It is not my task to dilate upon the remarks of Ms. Harris at the end of the memorandum and the reasons for rejection. They seem to imply that the Act does not oblige WorkCover to pay for courses where there is no rehabilitation in progress and the Worker does not have employment. That is a classical argument in a circle. He cannot get the employment unless he does the course but the Corporation will not pay for the course unless he has employment.

`... my feelings are that he would probably go on to do a German course and seek employment interstate'

are gratuitously offensive. The remarks manifest a somewhat singular attitude from a senior operative, (as a work placement rehabilitation adviser), charged with overseeing of the rehabilitation of injured Workers.

Mr. Minden agreed with the proposition put by the Worker that injured Workers were expected to seek employment, and that WorkCover expected the Workers to go out and find jobs if they were on rehabilitation. Further, that attitude was meant to persist after the formal rehabilitation course finished (as it did in this case apparently sometime in May 1992).

The situation seems to me that the Worker sought approval early in February for a course. He continued to seek approval. The Compensating Authority at best did nothing. Minden knew the course was being undertaken. He must have known that the Worker was paying $15.00 an hour out of his own pocket in order to obtain skills. Yet Minden did nothing until mid July to obtain approval from those clothed with the authority of giving it.

A conference was arranged in July. The claim was rejected.

I find as a fact that the Worker was not told of that decision by either Gail Harris or by Eric Minden - the people who were the point of contact between him and the Compensating Authority. Neither Ms. Harris nor Ms. Schulz gave evidence.

The issue is whether in the circumstances it can be fairly said that the Worker had the authority pursuant to Section 32(2)(c): or Section 32(2)(i).

That the Worker undertook a language course and paid for it, is not in dispute.

That this activity was generated and motivated by the Worker's desire and aim to rehabilitate himself, is not in dispute - and to the extent that it might be in dispute I find as a fact that the desire and aim deposed to by the Worker, has been made out to my satisfaction.

I have had some real difficulties with this claim. Initially, it seemed as though the refusal to accede to the claim was the subject of an Application for Review under the former Section 95; such Application being made out of time on 12 December 1996 and relating to a decision made by the Corporation in mid-1992.

That Application was rejected by the Registrar of the Workers Compensation Tribunal on the basis of Section 17(4) of the Transitional Provisions of the 1996 Act.

There is no information on the file as to when the Notice of Dispute in respect of the decision was filed. There is no way of knowing whether the time limit prescribed by Section 90A(1) has been observed.

I assume that in the preliminary discussions leading up to Gilchrist D.P. making the reference and enlargement Order of 11 August 1997 - the Respondent did not take the point on time. It was certainly not taken before me. On the basis of Robinson v. Craven (1994) 63 S.A.S.R. 267 the point need not concern me further.

There is no significant conflict on the facts. I find them to be:

1. The Worker embarked upon a Japanese language course that lasted from 25 February to 23 November 1992.

2. The cost of the course was $4,537.00 and the travelling amounted to 7031 kilometres. There was no challenge by the Respondent to those figures.

3. In 1992 the Worker sought permission from the Corporation on numerous occasions to undertake the course.

4. In 1992 and after, the Worker sought reimbursement of the cost of the course and travelling, on numerous occasions.

5. The Worker undertook the course because he had been left with the impression by Eric Minden of the Corporation, and Sonia Schulz of the Commonwealth and Rehabilitation Service that he had an (unspecified) obligation to continue to look for work, otherwise his compensation benefits would be adversely affected.

6. Minden and Ms. Harris of the Corporation knew that the Worker embarked upon the course. A conference took place in late July 1992 with Harris and others, at which the Worker was present. The content and value of the course was discussed.

7. Just prior to that, or perhaps at that conference, the Worker provided the Corporation with appropriate costings and receipts for payment for the course.

8. It was not until after the course was finished that the Corporation, on a date I cannot ascertain, informed the Worker that it would not pay for the course.

