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[1999] VSC 249
Supreme Court of Victoria
1999-07-02
Smith, J.
Original judgment source is linked above.
Administrative Law - Workcover claim - Medical Panel - Convenor - extent of obligation to accord natural justice.
(a) the decision made by the first defendant to convene a Medical Panel to consider medical questions referred by the Workcover Conciliation Service in relation to the plaintiff (b) the decision made on 12 October 1998 by the Medical Panel constituted by the second, third and fourth defendants in answer to medical questions referred by the Workcover Conciliation Service in relation to the plaintiff.
She also seeks orders in the nature of Mandamus that the Medical Panel convened by the first defendant and constituted by the second, third and fourth defendants consider any medical questions in relation to the plaintiff in accordance with law. Finally, she seeks directions from the court to achieve that result. Directions sought include directions
"for the giving of an opportunity to the plaintiff by herself and by her legal representatives of being heard on - (a) the proper form and content of the medical questions to be determined by, (b) the material already in the possession of, and (c) material to be sent to - the Medical Panel."
At the commencement of the hearing, HIH Worker's Compensation (Vic) Ltd and Eastern Health Care Network were added as defendants. It was those defendants who were represented and opposed the application.
"According to histories given to a number of examiners it appears that this lady was carrying out her duties as a Supervisor in the Catering section of the Alfred Hospital on 1 September 1992 when she received a severe electric shock from a piece of equipment known as a Carusel. She was thrown backwards on to a chair. She noticed numbness in the right hand and was advised to go to Casualty however, she continued working and completed her shift. The next day she attended work and was sent to Casualty but had no time from work. She continued working until 1995 but ceased due to continual pain in the hand. There were then periods of returns to work but eventually in 1995 ceased again and has not worked to date."
"A. Your incapacity is no longer caused or materially contributed to by an injury arising out of or in the course of your employment. B. Your employment is no longer a significant contributing factor to your injuries. C. You have been in receipt of weekly payments for 104 weeks and you do not have a Serious Injury and you are not totally and permanently incapacitated. D. You are no longer incapacitated for employment."
The document noted that reports were sent to the Panel from Mr Elsner and Doctors Mendleson, Turecek and Baker on behalf of the insurer and from Dr Moore and Mr Strangward for the worker. The reports were identified by their dates. The document also stated that it had been agreed at the conference of parties held on 14 August 1998 that on the basis that the medical evidence presented by the parties was conflicting, then this matter should be referred to the Medical Panel. In terms, the document did not say that the worker had agreed to the actual questions. The document set out the questions referred by the Conciliator to the Medical Panel. They were as follows:
"A. What is the nature of the workers medical condition relevant to injury B. What is the extent to which any physical or mental condition resulted, or was materially contributed to by the injuries C. What is the workers degree of impairment in relation to the condition/s identified in response to questions (a) when assessed in accordance with s.91. D. Is the worker capable of performing her pre-injury duties. E. If not, does the worker have a current work capacity. F. If so what employment would, and what employment would not constitute suitable employment. G. Does the worker have no current work capacity. H. Did the workers incapacity for work result from, or was it materially contributed to by the injury."
"ENQUIRIES Please contact me on 9628 1174 if you have any queries concerning this referral."
I assume that the concluding statement was directed, as the letter was, to the Medical Panel.
"The more relevant and complete the information the better. This will help the Medical Panel doctor understand your injury or condition"
It then referred her to a brochure which was said to be enclosed. There was no evidence before me that it was and no evidence as to its contents.
A. Mrs Weerappah does not suffer from any medical or psychiatric condition related to the injury. B. Her current physical and mental conditions have not resulted from nor were they materially contributed to by the said injury. C. As there is no identifiable permanent work related mental or physical condition, the degree of impairment in accordance with s.91 is zero per cent. D. Yes the worker is capable of performing her pre injury duties. E. Not applicable - the worker is capable of performing her pre injury duties. F. Not applicable - the worker is capable of performing her pre injury duties. G. The worker has a current work capacity. H. The worker has no incapacity for work."
