1. The applicant Mr Antonios Papadopoulos was employed by The Parish Church of St James, the respondent, as a full time Facilities Manager in September 2015.
2. In June 2023 the applicant was overseeing the refurbishment of a rectory site in Paddington which required floor boards that had developed rot to be replaced. A contractor pulled up all the floorboards revealing that some of the structural wooden frames under the floor also needed replacement.
3. During his inspection of the site on 7 June 2023 the applicant was walking on a joist which twisted due to rot, causing him to fall about half a metre to the strip flooring below. He alleges he hit his neck and right armpit on the concrete and timber strip flooring and injured his hands that he held out to catch his fall.
4. The applicant was not initially aware of the extent of his injuries however his symptoms progressed and he consulted his general practitioner in about August or September 2023. Professor van Gelder carried out cervical spine surgery on 24 April 2024, and as the applicant's condition worsened surgery was carried out on 13 May 2024. Further surgery by way of a cervical foraminotomy operation at C3/4 is recommended.
5. On 28 November 2023 the respondent issued a notice under s 78 of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act) disputing liability for the applicant's cervical spine injury. The dispute was maintained on 12 January 2024 following internal review.
6. The applicant lodged an Application to Resolve a Dispute with the Personal Injury Commission (Commission) on 1 October 2025 claiming past and future medical expenses including for the cervical spine surgeries.
7. The dispute was listed for conciliation conference and arbitration hearing on 19 December 2025.

1. The parties agree the following issues remain in dispute:

(a) whether the applicant sustained a cervical spine injury on 7 June 2023 pursuant to ss 4 and 9A and/or 4(b) of the Workers Compensation Act 1987 (1987 Act),

(b) whether the applicant failed to give notice of injury within the time prescribed in s 254 of the Workplace Injury Management and Workers Compensation Act 1998, and

(c) whether the applicant is entitled to the payment of medical expenses as a result of injury, including the cervical foraminotomy and posterior discectomy, the anterior discectomy and interbody fusion at C6/7 and the proposed cervical foraminotomy at C3/4, pursuant to s 60 of the 1987 Act.

1. The parties appeared for conciliation conference and arbitration hearing on 19 December 2025 in Sydney. Mr Justin Hart of counsel appeared for the applicant instructed by Ms Lucette Combo-Matsiona, legal practitioner. Mr Tom Grimes of counsel appeared for the respondent instructed by Ms Laura Risti, legal practitioner. Ms Ozer was also present.
2. During conciliation the respondent advised it no longer pressed failure by the applicant to give notice of the injury, and the applicant advised he did not press the claim for future surgery today. The parties agreed a general order for future medical or related expenses is appropriate if the applicant's claim succeeds. The applicant's Application to Lodge Additional Documents dated 19 December 2025 was admitted by consent if lodged with the Commission before close of business on 19 December 2025.
3. I am satisfied the parties to the dispute understand the nature of the application and the legal implications of any assertion made in the information supplied. I have used my best endeavours in attempting to bring the parties to the dispute to a settlement acceptable to all of them. I am satisfied the parties have had sufficient opportunity to explore settlement and that they have been unable to reach an agreed resolution of the dispute.

1. The following documents were in evidence before the Commission and considered in making this determination:

(a) Application to Resolve a Dispute (ARD) and attached documents;

(b) Reply and attached documents. and

(c) applicant's Application to Lodge Additional Documents (ALAD) dated 19 December 2025 and attached documents.

1. No application was made to call oral evidence or to cross examine any witness.

1. The applicant relies on his statement signed on 18 September 2025.
2. His work duties as a Facilities Manager with the respondent are varied and include opening the Church, lighting candles, general administrative duties, safety walks to look for defects or anything that needs to be repaired or cleaned up, arranging contractors for maintenance works and overseeing those works.
3. The applicant describes his injury on 7 June 2023. A contractor had pulled up all the floorboards in the Paddington premises where the injury occurred and an electrician, Mr Michael Habib, was present at the time. At about 10.30am while inspecting the premises the applicant received a call from the rector as he was walking on the joist which twisted due to rot causing him to fall.
4. As he fell through the floor for about a metre the applicant hit the right side of his neck as well as his right armpit on the timber and concrete strip flooring as he had his hands out to catch his fall. He injured his lumbar spine, cervical spine and arm.
5. Mr Habib immediately came to help him where he had fallen. The applicant was on the phone to his boss, the priest, at the time of the fall and the applicant told him of the fall at the time. He later informed his direct manager Mr Chris Lock of the fall but told him not to lodge a workers compensation claim as he thought perhaps his injuries were only minor.
6. The applicant immediately experienced bruising and tenderness around the right side of his chest, neck and armpit as well as his right knee, and he took painkillers.
7. Over the following months the pain and subsequent symptoms became more persistent. He lost sensation in two then four of the fingers of his right hand and developed pins and needles.
8. He consulted his general practitioner in about August or September 2023 as he started to lose sensation in his right thumb and index finger. He complained of constant neck pain. He could not tilt his head up without a lot of pain and he could not turn his neck to the sides.
9. After investigations were carried out he consulted Professor van Gelder on 7 May 2024. The applicant had an anterior cervical discectomy and fusion operation and two weeks later on 13 May 2024 he had a C6/7 anterior cervical discectomy and fusion with a better result.
10. Although the symptoms were much better the applicant still experienced pain. He had constant burning radiating from the elbow to his hand and fingers, with pins and needles and numbness. His hand swelled up and changed colour with activity, and the applicant had a cold feeling in his hands where he had to wear a glove. He still had restrictions in his neck and arm with sharp pain. Pain also started to develop in his left arm.
11. The applicant had a nerve conduction study and consulted Dr Rajib Dutta. He saw Professor van Gelder who recommended further cervical surgery to relieve his neck and right shoulder pain and regain some right arm function and comfort with gaining some work capacity. He also had physiotherapy treatment.
12. He seeks medical treatment expenses incidental to his injury.

