(a) while she had suffered advanced degenerative changes in her knee prior to the June 2015 incident, she was asymptomatic;

(b) the June 2015 incident resulted in an aggravation of her pre-existing condition;

(c) she has remained symptomatic since the June 2015 incident;

(d) her medical expert, Dr Le Leu, diagnosed her in 2023 as still suffering from an exacerbation of the previously asymptomatic advanced degeneration of her right knee;

(e) the opinions of IRT's medical experts, Dr Miniter and Dr Mills, that any aggravation in her pre-existing condition should have resolved long ago, are unsupported by any explanation;

(f) the prognosis for her knee is poor and she needs a knee replacement; and

(g) her claim remains accepted by IRT, which has not sought leave to reject the claim. Accordingly, Ms Skanthan is entitled to recover all reasonable treatment expenses relating to her claim.

(a) while the June 2015 injury remains accepted, Ms Skanthan has not sought to be paid, and no payments have been made, with respect to that injury in around 10 years;

(b) IRT's medical expert, Dr Miniter, considered that any aggravation of Ms Skanthan's pre-existing condition in her right knee would have resolved within three months and she now simply has severe arthritic disease in her knee (and in her other knee and lower back);

(c) the opinion of IRT's medical expert, Dr Miniter, should be preferred to the opinion of Dr Le Leu with respect to Ms Skanthan's treatment needs for her claimed orthopaedic injury, given that Dr Miniter has relevant specialist expertise as an orthopaedic surgeon, as compared to Dr Le Leu, who is an occupational physician; and

(d) an examination of each of the invoices that Ms Skanthan relies on in support of her claim shows that the claimed medical treatment was not received in relation to the June 2015 injury.

1. The two key legislative provisions governing my consideration of the parties' positions are ss 70 and 134 of the WC Act.
2. Subsection 134(1) of the WC Act provides that:

If a worker makes a claim in relation to an injury for which compensation is payable under the Act, the licensed insurer is liable to pay ... compensation for costs in relation to the injury until the insurer rejects or settles the claim.

1. I note that the concept of a 'claim' for the purposes of s 134 of the WC Act refers to the whole of the claim Ms Skanthan made in 2015 and not to the present demand that Ms Skanthan makes for the payment of medical treatment costs: Stowe Australia Pty Ltd v Kelly [2013] ACTCA 18 at [44].
2. As Ms Skanthan notes, her claim for the 2015 injury was accepted by CGU and has not been rejected or settled. Accordingly, CGU remains liable to pay compensation for costs in relation to that injury.
3. 'Compensation for costs' refers to compensation to which Ms Skanthan is entitled under Part 4.5 of the WC Act. Relevantly, this includes a claim for medical treatment under s 70 of the WC Act. That provision provides that IRT is liable to pay the cost of medical treatment reasonably received in relation to the injury.
4. Thus, while CGU remains liable to pay compensation for costs in relation to the 2015 injury, it is only liable to pay the costs which Ms Skanthan seeks to recover if they are for medical treatment in relation to the 2015 injury. The burden of proving that fact rested with Ms Skanthan: r 3950, Court Procedures Rules 2006 (CPRs).

1. Ms Skanthan has suffered three workplace injuries. She suffered:

(a) an injury to her back whilst working for IRT in December 2014;

(b) the 2015 injury; and

(c) a second injury to her back in 2021.

1. She also suffers from degenerative osteoarthritis in both her knees and back, and has done so since at least 2015.
2. The parties tendered expert medical evidence and other clinical records and reports in relation to Ms Skanthan's various medical conditions. I have considered that evidence below.

