101 Although it was not doubted that the Plaintiff had a disc herniation at the L4/5 level, its relevance to the Plaintiff's complaints was in issue. Professor Robert Oakeshott, who examined Mr Jovanovski for the Defendant, noted the disc herniation reported in the MRI of 6 September 2004 but said that he could not correlate the herniation with any symptoms or objective clinical findings that he made on examination on 30 August 2007. Professor Oakeshott said further that he could not identify any evidence from his consultation and examination on that day that Mr Jovanovski aggravated, accelerated or exacerbated a pre-existing condition in his back or neck in the accident.
102 Professor Oakeshott examined Mr Jovanovski again on 26 November 2009. He noted that Mr Jovanovski admitted that he had improved since the previous consultation with regard to various symptoms. Professor Oakeshott said that pain was "definitely not an issue at any time" in the consultation of 26 November 2009.
103 He expressed his conclusions as follows:
I have not been able to identify any objective clinical evidence of any physical injury or underlying pathology in Mr Jovanovski's neck or lower back or any other part of his body that could be attributed to the incident at work on 23 February 2004.
It is my opinion that his ongoing symptoms are arising from factors other than any physical injury that was allegedly caused at work on 23 February 2004. That is, I consider that there is a psychosocial component to his alleged symptoms.
Mr Jovanovski has made a complete and permanent recovery from any alleged injury that occurred to his lower back or neck at work on 23 February 2004 as I was unable to identify any objective clinical evidence of any such injury at today's consultation.
He does not have any permanent impairment of his neck or back arising from any alleged injury that occurred to his neck or back on or around 23 February 2004.
I have not been able to identify any objective clinical evidence of any physical injury or underlying pathology in his neck or lower back that was allegedly caused at work on 23 February 2004 and that would prevent him from working full time without restrictions indefinitely in any job that he so desired.
104 Mr Jovanovski also saw Dr Matheson, a neurosurgeon, on 26 March 2008 and again on 26 November 2009. In his report of the first examination Dr Matheson concluded this:
The evident thing here is that he was able to work until he was sacked in December 2004 so it would appear that his spinal problems are fairly trivial and not related to this accident. They are merely some age-related degenerative changes which would give him some pain from time to time but the widespread symptoms he complains about make no sense and are clearly somatised. Thus I do not believe that there has been any residual disability from the incident of 23/02/04. It was simply a fall from which he recovered and did not prevent him working. He has only pursued matters after he has lost his job and he does appear, at this stage, to have a somatised disorder. This is shown by his inconsistent straight leg raising and his widespread unconvincing complaints.
105 Dr Matheson's conclusion in November 2009 was unchanged. He said that Mr Jovanovski had a minor back disability which has been exaggerated beyond all reasonable proportions. He said Mr Jovanovski did not have a work-related disability. His fall would have produced a back pain for a short period of time but there was no residual disability. He thought Mr Jovanovski was fit for driving work if he chose to do it. Dr Matheson was not required for cross-examination - nor were most of the Plaintiff's doctors.
106 Dr Peter Moloney treated Mr Jovanovski in 2004 and 2005 and saw him for the purposes of a medico-legal examination in March 2007. Dr Moloney treated Mr Jovanovski by epidural injection into the lumbar spine.
107 Both Dr Moloney and Professor Oakeshott gave evidence concurrently at the hearing. Although no formal conclave had been held, the Doctors met before giving evidence and reached agreement on one matter relating to the report of the MRI of 6 September 2004. The agreement was that the extruded disc fragment referred to could have occurred at the time of the injury but equally it could have happened at some other time either before or after the accident simply as a result of the degenerative process.
108 Dr Moloney gave evidence that, whilst not withdrawing from the agreement he and Professor Oakeshott had reached, he took the view that more likely than not the back pain and the leg pain was as a result of the extruded disc fragment. Certainly, Professor Oakeshott agreed that the sort of trauma the Plaintiff experienced in the fall could cause a protrusion in the way it was reported. Dr Moloney also accepted that radiological evidence could show gross degenerative changes, bulging discs and obvious compression of the nerve root but all of those matters could be asymptomatic in a person. However, he thought there was correlation between the appearances of the spine on the MRI and the back and leg pain of which the Plaintiff complained.
109 It would be fair to say that Professor Oakeshott appeared to place more importance on the history that he obtained from Mr Jovanovski and what he found on examination than on the radiological findings. Dr Moloney, on the other hand, says that the radiological findings are consistent with the pain and discomfort reported to him. Dr Moloney also relies on the fact that the injections given to Mr Jovanovski in the lumbar spine worked to relieve the leg pain as an indication that there is a link between the inflammation of the nerve root (as demonstrated on the MRI) and the pain of which Mr Jovanovski was complaining.
