1. The questions that were referred to the original medical panel (that are relevant to this determination) together with the answers to those questions provided by the Chair of the original medical panel are as follows:

Question: Does [the applicant] have an imminently fatal asbestos-related disease? > > Yes > > Question: What is the asbestos-related disease or diseases? > > Asbestosis > > Question: Is the contraction of the disease or diseases reasonably attributable to exposure to asbestos at work? > > Yes. The claimant was exposed over a 12 year period ending in 1989 in his capacity as an apprentice, then qualified carpenter/joiner > > Question: Does the person have an imminently fatal asbestos-related disease? > > No * > > Question: Does the person have a non-imminently fatal asbestos-related disease? > > Yes * > > Question: General comments (if any). > > A complex determination given the revised opinion regarding the aetiology of his interstitial lung disease from his treating clinician (the original diagnosis was idiopathic pulmonary fibrosis (IPF) and he was prescribed anti-fibrotic therapy on this basis). > > Question: Reasons for decision or reasons why unable to make a decision. > > [The asterisks in the answers above refer to the answer to this question] This was a majority decision in favour of a diagnosis of asbestosis despite the absence of benign asbestos pleural disease on imaging, based on the exposure history with ample time lag and the UIP [unusual interstitial pneumonia] pattern seen on lung biopsies (this is common to both asbestosis and IPF). > > There was then a split decision in terms of whether this should be considered a non-imminently fatal or imminently fatal condition, but it was agreed that another impairment assessment should be commissioned.

2. The separate answers to the Commissioner's questions provided by the Chair (as panel member) and each of the other two panel members disclose that one panel member did not consider that the applicant had an asbestos-related disease, and although the other two panel members considered the applicant had the asbestos-related disease of asbestosis, one panel member considered it to be non-imminently fatal, and the other considered it to be imminently fatal. In accordance with the recommendation for further impairment assessment, the applicant was assessed by Dr A Ernst, Occupational Medicine Specialist.
3. Section 71 of the ARDC Act requires the Commissioner to treat the determination of the medical panel of the medical question referred to it as conclusive evidence of that medical question.
4. On the basis of the original medical panel's decision, and in accordance with s 71 of the ARDC Act, the Commissioner determined that the applicant has a non-imminently fatal asbestos-related disease.

1. The applicant's referral to the Tribunal was accompanied by all of the material that had been filed in support of the application, together with additional documentation provided to the Commissioner at a later date, specifically the results of lung function testing performed on 29 April 2024, and an independent expert report of Dr Jonathan Burdon, Consultant Respiratory Physician.
2. In support of the referral, the applicant later filed additional medical evidence which consisted of clinical records of the Fiona Stanley Hospital where the applicant has been a patient and a medical report of Dr Meow Cheong Yaw, Consultant Physician, Advanced Lung Disease and Lung Transplant Unit, Respiratory Medicine, Fiona Stanley Hospital dated 2 April 2025.