1. Dr Raymond Wallace, orthopaedic surgeon, prepared a report dated 19 October 2015 at the request of CGU. Dr Wallace examined Ms Skanthan on 7 October 2015 following the June 2015 incident.
2. Dr Wallace noted that Ms Skanthan underwent MRI investigation on 30 July 2015, which showed significant tricompartmental osteoarthritis in the right knee, particularly affecting the medial compartment, as well as joint effusion (accumulation of excess fluid) and chondromalacia (softening and deterioration of cartilage) at and around the knee joint.
3. He commented that Ms Skanthan reported significant improvement in her right knee symptoms since the June 2015 incident but that she complained of constant aching pain at the infrapatellar region of her right knee.
4. Dr Wallace concluded that Ms Skanthan had suffered a soft tissue injury in her right knee, and aggravation of the pre-existing degenerative tricompartmental osteoarthritis in that knee, as a result of the June 2015 incident. Ms Skanthan denied (and continued at the hearing, without contradiction, to deny) that she had suffered any history of symptoms in her right knee prior to the incident and Dr Wallace considered that the incident was the main contributing factor to her knee condition at the time of preparing his report. He considered that it was likely that her condition would improve with a conservative regimen of treatment over the following two months.
5. Dr Wallace saw Ms Skanthan again on 12 May 2022, that time in relation to the back injury that Ms Skanthan suffered at work in September 2021. Dr Wallace's report, dated 20 May 2022, was prepared at the request of IRT's then workers compensation insurer, QBE Insurance. Ms Skanthan complained of intermittent aching pain in her lumbar spine, radiating to the right buttock and right leg.
6. Dr Wallace concluded that Ms Skanthan had suffered a musculoligamentous strain of her lumbar spine and aggravation of pre-existing multilevel degenerative lumbar spondylosis (age-related degeneration of the vertebrae and discs in the lower back) as a result of the work incident. He considered that the aggravation was likely to cease over the following three months.
7. Dr Wallace also noted that Ms Skanthan had previously suffered an injury to her back in December 2014 but that Ms Skanthan reported that her symptoms in relation to that injury settled with conservative treatment. Dr Wallace considered that, similarly, Ms Skanthan had a good prognosis for ongoing recovery of function in relation to her 2021 back injury with conservative treatment over a six month period.
8. Dr Leon Le Leu, occupational physician, saw Ms Skanthan on 6 February 2023 at the request of her legal representatives. He provided a report dated 15 February 2023.
9. Dr Le Leu noted that Ms Skanthan complained of pain in her right leg, down the back of her thigh and calf. He noted that she complained of pain in her right knee the previous day but not on the day of examination. Ms Skanthan reported that the knee still swelled a bit. She reported tenderness in both her right knee and her spine.
10. Dr Le Leu diagnosed Ms Skanthan's knee pain as being the result of the exacerbation of the previously asymptomatic advanced degeneration of her right knee. He observed that the prognosis for her knee was poor and that she would eventually need a knee replacement.
11. Dr Paul Miniter, orthopaedic surgeon, saw Ms Skanthan on 26 September 2025 at the request of CGU's legal representatives and prepared a report dated 2 October 2025. He noted that Ms Skanthan presented in some distress, complaining of significant pain in her knees and lower back.
12. Dr Miniter also noted that:

(a) Ms Skanthan had undertaken an MRI scan of her right knee on 30 July 2015 (as recorded by Dr Wallace), and an x-ray of her knee on 2 March 2023, both of which demonstrated severe arthritic disease in Ms Skanthan's right knee;

(b) MRI scans of both Ms Skanthan's knees in 2018 demonstrated severe arthritic disease;

(c) Ms Skanthan had undergone an x-ray of her left knee on 5 July 2021, which demonstrated advanced medial compartment osteoarthritic change. The clinical history recorded that Ms Skanthan complained of right posterior thigh pain for a few months as well;

(d) investigations had been undertaken of Ms Skanthan's lumbar spine on 23 January 2015, which demonstrated degenerative change at the L5/S1 level, with there being a broad-based disc bulge, impingement on the right-hand side of the S1 nerve root and degenerative change at the L4/5 level. An MRI scan of the lumbar spine on 13 January 2022 demonstrated severe arthritic disease involving the L4/5 and L5/S1 levels. Clear evidence of impingement of the L5 nerve roots was also identified; and

(e) an MRI scan of Ms Skanthan's right femur was undertaken on 15 October 2024 which demonstrated a degree of endosteal sclerosis (abnormal increase in bone density) over the posterior aspect of the medial portion of the distal femur (back side of the top part of the knee joint).

