The 2011 decision of the Tribunal
7 As will later appear, I do not accept the submission on the part of the applicant that the facts found by the Tribunal in its 2011 decision have ceased to be relevant to, or available for the purposes of, the 2014 decision. I therefore next set out the facts found by the Tribunal in its 2011 decision.
8 The Tribunal found at [3] that the only matter before it was whether Comcare was liable to pay compensation for aggravation of Mr Smith's hip osteoarthritis under s 14 of the SRC Act. At [8], the Tribunal stated the issue under s 14 as whether Comcare was liable to provide rehabilitation and to pay compensation to the applicant for aggravation of the disease which has resulted in the incapacity for work or in impairment.
9 At [10], the Tribunal said the case for the applicant was that the aggravation of his hip osteoarthritis was contributed to by the nature of the duties he performed as a meat inspector, in particular the need, over many years, for him to move and lift parts of animal carcasses while bending forward to do so and the repetitive nature of turning frequently to sterilise and sharpen his knives. The case for Comcare was that the medical opinion was that such activity as carried out by the applicant would only contribute to osteoarthritis if it involved heavy lifting and that this was not the case with the applicant's meat inspection functions.
10 The Tribunal set out in some detail the work that Mr Smith did at the abattoirs chiefly at Forbes, Blayney and Wagga Wagga. The Tribunal described the separate stations for the various parts of the various animals. It referred to the different work involved for cattle, sheep and pigs at Forbes and Blayney and for beef and mutton until 1993 at Wagga Wagga. (In light of the subsequent limitation of the claim to 1983-1993 I do not refer to the findings of the Tribunal for the period after 1993.)
11 The description of Mr Smith's work by the Tribunal referred to what physical activities were necessary for him to perform his meat inspection duties. For example, at [19] the Tribunal referred to mutton inspection being more difficult at Wagga Wagga because of the higher speed and increased level of bending and twisting involved. There was either a lower chain or higher work platform such that bending was to a greater degree.
12 The Tribunal referred to the evidence of Mr Kevin Evans, the New South Wales Meat Resource Manager. He agreed that before 2010 meat inspectors had to reach out for some of the viscera material. Although it is not clear what period Mr Evans was referring to, the Tribunal at [36] set out his evidence that the viscera positions required the inspectors to bend over a moving table to inspect the various organs and to incise glands. He agreed that viscera had to be turned over but that, in relation to livers, these were not lifted completely from the table but merely rolled over.
13 The Tribunal referred to the evidence of Mr Robert Hair in relation to a DVD. Mr Hair said that the inspectors shown in the DVD were required to carry out their functions as they would have done in the period when Mr Smith was working at the Wagga Wagga abattoir. Mr Evans' evidence was to the same effect. In this respect, the Tribunal said:
69. The viscera table moved slowly from the left to right, as it was faced by the inspectors. Two inspectors were depicted on three or four separate inspections each. They completed their tasks with some bending forward to bring items closer. However this bending was to a minor degree. The only lifting of product was in relation to the livers but this was more in the sense of a sidewards movement to roll the liver over. With the inspector standing erect, this was done quickly and in an apparently effortless manner, assisted by the slipperiness of the table surface, with the inspected item barely leaving the surface of the table. After each inspection, the inspector retreated from the table for a metre or so, turned and rinsed his knife in a sink. This action did not require any bending by the inspector.
70. Inspection of heads and tongues was conducted in conjunction with each other. These were suspended, alternatively, from hooks which moved slowly from left to right. One inspector was depicted performing his duties on several sets of heads and tongues. The procedure displayed no lifting and only a minor degree of forward bending.
71. The final segment showed carcasses which had been cut in half along their spines. These half carcasses moved from left to right suspended by hooks on a conveyor. The DVD depicted an inspector working, in turn, on seven of these half-carcasses. He stood on the rise/fall platform, which he activated to move upwards to access higher parts of the carcass, and reached forward by bending to a minor degree. There was no lifting. The inspector rotated the carcass to inspect the more distant components and this was achieved with no apparent effort.
14 The Tribunal referred to the medical evidence.
15 Mr Smith commenced seeing his general practitioner, Dr Renshaw, in 1997 about hip pain.
16 Dr Paul Miniter, orthopaedic surgeon, completed a report on 15 September 1997. He felt that Mr Smith had osteoarthritis of the right hip.
17 Dr Warwick Huntsdale, orthopaedic surgeon, completed eight reports between November 2008 and April 2010. Dr Huntsdale conducted hip replacement surgery on Mr Smith on 9 December 2008 at Wagga Wagga. In his report of April 2010, the Tribunal said at [42], Dr Huntsdale confirmed his opinion that, in the absence of heavy work, Mr Smith's job would not contribute to Mr Smith's hip condition.