9. The formal decision not to pay had been taken on or about 24 July 1992. That decision was not communicated to the Worker by either Minden or Harris, who had at least a moral if not a legal obligation, so to do.

10. The Corporation did not authorise (within the terms of either Section 32(2)(c) or Section 32(2)(i) the Worker to incur the cost of this course.

The point at issue in this Judicial Determination is solely whether the Worker was authorised by the Corporation, or its functionaries, to embark upon the course and, as the result of that authorisation, is he therefore entitled to recoup the expenses therefor. The propriety of the decision not to authorise, is not the issue before me. I repeat, that authorisation itself is the sole issue which was debated before me.

This particular issue has been bedevilled by the appalling relationship between the Worker and the Compensating Authority, which has existed at least since 1993. The Worker on many occasions embarked upon a campaign of being gratuitously offensive to those handling his matters. He has a well developed sense of grievance against the Compensating Authority. The source of that grievance has been fuelled by the fraud investigators of the Corporation leading to the prosecution.

However, the ultimate finding of fact on this aspect of the Judicial Determination is that the Japanese language course was not authorised. The failure of the Corporation to communicate its decision in writing after 24 July 1992 is inexcusable. Minden, Harris and others, sat by supinely and allowed the Worker to incur expense, knowing full well that he would not be reimbursed therefor.

I have given anxious consideration as to whether Section 85 could be invoked, ie whether that Section that imports the concepts of equity and good conscience and the substantial merits of the case might be of assistance to the Worker. Section 85, upon reflection, is of no assistance. Consistent with authority, that Section is procedural and governs the procedure to be adopted. It does not alter the substitive law. That is made clear from G.M.H. Automotive Limited v. Kalagorinis [1994] SASC 5064; (1994) 62 S.A.S.R. 492 and Simpson v. Archipresti (1989) 53 S.A.S.R. 9 at p.4 per Cox J. The Worker's claim must therefore fail.

This is a Notice of Dispute rising out of an order made in the Magistrates Court. Following the plea of guilty mentioned earlier the prosecution applied for costs. It was entitled to do so pursuant to Section 120(3) of the Act. I am informed from the bar table that the following costs were ordered by Mr. Deegan S.M.:-

Initially WorkCover claimed $17,386.37 for prosecution costs. This was reduced by Mr. Deegan S.M. to $8,000.00. The total payable in the Magistrates Court is $13,317.00.

Mr. Moore-McQuillan says he has unsuccessfully sought from the Magistrates Court, and from the Registry of that Court relief in that he wishes to have a `break-down' of the investigation costs initially in the sum of $17,386.37. He has been supplied with a document - the costings on that document are in some cases simply lump sums. He wants to know how the original $17,386.37 was made up.

That might at first sight seem to be a matter peculiarly within the jurisdiction of the Magistrates Court. However he asserts that `he has been told' that it is a matter for the Tribunal or alternatively there is simply nothing that he can do about it.

I have every sympathy with Mr. Moore-McQuillan in his attempt to obtain a detailed break-down of such a large claim for costs against him - irrespective of whether it was cut in half by the learned Magistrate. The mere fact that such a significant cut was made would lead one to the conclusion prima facie in any event that the initial claim was unjustifiable.

It is my firm view that the Tribunal has no jurisdiction to deal with the claim, and other than expressing my sympathy for his predicament I can do nothing.

This is a very contentious issue which involves a claim for house cleaning, yard cleaning and car cleaning. The Worker claimed $8,010.00 for house cleaning being $30.00 a week from 1 January 1991 to 12 February 1997. He was claimed the cost of yard cleaning at $45.00 per time once a month, and car cleaning $40.00 per time once every six weeks.

The Worker gave evidence that the nature of his injuries were such that he has engaged casual house cleaners over the years, paid them in cash about $30.00 a time. This has been going on for 3½ years.

He said he did not make a claim or seek authorisation prior to January 1997, because he did not know that he was entitled to make a claim.

