there is evidence of underlying osteoarthritic degenerative change in the applicant's cervical spine and right shoulder. For that reason, I do accept that the applicant sustained an aggravation or exacerbation of such pre-existing degenerative condition.
Is compensation precluded by operation of s 254 and/or s 261 of the 1998 Act?
What is the extent and quantification of the applicant's entitlement to payment of permanent impairment compensation pursuant to s 66 of the 1987 Act?
(a) ARD and attached documents;
(b) Reply and attached documents;
(c) ALAD by worker and all attachments, and
(d) ALAD by insurer and all attachments.
(a) the applicant sustained injury to his cervical spine and right shoulder as a result of the nature and conditions of his employment with the respondent, with a deemed date of injury of 23 August 2024, being an acceleration, acceleration, exacerbation and deterioration of a disease in the course of his employment and the employment was a substantial contributing factor to the acceleration, acceleration, exacerbation and deterioration, pursuant to s 4(b)(ii) of the 1987 Act, and
(b) compensation is not precluded by operation of s 254 and 261 of the 1998 Act.
(a) the matter is remitted to the President to be referred to a Medical Assessor for an assessment as follows:
(b) the materials to be referred to the Medical Assessor are to include:
(i) the ARD and all attachments;
(ii) the Reply and all attachments;
(iii) ALAD by worker and all attachments, and
(iv) ALAD by insurer and all attachments.
[5] Kooragang, Kirby J at [461], also at [463] - [464] (Sheller and Powell JJA agreeing).
Gamlin
State of New South Wales
(1994) 35 NSWLR 452
(1964) 110 CLR 626