The first issue: Does the law preclude a sudden disturbance of a person's physiological state from being an "injury" if that disturbance is an inevitable consequence of an underlying disease?
47 There was no dispute between the parties that Mr Szajna was an employee of the respondent, that he had suffered ventricular fibrillation in the course of his employment and that the ventricular fibrillation had resulted in his death. The dispute was confined to whether he had suffered an injury within the meaning of that word in ss 5A(1) and 14(1) of the SRC Act.
48 As the definition of "injury" in s 5A(1) of the SRC Act is pivotal to this appeal, it is worth repeating. Under that provision:
"injury" means:
(a) a disease suffered by an employee; or
(b) an injury (other than a disease) suffered by an employee, that is a physical or mental injury arising out of, or in the course of, the employee's employment.
49 The applicant contended before the Tribunal that Mr Szajna suffered "an injury (other than a disease)", within paragraph (b) of s 5A(1), namely ventricular fibrillation. She did not argue that Mr Szajna had suffered a "disease" within paragraph (a).
50 The applicant proceeded in this way because the definition of "disease" in s 5B(1) of the SRC Act requires that there be a contribution to the ailment to a significant degree by the employee's employment. There was no evidence that Mr Szajna's employment with the respondent made any contribution to his coronary artery disease or to the consequent ventricular fibrillation that led to his death.
51 The words "in the course of, the employee's employment" in paragraph (b) of s 5A(1) (as an alternative to "arising out of") have the effect that no causal link is required between the "injury (other than a disease)" and the employment. It is enough that an "injury (other than a disease)" is sustained by an employee while performing his or her duties or doing something that he or she is reasonably required, expected or authorised to do in order to carry out such duties: Henderson v Commissioner of Railways (WA) (1937) 58 CLR 281 at 293-294 per Dixon J.
52 Accordingly, the issue for the Tribunal was whether the ventricular fibrillation suffered by Mr Szajna was an "injury (other than a disease)". In that expression, the word "disease" bears the meaning that it is given under s 5B(1): Australian Postal Corporation v Burch (1988) 85 FCR 264 at 268 ("Burch"). As there was no suggestion that Mr Szajna's ventricular fibrillation was a "disease" as defined in s 5B(1), the issue for the Tribunal devolved to whether the ventricular fibrillation was an "injury" under the ordinary meaning of that word.
53 The ordinary meaning of "injury" in workers' compensation legislation is "a sudden or identifiable physiological change": see Kennedy Cleaning Services Limited v Petkoska (2000) 200 CLR 286 ("Petkoska") per Gleeson CJ and Kirby J at [35]; Zickar at 336 per Kirby J. It is something distinct from the defect, disorder or morbid condition which enables it to occur: Accident Compensation Commission v McIntosh [1991] 2 VR 253 ("Accident Compensation Commission v McIntosh") per Murphy J at 262; Zickar at 335 per Toohey, McHugh and Gummow JJ; Petkoska at [36], [39] per Gleeson CJ and Kirby J. The issue arising here is whether the law qualifies the meaning of "injury" by providing that it does not encompass the inevitable consequence of an underlying disease.
54 Some of the submissions to the Tribunal concerning the significance of whether Mr Szajna's ventricular fibrillation was an inevitable consequence of his underlying coronary artery disease cited Ferro as their source. In Ferro, an employee had underlying coronary artery disease which resulted in ventricular fibrillation while he was at work, causing permanent brain damage. In that case, the Tribunal stated that:
45. The respondent contended that Mr Ferro's coronary occlusion and the ventricular fibrillation were inevitable. In Zickar v MGH Plastic Industries Pty Limited (1996) 187 CLR 310 (Zickar) the principle enunciated by the minority, and implicitly acknowledged by the majority, was that the inevitable consequences of the progress of a disease are not considered to be an injury simpliciter.
55 The Tribunal in Ferro went on to consider Burch and Petkoska and stated that:
48. Neither Burch nor [Petkoska] have challenged the clear recognition in Zickar that inevitable consequences, such as the progress of a disease, are not considered an injury simpliciter.
56 In Ferro, the Tribunal considered that the decision in Zickar established a "principle" that an inevitable consequence of a disease cannot amount to an "injury". It is necessary to examine Zickar to see whether it did establish such a principle. It will then be necessary to consider whether the Tribunal in this case purported to apply any such principle.