Sometime in January 1997 he spoke to Mr. Morgan from VACC. He was told it was a simple matter of going to the doctor and getting him to write out a report in order for the claim to be authorised. In response to Mr. Morgan's request he obtained a report from Mr. H.I.M. Moss orthopaedic surgeon dated 10 February 1997 (Exhibit W4/1) which says:-

`This is to certify that I am continuing to treat this man regarding problems of pain in both knees. I understand that as a result of the pain he experiences on standing and twisting etc. he has difficulty carrying out his normal household chores as well as maintaining his household in particular the yard and lawns and in addition cleaning the car. I believe that he would benefit by having assistance with these activities and I would support a claim on his behalf for this.'

The Worker's evidence is generally corroborated by an action sheet in the claims management case notes dated 31 January 1997 which is in evidence, and in which this appears:-

`The Worker then stated he can't do various tasks around home I can assess this and provide him with home help e.g. mowing, washing car etc. I advise that the treating doctor needs to confirm needs and the Worker's inability to do the said tasks. I'm not a doctor and would not make assessments. I said I would write to Dr. Moss and raise the issues.'

Dr. Moss' report was duly sent to VACC. The response came in a letter of 25 July 1997 (Exhibit R4/1).

I further advise in relation to your claim for house cleaning, lawn mowing and other related expenses a weight loss programme through the Jenny Craig group and a Japanese Language Course.

VACC has not and will not be authorising the payment of such costs should they be incurred by you. If you have incurred costs and expenses for which you now seek reimbursement then we ask that you formally claim those costs by presenting us with actual receipts and we shall make a decision which will be subject to usual rights of review.'

The letter then deals with other claims and concludes:-

`The Act states: compensation for medical expenses etc.

32(2) reasonably incurred by the Worker in consequence of having suffered a compensable disability.

32(i) any other costs (or classes of costs) authorised by the Corporation.

VACC has determined that the aforementioned expenses incurred are not reasonably incurred having regards to Section 32 of the Act 1986.'

The letter then sets out the usual `Rights of Review'.

`Pursuant to Section 90 of the Workers Rehabilitation and Compensation Act 1986 as amended you have the right to request a review of this decision by an Officer of the Workers Compensation Tribunal etc.'

Pausing there, `house cleaning' was but one of a series of six sets of expenses claimed.

(a) The words `reasonably incurred' do not appear in 32(2) but in 32(1).

(b) There is no section such as 32(i). It is 32(2)(i).

(c) There is no section such as 32(d). It is 32(2)(d).

I mention these things because VACC has become punctilious in requiring the Worker observe the letter of the Act. It does not perceive itself to be under a similar obligation of accuracy.

The letter states firstly there is a decision that the compensating authority has not in the past and will not in the future authorise the payment of such costs. Such a decision is ultra vires. It is improper that a decision should be made as to future claims before the claims are made. The letter is almost unintelligible. It asserts that it will reject future claims and then requires those claims (to be rejected) to be substantiated by `actual receipts'. It goes on to include forms for claiming Section 32 expenses!

Secondly, VACC concedes that the decision not to pay the house cleaning, lawn mowing and other related expenses is subject to `the usual rights of review'.

Thirdly, VACC determined that the expenses incurred were not `reasonably incurred'.

Interestingly, when Mr. Morgan gave evidence he said he could recall the conversation relating to the claim and he advised that it was normal practice to have the doctor write a letter of explanation, setting out what was needed and why - and once received by the Compensating Authority it would be considered.

However, Mr. Morgan said he did not authorise incurring such expenses. Mr. Morgan asserted that before he would approve claims for household assistance, he required a certificate or a report of Mr. Moss. He also conceded he did not require an `independent' medical examination. He said that the grounds for rejection was the inability of the Compensating Authority to confirm that the expenses claimed were warranted as part of the claim. He agreed that the real ground for rejection was not as set out in the letter but on another ground altogether i.e. it did not comply with Section 32 - i.e. the expenses were not authorised.

The ground of rejection relied upon by counsel the Respondent in addresses became not the ground set out in the letter at all.