1. Dr Miniter could find no evidence of injury or of any aggravation of Ms Skanthan's pre-existing pathology. He considered that Ms Skanthan simply has severe arthritic disease affecting both knees and her lower back. He considered that her conditions had definitely increased in intensity over time as the arthritic process in her back and knees 'increased relentlessly'.
2. Dr Miniter opined that Ms Skanthan falling onto her right knee could have caused a brief degree of aggravation but that it would have stopped over a three-month period. He noted Dr Le Leu's observation from his February 2023 report that Ms Skanthan would eventually need replacement of both her knees but commented that that need was not related to Ms Skanthan's work injuries.
3. Dr Ross Mills, consultant occupational physician, examined Ms Skanthan on 1 October 2025 at the request of CGU's legal representatives and prepared a report dated 2 October 2025. Dr Mills noted Ms Skanthan's complaint of ongoing back pain since the incident in December 2014 and ongoing knee pain since the incident in June 2015.
4. Dr Mills concluded that the December 2014 and June 2015 incidents did not explain her symptoms. He expressed the view that, if Ms Skanthan had injured her knee in the manner she described, he would have expected there to be significant knee pathology (which there was not), which would have resolved within 12 months in any event. He also considered that the location of Ms Skanthan's symptoms was not consistent with them being attributable to either an injury to her knee or back as described by Ms Skanthan. He noted that physical examination failed to demonstrate any abnormalities other than probable advanced bilateral knee osteoarthritis and obesity.

1. In 2022, Ms Skanthan's general practitioner, Dr Srinivas Vure, referred her to Dr Yeong Lau, orthopaedic surgeon, for consideration of the source of pain in her right leg. Dr Lau wrote to Dr Vure on 21 November 2022, advising that he suspected that Ms Skanthan's back condition was the source of her pain and that a referral to a spine surgeon would be appropriate once he had had the opportunity to consider the results of an MRI scan of Ms Skanthan's right femur that he had recommended.
2. An MRI scan of Ms Skanthan's right femur was undertaken on 7 March 2023. The report, dated 9 March 2023, stated that no definite abnormality of the femoral shaft could be identified. The report also noted that prominent degenerative changes of the knee with synovitis (inflammation of membrane) and effusion could be seen.
3. On 18 March 2024, Dr Vure noted in Ms Skanthan's clinical records that she needed referral to a knee surgeon. On 13 September 2024, Dr Vure recorded that Ms Skanthan had seen Dr Lau and that she was to have knee surgery.
4. On 15 July 2024, the Canberra Health Services' orthopaedic screening clinic (OSC) wrote to Dr Vure following an examination of Ms Skanthan. The report noted that Ms Skanthan had been referred by Dr Vure with respect to worsening right hip/thigh and knee pain on 8 May 2024. The diagnosis given by the OSC was of 'Right end stage knee osteoarthritis change'. OSC recommended a follow-up with Dr Lau.
5. Ms Skanthan subsequently attended on Dr Lau, who reported to Dr Vure on 7 September 2024. He provided a diagnosis of bilateral knee osteoarthritis, with Ms Skanthan's right knee being more severe than her left. He recommended, amongst other things, a repeat MRI scan of Ms Skanthan's right femur and that Ms Skanthan be placed on the public waiting list for a total knee replacement.
6. On 15 October 2024, Canberra Imaging Group produced a report following an MRI scan of Ms Skanthan's right femur. The report noted subtle endosteal sclerosis (abnormal increase in bone density) along the posterior medial aspect of the femoral diaphysis (back and inner surface of the thigh bone). The report also noted that the MRI scan partially imaged severe right knee osteoarthritis and left knee osteoarthritis.
7. On 19 January 2025, Dr Vure recorded that Ms Skanthan needed a disability parking permit given her chronic low back pain and knee pain, her wait for surgery and her obesity. Dr Vure completed a disability parking permit application on that date, recording that she had an arthritic condition that affected her mobility.
8. Ms Skanthan's clinical records note that, on 28 January 2025, Dr Vure referred her for an MRI scan of her spine, given her reported low back pain which radiated down her right side. She had had a flare-up of her back pain. The notes for that consultation record that Ms Skanthan was taking Tramadol for pain management.
9. On 7 April 2025, Dr Vure noted that Ms Skanthan presented with leg pain and back pain and requested pain medication. Dr Vure prescribed Tramadol. On 3 October 2025, Dr Vure recorded that Ms Skanthan reported experiencing bilateral leg swelling and back pain requiring pain medication. He again prescribed Tramadol.