1. Dr Dan examined the applicant on 7 April 2025 and reports on 11 April 2025 the applicant suffered a significant injury which caused "a degree of disc protrusion on already age consistent degenerative change effected spine which caused the symptoms of which he complains."[1]
2. His ongoing pain, numbness and restricted cervical movements are a direct consequence of the subject incident in Dr Dan's opinion. The subject accident was the main contributing factor to his injury on a background of pre-existing age related changes.
3. The applicant has undergone appropriate surgery and it is possible that further surgery may be required.
4. Dr Dan assesses 30% whole person impairment of the cervical spine.

Associate Professor James van Gelder, treating neurosurgeon and spine surgeon

1. On 30 October 2023 Associate Professor van Gelder reports the applicant is suffering from unmanageable right cervical radicular symptoms since July. His symptoms came on a few weeks after the fall in June when he developed neck pain and when he could not move his neck. The pain radiated down his right arm and he developed painful paraesthesia in his hands. A request for an anterior cervical discectomy and fusion at C6/7 is made to the insurer.
2. Associate Professor van Gelder notes the cervical spine CT scan on 8 September 2023 and the MRI on 13 October 2023 that show cervical spondylosis at C3/4 and foraminal disc herniation at C6/7. The C6/7 foraminal disc herniation best accounts for the applicant's acute onset of symptoms. Treatment options were discussed.
3. On 28 November 2023 Associate Professor van Gelder says the applicant is suffering from right cervical radicular pain and his symptoms are worsening. He has a known C6/7 herniation, is attending physiotherapy and meets the criteria for patients who will have rapid relief from cervical surgery to decompress the C7 nerve root and remove the disc herniation.
4. On 3 January 2024 Associate Professor van Gelder confirms the applicant meets the criteria for patients who benefit from cervical surgery such as an anterior cervical discectomy and fusion or a posterior foraminotomy and posterior discectomy, declined by the insurer.
5. The doctor's opinion is the applicant's condition was precipitated by the work accident in June and the condition and nature of his work and the fall in June are likely significant contributing factors.
6. On 23 April 2024 Associate Professor van Gelder records the applicant has ongoing shooting pain from the cervical spine into the left upper limb, right thumb, first and second finger paraesthesia and pain, an inability to reach shoulder height with right upper limb due to pain and restriction, and an inability to make a full fist.
7. On 29 April 2024 Associate Professor van Gelder reports the applicant was admitted on 24 April 2024 for a C6/7 right cervical foraminotomy and discectomy operation. He refers to a work related injury in October 2023 and describes his symptoms. The applicant had an updated MRI scan on 20 April 2024 that showed the known neural foraminal stenosis at C3/4, more advanced foraminal stenosis and a lateral disc herniation at C6/7 impacting the C7 nerves on the right.
8. The applicant reported numbness and pain immediately postoperatively that settled with a dose of Ketamine and opioid analgesics.
9. Associate Professor van Gelder reports on 24 June 2024 and 21 August 2024 that spinal surgery was recently carried out and he recommends work restrictions.
10. On 7 April 2025 Associate Professor van Gelder provides a medico-legal report. The injury and treatment are described. The CT scan and MRI scan showed common age-related degenerative changes. There was bilateral spondylitic neural foraminal stenosis at C3/4, and a large right C6/7 intervertebral disc herniation impacting a C7 nerve for which he had a cervical injection in September 2023.
11. Associate Professor van Gelder comments on Dr Casikar's report of 22 December 2023.
12. The applicant continued to suffer intolerable symptoms and eventually decided to have a C6/7 posterior cervical foraminotomy and discectomy on 24 April 2024. On 13 May 2024 he had an anterior cervical discectomy and fusion operation at C6/7.
13. A CT scan of the cervical spine on 19 October 2024 showed a satisfactory fusion at C6/7 and severe neural foraminal stenoses at C3/4 bilaterally from cervical spondylosis. The applicant continued to experience neuropathic symptoms affecting his right arm, thumb and index finger. Despite surgical treatment he has ongoing radiculopathy. He has also sustained a right shoulder injury and a tendon injury to his right elbow, and he has permanent nerve injury affecting his right arm and hand.
14. Associate Professor van Gelder confirms the applicant's employment was the main contributing factor to his work related shoulder and cervical spine injury, caused by the fall in June 2023 with a secondary contribution of the conditions and nature of his work performing manual work and overhead work as a handyman, facilities manager and bell ringer. The injury is the reason he had to have cervical disc surgery at this stage in his life in 2024.
15. On 30 June 2025 Associate Professor van Gelder writes to the insurer requesting approval for a treatment plan including his recommended cervical foraminotomy operation at C3/4 on the right side. The request for approval of cervical foraminotomy at C3/4 includes surgical items of $8,220.

Dr Rajib Dutta, treating pain management specialist

1. Dr Dutta reports on 6 August 2024 that the applicant has had pain in the right hand and wrist since September 2023, secondary to the injury when he fell through a floor and his neck, right side right arm pit and pectoralis muscle were injured.
2. On examination the applicant has significant pain involving the right side of the neck and there is mild tenderness also noted on his right shoulder. He is already going to physiotherapy which is going to be helpful long-term, and Dr Dutta recommends increased medication.
3. The doctor's impression is the applicant has complex pain impacting his neck and right upper limb and his condition is showing limited improvement from a functional point of view. The treatment plan is a combination of exercise, manual therapy and education. He has a mixture of range of motion and strength exercises to complete at home.

1. Mr McMullan reports on 23 April 2025 the applicant has complex pain impacting his neck and right upper limb with limited improvement from a functional point of view. His neck range has improved but his upper limb function seems to be worsening.
2. Physiotherapy is primarily for symptom management at this stage and will unlikely bring significant functional improvements. The treatment plan is to review the applicant every three to four weeks primarily for symptom management.