Overview of medical evidence relied upon by the applicant

1. Professor F Lake, Consultant Respiratory Physician, noted the history relating to the applicant who had initially been diagnosed with idiopathic pulmonary fibrosis. She noted that upon review of recent and previous CT scans small areas of calcified plaques, consistent with asbestos exposure, had been retrospectively identified. Although the calcified plaques had been present for many years it was not ever formally reported on or identified, but later recognised to have slowly increased over time. It was Dr Lake's opinion that the pleural plaques were induced by asbestos. The applicant's diagnosis was revised to that of "asbestos-related interstitial lung disease (asbestosis) and asbestos-related calcified pleural plaque". Professor Lake noted that the revised diagnosis would not make any difference to the treating team's approach towards the applicant's future care.
2. Professor Thomson reviewed radiological scans covering the period January 2006 to October 2023. He noted that the CT examinations showed evidence of typical raised calcified pleural plaques on the right side consistent with asbestos-related pleural disease which appeared first in April 2022. Specifically, he considered that the applicant showed radiological evidence of interstitial lung disease consistent with a diagnosis of asbestosis. He agreed with the opinion of Dr Lake (as set out above).
3. Professor Brims' report disclosed that he examined the applicant on 28 August 2024. He noted that the term 'asbestosis' refers to pulmonary fibrosis caused by asbestos fibre exposure and inhalation and is clinically and radiologically indistinguishable to idiopathic pulmonary fibrosis. He emphasised the significance of a history of exposure to asbestos and opined that pulmonary fibrosis could not be considered to be idiopathic in the context of known exposure to a pro-fibrotic agent, such as asbestos. He also noted that there is no known threshold of exposure to asbestos below which individuals will not develop asbestosis. Professor Brims considered that where the applicant had clinical characteristics of pulmonary fibrosis, radiological and biopsy results consistent with both UIP or asbestosis, and a clear history of 13 years' exposure to asbestos dust, the appropriate diagnosis was that of asbestosis. In terms of the applicant's life expectancy, Professor Brims referred to statistical likelihood of the applicant's death within one, two or three years as 16.2%, 29.9% and 42% respectively.
4. Dr Burdon was provided with copies of the materials that had accompanied the applicant's claim for compensation and provided an expert witness report dated 22 December 2024. Dr Burdon noted the briefing history provided by the applicant's solicitors in relation to the applicant's employment as a carpenter and joiner in Tasmania, commencing with an apprenticeship in 1977 and continuing through until about 1990. Dr Burdon considered that the applicant had had a "past significant exposure to asbestos containing dust and materials".
5. Dr Burdon also reviewed the applicant's medical history, including the results of testing and radiological investigations. In response to a number of questions put to him by the applicant's solicitors, he expressed his opinion as follows:
   • The applicant suffers from benign asbestos-related pleural disease and asbestosis. Dr Burdon formed his opinion based on the applicant's occupational exposure to asbestos, his medical history and his radiographic and respiratory physiological findings, which were consistent with the diagnosed conditions, and noted that other causes of pulmonary fibrosis had been excluded.
   • The history of asbestos exposure and inhalation during the course of the applicant's employment and radiographic findings were consistent with the diagnoses.
   • Without lung transplantation the applicant was likely to die within the next two years and the applicant's asbestosis would be the cause of his death or, if not, it would make the most significant contribution to his death.
6. Dr Yaw noted that the applicant was known to the Advanced Lung Disease Unit of Fiona Stanley Hospital in Western Australia as he had been referred initially for consideration of lung transplantation as a treatment option for severe interstitial lung disease. Although the applicant was initially diagnosed with idiopathic pulmonary fibrosis, Dr Yaw noted that the diagnosis was subsequently revised to asbestosis, based on the presence of asbestos plural plaque, radiological and histological findings in keeping with an unusual interstitial pneumonia pattern, as well as significant inhalation asbestos exposure in the past. Dr Yaw noted that the disease was progressive and there had been recorded deterioration on various assessments. He also noted the applicant was symptomatic with breathlessness on minimal exertion, chronic cough and fatigue which was significantly impacting on the quality of the applicant's life.
7. Based on the disease behaviour and trajectory Dr Yaw predicted the applicant would have a survival of less than two years without lung transplantation. Dr Yaw noted the significant medical history of the applicant and noted also that consideration had been given to lung transplantation as a potential treatment option but because of a number of complex issues the applicant was not, at the time of the report, considered to be a candidate for a lung transplant. The issues noted by Dr Yaw that mitigated against lung transplantation increased the surgical risk and potentially correlated to a poor lung transplant outcome.

1. The parties requested that the referral should proceed by the Tribunal notifying the Commissioner that the Tribunal required the Commissioner to refer a medical question to a medical panel pursuant to s 142(1)(b) of the ARDC Act.
2. In accordance with the request from the parties, and being satisfied that it was appropriate to exercise the Tribunal's discretion to do so in accordance with s 142(2) of the Act, by notification to the Commissioner pursuant to s 142(1)(b) dated 2 July 2025, the Tribunal required the Commissioner to refer to a medical panel particular medical questions relevant to the determination of this referral. I will refer to the medical panel convened by the Commissioner at the request of the Tribunal as 'the medical panel'.
3. Materials to be provided to the medical panel, as agreed between the parties, were provided to the Commissioner. They included all of the materials filed and relied upon by the applicant in support of his referral.
4. On 1 August 2025, the Tribunal received notice from the Commissioner that the medical panel had returned answers to the medical questions referred to it, and completed documentation from medical panel members was provided to the Tribunal.

1. The medical panel's answers to the questions referred to it were set out in the report of the Chair of the medical panel as follows:

Question: Does [the applicant] have an imminently fatal asbestos-related disease? > > Yes. > > Question: Does [the applicant] have a non-imminently fatal asbestos-related disease? > > Yes. > > Please provide reasons for your decision > > There as [sic] a split decision over whether [the applicant] suffered from asbestosis or IPF. > > [Panel member A] felt that based on the history and the asbestos exposure that the diagnosis was one of IPF and hence not asbestosis and therefore prognosis was not relevant in this case. > > [Panel member B] felt that on the basis of history of exposure, histology and disease progression that asbestosis was the diagnosis. Given this diagnosis and the recent lung function then death was more likely within the next two years. > > I concur with [Panel member B] that given the exposure to a fibrogenic compound over a number of years with a significant lag period that this could not be classified as idiopathic. As the histology is similar between the two diagnoses I am happy to call this asbestosis. As stated above with [Panel member B] the recent progression and clinical description would suggest death in the next two years is likely.

2. The report of the Chair of the medical panel annexed reports from Panel members A and B. I have considered the reports of Panel members A and B and am satisfied they have been adequately summarised by the Chair of the medical panel in his report.

1. Following the decision of the medical panel, written submissions on behalf of the applicant were filed and served on 21 August 2025. On 12 September 2025, the Commissioner indicated that the Commissioner would not make any written submissions in relation to this matter but was content to have the matter determined on the papers by the Tribunal, as sought by the applicant.