1. As noted earlier in these reasons, Ms Skanthan suffers from degenerative osteoarthritis in both her knees and back, and has done so since at least 2015. She suffered workplace injuries to her back (in 2014 and 2021) and to her right knee (in 2015).
2. In relation to her right knee condition, Ms Skanthan suffers from significant degenerative osteoarthritis, as well as joint effusion and chondromalacia at and around the knee joint, and has done so since prior to the June 2015 incident. As a result of that incident she suffered a soft tissue injury to her knee and aggravation of her pre-existing osteoarthritis.
3. Ms Skanthan submits that that aggravation, and its impact on her, continued during the 2023 to 2025 period. She relies on her evidence that her symptoms continued (and became worse) after the 2015 incident and Dr Le Leu's diagnosis that, at the time of his report in February 2023, Ms Skanthan's was suffering from an aggravation of her pre-existing right knee condition.
4. On the evidence before me I am not satisfied that the 2015 injury had a continuing impact on Ms Skanthan between 2023 and 2025. I consider that it is likely to have resolved by early 2016, by which time Ms Skanthan ceased making claims for medical treatment in relation to her right knee. It had certainly resolved well before 2023. I am of the view that Ms Skanthan's need for a knee replacement arises directly from the degenerative osteoarthritis in her knee, not the aggravation of that condition caused by the 2015 incident.
5. While Dr Le Leu diagnosed Ms Skanthan's knee pain in 2023 as being the result of the aggravation of her pre-existing knee condition, he provided limited reasoning for that view. He stated merely 'She appears to have had no symptoms in the right knee before the incident of June 2015 but has had them ever since'.
6. Dr Le Leu did not engage with the question whether the aggravation that resulted from the 2015 injury could have continued to impact Ms Skanthan so many years after the incident, nor with the impact of Ms Skanthan's pre-existing conditions. Dr Le Leu recorded the outcome of the 30 July 2015 MRI scan but he did not consider the significance of Ms Skanthan's pre-existing condition other than to observe that it was apparently asymptomatic at the time of the MRI scan.
7. In contrast, IRT's experts, Dr Miniter and Dr Mills, explicitly considered the nature of the 2015 incident and the extent to which that incident could have aggravated Ms Skanthan's pre-existing knee condition and, relatedly, the length of time it would likely have taken for the aggravation to resolve and whether her knee condition remained aggravated at the time of assessment.
8. As I have noted above, Dr Miniter found no evidence of injury or of any aggravation of Ms Skanthan's pre-existing conditions. He considered that Ms Skanthan simply has severe arthritic disease affecting both her knees and that her conditions had increased in intensity over time as the arthritic process in her knees 'increased relentlessly'. He opined that Ms Skanthan falling onto her right knee could have caused a brief degree of aggravation but that it would have stopped over a three-month period. Dr Mills found that the location of Ms Skanthan's pain symptoms is not consistent with the injury to Ms Skanthan's knee that she described. He noted that there was no significant knee pathology which would explain the symptoms, which should have resolved within 12 months in any event.
9. I accept the opinion of Dr Miniter that the aggravation of Ms Skanthan's pre-existing knee condition had ceased long before 2023. I do not accept Dr Le Leu's contrary opinion.
10. As IRT submitted, Dr Miniter's area of expertise, as an orthopaedic surgeon, involves a greater level of specialisation relevant to diagnosing Ms Skanthan's condition, as compared with Dr Le Leu's (and Dr Mills') area of speciality. His opinion is also supported by reasons which took into account the relevant circumstances and medical evidence in a way that Dr Le Leu's opinion does not.
11. The view expressed by Dr Miniter (and Dr Mills), that any impact on Ms Skanthan from the June 2015 incident would have been short-lived, is consistent with Ms Skanthan's statement to Dr Wallace in October 2015 that she had experienced significant improvement in her right knee symptoms since the incident a little over two months beforehand and with Dr Wallace's view that her condition was likely to improve with a conservative regimen of treatment over the following two months.
12. Dr Miniter and Dr Mill's views are also consistent with the fact that Ms Skanthan did not make any claim for costs incurred for medical treatment of her right knee between early 2016 and 2023. This may be contrasted with the six month period following the June 2015 incident, in which she made multiple claims.
13. While Ms Skanthan gave evidence that she took pain medication after 2015 for both her back and her knee, but that she did not need to make any claims for medical treatment for her knee because the pain medication she required for both conditions was paid for by QBE in relation to her back injury, I consider that Ms Skanthan's evidence on this point is unreliable.
14. Firstly, she gave inconsistent evidence about the reason why she took the pain medication. In cross-examination she was initially clear that she had taken pain medication from 2015 for her back and not for her knee. She then said that she took pain medication for both her back and her leg (in circumstances, it is to be recalled, where Ms Skanthan suffered from pain in her right leg separately from her knee). In re-examination, she repeated that she had taken pain medication for both her back and her leg before agreeing, on being led by her Counsel, that she took pain medication for her right knee.
15. Secondly, the fact that she told Dr Wallace that her right knee symptoms had improved significantly between June and October 2015, and the fact that she made no claims after January 2016 in relation to the June 2015 injury (even though she gave evidence that she thought she would have made a claim for medication if she believed it related to the June 2015 injury), suggest that it was not the June 2015 injury which resulted in her ongoing experience of pain in her right knee.
16. Ms Skanthan's explanation for the absence of any claims after 2016 (that her pain medication was paid for by QBE in relation to her back injury) does not explain why she did not make any claims prior to her back injury in 2021, nor why she did not make any claims for treatment and investigation of her right knee between 2016 and 2023. If, as Ms Skanthan said, the impact of the June 2015 injury continued after 2015, and the pain in her knee became progressively worse, something about which she said she constantly asked Dr Vure, I would have expected Ms Skanthan to continue to make claims for medical treatment after January 2016.
17. Thirdly, and relatedly, Ms Skanthan gave inconsistent evidence in relation to the reason why she did not submit claims to CGU after January 2016. As noted above, she ultimately gave evidence that she did not need to make any claim for pain medication for her knee because QBE paid for the medication she required with respect to her 2021 back injury. Earlier, she gave evidence that, given she had an accepted claim managed by QBE, she did not know to whom she needed to submit a claim. Even if Ms Skanthan could have been confused by the involvement of two insurers from 2021, she clearly was not confused between June 2015 and January 2016 (when CGU made multiple payments to Ms Skanthan) and she could not have been confused between January 2016 and 2021 (given that she did not suffer any additional workplace injury in that period).
18. Separately, I note that the pain experienced by Ms Skanthan during the 2023 to 2025 period, both in her right knee specifically and in her back, right leg and knees more generally, is explained in the contemporaneous medical records otherwise than by reference to the aggravation of Ms Skanthan's pre-existing right knee condition. Between 2022 and 2025, Ms Skanthan was referred for various MRI scans and specialist consultations, and was advised, with respect to her back pain and associated right leg pain, and osteoarthritis in her knees. There is no mention in the contemporaneous medical records of any investigation or treatment in that period of the possible ongoing impact of the June 2015 injury.
19. The prescriptions Ms Skanthan received for Tramadol in January and April 2025 were for Ms Skanthan's low back pain. As Dr Wallace found, Ms Skanthan suffers from chronic back pain as a result of multilevel degenerative lumbar spondylosis, which was aggravated by her 2021 work injury, as well as a broad-based disc bulge and impingement on the right-hand side of her S1 nerve root. The pain from Ms Skanthan's back radiates down her right leg, and had done so since at least 2021.

