austlii:nsw/NSWPIC/2025/380
General information, not legal advice.
NSWPIC
2025-08-06
Original judgment source is linked above.
2 April 2009. 2. As a result of his injury, for the period from 7 November 2017 to date and continuing, the applicant has required reasonably necessary gratuitous domestic assistance provided by his partner, Ms Maryanne Thorman at an average rate of 22.5 hours per week. 3. For the above period, the respondent has been paying for gratuitous domestic assistance at a rate of 10.5 hours per week. 4. Pursuant to s 60AA of the Workers Compensation Act 1987:
(a) the respondent is to pay the applicant's gratuitous domestic assistance in the amount of $193,833.21 calculated as follows:
AGREED S60AA HOURLY RATE
Less total gratuitous assistance paid by GIO as per the list of payments dated 15 May 2025
(b) the respondent is to pay for gratuitous care for 22.5 hours per week from 16 May 2025 to date and continuing at the relevant statutory rate from time to time;
(c) payments made in accordance with Order 4(a) are to be paid to Ms Maryanne Thorman, and
(d) payments made in accordance with Order 4(b) above are payable to Ms Maryanne Thorman, or the person otherwise providing the care.
A brief statement is attached setting out the Commission's reasons for the determination
24 June 2024. 5. The circumstances of the applicant's injury are set out at [10] of his initial statement, where he notes that on 2 April 2009, he was checking the load on the back of his truck by climbing onto its tray. The applicant had just sat down on the tray when the truck suddenly rolled forward approximately 1m, causing him to slip and land on the roadway on his upper back. 6. There is no question the applicant's condition gradually worsened, and between December 2009 and 2012, he underwent multiple surgical procedures including but not limited to an L3/4 disc replacement procedure and L5/S1 instrumental fusion. 7. Additionally, the applicant suffered various infections and complications from his surgery leaving him with serious ongoing pain, discomfort, restriction of movement and negative impact on his activities of daily living. 8. In the applicant's most recent statement, dated 23 September 2023, he notes his back problems and pain have continued to deteriorate since the consent orders were made in the Workers Compensation Commission in September 2017. The applicant noted Ms Thorman had continued to carry out domestic assistance for him and had maintained weekly diaries of the personal care and domestic assistance she had carried out. The applicant states those diaries were submitted to the respondent's insurer on a regular basis; however, the respondent has not increased the amount it has paid for the domestic assistance provided to the applicant. 9. Altogether, the applicant has had seven surgeries to his spine, including an L1/2 fusion with disc spacer and L3 to S1 fusion.
(a) Application to Resolve a Dispute (Application);
(b) Reply;
(c) respondent's Application to Lodge Additional Documents (ALAD) dated 3 February 2025;
(d) applicant's ALAD dated 4 February 2025;
(e) applicant's ALAD dated 8 May 2025;
(f) respondent's ALAD dated 8 May 2025;
(g) a list of payments as at 1 May 2025;
(h) updated list of payments effective 15 May 2025;
(i) applicant's aide-mémoire lodged at the hearing;
(j) respondent's aide-mémoire lodged at the hearing, and
(k) respondent's Schedule of Quantum.
The amount payable for domestic assistance provided to the applicant
"(1) If, as a result of an injury received by a worker, it is reasonably necessary that any domestic assistance is provided for an injured worker, the worker's employer is liable to pay, in addition to any other compensation under this Act, the cost of that assistance if:
(a) a medical practitioner has certified, on the basis of a functional assessment of the worker, that it is reasonably necessary that the assistance be provided and that the necessity for the assistance to be provided arises as a direct result of the injury, and
(b) the assistance would not be provided for the worker but for the injury (because the worker provided the domestic assistance before the injury), and
(c) the injury to the worker has resulted in a degree of permanent impairment of the worker of at least 15% while the assistance is to be provided on a temporary basis as provided by subsection (2), and
(d) the assistance is provided in accordance with a care plan established by the insurer in accordance with the Workers Compensation Guidelines.
(2) Compensation is not payable under this section for gratuitous domestic assistance unless the person who provides the assistance has lost income or forgone employment as a result of providing the assistance.
(3) Compensation payable under this section for gratuitous domestic assistance is payable as if the cost of that assistance was such sum as may be applicable under s 61(2) in respect of the assistance concerned."
