And also the following:
"[The] courts should be concerned to analyse the facts in each case in order to determine whether the applicant knew the nature of the injury and, if so, in a broad way the extent of the injury, the nature of which is known. Practically speaking the resolution of the inquiry whether the applicant was unaware of the nature of the injury should throw considerable light on the task of resolving the second inquiry as to the extent of the injury. For instance, a finding that the applicant is aware that he or she has suffered a serious neck injury involving damage to the spine will, in general, provide an answer to the inquiries as to both nature and extent. In this context I would emphasise that the court is concerned not with the technical name or description of an injury but its effect, actual and potential, upon the applicant."
19 The concepts of "nature" and "extent" differ in meaning and, as Clarke JA accepted, it does not necessarily follow that a finding that a plaintiff was aware of the nature of an injury is equivalent to a finding that the plaintiff was aware of the extent of the injury. A close inquiry must be made into the facts of each case. While in one case knowledge of a serious neck injury involving damage to the spine may constitute knowledge of the nature and extent of the injury sustained, in another case knowledge of some pain in the arm following a blow to the wrist may not constitute knowledge of the extent of the injuries if serious complications to the arm arise years later.
20 In determining the extent of the personal injury suffered, the "extent" of the injury is to be determined as at the date of the application: Harris v Commercial Minerals Ltd (1996) 186 CLR 1. Expectation as to the likely consequences of an injury is an element in determining an applicant's awareness of the extent of the injury; it is the applicant's expectation that is relevant, not that of a reasonable person: Harris at 13. As the High Court observed in Harris (at 13):
"Thus, if an applicant knew at the expiration of the relevant period that he or she suffered from a diseased spine, it does not necessarily follow that the person was aware of the "extent of personal injury" if eventually the disease caused the vertebrae to collapse. Whether the applicant was aware of 'the extent' of the injury would depend on whether that person was aware that there was a real chance that the vertebrae would collapse as the result of the disease".
21 In Harris the High Court went on to say (at 13):
"In Ditchburn v Seltsam Limited (1989) 17 NSWLR 697 at 704, per Kirby P, (with whom Hope AJA agreed) the New South Wales Court of Appeal held that early signs and symptoms may not constitute sufficient indication of the 'nature and extent' of personal injury. In F J Walker Limited v Webber (unreported, New South Wales Court of Appeal, 16 November 1989) the same Court also stated that:
'One can know 'the nature and extent' of one's injury even if one is ignorant of the final form which it will take. Few plaintiffs ever know this, even at the time of trial and it would be difficult to attribute to Parliament an intention that potential plaintiffs may completely disregard limitation periods merely because they are unable to predict their final state'.
These statements imply, correctly in our opinion, that an applicant may have been aware of the extent of his or her injury even though he or she does not expect all its precise consequences, for it is not necessary that the applicant should foresee the exact course of the disease or be aware of all its pathological and physiological incidents. If the applicant was aware that the injury would deteriorate, he or she may be aware of the extent of the injury for the purpose of s 60I(1)(a)(ii) even though the injury developed particular consequences that the applicant did not precisely foresee. As long as the consequences are of a kind that an applicant expected to occur, the applicant will be aware of the extent of the injury. The nature or extent of the injury is not synonymous with the precise pathology or consequences of the injury."
22 The High Court concluded (at 16):
"The extent of the worker's condition had to be determined as at the date of the application. By that time the worker was not only fully incapacitated for work, he was also suffering from depression and impotence and his life expectancy was known to have been shortened. His depression and impotence were obviously unknown to him at the expiration of each limitation period. Consequently, those two matters by themselves entitled the learned judge to find that at the end of each period the worker was unaware of the extent of his injury as it existed at the date of the application".
23 Accordingly, in order to determine whether, at a particular date, an applicant knew the nature and extent of his injury, it is necessary to make factual findings as to both the nature and extent of the injury in question.
24 Sidis DCJ did not differentiate between the nature and extent of the opponent's injury. She held merely that the first date upon which the opponent was aware of the "seriousness of his injury" was in September 2000. A finding only of knowledge of the seriousness of the injury conflates nature with extent. It is therefore necessary to examine the evidence relating to these issues and to determine the nature and the extent of the injuries suffered by the opponent as at the date his application was heard, namely, 10 September 2001.