1. The conclusion I have reached, that the June 2015 injury did not continue to impact Ms Skanthan between 2023 and 2025, necessarily means that the medical treatment she received in that period must have concerned her other medical conditions.
2. I have nevertheless considered each of Ms Skanthan's claims. For the reasons which follow, I consider that the evidence that Ms Skanthan relies on in support of her claims is insufficient to establish that the claimed treatment relates to the June 2015 injury.

1. Ms Skanthan claims $633.25 for an expense she incurred from I-MED Radiology. The invoice records that the treatment was provided on 7 March 2023 and was for 'MRI MSK - Derangement of Hip'. A report that was prepared in relation to the MRI scan on 9 March 2023 concludes 'I cannot identify any abnormality of the femoral shaft'. The report also noted that prominent degenerative changes of the knee could be seen.
2. As noted earlier in these reasons, the MRI scan that was performed on 7 March 2023 was undertaken as part of an investigation into pain that Ms Skanthan was experiencing in her right leg. Her orthopaedic surgeon, Dr Lau, considered that her back condition was the source of the pain and, in November 2022, he recommended that she undertake an MRI scan of her right femur. It is clear from the report that was prepared in relation to the MRI scan on 9 March 2023 that that was the focus of the scan. Consistently with that view, I note that Ms Skanthan's clinical notes from 15 October 2024 include a report from Canberra Imaging Group which describes the 9 March 2023 report as the 'I med MRI right femur report 9 March 2023'.
3. While the radiologist also identified degenerative changs in Ms Skanthan's knee, that is not what was being investigated. In any case, the aggravation of Ms Skanthan's degenerative osteoarthritis that had been caused by the 2015 incident had long since resolved by March 2023.
4. It is, accordingly, clear from both the nature of the MRI scan ('derangement of hip') and the reason for the MRI scan being undertaken, that the treatment given on 7 March 2023 was unrelated to the 2015 injury.