1. The applicant requests that the Tribunal determine the proceedings on the papers without an oral hearing. The Commissioner does not oppose this request.
2. The applicant says that it is appropriate to determine the matter without an oral hearing and refers to previous decisions of the Asbestos Compensation Tribunal (Tas) in support of the application. In particular, the applicant submits that it is appropriate for the Tribunal to determine this matter on the papers without an oral hearing because:

(a) the application for referral raises a limited factual contest about whether the applicant's asbestos-related disease of asbestosis is an imminently fatal asbestos-related disease or non-imminently fatal condition asbestos-related disease

(b) the applicant's exposure to asbestos in the course of employment in Tasmania is not in contest

(c) the Commissioner determined the applicant's claim for compensation by adopting the opinions of the original medical panel and Dr Ernst

(d) since the commencement of this proceeding, the applicant has provided further material supporting a finding that his asbestos-related diseases of asbestosis is an imminently fatal asbestos-related disease

(e) after the Tribunal required the Commissioner to refer relevant medical questions to a different medical panel, the medical panel determined that the applicant has an imminently fatal asbestos-related disease

(f) the medical panel was provided with all of the material that was provided to the original medical panel, but also material obtained since the commencement of the proceeding, that was not before the original medical panel.

(g) the Commissioner does not rely upon any additional material, does not object to the Tribunal receiving any of the applicant's evidence and does not seek to cross examine any of the applicant's witnesses.

(h) there would be costs associated with an oral hearing that would generally be borne by each party in accordance with s 146 of the ARDC Act

1. I accept the submissions made by the applicant in relation to the question of how this hearing ought to proceed. I note the Commissioner does not oppose the request for determination of the matter on the papers, and to follow that course would be consistent with previous decisions of the Asbestos Compensation Tribunal under the ARDC Act.
2. This matter will be determined on the papers without the need for an oral hearing.

1. The applicant submits that the Tribunal ought to make the following determination:

(a) That the applicant has a compensable disease within the meaning of that term in s 6 of the ARDC Act in that:

(iii) He has the asbestos-related disease of asbestosis; and

(iv) His asbestos-related disease is reasonably attributable to exposure in the course of his employment in Tasmania.

(b) He has an imminently fatal asbestos-related disease being asbestosis.

(c) He is a person entitled to compensation under s 29(1) of the Act.

1. Further, the applicant asks the Tribunal to make the following orders consequent upon the above determinations:

(a) That the applicant is entitled to compensation under the ARDC Act for the compensable disease on the basis that:

(i) He has the asbestos-related disease of asbestosis;

(ii) The asbestos-related disease is reasonably attributable to exposure in the course of the applicant's work in Tasmania.

(b) The applicant has an imminently fatal asbestos-related disease being asbestosis.

(c) The Commissioner is to determine the applicant's entitlement to compensation under the Act and to pay to the applicant (via his legal representatives) his entitlement within 14 days of the determination.

(d) There be no orders as to costs of the proceedings.

The applicant's submissions about the substantive issues

1. The applicant submits that the Tribunal should accept the majority decision by the medical panel as determinative of the medical questions in these proceedings for the following reasons:

(a) The medical panel was provided with all relevant material including material that was not available to the original medical panel.

(b) The medical panel has provided cogent and persuasive reasons for its determination.

(c) The majority decision of the medical panel is consistent with the applicant's treating physicians

(d) To date the Commissioner has not filed any expert evidence contrary to the determination of the medical panel, nor the expert evidence relied upon by the applicant.

1. It has been acknowledged by a significant number of the medical practitioners involved in this proceeding, including treatment providers, independent specialists and members of the medical panels, that this is a complex matter.
2. I give significant weight to the determination of the medical panel (noting that it was a majority decision) where the panel had available to it all of the material relevant to the medical questions that were ultimately put to it, including the applicant's history of exposure, opinions of treatment providers and independent experts, and the complete picture of the results of investigations and progression of the applicant's condition up until the time of the medical panel's determination.
3. Having considered the material provided to the medical panel and the determination of that panel, including the reasons provided by the majority of the panel for its determination, I am satisfied it is appropriate for me to accept the medical panel's determination.
4. I accordingly determine:

(a) The applicant has a compensable disease within the meaning of s 6 of the Asbestos- Related Diseases (Occupational Exposure) Compensation Act 2011 in that:

(i) He has the asbestos-related disease of asbestosis.

(ii) The contraction of his asbestos-related disease is reasonably attributable to exposure to asbestos in the course of his employment as a worker in Tasmania.

(b) The applicant has an imminently fatal asbestos-related disease being asbestosis.

(c) The applicant is a person entitled to compensation under s 29(1) of the Asbestos-related Diseases (Occupational Exposure) Compensation Act 2011.

1. In the light of the above determinations I make the following orders:

(a) The applicant is entitled to compensation under the Asbestos-Related Diseases (Occupational Exposure) Compensation Act 2011 for a compensable disease on the basis that:

(iii) He has the asbestos-related disease of asbestosis.

(iv) The asbestos-related disease is reasonably attributable to exposure to asbestos in the course of his employment as a worker in Tasmania.

(b) The applicant has an imminently fatal asbestos-related disease being asbestosis.

(c) The Asbestos Compensation Commissioner is to determine the applicant's entitlement to compensation under the Act and to pay to the applicant (via his legal representatives) his entitlement within 14 days of these orders.

(d) There are no orders as to the costs of the proceeding.