"Receipt of referrals 8. The Convenor will examine each referral and if a question is not clear in its meaning or is not a statutory medical question appropriate to be determined by a Medical Panel, the Convenor will not convene a Panel to address the question until he consults the person making the referral with a view to clarifying or amending the question/s. 9. The Convenor will endeavour to ensure that that (sic.) all parties concerned have been or will be provided with a copy of the referral and all supporting documents received from the referring body. Further information 10. The Convenor may, before convening a Panel in a particular case seek such further information and advice that the Convenor considers necessary or desirable for the proper consideration of the medical question by a Medical Panel. 11. The Convenor will advise all parties in writing of any further information and/or advice that he receives in relation to the referral."
Counsel for the plaintiff submitted that the Convenor failed to apply the procedure set out in the directions in cl. 8, 9 and 10. He could not have considered the questions (Direction 8) because if he had he would not have allowed them to proceed. On the evidence, he took no steps in accordance with Direction 9. He did not seek the information about the original injury needed to make any sense of the questions (Direction 10). Counsel also referred to further clauses concerning the Convenor's duties:
"18. the Convenor will notify the worker of examination appointments, and will ensure that the notification is accompanied by :- * an information booklet relating to Medical Panels (which explains, among other things, the procedures of Medical Panels and the legal status of the opinions); * a list of all relevant documents in the Panel's possession; * a request that the worker supply to the Convenor, for distribution to the Medical Panel, copies of any additional documents in the worker's possession (including documents in possession of the worker's legal representative) that relate to the medical question(s) referred; and * advice as to the possible implications of the failure to attend a Medical Panel appointment or the failure to supply documents or answer questions."
Counsel for the plaintiff submitted that while Doctor Nisselle claimed to have complied with the directions, no booklet or list of documents or invitation to supply further documents was delivered to the worker. Counsel for the plaintiff then referred to clauses dealing with the Convenor's obligations on receipt of the opinion.
"29. The Convenor will ensure that the Certificate of Opinion and the Reasons for Opinion are in the appropriate form and that the medical questions have been answered. 30. If the Convenor believes there is any deficiency in relation to the form of the answers to the Medical Questions on the face of the Certificate of Opinion or Reasons for Opinion then he will communicate his concerns to the presiding member of the Medical Panel in a manner that does not undermine the independence of the Panel in the exercise of its functions. 31. On receiving details of the concerns of the Convenor, the presiding member will communicate with the other Panel Members with a view to deciding whether or not to take any further action in relation to the opinion and the reasons, and to re-drafting Certificate of Opinion and/or Reasons for Opinion. 32. After the Panel resolves the concerns over the form of the Certificate of Opinion and/or Reasons for Opinion, the presiding member will forward the final document to the Convenor. 33. On receiving the final Certificate of Opinion and final Reasons for Opinion from a Medical Panel, the Convenor will immediately forward the Certificate of Opinion to the referrer. Where the referral was received from an Authorised Insurer, Victorian Workcover Authority or Self insurer, a copy of the Certificate of Opinion will also be forwarded to the worker. 34. On request from a relevant party, the Convenor will provide a copy of the written Reasons for Opinion."
Counsel for the plaintiff submitted that the Convenor was given an active role in the decision making process and, having regard to what appears in the Certificate of Opinion and Reasons, failed to discharge his obligations.
"Where a member/s of a Medical Panel examining a worker possesses information, or is aware of any circumstances or consideration, that is contrary to anything that the worker says to the member/s, the member/s should inform the worker of the matter and invite the worker to make any desired comment on it within a specified time and, subject to statutory time limits, the Medical Panel's opinion should not be concluded until such comment has been received or the specified time has expired, as the case may be. The worker's comment should be taken into consideration by the member/s."
(a) a denial of any opportunity to be heard on the form and content of the medical questions to be put to the Panel (b) a lack of notice of any reference to the medical Panel and (c) the denial of an opportunity to put forward material relating to the medical questions both as to their form and as to the merits of the matters referred to the medical Panel.