1. The Surgical Procedure Report for the C6/7 anterior cervical discectomy and fusion at Sydney Adventist Hospital is dated 13 May 2024.
2. The CT cervical spine of 8 September 2023 demonstrates at C3/4 bilateral foraminal stenosis likely compressing the exiting C4 nerve roots bilaterally, mild right foraminal stenosis at C4/5 and potential site of irritation of the right C5 nerve root, and C5/6 is normal.
3. There is a report of the CT-guided right C5 nerve root sleeve block on 12 September 2023.
4. The MRI cervical spine report of 13 October 2023 concludes there is minor posterior disc bulge at C3/4, and bilateral severe neural exit foraminal narrowing due to uncovertebral joint arthropathy with impingement of the exiting C4 nerve roots. There is minor posterior disc bulge at C4/5 with severe right and moderate left sided neural exit foraminal narrowing due to uncovertebral joint arthropathy with impingement of the exiting right C5 and possibly left C5 nerve roots, and at the exiting right C7 nerve root.
5. The MRI cervical spine report of 2 May 2024 shows there has been right C6 laminectomy plus decompression and C6/7 discectomy. There remains moderate lobulated herniated disc material at the right paracentral to uncovertebral region which is suspected of still causing impingement of the adjacent exiting right C7 nerve root. Background mild to moderate multilevel degenerative change involving the remainder of the mid levels of the cervical spine with further potential sites of cervical nerve root impingement is recorded.
6. A nerve conduction study report of 27 June 2024 concludes there is neurophysiological evidence of chronic denervation in the C7 innervated muscles more markedly noted in the triceps on the right, suggestive of root pathology. The nerve conduction studies were within normal limits.
7. A CT cervical spine report of 19 October 2024 reveals postsurgical changes and fusion of the C6/7 disc, reduction of the joint space with adjacent endplate sclerosis and osteophytes. Degenerative changes are more significant at C3/4 level.

1. Clinical records of Belmore Medical Centre include Dr Parab's note on 6 September 2023 that the applicant has right thumb and second and half the third finger numbness for two weeks and he is using a splint at night. On examination he has mild neck tenderness.
2. The reason recorded for the visit on 12 September 2023 is for cervical osteoarthritis and foraminal stenosis with radiculopathy, and the doctor notes the applicant is travelling to Las Vegas.
3. Stenosis is noted on 21 September 2023. On 5 October 2023 the applicant's symptoms worsened post-holiday with increased sensitivity and flare up of pins and needles and numbness and burning, and he is likely to go through workers compensation. A workers compensation certificate is issued on 10 October 2023. The applicant has constant numbness throughout the arm at work.
4. There are records that follow regarding treatment of the applicant's cervical spine and the workers compensation claim. On 29 July 2024 the applicant's neck pain has worsened with the symptoms occurring continuously and a diagnosis is noted of chronic regional pain syndrome.

1. The schedule of expenses with invoices attached totals $26,591.95 and includes past surgery expenses, pharmacy and related expenses.

1. The applicant's text messages with Mr Lock are dated 7 June 2023;

(a) the applicant sends a photo of the Paddington site with the floor boards pulled up, he asks at 9.41am if he could get the plumbers in to remove all water and gas pipes from under the floors, and the reply is "Approved";

(b) at 1.40pm on 7 June 2023 the applicant reports he has met with the contractor from Precision Flooring and discusses possibly more timber is needed to replace the joists, the flooring is non-compliant but he will wait for the proposal, and

(c) a further text from the applicant that day reports on the removal of old pipes and gas flues, that the electricians had finished new cabling so all was done except for the floors, and he texts "mentioned the AC electrician to Fr Christopher, also on our very long chat this morning after falling through the floor and nearly smashing my phone again".[2] He then says "I'm sure he heard all the profanities that came from my mouth as I was more worried about the phone than my limbs."[3]

1. The respondent relies on its dispute notices of 28 November 2023 and 12 January 2024.

Dr Vidyasagar Casikar, independent neurosurgeon

1. On 22 December 2023 Dr Casikar provides a report to the respondent and diagnoses a soft tissue injury to the shoulder.
2. Dr Casikar says the symptoms of hypoaesthesia from C5, 6, 7 and C8/T1 are not consistent with the MRI findings and Professor van Gelder's suggestion of a cervical fusion. Because of this inconsistency Dr Casikar's opinion is that perhaps a nerve conduction study should be performed to ascertain whether there is in fact a neurological injury in the cervical spine.
3. Dr Casikar is not very sure the cervical surgery suggested by Professor van Gelder is acceptable as the clinical examination is inconsistent with the radiological findings. Dr Casikar is not convinced the multisegment degenerative disease shown on the MRI is due to his injury.

1. The AB Investigations report of 8 November 2023 attaches photographs of the Paddington site and statements of the applicant, Mr Chris Lock and Mr Michael Habib.
2. In the applicant's signed statement of 6 November 2023 he describes his work with the respondent and the work being carried out at the Paddington site. He describes the injury on 7 June 2023 and his treatment. Initially he felt it was only a very minor injury "however as time went on over the following months the pain and subsequent symptoms of ongoing injury started to become more present."[4]
3. Draft and unsigned statements of Mr Lock are Mr Habib are attached to the report.
4. Also attached are particulars requested and provided by the respondent, the position description - facilities manager, a letter of employment dated 1 July 2020, a letter regarding alteration of work hours dated 12 December 2022, Dr Arjunamani's referral to Associate Professor van Gelder of 10 October 2023, Mr Lock's emails of 6, 7 and 10 September 2023, a national code for personal behaviour dated 2022, the applicant's leave history, screen shots of text messages between the applicant and Mr Lock, and the tax invoice of Lancet Electrical & Automation Pty Ltd.