(a) Section 32(2)(i) says those costs which are compensated are:-

(i) any other costs (or classes of costs) authorised by the Corporation.

These costs have not been authorised by the Corporation.

Therefore the Worker is not entitled to be compensated for those costs.

(b) The authorisation or non-authorisation is incapable of being re-examined by the Tribunal.

(c) That even if the Tribunal could re-examine the costs, the doctor's certification cannot be retrospective.

As far as I can see, the power of the Tribunal to examine a decision made under 32(2)(i) has not been the subject of a decision by this Tribunal or its predecessor. There have been a number of decisions on Section 32. The nearest I can find is the decision of Parsons J. in T.A. Stevens v. WorkCover Corporation (Northern Butchers Pt. Pirie Abattoirs Pty. Ltd.) (1995) W.C.A.T.R. I 740 where her Honour held that the rejection of a claim made under Section 32(2)(f) dealing with the costs of a nurse etc. was reviewable.

In The Corporation re Bugeja A.55/1995 I held that a policy limiting the number visits to a physiotherapist was not examinable by the Review Officer - it could only be the subject of proceedings for judicial review.

In Watkins v. Dembicon A.131/1995 Gilchrist D.P. held that the decision of the Corporation to reject a claim for the cost of cleaning services in that case was not a reviewable decision. His Honour gave no reasons. That decision may well have been based on the proposition that the services were not part of a rehabilitation program.

Various activities of the Compensating Authority in the Act are non-reviewable. In such cases the Act usually makes that quite explicit. Section 42(9) and Section 42A(9)(a) are examples.

A claim for Section 32 expenses is a claim for compensation. It is a monetary benefit payable under the Act (Section 3).

Hence it is clear that a claim for the type of expenses now the subject of consideration is a claim for compensation.

The Worker has the onus of showing that the costs were `reasonably incurred' in consequence of having suffered a compensable disability. In my view that onus has been discharged by the medical report of Mr. Moss mentioned above.

I now turn to the issue of whether the decision to pay is in the absolute discretion of the Corporation. I first find as a fact that the services were incurred as the result of the Worker having suffered a compensable disability and were reasonable incurred.

Is the decision not to authorise `non reviewable'.

In my view it is not. That would be reading into the Act something that Parliament has not thought fit to put there. It would have been an easy matter for Parliament to have worded Section 32(2)(i).

`... as any other costs (or classes of costs) as authorised by the Corporation in its discretion or its absolute discretion.'

The fact that throughout the Act various decisions of the Corporation are said to be immune from review, leads one to the conclusion that unless the right of review is explicitly taken away then it is reviewable, providing that the claim can be brought within Section 89A.

Mr. Moore-McQuillan says, and I accept, that the reason he did not make the claim before January 1997 was that his Case Managers had never told him (and this in breach of their moral duty under the Act) that he was entitled to such assistance. I accept that to be the true position at least that he was not properly informed. It may well be that Mr. Moore-McQuillan was motivated by his experiences in the Magistrates Court early in 1997 to trawl through the Act with a fine tooth comb to ensure that he was receiving his entitlements. There can be no criticism of that. There is substance in his complaint that the reason why he did not make the claim prior to January 1997, in spite of a plethora of case managers, rehabilitation advisers and other administrators, was that he was not at any time told that the service for which he claims was available to him pursuant to an Act of Parliament.

The function of Case Managers and rehabilitation advisers is peculiarly within the ambit of the Compensating Authority - however, on any view of their function, it is wider than saving money for the Authority. Their role ought to have regard to Section (2)(1)(a)(ii), (iii), the objects of the Act.

I am not persuaded that the letter from Dr. Moss cannot be retrospective. The evidence to support the supplying of the service which might lead to an authorisation, is not of itself necessarily prospective.

In my view the ground of rejection given in the letter of 25 July 1997 is not sustainable and I quash it. To the extent that it has been changed, amended and expanded in argument before me, I reject the submissions.

I find as a fact that the services claimed for were a consequence of the Worker suffering a compensable disability and that the expenses have been reasonably incurred. I find that the expenses are reasonable.