Ms Cunningham and Mr Toovey. However, in circumstances where the question of any deterioration is in issue, there is some strength in an expert being able to compare their own observations across some seven years. 11. Each of the OTs has set out useful and detailed reports regarding their observations and findings. In determining the level of reasonably necessary assistance, it is necessary to first examine the findings on functional examination over time to assess whether the applicant has suffered any serious decline since the making of the consent orders in late 2017. The OTs each make comments on their findings in relation to the applicant's condition under specific headings in their reports. It is appropriate to deal with those functional categories in turn.
Ms Worton noted the applicant's movements to be "slow and stiff, and he tended to hold furniture and fixtures throughout" mobilising. The applicant recalled having five falls in the preceding six months. 2. On balance, I accept the applicant had suffered a worsening of his mobility over the period between 2017 and present. The observations of both OTs support a finding that he is capable of walking reduced distances and does so in a less steady fashion than in 2017.
"...Mr Plater has become increasingly dependent on Maryanne Thorman since 2017 and has ceased to complete tasks, such as very basic meal preparation and very short distance driving tasks, which has resulted in his reduced tolerance for activity and subsequent deconditioning causing an increase in support hours provided by Maryanne."
Ms Thorman, one might ask "Is that not a consequence of his injury?" This inquiry is a question of causation, requiring a commonsense evaluation of the causal chain. Such evaluation plainly leads back to the applicant's injury, and there is nothing which is seriously suggested as having broken the chain of causation between the injury and the applicant's current status. As such, I accept there has been a serious deterioration in the applicant's capacity to carry out domestic tasks since 2017, leading to a materially greater reliance on Ms Thorman.
"I consider that the hours recommended in section 8.0 [of her report] would have been required from the date of agreement on 7 November 2017. The hours supported have not taken into consideration any agreement for gratuitous care and are calculated as total support required."
Ms Worton's individual findings on assessment are to be disregarded. 3. Rather, it is necessary to examine the categories of care provided to determine the amount which is reasonably necessary. Such a task will involve an assessment of whether the deterioration in the applicant's condition has led to an increased requirement for care. For the purposes of this exercise, it is convenient to use the categories set out in the executive summary of Ms Collins' most recent report, which are set out on p 101 of the Application. Dealing with each in turn, I make the following findings.
"People are social beings, and most of us appreciate the company of family, friends and colleagues. But the benefits we derive from that society is not a service provided by those others to us. Nor can we, as I have said, provide that support to ourselves."
Ms Thorman with the procedures which they adopt in attending to the applicant's needs. It is apparent that although his condition has deteriorated since 2017, the applicant already required a large degree of assistance when the consent orders were entered into, a proposition with which Ms Collins plainly agrees, as she has not increased the level of care under this category which she believes is reasonably necessary.
Ms Collins' assessment to be reasonable, and an award at the rate of 3 hours per week for past and future will be made.
Ms Collins' assessment excessive in the circumstances and allow 1 hour per week for the past and future.
Ms Thorman used to attend to shopping together, I find Ms Worton's assessment inadequate. Ms Collins allowed an additional 1 hour for shopping, noting the total time spent on this activity by Ms Thorman was 2 hours. On balance, I do not believe it is appropriate to allocate half of the total time spent shopping as additional to that which would otherwise have been carried out, as in my view there will always be joint items purchased when people shop together, rather than a strict 50:50 delineation between time spent shopping for one partner and the other. Doing the best I can, I find a past and future allowance for this component of 45 minutes per week is appropriate.
Ms Collins assessed this requirement at 2.5 hours per week, noting the applicant often had to travel to Kempsey for medical and other appointments, which is 25 minutes away. 2. For her part, Ms Worton broadly agreed with the requirement for such assistance, however, did not quantify it and instead recommended an OT driving assessment. 3. Given only Ms Collins has quantified this component, and Ms Worton has not indicated it was inappropriate to do so despite preferring the applicant undergo an assessment, I accept
Ms Collins' view and will allow the claimed 2.5 hours per week for this category of the claim.
Less total gratuitous assistance paid by GIO as per the list of payments dated 15 May 2025
Ms Thorman from the date of this decision at the rate of 22.5 hours per week.
Plater
Scrappy Joes Metal Recycling Pty Ltd [2025] NSWPIC 380;
(1994) 35 NSWLR 452