1. Updated records of the Belmore Medical Centre are with the reply and will be referred to where relevant.

1. The List of Payments shows payments made for the applicant's medical treatment totalling $7,104.57.

1. The applicant made oral submissions which have been recorded and form part of the Commission's record. These are set out below.
2. The applicant submits he sustained a frank injury to his cervical spine.
3. The applicant does not give a perfect history to everybody which if anything is a virtue not a vice as people who experience severe injuries do not give their histories perfectly to every doctor at every point in time, and it is often the case that symptoms are delayed and not reported immediately. There is a clear explanation in this case offered by the applicant.
4. There is no dispute the incident actually happened on 7 June 2023. The applicant relies on his statement where he describes his injury, that Mr Habib comes over and Mr Lock was on notice of the fall.
5. The mechanism of injury from a lay perspective described by the applicant is consistent with force applied to the right side of the neck and with the pathology that is the subject of two surgeries in the past.
6. The applicant was not immediately aware of the extent of the injuries which is consistent with some of the text messages, and he immediately takes over the counter medication which does not solve the problem. The symptoms start to become more persistent until he loses sensation in two fingers progressing to four. He then seeks treatment.
7. The delay in seeking treatment in August or September 2023 is only a matter of months. The applicant has investigations and ultimately consults Professor van Gelder in late 2023 and proceeds to surgery in April and another surgery in May 2024. He has a nerve conduction study and further cervical spine surgery is recommended.
8. Dr Casikar examined the applicant over Zoom which is uncontested although not in his report, and this undercuts the real significance of the weight that can be placed on that report when weighing it up against the Associate Professor van Gelder.
9. Dr Dan takes a pretty consistent history and talks about the numbness, pins and needles and swelling of the hand and range of movement restriction of the right side of the neck which is consistent with the fall. His opinion is it is a significant injury and it is a disc protrusion. This is consistent with the radiology, and there is degenerative change so that there is an aggravation with the symptoms a direct consequence of the subject injury. There are no pre-existing symptoms and there is a frank injury that caused fairly significant pathology in the neck.
10. On 3 January 2024 Associate Professor van Gelder clarifies a typographical error in his report of 30 October 2023 and confirms the nature of the applicant's work and his fall in June 2023 are likely contributing factors.
11. The report of 7 April 2025 includes an important opinion the applicant submits about the deficiencies in Dr Casikar's report where he describes the injury as a soft tissue injury due to the shoulder and inconsistent neurological findings. Most critically it is a Zoom examination and there are some issues with that, most significantly that Dr Casikar fails to appreciate the radiology that shows the C6/7 disc herniation which is completely overlooked. Associate Professor van Gelder and Dr Dan both refer to this. Dr Casikar fails to appreciate the significance of the injury perhaps explaining why he downplays it as a soft tissue injury, which goes to the weight that ought to be given to this report.
12. Dr Casikar in his report completely fails to appreciate what the MRI reveals which is not just a background of degenerative change but a herniation, and this leads to his conclusion of a soft tissue shoulder injury. This opinion is not given in a fair climate and it ought to be put to one side in the applicant's submission.
13. The applicant's statement with the factual report is consistent with the evidence in his later statement. Mr Habib saw the incident happen and significantly says from what he saw the injury and the fall was legitimate.
14. Mr Lock says he received text messages from the applicant in June 2023 and in none of that correspondence did he ever indicate that he had fallen or slipped or hurt himself in any capacity. He attaches some text messages with photos and all of the messages complete the story. On 7 June 2023 the applicant sends a text message to Mr Lock that says;

"I mentioned the AC electrician to Fr Christopher, also on our very long chat this morning after falling through the floor and nearly smashing my phone again.

I'm sure he heard all the profanities that came from my mouth as I was more worried about the phone than my limbs."[5]

1. Mr Lock's statement appears to be misleading and no weight should be put on it, and secondly it is consistent with the idea that there was not as the applicant apprehended at the time a significant injury, again, it is consistent with the later reporting. This is the most contemporaneous document we have.
2. The applicant referred to the clinical records and the first report on 6 September 2023. The applicant then travels to Las Vegas and there is a CT scan and radiculopathy discussed on 12 September 2023. On 5 October 2023 the symptoms have worsened post-holiday with a flare up of pins and needles and it will likely go through workers compensation. On 10 October there is constant numbness recorded throughout the arm at work.
3. There is largely consistent reporting of the injury although it is not said in the same way as in his statement. The doctor presumably has a busy practice, he has not been cross examined about his usual practice in recording clinical notes, and he is not interested in preserving forensic accounts of the injury. His treatment of the patient is a different context and it is not a verbatim reporting, it is a shorthand account of what has happened.
4. It cannot be drawn from this alone some inference of how the injury happened and it is largely consistent even though there are imperfections in the way in which the history is given. The applicant submits that imperfections if anything support reliability as there is no concerted effort to give a complete account of how the injury happens.
5. The fact the applicant does not say he was injured in this specific manner, with the applicant's largely uncontested account supported by Mr Habib who saw the fall, and which is entirely consistent with the mechanism of injury to the neck supports the reliability of his account of the injury.