57 In Zickar, an employee suffered a ruptured aneurysm while he was at work, which caused an intracerebral clot and occlusion of a cerebral artery, resulting in brain damage. The evidence of Dr Stening, a neurosurgeon, was that an aneurysm is an area of weakness in the wall of a blood vessel supplying the brain. The weakness in the blood vessel wall balloons out and becomes thinner and thinner until the pressure of the blood behind it causes a tear, resulting in a leakage of blood into the fluid surrounding the brain. The blood's clotting mechanism may stop the bleed from progressing, but eventually the clotting mechanism breaks down causing a major rupture which is usually fatal. This is what had apparently happened to the employee in that case.
58 The structure and content of legislative provision considered by the High Court in Zickar was similar to s 5A(1) of the SRC Act. That provision defined "injury" to mean, relevantly, "personal injury" in paragraph (a) and "disease" in paragraph (b). The issue for the High Court was whether the definition of "injury" should be construed to mean that the natural consequences of a disease could be a "personal injury" within paragraph (a), or whether such consequences were only capable of coming within "disease" in paragraph (b). It is relevant to note that the case involved not merely the construction of "personal injury" but also the construction of the whole of the defined term "injury".
59 The minority judgment was given by Brennan CJ and Dawson and Gaudron JJ. Their Honours followed a long line of High Court authority which held that an identifiable physiological change resulting from the natural progression of a disease was not "injury by accident" or "injury" within the ordinary meaning of those terms in the relevant statutes. Their Honours referred, for example, to The Commonwealth v Ockenden (1958) 99 CLR 215, where Dixon CJ and Fullagar and Taylor JJ said at 224:
Accordingly, for the purposes of the Commonwealth Employees' Compensation Act it is still true that a worker does not suffer personal injury by accident arising in the course of his employment where he suffers, at his place of employment, a sudden and distinct physiological change as the product of the inevitable development of a progressive disease from which he is suffering and where such change can in no way be attributable to or associated with some incident of his employment.
60 In construing the meaning of "injury", Brennan CJ and Dawson and Gaudron JJ applied Hockey v Yelland (1984) 157 CLR 124 which held that if an autogenous disease naturally progresses until it results in incapacity there is no "injury". The minority held that the essential steps and reasoning in Hockey v Yelland were established by a consistent and unbroken line of authority and concluded that the sole consequence of a progressive autogenous disease is not an "injury".
61 Therefore, the Tribunal in Ferro was correct that the minority in Zickar took the view that the inevitable consequences of the progression of a disease are not considered to be an "injury simpliciter" within paragraph (a) of the definition of "injury" considered in Zickar. That definition is not relevantly distinguishable from the definition of "injury" in s 5A(1) of the SRC Act. However, the minority's view cannot be considered to establish a "principle" unless it is consistent with the position adopted by the majority. That remains to be examined.
62 The majority consisted of Toohey, McHugh and Gummow JJ, who delivered a joint judgment, and Kirby J who delivered a separate judgment. In the joint judgment, their Honours explained that Hockey v Yelland must be read in its confined context of deciding whether the decision of the Tribunal in question demonstrated any error on the face of the record. Their Honours said at 333:
If nothing more appeared than that the haemorrhage was merely the culmination or climax of a progressive disease, it could not be said that the rejection of the claim by reference to the opening words of the definition disclosed an error on the face of the record. But that is not the present case.
63 Their Honours continued at 334:
But the present case is not one of an autogenous disease. Or, to put it more accurately, it is not an autogenous disease upon which the appellant relies. It may be accepted that the aneurism was an autogenous disease but the appellant's claim to personal injury within par (a) was based on the rupture which occurred. From Dr Stening's evidence, it is clear that the rupture of the aneurism was not inevitable and further that the rupture may have been minor, allowing the appellant, after treatment to return to his previous occupation. If there was no rupture there would be no event answering the description of personal injury and the appellant would be driven to rely upon par (b) of the definition. But there was such an event and the presence of a disease does not preclude reliance upon that event as personal injury.
64 Their Honours went on to say at 334-335:
To say that the aneurism was a disease does not answer the question whether the rupture itself can fairly be described as an injury.