The Worker is entitled to reimbursement of money paid for housekeeping and house cleaning. I have performed a rough calculation. I take into account the fact that some of the services were supplied gratuitously by the Worker's partner. That was the subject of the Stevens' Case as mentioned above (albeit under a different section of the Act). I will allow the sum of $5,000.00 for house cleaning from 1 January 1991 to date - rather than $8,010.00.

For yard cleaning, I will allow $2,500.00 instead of $3,510.00.

I will allow car cleaning in the total amount to date of $1,250.00 rather than the amount claimed which is approximately $2,253.00.

This claim is for $421.00. It arises from dental treatment given to the Worker by Dr. F.J. Van Der Linden following a fall at home.

The Worker in evidence said that `my leg gave way and I knocked out the filling in the back tooth. Dr. Van Der Linden put in an emergency filling. The bill was presented to Bob Morgan and he said `Have you got the receipts'. I gave him the receipts and he said `Look you got to get us a doctor's report'.

A doctor's report was tendered, dated 19 March 1997. (Exhibit W5/1) states that the Worker:-

`... attended for a consultation on October 11th 1996 re damage sustained to his lower right second molar as the result of a fall and the examination in radiograph showed that the disto-lingual cusp of the tooth had been fractured'.

The report was handed to Messrs. Donaldson and Walsh solicitors for the Respondents on 8 April 1997. No evidence-in-chief was led from Mr. Morgan as to when it was received by VACC. However in cross-examination it transpired that Messrs. Donaldson Walsh never passed on the medical report to VACC. I invited an explanation from Mr. Luke of this unusual occurrence. None was forthcoming.

This was particularly odd in view of the fact that on (W/10/2) 20 February 1997 in response to the claim for the dental treatment VACC, wrote a letter first of all stating the substance of Section 52 then saying:-

`We note your claim for compensation lodged on 6th February 1997 did not have a prescribed medical certificate attached to it.

In order to properly determine your claim for compensation VACC requires a prescribed medical certificate and a medical report from your certifying medical practitioner Dr. Van Der Linden.

To obtain medical information from Dr. Van Der Linden we enclose a medical authority to be completed and returned to us as soon as possible.

VACC also requires that the prescribed medical certificate from Dr. Van Der Linden to be forwarded as soon as possible.

We also require a statement from you in relation to the injuries allegedly sustained on 11/10/96. We will in contact with you shortly in this regard.'

The Worker in fact obtained a medical report, handed it to VACC's solicitors, who did not hand it to VACC.

As to the statement that `we will also require a statement from you in relation to the injuries allegedly sustained' etc., this is ironic if nothing else, because on 4 March 1997 VACC obtained an ex parte restraining order - effectively preventing such communication.

That claim was disposed of by a letter of 18 July 1997 i.e. six months after it was made. It was rejected as one of forty-two claims `on the grounds' that:-

4. Further that VACC required examinations by a number of medical experts.

VACC were not to know that the very medical report they sought had been in the hands of their solicitors for over 3 months.

The point taken by the Corporation at the Judicial Determination was that because the claim for the teeth is number thirty in the series of forty-two as claims which are the subject of Notices of Dispute that matter cannot be heard by me in this Judicial Determination.

Such an approach is quite specious. The claim for compensation was made on 6 February 1997.

It is the subject of the letter written by VACC to the Worker on 20 February 1997.

The medical report mentioned in that letter was obtained by the Worker and handed to VACC's solicitors 8 April 1997.

The solicitors did not transmit the medical report to their clients and proffered no explanation.

VACC reject the claim on 18 July 1997 on grounds that inter alia the Worker has not submitted to a medical examination. The only medical examination that has ever been arranged is not with a dental surgeon but with an orthopaedic surgeon. The letter of instructions to the orthopaedic surgeon that might support Mr. Morgan's contention that an opinion was required as to whether the knee might have collapsed is never produced.