* documents to the parties in simple form setting out the questions referred
* a list of the documents supplied by the Conciliator to the Panel
* an invitation to the parties to make comments on the questions and materials, they having had no opportunity before the Conciliator
* an invitation to add any materials which the parties argued were relevant to the questions
and nominated a limited time in which to attend to those matters. The Panel or Convenor should also have asked that, if any further information was to be supplied, it should be supplied to the opposing parties. The plaintiff conceded that if those steps had been taken by the Convenor, they would have discharged the obligation to accord natural justice whether it was imposed on the Convenor or the Panels. It was said, also, that in the circumstances of this case a specific obligation arose to give the worker the opportunity
* in person or in writing to place material before the Panel to deal with the video tape.
* to detail the earlier history of the matter at the time of the examinations or at another time.
"Where the decision in question is one for which provision is made by statute, the application and content of the doctrine of natural justice or the duty to act fairly depends to a large extent on the construction of the statute. In Mobil Oil Australia Pty Ltd v Federal Commission of Taxation, Kitto, J. pointed out that the obligation to give a fair opportunity to parties in controversy to correct or contradict statements prejudicial to their view depends on ` the particular statutory framework'. What is appropriate in terms of natural justice depends on the circumstances of the case and they will include, inter alia, the nature of the enquiry, the subject matter and the rules under which the decision maker is acting . . . "
Counsel also referred to the following passage from the judgment of Brennan, J. at 627:
"What the principles of natural justice require in particular circumstances depends on the circumstances known to the repository at the time of the exercise of the power or the further circumstances which, had he acted reasonably and fairly, he would then have known. The repository of a power has to adopt a reasonable and fair procedure before he exercises the power and his observance of the principles of natural justice must not be measured against facts which he did not know and which he would not have known at the relevant time though he acted reasonably and fairly. As the obligation to observe the principles of natural justice is not correlative to a common law right but is a condition governing the exercise of a statutory power, the repository satisfied the condition by adopting a procedure which conforms to the procedure which a reasonable and fair repository of the power would adopt in the circumstances when the power is exercised. When the question for the court is whether the court is satisfied, the court must place itself in the shoes of the repository of the power to determine whether the procedure adopted was reasonable and fair.
For the defendants it was submitted that there was an obligation on the Panel to accord procedural fairness to all parties and that this was a heavy responsibility. Counsel also submitted that, while the Panel had done nothing to draw matters to the attention of the plaintiff or her solicitors, nonetheless, there had been no breach of natural justice because the plaintiff and her solicitors had received all necessary information to enable her to have a fair hearing prior to the Panel's decision. Counsel submitted that the Conciliation Officer had advised the solicitors of the reference and the questions referred and the materials supplied. The Convenor had, in the document relating to medical examinations, informed the plaintiff of the identity of the Panel and the identity of the Convenor. Further it was put that the plaintiff had the opportunity at each of the examinations to say whatever was necessary. She had the opportunity also to raise any matters and refer any documents she wished including the original claim form and there was no evidence to suggest she was prevented in any way from doing so. It was further submitted that there was no obligation upon the Panel to raise matters specifically. The opportunities were there, at the medical examination appointments to give a full history and to deal with any other issues such as the content of the questions or the provision of early history or explanations of the video tape.
"63 Establishment and Constitution (1) Medical Panels must be constituted as necessary for the purposes of this act to carry out such functions as may be conferred on a Medical Panel under this Act." Section 63 goes on to refer to the appointment of members for the Panels by the Governor in Council and the appointment of one of them as Convenor by the Minister. It is then provided: "(4) Each Panel must consist of one, two or three members nominated by the Convenor of the Medical Panel." The powers and procedures of a Medical Panel set out in s.65 as follows: "65. Procedures and powers (1) A Panel is not bound by the rules or practices as to evidence, but may inform itself on any matter relating to the reference in any manner it thinks fit. (2) The Panel must act informally, without regard to technicalities or legal forms and as speedily as a proper consideration of the reference allows. (3) . . . (4) Any attendance of a worker before a Medical Panel must be in private, unless the Medical Panel considers that it is necessary for another person to be present. (5) A Panel may ask a worker -
(a) to meet with the Panel and answer questions
(b) to supply copies of all documents in the possession of the worker which relate to the medical question to the Panel;
(c) to submit to a medical examination by the Panel or by a member of the Panel.