18 Professor Neil Sambrook, rheumatologist, completed three reports in 2010. Professor Sambrook took a history from Mr Smith including that relating to his abattoir work. This noted references to Mr Smith undertaking considerable lifting and twisting while inspecting the heads of the animals as well as considerable lifting, reaching for and twisting various organs at the viscera table and that this included livers weighing 6 to 10 kgs. Professor Sambrook also referred to studies in which the risk of hip osteoarthritis was related to occupations which entailed regular heavy lifting, such as the daily moving of weights greater than 25 kg by hand with prolonged standing and walking over rough ground. Professor Sambrook considered that the nature of Mr Smith's work was such that it would have contributed to his hip osteoarthritis. In his second report, Professor Sambrook referred to a further study which implicated heavy manual work in hip osteoarthritis, where heavy manual work was defined in terms of standing and lifting light objects. A third study Professor Sambrook identified found an increased risk of hip osteoarthritis from moderate tasks such as lifting weights of more than 4.5 kg as well as bending, twisting and reaching activities. Professor Sambrook likened these descriptions to the work activities of Mr Smith. Professor Sambrook was unable to give oral evidence or provide a further report for health reasons.
19 The Tribunal then considered, over eight paragraphs, the evidence of Dr Christopher Browne, rheumatologist. Dr Browne completed a report on 19 July 2011 after seeing Mr Smith on 7 July 2011. He had read Mr Smith's statement as to the nature of his abattoir duties. Dr Browne considered that the onset of osteoarthritis was probably in the late 1990s.
20 Dr Browne considered that even rolling over the viscera in a flexed position was sufficient to aggravate a hip condition. He considered that the mutton chain was the most significant factor in relation to impacting the hip.
21 Dr Browne was aware that, in his early years, Mr Smith had been required to inspect viscera in a wheelbarrow and that this required a greater degree of lifting of the viscera material which he understood could weigh from 6 to 10 kgs, and bending. Dr Browne's understanding from Mr Smith was that the mutton inspection had been an arduous process because of the greater speed involved but that Mr Smith had not been required to inspect sheep carcasses after 1993.
22 Dr Browne's opinion was that Mr Smith's work as a meat inspector did not cause his hip osteoarthritis but that it was responsible for aggravating the condition. His opinion was that the material consideration in Mr Smith's work was that he was required to lift weights while bending forward such that his hips were in a flexed position at that time. It was this factor, he said, which increased the level of stress to his hip joint because it was in a disadvantaged position.
23 Dr Browne considered that the onset of osteoarthritis in Mr Smith's case was likely to be in 1997 rather than earlier and related to the duties from 1993 to 1997. At [63], the Tribunal said that Dr Browne's opinion was that the aggravation relevant to Mr Smith's claim was in 1997.
24 The Tribunal set out over six paragraphs the evidence of Dr Neil McGill, rheumatologist, who had completed three reports in the period September 2010 to May 2011.
25 Dr McGill first saw Mr Smith in September 2010 and recorded a history of Mr Smith's abattoir duties. He recorded Mr Smith as advising that he was required to bend forward and reach for items in order to inspect them but that there was no heavy lifting in his work. He also recorded that Mr Smith had not experienced any specific injury to his hip.
26 Dr McGill referred to several studies in relation to hip osteoarthritis. After reviewing that material, Dr McGill gave his opinion that the studies showed that hard physical work involving heavy lifting was needed over a prolonged period in order to be associated with increased prevalence of hip osteoarthritis. Dr McGill concluded that mere repetitive work was not so associated. Dr McGill's opinion was that the nature of the abattoir work by Mr Smith was not of a type that would increase the likelihood of developing osteoarthritis of the hip.
27 Dr McGill said there was no study that confirmed the opinion of Dr Browne that heavy lifting was not a requirement for the development of osteoarthritis in the hip. He also disagreed with Dr Browne's reference to the greater impact on the hip joint if weight was carried while the hip was in the flexed position. Dr McGill said that, when flexed, there would be no greater impact on the hip joint because the surrounding muscles would compensate by taking the additional strain.
28 In a different context, that of s 53 of the SRC Act, the Tribunal found that Mr Smith did not become aware of the potential relationship between his hip osteoarthritis and his employment until after he underwent hip surgery by Dr Huntsdale in December 2008.
29 At [73] onwards the Tribunal evaluated the medical evidence, that of Professor Sambrook and Dr Browne which supported a relationship between Mr Smith's hip osteoarthritis and his employment and that of Dr Huntsdale and Dr McGill who reported an absence of such relationship.
30 The Tribunal said at [75] that Dr Browne considered that Mr Smith's meat inspection duties contributed to his hip osteoarthritis either on the basis that he lifted substantial objects or on the basis that he lifted or carried heavy objects with the hip in an uncomfortable position.
31 Dr McGill accepted that physically demanding work continued over many years was associated with increased prevalence of hip osteoarthritis but was of the opinion that the nature of Mr Smith's abattoir work was not of that type. Dr McGill rejected Dr Browne's opinion that there was greater impact on the hip joint if weight was carried while the hip was in the flexed position.
32 The Tribunal then summarised at [78] the third party reports referred to in the reports of the doctors.
33 The reasoning of the Tribunal was, put shortly, that an association could only be sustained where there was heavy lifting in employment, unless there was much lifting of light objects. The Tribunal found at [79] that Mr Smith's meat inspection duties at Wagga Wagga did not involve him in heavy lifting and the turning of items at the viscera table was a motion which was more one of quickly flipping the item over rather than of lifting.
34 The Tribunal distinguished and did not accept the opinion of Dr Browne because there was no heavy lifting and indeed no substantial lifting at all.