Thus in Darling Island Stevedoring & Lighterage Co Ltd v Hankinson [(1967) 117 CLR 19] a worker suffered pain and later paralysis caused by the collapse of one or two infected vertebral bodies. The consensus of medical opinion was that the infection, unless discovered and treated successfully, would in the ordinary course of events have progressed ultimately to produce a collapse of the vertebrae and incapacity. The Workers' Compensation Commission treated the matter as an aggravation, acceleration, exacerbation and deterioration of a pre-existing disease. However, this Court held that the collapse of the vertebrae was an "injury" in the ordinary sense without resort to the extended definition in s 6(1)(b) of the Workers' Compensation Act 1926 (NSW). The decision is mentioned in Hockey v Yelland without any doubt being cast on its correctness.
65 I do not think that the judgment of Toohey, McHugh and Gummow JJ in Zickar supports any "principle" that the inevitable consequences of a disease cannot be an "injury" within the ordinary meaning of that word. Their Honours' citation of Darling Island Stevedoring & Lighterage Co Ltd v Hankinson (1967) 117 CLR 19, a case dealing with the consequence of a disease that was inevitable in the ordinary course of events, is inconsistent with any such principle. No support for such a principle can be inferred from their Honours' reference to Dr Stening's evidence that the rupture of the aneurysm was not inevitable. Their Honours were saying only that any evidence that the rupture was inevitable would have been relevant to the question of whether there was an "injury". Their Honours indicated that other factors affected that question, including whether the consequences of the rupture would have been less severe than from the mere progression of the disease, and whether the consequences could have been ameliorated by treatment. I consider that their Honours were saying no more than that the question of whether the consequences of a progressive disease amount to an "injury" depends on the evidence, and that whether such consequences are inevitable is a factor to be considered. Their Honours decided that as a matter of construction of the definition of "injury", a rupture which is a consequence of an underlying disease is not necessarily excluded as a "personal injury" within paragraph (a).
66 Kirby J's judgment is to similar effect. His Honour considered that Hockey v Yelland should be overruled and then said at 352:
The approach to the definition of "injury" which I have favoured does not necessarily mean that every catastrophe connected with a progressive disease will fall within the definition of "personal injury" primarily so defined. Whether, in the case of a progressive disease, leading inevitably to a sudden or identifiable pathological change, it can be said that such change constitutes a "personal injury" can be left to determination on a case by case basis. It must be assumed that parliament intended the extended definition, enacted to cover cases of "disease" within s 4B of the 1987 Act, to have some operation.
67 In Burch, the employee had cardiomyopathy and apparently suffered an occlusion, or blocking, of a cerebral artery which caused a stroke. The claim for compensation was brought under the SRC Act. The Full Court considered that the stroke, which had been caused by the occlusion of an artery, could amount to an "injury". The Court cited the following passage from Accident Compensation Commission v McIntosh at 263, which, in my view, is far from supporting any principle to the effect suggested in Ferro:
Long before the inclusion of these references to "disease" in the definition of "injury" [in the New South Wales legislation considered in O'Neill v Lumbey (1987) 11 NSWLR 640], claims for coronary occlusions, cerebral haemorrhage, ruptured aneurysms, aorta, oesophagus etc had commonly been made and had succeeded if occurring during a protected period, on the basis that they were "injury by accident", being clearly a physical injury - and accidental - being unexpected by the worker at the time that they occurred: cf. Clover, Clayton & Co. Ltd. v Hughes [1910] AC 242.
68 In Petkoska, an employee had been suffering from a condition of the heart which led to fibrillation and the release of a clot into the blood stream which then caused a stroke. A magistrate found that the employee had sustained a "physical injury" even though the stroke was probably initiated by heart disease. The employer argued that the legislation considered there was distinguishable from that considered in Zickar and that the stroke, being a consequence of a disease, was not an "injury".
69 McHugh, Gummow and Hayne JJ gave a joint judgment in which they concluded that the legislation under consideration was even more strongly in favour of the worker than in Zickar. In the course of their judgment, their Honours said:
68 The circumstance that a sudden physiological change has been caused or provoked by disease does not prevent it from constituting a "physical injury" for the purposes of s 7(1).
70 Gaudron J gave a separate judgment agreeing with McHugh, Gummow and Hayne JJ, but added some observations. Her Honour said:
50 Whether physiological change resulting from a progressive disease that is not employment related is or is not an injury for the purposes of workers' compensation legislation depends on the terms of the legislation in question. There is no doubt that, as a matter of ordinary language, the word "injury" is apt to include sudden physiological change resulting from a disease, as in the case of stroke resulting from progressive heart disease or the rupture of an aneurysm as a result of the progressive weakening of an arterial wall.
