Relevant provisions of the SRC Act
16 Central to this appeal is a proper understanding of the interrelationship between ss 4, 5, 14, 19, 53 and 54 of the SRC Act.
17 The legislative scheme established by the SRC Act is concerned with compensating Commonwealth employees and employees of licensees, for injuries arising out of, in the course of, or that were significantly contributed to, by their employment. Since its inception, the SRC Act has given "pivotal importance" to the concept of "an injury": Canute v Comcare [2006] HCA 47; (2006) 226 CLR 535 at 539, [8]. See also Comcare v Lofts [2013] FCA 1197; (2013) 217 FCR 220 at [9].
18 The liability to compensate an employee under the SRC Act depends on an "injury". "Injury" is not used in a "global sense" and the structure of the SRC Act assumes that an employee may suffer more than one "injury": Canute at [10]. The word "injury" is defined in s 5A of the SRC Act.
19 As a preliminary observation, ss 69(a) and s 72(a) of the SRC Act, provide that John Holland, as a licensee, has the same functions as Comcare depending on the scope of its licence:
69 Subject to this Act, Comcare has the following functions, in addition to its other functions under this Act:
(a) to make determinations accurately and quickly in relation to claims and requests made to Comcare under this Act;
(b) …
72 In performing the function referred to in paragraph 69(a), Comcare:
(a) shall be guided by equity, good conscience and the substantial merits of the case, without regard to technicalities;
(b) …
20 Section 4(8) of the SRC Act provides that:
A reference in this Act to an injury suffered by an employee is, unless the contrary intention appears, a reference to an injury suffered by the employee in respect of which compensation is payable under this Act.
21 Section 5A defines "injury" as meaning, amongst other things:
(a) …
(b) an injury (other than a disease) suffered by an employee, that is a physical or mental injury arising out of, or in the course of, the employees employment; or
(c) an aggravation of a physical or mental injury (other than a disease) suffered by an employee (whether or not that injury arose out of, or in the course of, the employee's employment), that is an aggravation that arose out of, or in the course of, that employment.
22 The structure of the SRC Act is such that the SRC Act does not apply in relation to an injury to an employee unless notice in writing of the injury is given to the relevant authority in accordance with the requirements of s 53.
23 Section 53 provides:
(1) This Act does not apply in relation to an injury to an employee unless notice in writing of the injury is given to the relevant authority:
(a) as soon as practicable after the employee becomes aware of the injury; or
(b) …
24 Notice having been given in accordance with s 53, s 54 provides for the claims procedure:
54 Claims for compensation
(1) Compensation is not payable to a person under this Act unless a claim for compensation is made by or on behalf of the person under this section.
(2) A claim shall be made by giving the relevant authority:
(a) a written claim in accordance with the form approved by Comcare for the purposes of this paragraph; and
(b) except where the claim is for compensation under section 16 or 17 - a certificate by a legally qualified medical practitioner in accordance with the form approved by Comcare for the purposes of this paragraph.
(3) Where a written claim, other than a claim for compensation under section 16 or 17, is given to a relevant authority under paragraph (2)(a) and the claim is not accompanied by a certificate of the kind referred to in paragraph (2)(b), the claim shall be taken not to have been made until such a certificate is given to that authority.
(4) If a claim relating to an employee is given to Comcare, Comcare must cause a copy of the claim to be given to the principal officer of the Entity, Commonwealth authority or licensed corporation in which the employee was employed at that time.
(5) Strict compliance with an approved form referred to in subsection (2) is not required and substantial compliance is sufficient.
25 If the claim is accepted, the obligation to pay compensation is found in s 14 of the SRC Act: Woodhouse v Comcare [2021] FCAFC 95; (2021) 285 FCR 14 at [104].
26 Section 14, insofar as relevant, provides:
14 Compensation for injuries
(1) Subject to this Part, Comcare is liable to pay compensation in accordance with this Act in respect of an injury suffered by an employee if the injury results in death, incapacity for work, or impairment.
(2) …
27 The respondent in this case referred repeatedly to a claim for compensation under s 14. That is not the case. A claim is made under s 54. The Full Court made clear in Lees v Comcare [1999] FCA 753; (1999) 29 AAR 350 at [34], that a determination under s 14 amounts to no more than a determination that in the circumstances of this case, John Holland "is liable to pay compensation in accordance with this Act" in respect of a particular injury with the amount of compensation and the person or persons to whom the compensation will be payable and the time or times at which the liability gives rise to a present obligation to make payments all being determined under other provisions of the SRC Act.
28 The Full Court continued at [35] that a determination under s 14:
… will involve findings on the following matters. First, that an appropriate notice of injury has been given to the relevant authority as required by s 53 of the Act; secondly, that a claim for compensation has been made as required by s 54 of the Act; thirdly, that the person who made the claim or on whose behalf the claim was made was an "employee" at the time of the alleged injury (ss 4 and 5); fourthly, that the employee suffered an injury (s 4); and finally, that the injury has resulted in death, incapacity for work or impairment.