1. The respondent made oral submissions which have been recorded and form part of the Commission's record. These are set out below.
2. In his statement the applicant says in terms of symptomatology that immediately after the injury he fell and hit the right side of his neck as well as his right armpit on the timber and concrete strip flooring as he had his hands out to catch his fall. He says he sustained permanent impairment to his neck. He goes on to say in terms of symptomatology that immediately after the injury he experienced bruising and tenderness around the right side of his chest, neck and armpit as well as his right knee.
3. This evidence of bruising and tenderness of the neck and the injury is not supported by the other accounts in the other statements. The applicant's earlier statement he says he initially felt fine and he felt it was only a very minor injury, and he was treating it for some time with Voltaren and other over the counter remedies. There is no mention of bruising or tenderness and no specific mention of the neck in this statement.
4. The text messages the applicant refers to do not support the account in applicant's recent statement that there was bruising and tenderness around the neck immediately after the injury. The applicant refers to his limbs and the respondent submits the neck could not possibly be fairly interpreted as a limb.
5. This does not support the applicant's statement evidence including tenderness or bruising around the neck, and there is no support in the subsequent contemporaneous evidence of pain and symptoms relating to that body part.
6. The applicant has seen the general practitioner on four occasions after the injury on 7 June 2023; 17 June 2023, 1 July 2023, 24 July 2023 and again on 25 August 2023. Despite those four attendances and the applicant's statement evidence that there was immediate tenderness and bruising in the neck and that pain continued, that has not been mentioned at all to his general practitioner those four times.
7. The applicant's statement evidence is that around August or September 2023 he consulted his treating doctors at Belmore Medical as he was starting to lose sensation in his right thumb and index finger, he complained of constant neck pain and not being able to tilt his head up without a lot of pain. However if this is interpreted as the pain being constant, this pain, bruising and tenderness in the neck was not mentioned on four occasions. If it was not constant between 7 June 2023 and 6 September 2023 then this does not support the onset of an injury as alleged. Either way the respondent's submission is the applicant's statement evidence and the objective treating evidence is not consistent.
8. The first treating doctor's note where the neck is mentioned is on 6 September 2023 where he says he has right thumb and second and third finger numbness for the last two weeks, so from about the end of August which is a long way from the date of injury on 7 June 2023. The applicant is using a splint at night with the reason for visit being question mark cervical radiculopathy.
9. There is no reference to the fall whatsoever in the treating notes and it is quite clear the treating notes are not consistent with the applicant's evidence as he does not mention the fall and the dates are completely inconsistent in terms of the onset of the thumb and finger numbness of two weeks. This is not the only account of what happened made by the general practitioner.
10. There is a reference to travelling to Las Vegas on 12 September 2023 and worse symptoms noted on 5 October 2023 after that holiday, likely going through workers compensation. The history on 10 October 2023 is constant numbness throughout the arm at work, works at historic church, rings bell, so again there is no reference whatsoever to the fall, although there is an acknowledgement of the workers compensation claim and a certificate. The only real possible reference to a mechanism of injury from work is from ringing the bell.
11. The referral from the general practitioner to Associate Professor van Gelder on 10 October 2023 quite clearly says the applicant presents with paraesthesia, numbness and reduced power of his right upper limb since 23 August 2023 at work and he pulls heavy bells as part of his job. This is not a pleaded injury and this history is totally inconsistent with the pleaded injury and it does not refer to a fall, it provides no timeline and provides a completely different cause for the onset of this right upper limb pain and paraesthesia.
12. The respondent submits that when a doctor writes to another doctor, especially a general practitioner to a specialist, they take care in terms of the history they provide as to the cause of symptomatology and the background of injury. This completely does away with the applicant's submissions of the lack of reliability of the clinical notes as he has gone into print to a fellow doctor and makes no reference to the actual mechanism of injury pleaded, with a different mechanism of injury and a completely difference time of onset, some two and a half months later.
13. This is unexplained by the general practitioner and there is no attempt from the applicant to obtain a report from him to acknowledge inconsistency in reporting the onset of symptoms due to pulling heavy bells, there is nothing.
14. Dovetailing with that submission is the Certificates of capacity from the same general practitioner commencing on 10 October 2023 with a diagnosis of C5/6 radiculopathy and a date of injury of 23 October 2023, nowhere near 7 June 2023. How the injuries relate to work is completely absent. The respondent's submission is that the most accurate account of how the general practitioner considers what has occurred is the referral letter to Associate Professor van Gelder, from pulling the bell in August 2023.
15. The subsequent certificates of capacity do not proceed to correct this and they do not provide an opinion that the injury was caused as alleged. The respondent then refers to the further ten certificates between 17 October 2023 and 30 May 2024 that are in the same terms.
16. The treating notes, the referral letter and the certificates provide no resemblance to or support for the mechanism of injury.
17. The other treating evidence of concern the respondent submits is Associate Professor van Gelder's report dated 30 October 2023 where he says the applicant explained he had a fall through a rotted floor in a building in June and symptoms came on a few weeks later when he developed neck pain.
18. The respondent submits that is not consistent with the applicant's statement and it is not consistent on causation that the onset of symptomatology would be a few weeks later if you accept it is within proximity of the fall.
19. In Dr Casikar's report he also takes a history of injuries to the right arm, right thumb and index finger and two months later and he developed pins and needles. This is again another history that is not supportive the applicant's statement or of causation given the delay.
20. Dr Dutta's report dated 6 August 2024 says the applicant has got pain in the right hand and wrist since September 2023 and rather bizarrely the respondent submits says, this was secondary to an injury when he fell through the floor which he obtained pain per and injured his neck on the right side right arm pit and pectoralis muscle. The respondent submits those two sentences cannot be reconciled, but it is quite clear the history he has taken from the applicant or the general practitioner in a referral letter of pain only beginning in September 2023, long after the injury in June.
21. Dr Dan takes a history similar to the applicant's recent statement and that he started losing the feeling two or three months later, which is not consistent with the applicant's statement that he had constant neck pain.
22. There are inconsistencies in the histories on the onset of hand pain or immediate bruising, tenderness of the neck or constant pain since the injury this is not borne out by the objective evidence.
23. Whether any of these doctors provide an opinion relying on an incorrect history, whether they have grappled with the inconsistent onset of symptomatology and the cause in the treating notes, or the delay in the onset of the neck symptoms, depending on which version you accept, are significant and numerous inconsistencies where the applicant bears the onus to prove an actual persuasion.
24. The respondent's submission is these inconsistencies have not been corrected in terms of a report from the general practitioner and they have not been grappled with by any of the applicant's specialists or the independent medical expert.
25. For those reasons you would not find an injury to the neck as alleged in June 2023. If you accept the claim in terms of findings the claims for surgery will obviously follow.