It is asserted by obtaining VACC that the `statement' required from the Worker by VACC has been precluded, because any approach to the Worker was forbidden by the Restraint Order taken out by VACC. The whole exercise resembles the plot of a Compensation Catch 22. I am satisfied that it should be dealt with in these proceedings. I am satisfied that the Worker had a fall. I am satisfied that he incurred the expense as the result of the fall which was the result of the original compensable injury. I am satisfied that the costs of the medical treatment are reasonable.

I overturn the decision of the compensating authority in the decision letter of 18 July 1997.

The Respondent conceded it should be paid the $24.13 claimed.

This is a question of costs arising from proceedings before a Conciliation Officer. These were agreed to be paid but have not yet been paid.

This claim is for $745.80 being for the cost of `The Advertiser' and the `Weekend Australian' each Saturday. According to the Worker in early 1991 he embarked upon a Commonwealth Rehabilitation Scheme administered by a Sonia Schultz. He says that she told him that he was to buy the `Weekend Australian' and `The Advertiser' each week. He was to look for job referrals and he was to apply for two jobs out of the employment sections of each newspaper. When the CRS Scheme terminated he was informed by Matt Ging from WorkCover and Stan Coulter from WorkCover and Mark Saw from VACC that he was to continue to purchase `The Advertiser' and `The Australian' and to keep seeking employment. The Worker produced a list of all the jobs he applied for in 1991. In 1993 he embarked upon another program run by a C. Ellis of Morphett Vale. He was again informed that he had to purchase the `Weekend Australian' and the Saturday Advertiser. He had to take the newspapers' employment section with him to the course with two jobs nominated, for which he would apply.

The Worker did not produce a bill because he paid it on a Mastercard. He is unable to produce the Mastercard files as these were taken by WorkCover in its fraud investigation and have not been returned.

The Worker conceded that he was not told that he would be re-imbursed for the purchase of the newspapers, but he said he was told that if he did not buy the newspapers and apply for the job, he would lose his benefits.

He said that he did not make a claim for reimbursement before the beginning of 1997 because he did not know that he was entitled to be re-imbursed.

The Corporation answers that there is no evidence independent from the evidence of the Worker, that he was told to look at the newspapers as part of the job seeking process. The answer to that is there does not have to be. If there was an answer it would come from Sonia Schultz. She could have been called by WorkCover to refute the claim. She was not called. No explanation was given for her not being called. The Corporation also asserted the evidence only went so far as to show that the Worker was encouraged to look for work from these newspapers. This is not sufficient to establish the claim.

The uncontradicted evidence of the Worker in fact is, that he was told that if he did not purchase the newspapers his benefits would be curtailed. The Tribunal was told by Eric Minden that his policy was that when a Rehabilitation Program concluded the Worker was told that he had to continue to do those things which were designed to get him back into employment.

This claim and others includes an assessment of the Worker's credibility. In general I accept the Worker as a witness of truth. He is prone to exaggeration - an observation that concurs with the view of the Worker formed by Duggan J: the appeal of Moore-McQuillan v. Police (Supreme Court S6215 24 June 1997 p.2). The Worker's presentation is flamboyant and antagonistic and he lacks that detachment from the subject matter that Courts take for granted in forensic activity. He has a very well developed sense of grievance against the Compensating Authority. Yet he gave evidence on oath and submitted himself to cross-examination. By and large was not shaken and did not resile from his evidence-in-chief. The Worker may have been an uncomfortable difficult and tenacious client for the Compensating Authority to accommodate - but that is an issue altogether different from his veracity.

In my view the claim for $745.80 has been satisfactorily made out.

This claim for $1,356.00 relates to the purchase of Panadol/Panadeine. These he obtained from the local supermarket for $4.00 a packet and said that he used approximately a packet a week from 9 September 1990 sometimes more. The amount claimed up until 1 September 1997 is $1,356.00.

The claim was rejected on 25 July 1997 on the basis of Section 32(2), 32(1) and 32(d) (which does not exist). The determination says `that the costs claimed are not reasonable'.