29 The content, duration and means of satisfying the liability to pay compensation is to be found and worked out by determinations made under other sections of the SRC Act: Prain v Comcare [2017] FCAFC 143; (2017) 256 FCR 65 at [89]. These determinations give substance to the liability "… to pay compensation in accordance with this Act", provided for in s 14: Australian Postal Corporation v Oudyn [2003] FCA 318 at [31]. Subject to the criteria in each provision being met, an employee who suffers from an "injury" for which liability has been accepted under s 14 of the SRC Act, may be entitled to various kinds of compensation including for: medical expenses (s 16); incapacity for work (s 19); injuries resulting in permanent impairment (s 24); and household services and attendance care services (ss 29 and 29A). If there is no liability for an injury under s 14, no liability to pay compensation under the SRC Act can arise: Lees.
30 A determination under s 14 having been made, the amount of compensation payable to an employee who is incapacitated for work as result of an injury, other than an employee to whom ss 20, 21, 21A or 22 applies, none of which are relevant to this matter, is calculated in accordance with s 19 of the Act.
31 Since John Holland accepted liability in this case by consent order made in the Tribunal on 19 December 2019, the Tribunal in the present matter was concerned with whether the respondent was entitled to compensation under s 19 of the SRC Act. The Tribunal had to be satisfied that the criteria in s 19(1) were satisfied, including determining that there is an "incapacity for work" during the period under consideration. If the Tribunal is so satisfied, the formula provided for in ss 19(2) to (14) is applied to determine the quantum of compensation payable.
32 Section 4(9), a central provision in these proceedings, defines "incapacity for work" in the following terms:
(9) A reference in this Act to an incapacity for work is a reference to an incapacity suffered by an employee as a result of an injury, being:
(a) an incapacity to engage in any work; or
(b) an incapacity to engage in work at the same level at which he or she was engaged by the Commonwealth or a licensed corporation in that work or any other work immediately before the injury happened.
33 Once that structure is understood, in this matter, the following process emerges:
(1) A notice of claim complying with the requirements of s 53 is required;
(2) A claim for incapacity arising out of an injury to which the SRC Act applies (work injury) is made under s 54, accompanied by a medical certificate, albeit not necessarily in the approved form (s 54(5)). Upon acceptance of that claim, a liability arises to pay compensation (s 14);
(3) That liability is calculated in accordance with s 19;
(4) The liability to pay compensation to the respondent in respect of his injury applies while he is incapacitated for work as a result of the work injury (s 19);
(5) The liability to pay compensation to the respondent only operates whilst he is incapacitated for work as a result of the work injury (s 19);
(6) In circumstances where a claim has been made under s 54 and accepted such that the obligation in s 14 operates, if the incapacity continues past the expiry of the initial period of incapacity identified in the medical certificate which accompanied the claim under s 54, it is not the case that another claim in accordance with s 54 is required;
(7) There is no specific requirement in s 19 for the worker to provide medical certificates as to ongoing incapacity if the period of incapacity the subject of a claim under s 54 continues past the period identified in the medical certificate that accompanied the claim under s 54. Nonetheless, given the initial obligation imposed upon the employee in s 54 to provide a claim and a medical certificate as to incapacity, the context and purpose of the legislation is such that it is implicit in s 19 that the employee is obliged to provide further medical evidence as to ongoing incapacity arising from the work injury for the purposes of s 19. Were that not the case, the relevant authority will not be able to determine whether the incapacity consequent upon the work injury is continuing or not; and
(8) If the period of incapacity the subject of a claim under s 54 comes to an end: eg because the consequences of the work injury have resolved and the employee is no longer incapacitated, then in the event of a further injury, a new claim under s 54 accompanied by a medical certificate certifying incapacity will need to be made.
34 As to the seventh step, I note the relevant authority has the option under s 57 to require an examination by one legally qualified medical practitioner in circumstances where a notice has been given under s 53 in relation to an employee or an employee has made a claim for compensation under s 54.
35 Sections 57(1) and (2) provide:
(1) Where:
(a) a notice has been given to a relevant authority under section 53 in relation to an employee; or
(b) an employee has made a claim for compensation under section 54; the relevant authority may require the employee to undergo an examination by one legally qualified medical practitioner nominated by the relevant authority.
(2) Where an employee refuses or fails, without reasonable excuse, to undergo an examination, or in any way obstructs an examination, the employee's rights to compensation under this Act, and to institute or continue any proceedings under this Act in relation to compensation, are suspended until the examination takes place.
36 The terms of s 57(2) when considered in the context of s 57(1) suggests that the option of examination by a different medical practitioner is available to the relevant authority at any stage of the process including whilst the employee is receiving payments for incapacity for a work related injury. That is not inconsistent with the obligation on the employee to provide medical certificates as to ongoing capacity for the purposes of s 19. Rather, it provides an opportunity for the relevant authority to have the employee examined independently whether for the purposes of accepting a claim made under s 54 or for assessing ongoing incapacity for the purposes of s 19.
37 The power to request provision of information in s 58 is directed to information that the relevant authority may request from the claimant upon receipt of a claim.