25 The opponent's injuries were caused when he fell three metres from the roof on to compacted dirt. He received a severe injury to his left wrist and there was bruising and grazing over the posterior aspect of the left shoulder. It was found that he had sustained a fracture to the wrist with displacement involving the distal radius and ulna and which necessitated reduction and immobilisation by pins. At the hospital it was found that there was no bony injury to the left shoulder but the range of movement of the shoulder was restricted due to muscular tenderness and bruising.
26 The opponent has never contended that he is entitled to an extension of time because of lack of awareness in relation to his wrist injury. His claim in this regard has always rested on the nature and extent of his shoulder injury.
27 As at 10 September 2001, the opponent's complaints relating to his shoulder were that it was unstable to a serious degree (being prone to dislocation), that it caused restricted movement to a serious extent, that there was serious wasting of the shoulder girdle muscles, that it would continue to deteriorate in condition, that it required surgery if he wished to retain an active life and that, even with the surgery, he would be unfit for work requiring heavy lifting or active use of his left arm or shoulder. The latter complaint was of particular concern to the opponent who was employed as a carpenter in the building industry. There was evidence to support all these complaints and, save in one respect, they were not disputed.
28 The complaint that the claimant disputed was the assertion that, even with surgery, the opponent would be unfit for work requiring heavy lifting or active use of his left arm or shoulder. The claimant pointed to a report dated 17 August 2001 by Prof Sonnabend, a specialist in shoulder injuries, who said that surgical stabilisation of the shoulder would involve "three months absence from heavy manual work, such as carpentry or building". According to Prof Sonnabend, the success rate of such surgery was 95%.
29 The evidence that, even with the surgery, the opponent would be unfit for work requiring heavy lifting or active use of his left arm or shoulder consisted of a statement to this effect by the claimant in an affidavit. He said that his "treating doctors" gave him this information. These doctors included Prof Sonnabend. In cross-examination it was not put to the opponent that this evidence was contradicted by Prof Sonnabend's report and Prof Sonnabend was not cross-examined. The opponent's testimony can be reconciled with that of Prof Sonnabend's report on the basis that surgical stabilisation of the shoulder would involve only three months absence from heavy manual work, such as carpentry or building, but, even with the surgery, the opponent would be unfit for work that required heavy lifting or active use of his left arm or shoulder. In the light of the omission to cross-examine either the opponent or Prof Sonnabend, the evidence should be so construed.
30 Accordingly, the matter is to be approached on the basis that the opponent's complaints are accepted. It follows, in my view, that:
(a) The instability of the shoulder (causing its propensity to dislocation) and that condition which has resulted in restrictive movement (causing weakness in the shoulder girdle muscles and ligaments) fall into the category of the "nature" of the injury.
(b) The likelihood of continued deterioration, the degree of restricted movement, the need for surgery to enable the opponent to retain an active lifestyle, and the fact that even with surgery, the opponent would remain unfit for work requiring heavy lifting or active use of his left arm and shoulder, fall into the category of the "extent" of the injury.
31 I turn now to whether, by the relevant date (25 June 1998), the opponent was unaware of the nature and extent of his injuries as so defined.
32 After the opponent's fall in September 1991, his injuries, initially, were managed by the hospital and orthopaedic surgeons in Orange. The next doctor to examine the opponent's shoulder was Dr Matthews, a general practitioner. The opponent had been a regular patient of Dr Matthews since 1987. In a report dated 1 December 2000, Dr Matthews said that he had seen the opponent on eight to ten occasions over the past ten years (approximately) in connection with problems involving his left shoulder. The first hint of any involvement that Dr Matthews had with the opponent's shoulder was on 13 October 1992 and this was followed on 9 August 1993. Dr Matthews' report describes his examinations of the opponent on these dates as follows:
"[On 13 October 1992] he presented to my practice with (L) upper lateral chest wall tenderness and pain, aggravated by his general carpentry work over the preceding 1 - 2 months. He was prescribed a non-steroidal anti-inflammatory agent. When he presented again on 9.8.93 with similar problems in the (L) upper and lateral chest wall over the 6th and 7th ribs laterally, I organised a CXR - this test revealed no evidence of old fracture in the ribs or (L) shoulder."