110 In my opinion, Dr Moloney's view is to be preferred to that of Professor Oakeshott. Professor Oakeshott seemed keen to stress that what was shown on the radiological examinations might have occurred without a trauma (and so much can be accepted) and he appeared to give less weight to what was shown on the MRI on the basis that those matters could exist without symptoms (and so much can be accepted). I formed the impression, however, that he did not think Mr Jovanovski was genuine in his complaints because he had found some inconsistencies in the examinations he conducted. He also formed the view (correctly I think, and I will come to this presently) that there were psychological matters overlaying any physical problems.
111 On the balance of probabilities, Dr Moloney's view is more likely. Although Mr Jovanovski had degenerative changes in his lumbar spine he had no symptoms associated with those changes prior to the accident. The accident involved a fall of 2 metres onto his buttocks and such a fall could have produced the disc herniation found on the radiology carried out within a matter of months after the accident, and carried out because of continuing reports of pain and discomfort by the Plaintiff in his lower back and legs. That coupled with the fact that the injections he has been given into the lumbar spine relieved his pain to some extent over the period they lasted, persuades me that Dr Moloney's view is to be preferred. On balance, I consider that the disc herniation was caused by the fall, and that the pain the Plaintiff experiences in his lower back and radiating down into his legs has been brought about by that fall.
112 Although his complaints concerned his lumbar spine, Mr Jovanovski also says that he injured his neck in the fall. Unlike his lower back, he had sustained an injury to his neck some years earlier. The injury appeared to involve some timber falling onto his head and cutting it in about 1997. That resulted in Mr Jovanovski suffering from headache and neck pain for some period after 1997. The Plaintiff says this was only for a couple of weeks and that he was not continuing to get neck pain from the 1997 incident by the time of the accident in February 2004.
113 The MRI of September 2004 disclosed degenerative changes in the cervical spine at the C6/7 level. It was noted that there was a minor posterior disc bulge at that level with osteophytes. There was evidence of bilateral exit foraminal narrowing secondary to osteophyte arising from the uncovertebral and facet joints which were said to affect the C7 nerve roots. How those radiological findings might have been related to the headaches and the pain and restriction in the neck that Mr Jovanovski complains about was not really explored, particularly with the 2 doctors who gave evidence.
114 Mr Jovanovski's evidence about the short-term nature of his neck and head pains after the 1997 incident cannot be accepted. Dr Atkinson reported on 31 August 2004 that Mr Jovanovski had long-term problems with shoulder pain. Dr Davidson, a rehabilitation specialist who had been treating Mr Jovanovski since June 2005 reported that he had had a past history of headaches and neck pain from the previous injury where someone had dropped a heavy object onto his head. Dr Davidson reported that those headaches had persisted off and on since that time.
115 It seems likely, therefore, that although he has suffered an exacerbation of the neck problems with headaches, that was a pre-existing problem at the time of the present injury.
116 Almost all of the doctors who examined Mr Jovanovski in the latent physical complaints noted that there appeared to be overlaying psychological factors that bore upon the complaints made and their assessment of Mr Jovanovski. He was treated by a psychologist, Nicole Dill, who (as I have mentioned) gave evidence in the case. She had provided a lengthy report in November 2006 reporting on a number of consultations that she had with Mr Jovanovski during that year. She noted that his Personality Assessment Inventory clinical profile indicated that he suffered from significant symptoms of anxiety and depression, that he experiences and expresses stress in somatic/physical form, that he suffers from overt physical symptoms of tension and stress, that he experiences significant cognitive, affective and physical symptoms of depressed mood, that he experiences mental confusion and significant suicidal ideation.
117 She thought it highly likely that his condition would deteriorate if he perceived that justice has not been served through the legal proceedings and would be at high risk of harm to himself and others if the employer was found not to be liable for his injury and associated emotional difficulties.
118 She thought his significant levels of irritability, anger and frustration were likely to impede his return to work. The fact that his emotions were largely expressed as physical symptoms of tension and stress meant that his experience of chronic pain would continue to be exacerbated by substantial physical activity. She thought work would be required that did not involve a great deal of verbal communication or customer based interaction whilever his emotional difficulties were so pronounced.
119 Mr Jovanovski was seen by a psychiatrist, Dr John Pickering in December 2006. Although Dr Pickering did not entirely agree with the classification of Mr Jovanovski's disorders that Ms Dill had accorded him, he agreed that there was a psychiatric disorder present that consisted of the psychological cluster of symptoms that she had described. He said it was only a matter of a difference in labelling.