71 Gleeson CJ and Kirby J agreed that the appeal should be dismissed. Their joint reasons analysed the decision in Zickar, concluding at [39]-[40]:
It is impossible to reconcile the approach urged by the appellant in this case with the reasoning of the majority in Zickar. If the appellant's approach were adopted, the mere fact that an ascertainable lesion or dramatic physiological change had taken place or that the normal physiological state had been disturbed would be irrelevant because it would be no more than the outcome, direct or indirect, of a progressive congenital or other disease process. However, this is not the way the majority approached the matter in Zickar. It is also inconsistent with the approach in McIntosh and Burch. All of those cases require that consideration be given to the precise evidence, on a fact by fact basis, concerning the nature and incidents of the physiological change accepted at trial. If this evidence amounts, relevantly, to something that can be described as a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state, it may qualify for characterisation as an "injury" in the primary sense of that word. If such an injury happens within the protected period of employment, it is ordinarily compensable without proof of a specific causal connection with the worker's employment. If the propounded "injury" is distinct from the underlying pathology that constitutes a "disease" that directly or indirectly caused the sudden event to occur, it is unnecessary to proceed to the alternative and additional basis whereby, in such cases, compensation may also be recovered for the disease process if the statutory preconditions are met.
The foregoing approach does not rob the disease provisions of the Act of utility. They would apply in cases of a disease in the nature of dermatitis, lead poisoning, brucellosis and many others of a progressive type. The disease provisions remain as alternative and additional heads of entitlement where a disease pathology exists with the appropriate employment connection, and does not manifest itself in the kind of sudden physiological change or disturbance of the normal physiological state that will constitute an "injury" in the primary sense.
(Underlining added.)
72 Callinan J dissented in Petkoska. His Honour considered that the decision in Hockey v Yelland should be followed.
73 There is no suggestion in the judgments of the majority in Petkoska that an inevitable consequence of a disease cannot be an "injury" within the ordinary meaning of that word. In fact, the passages I have cited suggest the contrary.
74 The respondent's submissions to the Tribunal suggest that the decision of the Full Court of the Federal Court in Van Reesch supports the position that the inevitable consequence of disease cannot be an "injury". However, that is not so.
75 Another difficulty with the idea that there is a principle that the inevitable consequence of an underlying disease cannot amount to an "injury" within the ordinary meaning of that word lies in understanding what is meant by "inevitable". No doubt, there are many diseases of which it can be said that without treatment they will inevitably progress such that in the long term they will produce some sudden identifiable physiological change which is distinct from the disease. Some examples may be, depending on the evidence in a particular case, coronary occlusions, cerebral haemorrhages and ruptured aneurysms resulting in stroke. If, in fact, a person experiences such consequences in the short term, it is difficult to see why it must necessarily follow that the person has not suffered an "injury" in the ordinary sense of that word. The person has, after all, now experienced a sudden identifiable physiological change distinct from the disease that resulted in such change, regardless of the fact that such change would inevitably have been experienced in the long term.
76 What the cases establish is that:
(a) In order to decide whether an employee has sustained an "injury" within the ordinary meaning of that word, consideration must be given to the precise evidence on a case by case basis.
(b) If the evidence establishes something that can be described as a sudden and ascertainable or dramatic physiological change or disturbance of the normal physiological state, it may qualify as such an "injury".
(c) It is necessary to consider whether the propounded "injury" is distinct from the underlying pathology that constitutes a "disease" that directly or indirectly caused the sudden change to occur.
(d) The question of whether the physiological change or disturbance is the inevitable consequence of the progress of the disease may be relevant in deciding whether there is an "injury", but is not of itself necessarily determinative.
77 I consider that neither the decision of the majority in Zickar nor any other case since then establishes or supports any principle that the inevitable consequences of the progress of the disease cannot be an "injury". While such a principle is consistent with the view taken by Brennan CJ and Dawson and Gaudron JJ in Zickar and by Callinan J in Petkoska, theirs were dissenting opinions.
78 The references in the judgments of the majority in Zickar to "inevitability" are no more than an indication that there may be some circumstances in which it may be appropriate for a tribunal of fact to conclude that sudden manifestations of the inevitable consequences of an underlying disease may themselves be regarded as part of the disease, rather than an "injury". Gleeson CJ and Kirby J in Petkoska at [40] suggest that such circumstances may be unusual. I consider that that Ferro is incorrect insofar as it decided that a principle exists that the inevitable consequences of a disease cannot be an "injury" within the ordinary meaning of that word.