1. The respondent's submission proceeds on the basis that the applicant should have been alive to the fact that he might be litigating and he needs to have had a perfect history. You would be satisfied the applicant has suffered an injury.
2. Submissions have been made on the slight inconsistencies. The first one the respondent talks about is bruising and tenderness that was not mentioned in the first statement to an investigator although everything else is right and this is fairly trifling.
3. The text message does not say the applicant hurt his neck, as if at the time of experiencing something quite serious, falling through the floor, and he should be alive to the fact that he might be criticised for not referring to his pain everywhere in his body. There should not be real weight placed on that submission.
4. The applicant complains to the general practitioner on 6 September 2023 and the submission made is that he should have mentioned to the general practitioner what happened or the numbness and pain immediately is not a premise that can be accepted. The idea that everything the applicant said to a general practitioner on a particular day must be verbatim recorded in the clinical notes should not be accepted is the whole point of Mason v Demasi.[6]
5. Firstly you do not know that he did not, secondly it is consistent with him getting treatment by way of over the counter medications, and thirdly the context of those four attendances is for unrelated issues and you do not know whether he says; "by the way I am also having troubles with my neck". The inference that this can somehow be used to show he did not suffer the injury is the very point of Mason v Demasi.
6. He complains on 6 September 2023 of numbness which did not come up straight away. This is not inconsistent with his statement that he was not aware of the extent of the injury. He had pain and subsequent symptoms, initially lost sensation and developed pins and needles. He does not give a clear timeline about precisely when all of these things came on and that is to be expected. It is fanciful to expect the applicant should be expected to get the week right about particular symptoms.
7. The respondent says if it was such a serious injury then why did it take so long to report it, but there is no medical evidence for that. A lay assessment cannot be made about the seriousness of an injury and why symptoms did not come an earlier, or when he should refer that to a doctor who says it was that type of mechanism of injury and that type of pathology and you should have had symptoms by a particular time. That is pure speculation the applicant submits.
8. Dealing with the ringing of the bell, there are multiple things that can be consistent. Firstly he has had the injury, he is back at work, and ringing the bell could be purely aggravating the initial injury. It is not enough to say the mechanism of injury as pleaded never happened.
9. The respondent says the referral letter to Associate Professor van Gelder puts to bed any Mason v Demasi submissions, that is probably notoriously not the case but leaving that issue to one side, he pulls heavy bells as part of his job. He does not say he was injured as a result.
10. This is a referral in the context in which he is working and presumably he is ringing bells as part of his job and he has ongoing pain and he gets a referral for someone to assess that. The idea that this is inconsistent with the pleaded case is not made out by the language, he pulls heavy bells as part of his job. He does not say and by the way there was an injury in June 2023 and gives the full details as the applicant now gives in his statement, but it is not inconsistent with the pleased case at all.
11. The respondent says there is no report from a general practitioner dealing with this as if that is the applicant's fault. The respondent is asking you to draw inferences on the basis of the clinical material. While the applicant has the persuasive onus that there was an injury, the respondent cannot say on the one hand draw inferences against the applicant from those notes then complain we do not have a report to deal with it.
12. No weight should be put on the Certificate of capacity signed on 10 October 2023 with the date of injury of 23 October 2023 as the applicant submits as that cannot be right and so no weight can be placed on that certificate.
13. The applicant has made previously submissions regarding Dr Casikar's report.
14. The referral to the pain specialist on 27 July 2024 says the applicant has had neck pain with numbness along the fingers sustained from an injury in June. That is completely consistent with the applicant's case. It may be the doctor ended up getting it slightly incorrect in the way he recorded it but he got it correct in this referral saying there were symptoms from June 2023. This is the doctor who provides the earlier referral that refers to ringing the bell and so this is a doctor you cannot put real weight on as Mason v Demasi warns against doing.