1. Ms Skanthan claims $165 for an attendance on Dr Vure on 10 March 2023. The invoice records 'Workers Compensation Level C 15-30 min'.
2. I was not taken to any notes or other records relating to this attendance, although the date of the attendance is close to the date of the right femur MRI scan report. If the attendance concerned that report, it was unrelated to the 2015 injury for the reasons I have given in relation to Claim 1.
3. I note that the only workers compensation claim with respect to which Ms Skanthan appears to have made claims in 2023 concerned her 2021 back injury. It is likely that this was the workers compensation claim being referred to in the invoice for this attendance. This conclusion is supported by the fact that the MRI scan of Ms Skanthan's right femur was undertaken as a result of Dr Lau's view that the pain she was experiencing in her right leg emanated from her back condition.
4. I am not satisfied that the cost Ms Skanthan incurred for this treatment was related to the 2015 injury.

1. Ms Skanthan claims $90 for an attendance on Dr Vure on 31 July 2023. The invoice records 'Surgery consultation, Level B'.
2. I was not taken to any notes or other records relating to this attendance and I do not know what the purpose for the attendance was. Given that Dr Vure described the attendance on 10 March 2023 as being in relation to a worker compensation claim, the generic description given for this attendance suggests that he did not consider that it related to any workers compensation claim.
3. I am not satisfied that the cost Ms Skanthan incurred for this treatment was related to the 2015 injury.

1. Ms Skanthan claims $125 for an attendance on Dr Vure on 27 October 2023. The invoice records 'Surgery consultation, Level C'.
2. Like Claim 3, I was not taken to any notes or other records relating to this attendance and I make the same observations in relation to this claim as I have in relation to Claim 3. I am not satisfied that the cost Ms Skanthan incurred for this treatment was related to the 2015 injury.

1. Ms Skanthan claims $120 for an attendance on Dr Vure on 11 April 2024. The invoice records 'Surgery consultation, Level C'.
2. Ms Skanthan's clinical notes include a record of her attendance on Dr Vure on 11 April 2024. The notes record that Ms Skanthan needed her 'fluvax' (which I interpret to mean influenza vaccination) and a script for eczema, and wanted her 'BMD' (which appears to refer to 'bone mineral density'). The record also mentions 'leah notes' but I do not know what that refers to.
3. The action items recorded for the attendance were the production of a script and a bone density imaging request. As noted earlier in these reasons, an MRI scan of Ms Skanthan's right femur was undertaken on 15 October 2024, which may have been as a result of this action item. The report for that MRI scan noted subtle endosteal sclerosis along the posterior medial aspect of the femoral diaphysis. That is a separate medical condition to the osteoarthritis in Ms Skanthan's knees.
4. Accordingly, neither the generic description of the treatment given on 11 April 2024 in Dr Vure's invoice nor the clinical notes that Dr Vure produced in relation to his consultation with Ms Skanthan on that day, give any indication that the treatment given on 11 April 2024 related to the June 2015 injury. To the contrary, the clinical notes show that the consultation concerned other issues. This is consistent with my view that the June 2015 injury had resolved long before 11 April 2024.
5. I am not satisfied that the cost Ms Skanthan incurred for this treatment was related to the 2015 injury.