An altogether different defence was raised at the hearing. It was that there was no evidence of any recommendation by a medical expert. i.e. The Respondent relied on Section 32(2)(h) i.e. the Worker is entitled to the cost of medicine and other material purchased on the prescription or recommendation of a medical expert.

The orthopaedic problems that the Worker has had with his leg and knee have been known to the compensating authority since at least August 1991 and before. Subsequently there was an operation on the knee.

In the absence of a formal authorisation by a Doctor, the Worker on 20 October 1997 obtained a certificate from Mr. H.I.M. Moss saying as follows:-

`I also recommend to Mr. Moore-McQuillan to try to relieve his pain with over the counter pain relief for example Panadol or Panadeine as I don't believe that on a continuing basis he'd benefit from any therapeutic agent.'

If he was in pain, he had two alternatives. The first was to attend upon a doctor (at a cost of about $25.00 - $30.00), obtain a prescription and have it dispensed.

The second is to purchase over the counter analgesics at a supermarket.

The punctiliousness of the compensating authority in requiring a formal medical authorisation for the purchase of analgesics might be more impressive - if there was evidence that the Worker was made aware of his right to reimbursement and the conditions thereof. There was no such evidence. I refer to my earlier remarks about the ambit of the duties of a case manager.

The actual payment has been conceded. The Corporation accepts that if I hold that Dr. Moss' certificate can be applied retrospectively, the entitlement will be made out. I do so hold.

It seems to be no more than common sense to me that a perusal of the medical reports would raise the very real likelihood that the Worker was in continuous pain. Indeed in September/October 1997 when these matters were being heard the Worker was on crutches.

The Worker is entitled to a payment of $1,356.00 - although at the time of addresses the concession made on behalf of WorkCover seems to have escaped Counsel.

The curious point was taken that there is no `objective' evidence that the Worker paid the sum of $1,356.00. I do not know and I was not told what this means. The proposition seems to be that the Worker should have produced a receipt for every individual box of Panadol. That may be the case in the future but it will not foreclose an entitlement for the past.

This was a claim for mileage for attending Doctors. It was originally in the sum of $333.82 as 1,304 kilometres at 25.6c per mile. On 29 April VACC paid $147.46 leaving $186.36 owing. The Corporation's answer to this, is that no travel expenses are paid for the Worker to and from a chemist to pick up a script which is dispensed. That is correct. However no answer emerged as to claims for trips other than to the pharmacist. The Worker says and I accept that of the 1,304 kilometres, only 25 kilometres were for visits to the chemist - the balance was for visits to the doctors. This leaves 1,279 kilometres left at 25.6c per kilometre equals $187.97. $187.97 is still owing and that claim should be paid.

This is a claim for $36.00 hire fee of crutches. The claim was dealt with by letter of 27 August 1997 by a decision:-

`I advise that VACC does not at this stage accept liability for the expenses occurred by you in relation to the hiring and ongoing cost of crutches. Once we have been able to obtain the necessary information/medical reports by which to make an informed decision on your entitlements pursuant to Section 30 and 32 of the Act we will provide you with a formal determination on this matter.'

After some evidence had been given, liability for the sum of $36.00 was admitted on all without prejudice basis.

This is a claim for reimbursements of accountant's costs incurred in respect of another matter before the Tribunal. I have been told that the accountant's costs have been paid. The claim will be dealt with in that determination - not in this.

This consists of a series of mileage claims (R/4 - W10) between 19 February 1998 through to 27 June 1997.

(a) (R/5) The first was 19 February 1996 which was rejected. It was `city-pick up brief'. The reason given in evidence for rejection by Mr. Morgan, the VACC case manager, was that he thought `brief' was a legal document. It was therefore outside the WorkCover guidelines.

Over the decades I have been associated with Workers' Compensation claims and litigation, the common patois for a medical certificate obtained by a Worker is to refer to it as a `medical brief' or simply a `brief'. Why the Case Manager should think that the Worker was claiming expenses for mileage for picking up a `legal' document is beyond my comprehension.