Did the applicant sustain a cervical spine injury on 7 June 2023

1. There is no dispute the applicant fell through the floor at the respondent's Paddington premises on 7 June 2023 in the course of his employment.
2. The applicant has the onus to prove on the balance of probabilities he sustained a cervical spine injury that day on a commonsense evaluation of the causal chain.[7]
3. The relevant principles to discharge that onus were discussed in Nguyen v Cosmopolitan Homes,[8] including that the Commission must feel actual persuasion of the occurrence or existence of a fact that is found, and where the probability of it having occurred is less than it not having occurred, it is to be treated as not having occurred.[9]
4. 'Injury' in s 4(a) of the 1987 Act means a personal injury arising out of or in the course of employment. No compensation is payable in respect of an injury unless the employment concerned was a substantial contributing factor to the injury in accordance with s 9A of the 1987 Act.
5. What is required to constitute a personal 'injury' is "a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state."[10] While suddenness is not necessary for there to be an injury, it may be relevant in distinguishing a physiological change from the natural progression of an underlying disease.[11]
6. The weight of evidence supports a finding that the applicant sustained a cervical spine injury on 7 June 2023 in accordance with s 4(a) and s 9A of the 1987 Act.
7. The applicant's statement evidence on 18 September 2025 is that he hit the right side of his neck on 7 June 2023 and immediately experienced bruising and tenderness. He was not initially aware of the extent of his injuries, however over the following months the pain and subsequent symptoms started to become more persistent.
8. Dr Dan's opinion is the applicant suffered a significant injury which caused a degree of disc protrusion on an already age consistent degenerative change effected spine, which caused the symptoms of which he complains. There is a direct association between the condition found on examination and the injuries sustained the doctor says, and the subject accident was the main contributing factor to his injury.
9. Associate Professor van Gelder notes the acute onset of the applicant's symptoms. His opinion is the applicant's cervical spine injury was caused by his work-related injury in June 2023 with a secondary contribution to his cervical degenerative disease that predisposed him to cervical disc herniation because of his work with the respondent.
10. Although the applicant's CT and MRI scans show age-related cervical degenerative changes there is no evidence on 7 June 2023 the applicant had pre-existing cervical spine symptoms. Where a sudden identifiable pathological change also causes or can be characterised as an aggravation of a disease, that will not prevent it being a personal injury.[12]
11. Associate Professor van Gelder's opinion is that the applicant's employment was the main contributing factor to his cervical spine injury and the reason he had to have cervical disc surgery in 2024.
12. On 2 December 2023 Dr Casikar notes the background of a fall through a rotten timber floor on 6 March 2023, later 9 October 2023, with injuries to the right arm, arm pit, right thumb and index finger (injuries aside from the neck are not relevant in these proceedings), and he refers to loss of sensation in all four fingers.
13. Dr Casikar notes on examination the applicant's neck movements are reduced in all directions, refers to the MRI cervical spine of 13 October 2023, finds the clinical examination is inconsistent with the radiological findings, and diagnoses a soft tissue injury to the shoulder.
14. Associate Professor van Gelder comments that Dr Casikar's examination was limited as it was conducted by Zoom, there was no description of obvious neurological signs such as changes in reflexes, weakness and muscle wasting, and the disc herniation reported by the radiologist was overlooked.
15. I prefer Associate Professor van Gelder's opinion to that of Dr Casikar for the above reasons.
16. I accept it is more likely than not that the mechanism of the applicant's injury is the force applied to the right side of his neck in the fall on 7 June 2023 as the applicant submits.
17. The respondent's submission is the inconsistencies in the evidence on the mechanism of injury in the applicant's statements, the treating general practitioner notes, the referral letter to Associate Professor van Gelder on 10 October 2023 and the Certificates of capacity are significant, numerous and unexplained and his claim is not made out.
18. I do not accept that submission for the reasons below.
19. There are inconsistencies in his evidence as the applicant concedes, however on a consideration of all of the evidence I accept the applicant's statement evidence that he sustained a sudden identifiable physiological change in his neck on 7 June 2023.
20. The applicant's statements of 6 November 2023 and 18 September 2025 are generally consistent although the later statement includes that he immediately after the injury experienced bruising and tenderness around the right side of his chest, neck and armpit as well as his right knee.
21. In his first statement the applicant does not refer to injuring his neck on 7 June 2023 as the respondent submits, however he does not refer to any immediate physical injuries. The applicant says in his first statement he initially felt fine and felt it was only a very minor injury.
22. I do not accept the applicant's description of his symptoms immediately after the injury in his later statement is unsupported by his earlier statement, as his consistent evidence is that he believed the injury was only very minor until the symptoms worsened in the following months.
23. The applicant's text messages on 7 June 2023 refer to falling through the floor and nearly smashing his phone, and being more worried about his phone than his limbs. Mr Habib came to assist the applicant get out of where he had fallen. The fall itself is not disputed and I accept physical injuries are likely to have resulted from the nature of the fall on a common sense basis.
24. There is no reference in the applicant's text messages to bruising and tenderness around the neck as the respondent submits, although as in his first statement there is no reference made to any physical injury that day. This is consistent with the applicant's evidence that he initially felt it was a very minor injury.
25. The applicant's statement evidence is that for some time after the fall in June 2023 he treated himself by taking Nurofen, Voltaren and other over the counter remedies.
26. Over the following weeks the pain and subsequent symptoms started to become more persistent the applicant says, including constant neck pain and then loss of sensation in his fingers.
27. The respondent's submission is the applicant attended on his general practitioner four times after the fall on 7 June 2023 until the first record of neck pain and symptoms was made on 6 September 2023. In that period the records show the applicant attended the practice for injections and treatment of an unrelated condition as well as for a flu vaccination.
28. On 6 September 2023 the applicant first consults his general practitioner about his symptoms. Mild neck tenderness is found on examination, and right thumb and finger numbness for two weeks and the use of a splint at night are first recorded.
29. Dr Parab refers the applicant for a CT cervical spine on 8 September 2023 with a history of C5/6 radiculopathy. Dr Parab requests a CT guided steroid injection on 12 September 2023. Dr Arjunamani issues the first certificate of capacity on 10 October 2023 and refers the applicant to Associate Professor van Gelder.
30. I do not agree the applicant provides no explanation for any inconsistency in reporting his symptoms to a general practitioner as the respondent submits.
31. The applicant's statement evidence is that he initially felt it was only a very minor injury which he treated with painkillers and over the counter remedies until he developed loss of sensation in his fingers. His evidence is that he told Mr Lock not to lodge a workers compensation claim as he thought perhaps his injuries were only minor.
32. The applicant's consistent evidence is that his paraesthesia symptoms became worse in about August 2023. This is not inconsistent with his statement evidence of experiencing bruising and tenderness in his neck at the time of the fall followed by constant pain, and I accept the applicant's submission in this regard.
33. The respondent submits the general practitioner does not record details of the fall on 7 June 2023.
34. The applicant submits and I accept that inconsistencies between the applicant's evidence and a general practitioner's records ought to be treated with caution. It is accepted a busy general practitioner may fail to record all relevant matters in the particular circumstances of a case. There is no evidence of the circumstances of the consultation, the manner in which the history was obtained, the time taken and the accuracy of the recording, and a record is likely to be a summary rather than a verbatim recording.[13] An explanation is provided by the applicant in relation to the delay in consulting his general practitioner as discussed above.
35. The respondent submits the most accurate account of how the general practitioner considers what has occurred is in the record made on 10 October 2023 and the referral letter of that date. While this may appear as Dr Arjunamani's account of what occurred, I do not accept that account is accurate on the basis of the available evidence.
36. Dr Arjunamani's record on 10 October 2023 is that the applicant "rings bell"[14] and his letter referring the applicant to Associate Professor van Gelder on that date says the applicant presents with paraesthesia, numbness and reduced power of his right upper limb since August 23rd at work and "[h]e pulls heavy bells as part of his job".[15] I am not persuaded the cause of the injury is bell ringing.
37. I do not agree with the respondent's submission that a letter of referral from a general practitioner to a specialist will necessarily provide a careful and accurate history of the cause of symptoms and the background of an injury, noting the caution with which a general practitioner's records should be treated generally discussed in Mason v Demasi.
38. It appears Dr Arjunamani had seen the applicant once before 10 October 2023 and did not have the benefit of earlier or long term consultations with him.
39. The weight of the available evidence is that bell ringing at the Church after 7 June 2023 caused the applicant difficulty as he was doing that only using his left arm.[16] Following his examination of the applicant Associate Professor van Gelder takes a more detailed history and in his report of 30 October 2023 records the applicant explains he had a fall through a rotted floor in June 2023, and that he does bell ringing only using his left arm as a result of his injuries.
40. Dr Arjunamani's Certificates of capacity which commence on 10 October 2023 include the diagnosis of C5/6 radiculopathy with the date of injury of 23 October 2023. As the applicant submits this date is after the first Certificate is issued. The date the applicant was first seen for the injury at that practice is noted as 10 October 2023 which also appears to be inaccurate. There is no information included as the respondent submits on how the injury is related to the applicant's work.
41. Accordingly I do not place great weight on the information contained in the Certificates, the record made by Dr Arjunamani on 10 October 2023, or in the referral letter of 10 October 2023 that only refers to bell ringing at work.
42. Associate Professor van Gelder in his report of 30 October 2023 notes the applicant's cervical radicular symptoms came on a few weeks after the fall when the applicant developed neck pain and could not move his neck. Dr Dutta refers to right hand and wrist pain since September 2023 secondary to the June 2023 fall when he injured his neck. Dr Dan notes the applicant had constant neck pain and consulted his general practitioner when he started losing feeling in the right thumb and index fingers which felt constantly cold. Dr Casikar notes the applicant developed pins and needles about two months after the injury. The applicant's statement evidence is that the loss of sensation in his fingers progressed and he developed pins and needles.
43. I do not accept as the respondent submits that the development of symptoms of pins and needles and an increasing loss of sensation in his fingers is inconsistent with the applicant's statement evidence of immediate bruising and tenderness and constant neck pain from the fall in June 2023.
44. I am persuaded on the balance of probabilities the applicant sustained a cervical spine injury on 7 June 2023 in accordance with s 4(a) of the 1987 Act, and the employment with the respondent was the substantial contributing factor in accordance with s 9A of the Act.