33 It is to be noticed that the examination carried out on 13 October 1992 and 9 August 1993 was not focused on the opponent's shoulder. It seems that only peripheral attention was directed to the shoulder on those dates. The most the opponent could have known about his shoulder in that period was that there was no evidence of a fracture and, perhaps, it could be treated by anti-inflammatory drugs.
34 From November 1994 until March 1999 the opponent was working as a carpenter in the building industry. He found that using tools causing jarring or requiring a range of movement of the shoulder, or requiring elevation of the left arm above shoulder height, caused pain in his left shoulder. Nevertheless, he was able to perform his normal duties although he had some difficulties in doing so. Significantly, during this period, his physical condition was such that he did not consider it necessary to see a doctor about his shoulder and did not do so.
35 In 1997, the opponent began to experience dislocations in his shoulder. Initially, the dislocations would mend themselves (although, when the shoulder was first dislocated, the opponent needed to go to hospital to have the dislocation replaced). He did not seek medical attention for these dislocations. At a later stage, not more closely identified than "1998 or 1999", he needed to undergo treatment in hospital, under anaesthetic, to have his shoulder replaced.
36 In early 1999 the opponent's shoulder condition had reached a point where he was having difficulty coping at work. At that stage it became necessary for him to seek treatment. For this reason, in March 1999, he consulted Dr Matthews. This was the first consultation he had with Dr Matthews about his shoulder since 1993. Although not expressly dealt with in the evidence, the inference is that, at that consultation, the opponent asked Dr Matthews only about the pain and restriction in movement that he was experiencing. The instability of the opponent's shoulder was then not sufficiently troublesome for him to mention it to the doctor.
37 In March 1999 Dr Matthews advised the opponent to undergo physiotherapy treatment. This he did on a number of occasions but it had no beneficial effect. Eventually, in September 2000, Dr Matthews referred the opponent to Prof Sonnabend.
38 Dr Matthews was first told about the instability in the shoulder at a consultation on 31 September 2000. In his report of 1 December 2000 Dr Matthews said:
"At consultation on 31.9.00 he told me that during the preceding six years he had experienced a number of dislocations of the (L) shoulder. He has had to present to Orange Base Hospital Casualty on several occasions where the shoulder has been reduced under sedation. More lately, the (L) shoulder would occasionally dislocate when he elevated and moved the (L) arm posteriorly; on these occasions the shoulder would usually 'click back in' within ten minutes. Examination on 31.9.00 revealed a restriction of elevation of the (L) arm by slight pain and weakness. There was obvious wasting of the shoulder girdle muscles, especially from the posterior aspect. … Examination on 31.9.00 and 7.11.00 was difficult to interpret due to the fact that Mr Knight had had a recent bike accident on 30.7.00 … causing tenderness over the distal clavicle. However, the muscle wasting mentioned above, was clearly long standing, but the painful restriction of some shoulder movements may have been aggravated by his recent injury….
It is my feeling that in absence of a significant direct ligamentous injury to the (L) shoulder eg football injury, the history of instability and dislocation is most likely due to a progressive weakness in the shoulder girdle, muscles and ligaments secondary to a persistent favouring of the (L) arm following the severe injury to his (L) wrist and to a lesser extent, his (L) shoulder in the fall from the roof in October 1991."
39 In the course of cross-examination the opponent made a number of concessions that can be summarised as follows. During the period 1994 to 1998 the opponent experienced pain in his shoulder when using carpentry tools. In this period he had a loss of musculature and strength as well as a reduced range of movement in the shoulder (resulting in difficulty in raising his left arm above shoulder height particularly to the side of and behind his body). By December 1997, because he had had those symptoms for a long period of time, he realised that he had serious ongoing problems. He knew by 1998 that further treatment was "at least on the cards". By December 1997, these problems were of sufficient severity to cause the opponent to see a solicitor about bringing a claim against the claimant. He accepted that by 1998 he knew that he had a serious ongoing problem with his left shoulder.
40 In cross-examination it was put to the opponent:
"Indeed you realised by 1998, certainly after the heavy dislocation that future treatment in the form of some sort of surgery may be a possibility in the future, isn't that right?"