1. Ms Skanthan claims $125 for an attendance on Dr Vure on 7 April 2025. The invoice records 'Surgery consultation, Level C'.
2. Ms Skanthan's clinic notes include a record of her attendance on Dr Vure on 7 April 2025. The notes record that Ms Skanthan presented on that day with a range of issues, most relevantly including leg pain, for which Ms Skanthan sought pain medication, and back pain which flared up with prolonged standing. In terms of Ms Skanthan's past medical history, Dr Vure recorded Ms Skanthan's history of workers compensation claims through CGU and QBE, including her previous back injury in 2014. He noted that she had had a history of knee issues and that significant arthritis in the middle compartment of Ms Skanthan's knee joint had been noted in 2018.
3. The notes do not suggest that the past medical history was included for anything other than context for Ms Skanthan's presenting complaints. She was not being treated on 7 April 2025 for the issues which Dr Vure recorded in her past medical history.
4. The notes record that Ms Skanthan's current medication included Tramadol for pain management and that a further prescription for Tramadol was to be provided. While Ms Skanthan gave evidence that she used Tramadol for both her knee pain and her back pain, Ms Skanthan's clinical notes from her attendances on Dr Vure before and after her attendance on him on 7 April 2025 suggest that she was prescribed Tramadol for her back pain. This interpretation of the clinical notes is consistent with Ms Skanthan's explanation for the absence of any claims made to CGU after 2015 for the June 2015 injury, being that the pain medication she took for her back, which related to her 2021 workplace injury, was the same medication she required for her knee.
5. As noted earlier in these reasons, the notes from Ms Skanthan's consultation on 28 January 2025 record that Ms Skanthan had had a flare-up of her back pain and that Dr Vure referred Ms Skanthan for an MRI scan of her spine, given her reported low back pain which radiated down her right side. The notes for that consultation record that Ms Skanthan was taking Tramadol for pain management. The notes for Ms Skanthan's 3 October 2025 consultation record that Ms Skanthan reported experiencing bilateral leg swelling and back pain requiring pain medication and that Dr Vure prescribed Tramadol again.
6. To the extent that Ms Skanthan sought pain medication for her leg pain, that was a separate issue to the osteoarthritis in Ms Skanthan's knees. Indeed, Dr Vure separately identified the leg pain with which Ms Skanthan had presented from her past history of knee issues. As recorded in the notes for Ms Skanthan's 28 January 2025 consultation (and in Dr Wallace's report of 20 May 2022 and Dr Lau's report of 21 November 2022), the source of the pain in Ms Skanthan's right leg was her back condition, not her knee condition.
7. Accordingly, it is clear that Ms Skanthan's attendance on Dr Vure on 7 April 2025 did not concern the June 2015 injury.

1. Ms Skanthan claims $130 for an attendance on Dr Vure on 3 October 2025. The invoice records 'Surgery consultation, Level C'.
2. Ms Skanthan's clinic notes include a record of her attendance on Dr Vure on 3 October 2025. As discussed above in relation to Claim 6, the notes record that Ms Skanthan reported experiencing bilateral leg swelling and back pain requiring pain medication and that Dr Vure prescribed Tramadol. A range of other medical conditions are also mentioned in the notes for this consultation, however none are of any relevance to Ms Skanthan's claim.
3. It is clear that Ms Skanthan's attendance on Dr Vure on 3 October 2025 did not concern the June 2015 injury.

1. Ms Skanthan claims $17.97, being the cost to purchase a packet of 20 Tramadol tablets.
2. It is likely that this purchase followed the consultation on 3 October 2025, when Ms Skanthan was given a further prescription for Tramadol from Dr Vure. As discussed in relation to Claims 6 and 7, Dr Vure prescribed Tramadol for Ms Skanthan's back pain, not for the pain Ms Skanthan suffered as a result of the osteoarthritis in her knees. Accordingly, if the purchase relates to the prescription given to Ms Skanthan on 3 October 2025, it is clear that it did not relate to the June 2015 injury.
3. If the purchase did not relate to the prescription given to Ms Skanthan on 3 October 2025, the reason for the purchase is unexplained and I cannot find that it related to the June 2015 injury. As noted earlier in these reason, while Ms Skanthan gave evidence that she continues to suffer knee pain, and that she took Tramadol to ease that pain as well as her back pain, I accept the opinion of Dr Miniter that the June 2015 injury did not continue to impact Ms Skanthan in November 2025 and that the pain in Ms Skanthan's knees arose from the relentless natural progression of her degenerative osteoarthritis which had increased in intensity over time.

1. For the reasons set out above, I am not satisfied that the medical treatment which was the subject of any of Ms Skanthan's claims related to the June 2015 injury. Accordingly, I find that IRT is not liable to pay the costs of that treatment.

1. The starting position in relation to costs is that the successful party (IRT in this case) is entitled to be paid party-party costs by the unsuccessful party (Ms Skanthan) unless the Court otherwise orders: r 3968(1), CPRs.
2. However where, as here, the unsuccessful party is someone who claimed compensation honestly, the Court must not award costs against them: r 3968(3), CPRs. Accordingly, I make no order as to costs.

1. I make the following orders:
   1. The application is dismissed.
   2. There be no order as to costs.

I certify that the preceding ninety-seven [97] numbered paragraphs are a true copy of the Reasons for Decision of His Honour Magistrate Temby.