(b) Another rejected claim for mileage was on 20 March 1997 for travel to Dr. Bill Hill (R/5).

In the Claims Management case notes of 31 January 1997 (R/7) this appears:-

`Worker indicated he see arthritis specialist Bill Hill soon about his knees.'

`A. Dr. Bill Hill was a doctor that Mr. Moss referred me to for my knees because of the fact that they kept giving way.

You wanted some further information about Dr. Bill Hill.

A. Clarification on the knee for the consultation.'

`Q. You wanted further information from William Hill that he as a leading rheumatologist might have been asked by an orthopaedic surgeon to comment upon the state of somebody's knees that had been traumatised for some years.

A. Yes, we'd like to find out what - the condition of his knees as well.

Q. You're told on 31 January that there's going to be a consultation with Dr William Hill, who is as well-known as Prof Henderson, well-known as Dr Awerbuch in this area, isn't he'? I mean, they're the three big names in rheumatology in Adelaide, aren't they?

Q. You're told on 31 January that he's going to go and see William Hill. You're told he's been referred to see him on 20 March and this claim comes in about which you want further information - as to the necessity for it.

Q. No, the travelling expenses to Dr. Hill. ... you've refused to pay those pending further clarification, and yet wouldn't you regard it as being self-evident that - having been in the job that you've been in for 6 years that somebody who has had joints traumatised at some stage is going to be referred to a consultant in arthritic medicine or rheumatology (634).

A. I would say yes, it is self-evident, but I still think that it's still reasonable to want to seek further information as to what the treatment regime would be.

Q. That's got nothing to do with paying for the travelling. That might have something to do with paying for the treatment regime. What's it got to do with the travelling expenses.

Q.- Nothing at all. Has Dr. Hill ever submitted an account for this consultation.

`Q. ... Has it been disallowed under section 32(6) - Dr Hill's account.

Q. Hasn't been disallowed. It's just been not paid.

A. - That's correct - whilst I attempt to seek additional information.

Q. - What information have you sought from Dr. Hill.

That approach to the Worker's claim does no credit at all to the Case Manager. It does not sit well with the punctiliousness with which Morgan administered other Section 32 claims. It may help to explain the foundation of the Worker's frustration and antagonism. The only conclusion open is that this rejection of this claim for mileage was not bona fide.

(c) Again the Worker claimed travelling expenses for 3 April 1996:-

`A. My understanding of Mr. Moore-McQuillan's claim is that he had a knee injury, that he has lodged numerous other claims, one of which makes reference to a leg and that is currently in dispute. So in the absence of a resolution of the dispute I made a decision not to pay it at this point of time.

Q. So you say that was rejected because the claim had been originally for a knee, not for a leg.

`Q. ...There is a medical certificate at least that you received on 24 July 1996 saying, "Pre-existing chondromalacia aggravated by favouring the right leg as the result of left leg injury," but you never regarded this as being a leg injury at all; it was always a knee injury, was it.

There is a medical report from a specialist mentioned at p.557 where a leg injury is specifically mentioned. On p.2 of the Standard Medical Report form generated by WorkCover, the leg injury is mentioned.

A report from Mr. Moss on 20 June 1995 certified that gymnasium and swimming facilities are required in order to rehabilitate his body and lower limbs. In a report on 10 June Mr. Moss comments that the Worker lacked the feeling of security in the leg and that his knee was giving way from time to time.

Mr. Morgan's excuse for non payment - and reason for rejection `that it's an oversight on my part'. is singularly pallid. The rejection could not have been a bone fide excuse.

(d) The following claims should be allowed: pursuant to Section 32(7) of the Act.

Claim 9: (W/4/1) - W/9/2 - W/9/1 Analgesics 1,356.00

Parties are advised that if a party wishes to appeal against any part of this decision which raises a question of law such appeal must be filed with the Registrar in accordance with Form 11 within 14 days of the delivery of this decision and must be served on all parties.