Is the applicant entitled to payment of medical or related expenses

1. As I have found the applicant sustained a cervical spine injury on 7 June 2023, he is entitled to the payment of reasonably necessary medical or related expenses as a result of the injury pursuant to s 60 of the 1987 Act.
2. As the respondent notes the cost of the past surgeries will follow as the applicant has succeeded in establishing a cervical spine injury on 7 June 2023.
3. The surgeries on 24 April 2024 and 13 May 2024 I find on the evidence to have been reasonably necessary medical treatment as a result of the applicant's injury on 7 June 2023.
4. The applicant initially took pain medication, had physiotherapy treatment and was not making progress. He had cervical spine CT and MRI scans and a CT guided nerve root sleeve block.
5. He had a C6/7 right cervical foraminotomy and discectomy operation on 24 April 2024, and a C6/7 anterior cervical discectomy and fusion on 13 May 2024, following which there was some further improvement. Unfortunately the applicant has ongoing radiculopathy.
6. Associate Professor van Gelder recommended and carried out the two cervical spine surgeries. Dr Dan's opinion is the surgery was appropriate.
7. Dr Casikar on 22 December 2023 said the applicant's symptoms of hypoaesthesia from C5, 6, 7 and C8/T1 are not consistent with the MRI findings and Associate Professor van Gelder's suggestion for a cervical fusion, and he suggested a nerve conduction study should be performed. This study was carried out on 27 June 2024 and showed C7 radiculopathy.[17]
8. The evidence is that alternative treatment has been ineffective, the surgeries were appropriate with actual or potential effectiveness, they are accepted by the weight of medical experts and no issue is apparent on regulated costs.[18]
9. The applicant is entitled to the payment of reasonably necessary medical or related expenses arising from his cervical spine injury including the cost of surgery on 24 April 2024 and 13 May 2024 pursuant to s 60 of the 1987 Act on production of accounts, invoices and/or Medicare Notice of Charge.

1. The applicant sustained a cervical spine injury on 7 June 2023 pursuant to s 4 and s 9A of the 1987 Act.
2. The respondent is to pay the applicant's reasonably necessary medical or related expenses arising from his cervical spine injury on 7 June 2023, including the cost of surgery on 24 April 2024 and 13 May 2024, pursuant to s 60 of the 1987 Act on production of accounts, invoices and/or Medicare Notice of Charge.

[6] Mason v Demasi [2009] NSWCA 227.

[7] Kooragang Cement Ltd v Bates (1994) 35 NSWLR 452; (1994) 10 NSWCCR 796.

[8] [2008] NSWCA 246 (Nguyen).

[10] Trustees of the Society of St Vincent de Paul (NSW) v Maxwell James Kear as administrator of the estate of Anthony John Kear [2014] NSWWCCPD 47.

[11] Ky v Blue Leaf Food Group Pty Ltd [2016] NSWWCCPD 55 at [55].

[12] Yum Restaurants Pty Limited t/as Pizza Hut Restaurants v Watters [2010] NSWWCCPD 31.

[13] Mason v Demasi [2009] NSWCA 227 at [2].

[18] Diab v NRMA Ltd [2014] NSWWCCPD 72.