120 Dr Pickering thought the psychological factors were interfering with Mr Jovanovski's ability to work but thought he could be able to work light duties provided he was allowed time and movement that he needed. What would make the most difference, he said, would be settling the Court case "adequately" and at least getting his proverbial "pound of flesh".
121 Subsequently, Dr Pickering assessed his whole person impairment from his psychological and psychiatric problems at 5%, and he said that assumed some degree of recovery which is the probable but not definite outcome.
122 Mr Jovanovski was examined by Gregory Fathers, a psychologist, on 18 March 2008. Mr Fathers said Mr Jovanovski presented as a very anxious man with evidence of depressed mood and elevated anxiety due to his poor adjustment. Mr Fathers thought that he had been prone to emotional lability during his life and thought there was evidence of unstable underlying personality traits. They were consistent with the findings and opinion of Ms Dill.
123 Mr Fathers said Mr Jovanovski had not adjusted to the injury or to his changed personal and social circumstances as a result. He thought Mr Jovanovski's prognosis was guarded.
124 He thought Mr Jovanovski was fit for employment but not for return to work as a truck driver. He considered it important that Mr Jovanovski consider some work direction that would establish a distracting routine to provide an outlet for his problems.
125 In the light of all that evidence I find that Mr Jovanovski had underlying personality and psychological problems which have been either brought to the surface or exacerbated by the injury and its sequelae. Those psychological and psychiatric problems are interacting with his chronic pain from his lower back in particular, but also from the neck area.
126 I find that Mr Jovanovski experiences ongoing chronic pain which is relieved to some extent by the injections into his spine. He has an ongoing need for these. I find he has ongoing pain and restriction of movement in the neck and headaches. I accept Ms Dill's and Dr Pickering's findings in relation to his psychological and psychiatric symptoms including the depression and anxiety. All these matters interfere with his ability to sleep, they restrict his ability to do many physical tasks, including household tasks.
127 Almost all of the doctors except possibly Dr Davidson are of the view that Mr Jovanovski is capable of paid employment but many of them say that he is not fit for his pre-injury employment of truck driving. Dr Davison had expressed the view in June 2006 that he thought a job as a security officer would be suitable for Mr Jovanovski. However, his report of November 2007 said that he thought it unlikely Mr Jovanovski would ever again engage in gainful employment for which he was reasonable qualified by education, training or experience. That phrase has the ring of a disability insurance claim about it. Putting that aside, it is not clear from it whether Dr Davidson has changed his view that the Plaintiff would be able to work as a security officer or even in some other job which might require some retraining.
128 I accept Mr Maguire's evidence that Mr Jovanovski was a good worker. I accept the evidence of Mr Jovanovski and his wife that Mr Jovanovski loved his work as a truck driver and worked hard at it. Indeed, the hours he worked in the months after the accident are an indication that he was keen to work and was not, until the psychological factors took hold, using the injury as any excuse for an inability to work. But as the psychologists and psychiatrists make clear, his inability to return to the work he loved has had a serious impact on his life and in maintaining both his psychological and physical problems.
129 For all these reasons, I would assess Mr Jovanovski at 45% of the worst case. That entitles him to damages for non-economic loss of $213,000.
130 The other head of damage claimed is for loss of earning capacity. Mr Jovanovski has undoubtedly suffered a loss of earning capacity but I do not consider that it should be regarded as total incapacity nor as equal to his pre-injury earnings of $1400 net per week. There is a dearth of evidence about what specific work Mr Jovanovski would be capable of doing, and it is necessary to bear in mind his background, lack of education and lack of specific skills in that regard.
131 The only specific job suggested to Mr Jovanovski was that of a security officer on the basis that he had held for some years a security licence. No evidence was put forward of what amounts could be earned by him in that position or in any other light work occupation.
132 All that is known is that Mr Jovanovski in fact drives a minibus for charity a few hours per week and he appears capable of doing that.
133 Mr Jovanovski's contract was terminated by the Defendant on 3 December 2009 which just happened to be the date of his criminal trial and his plea of guilty. The letter from the Defendant to Motor Tech of 3 December 2004 terminating the arrangement said nothing about the criminal trial or the plea of guilty. It relevantly said this:
We note that the Contract required that Motor Tech, or an employee of Motor Tech, contact Matt from the Kingsfield site on the evening before a work day to receive instructions for the following day's contracted services. Matt from Kingsfield has advised that Motor Tech has not contacted him for the past 14 days to provide services.