"The Panel considered the medical reports of Misters Strangward and Elsner, of Doctors Mendelson, Turecek, Baker, Moore, Arulanatham and Gordan, the video tape provided by the authorised insurer and documentation by Mr Andrew Watt (Customer Service Officer FAI Workerscompensation). The Panel's opinion is based on the documents and tape provided, the worker's reported history and physical findings on examination."
I note that the reference to the "documentation by Andrew Watt" was accepted between the parties to be as a reference to the letter from FAI Workers Compensation Insurance to the plaintiff advising her that the payments had been stopped. This document somehow found its way before the Panel but nothing turns on the fact that it had that document and the plaintiff was not aware of it. It is an example, however, of the Panel having a document and failing to inform the parties of that fact. I note also that the reports of Doctors Arulanatham and Gordan were not referred by the Conciliation Officer to the Panel, but the plaintiff made no issue of that fact.
"But I am inclined to think that the general principle is that a rule of natural justice which goes to the very basis of judicature (as I think this does) cannot be waived. You cannot by waiver convert a nullity into a validity"
"With respect, I do not think that this proposition is sound. Counsel can always, I would have thought, waive, in the sense of not wishing to exercise, some procedural or other forensic rights. If he does so voluntarily, and with knowledge of the options open to him, it follows that he has not been deprived of any right or privilege and hence has not been denied justice."
It was put for the plaintiff that the defendants would have to establish that the plaintiff voluntarily and with knowledge of the options open to her made the deliberate choice not to exercise the rights that she had and that that is something the defendants cannot demonstrate on the evidence before me.
"A person likely to be affected by an administrative decision to which requirements of procedural fairness apply can support his or her case by appropriate information but cannot complain if it is not accepted. On the other hand, if information on some factor personal to that person is obtained from some other source and is likely to have an effect on the outcome, he or she should be given the opportunity of dealing with it: Kioa v West at 587 (Mason, J.) 628 (Brennan, J.). Within the bounds of rationality a decision maker is generally not obliged to invite comment on the evaluation of the subject's case: Sinnathamby v Minister for Immigration and Ethnic Affairs (1986) 66 ALR 502 at 506 (Fox, J.), 513 (Neaves, J.) . . . The general proposition set out above may be subject to qualifications in particular cases. Two such qualifications were enunciated by Jenkinson, J. in Somaghi at 108 - 109: 1. The subject of a decision is entitled to have his or her mind directed to the critical issues or factors on which the decision is likely to turn in order to have an opportunity of dealing with it: Kioa v West at 587 (Mason); Sinnathamby at 348 (Birchett, J.); Broasserd v Minister for Immigration and Ethnic Affairs (1989) 21 FCR 472 (Burchett, J.). 2. The subject is entitled to respond to any adverse conclusion drawn by the decision maker on material supplied by or known to the subject which is not an obvious and natural evaluation of that material: Minister for Immigration and Ethnic Affairs v Kooma (unreported), Full Court, Federal Court, 31 May (1990); Kioa v West at 573, 588 and 634.
His Honour observed that those qualifications may be no more than an application of the general requirement of procedural fairness in particular cases. As Gummow, J. there said at (359):
"in a particular case fairness may require the applicant to have the opportunity to deal with matters adverse to the applicants interest which the decision maker proposes to take into account, even if the source of concern by the decision maker is not information or material provided by the third party, but what is seen to be the conduct of the applicant in question."
(a) There was no direct contact between the Panel or the Convenor and the parties which purported to formally set up the Panel's review as between the parties.
(b) The only document sent by the Convenor to the parties was the letter to the worker advising the worker of medical examinations. Further, there was nothing done to indicate to the worker that there would not be a hearing, or similar procedure to deal with non-medical issues.
(c) There was nothing said or done to indicate that the examination would be the only contact that would occur between the worker and the Panel before the Panel expressed its opinion.
(d) There was no indication to the worker that the worker could do anything more than attend the examination and answer questions and generally "help the Panel doctor".
Weerappah
Nisselle [1999] VSC 249
(1985) 159 CLR 550
(1986) 67 ALR 21
(1986) 17 NSWLR 51
(1986) 66 ALR 502
(1989) 21 FCR 472