(a) date of injury: 7 December 2021 - personal injury and consequential condition;

(b) body systems: left upper extremity (elbow, forearm, wrist and hand) and the skin (TEMSKI - scarring), and

(c) method of assessment: whole person impairment.

1. The documents to be reviewed by the Medical Assessor are:

(a) Application to Resolve a Dispute dated 30 May 2025 and attached documents;

(b) Reply to Application to Resolve a Dispute dated 24 June 2025 and attached documents;

(c) Application to Lodge Additional Documents filed by the applicant on 30 July 2025 and attached documents, and

(d) this Certificate of Determination and Statement of Reasons.

A brief statement is attached setting out the Commission's reasons for the determination.

1. The applicant, Phillip John Yandell, is a 45-year-old man who was employed by the respondent, Walpett Engineering Pty Limited (Walpett), as a trades assistant/labourer.
2. On 7 December 2021, Mr Yandell alleges that, he and other workers were directed by Walpett employees to clear items within its warehouse. This involved moving steel beams and Z purlins from one area of the warehouse to another. Mr Yandell and another worker were required to move a stack of approximately 20 large Z purlins away from an entrance way. The Z purlins were approximately 1m wide and 8m in length. The Z purlins weighed about 50kg each. They were stacked on top of a wooden pallet. As Mr Yandell bent down to loop the crane strap underneath the pallet, the top Z purlins slid sideways and onto his left forearm, crushing it and causing injury.
3. Mr Yandell lodged a claim for benefits under the Workers Compensation Act 1987 (the 1987 Act).
4. On 17 May 2024, Employers Mutual Limited (EML), acting as the agent of NSW Self Insurance Corporation (icare), issued a dispute notice under s 78 of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act) denying an entitlement to lump sum compensation under s 66 of the 1987 Act.[1]
5. On 30 October 2024, Mr Yandell, through his lawyers, requested a review of the decision contained in EML's dispute notice dated 17 May 2024 under s 287A of the 1998 Act.
6. On 5 March 2025, EML issued the outcome of its review under s 287A of the 1998 Act maintaining its decision to deny liability.[2]
7. Mr Yandell, through his lawyers, lodged an Application to Resolve a Dispute (ARD) dated 30 May 2025 in the Workers Compensation Division of the Personal Injury Commission (Commission) claiming permanent impairment compensation under s 66 of the 1987 Act as a result of the injury sustained in the course of employment on 7 December 2021 in respect of his left upper extremity (elbow, forearm, wrist and hand) and scarring.

1. The parties agree that the only issue remaining in dispute is whether Mr Yandell suffered a consequential condition to his left hand as a result of the accepted injuries to his left elbow, left forearm and left wrist on 7 December 2021.

1. The issues in dispute were notified in the dispute notices referred to above.

1. The parties participated in a conciliation conference and arbitration hearing via MS Teams on 5 August 2025. Mr Mark Boulton of counsel appeared for Mr Yandell, instructed by Mr Patrick Gettrust, solicitor. Mr John Gaitanis of counsel appeared for Walpett, instructed by Mr Adrian Todesco, solicitor.
2. During the conciliation phase the parties agreed as follows:

(a) there is no dispute in respect of the injury to the applicant's left elbow, left forearm and left wrist on 7 December 2021 and consequential scarring, and

(b) Mr Yandell's lump sum claim under s 66 of the 1987 Act will be referred to a Medical Assessor for the assessment of whole person impairment (WPI) following the determination of the injury in dispute.

1. I am satisfied that the parties to the dispute understood the nature of the application and the legal implications of any assertion made in the information supplied. I have used my best endeavours in attempting to bring the parties to the dispute to a settlement acceptable to all of them. I am satisfied that the parties have had sufficient opportunity to explore settlement and that they have been unable to reach an agreed resolution of the dispute.

1. The following documents were in evidence before the Commission and considered in making this determination:

(a) ARD dated 30 May 2025 and attached documents;

(b) Reply to ARD (Reply) dated 24 June 2025 and attached documents, and

(c) Application to Lodge Additional Documents (ALAD) lodged on behalf of Mr Yandell dated 30 July 2025 and attached documents.

1. Neither party sought leave to adduce oral evidence from or to cross-examine any witness.

1. In evidence there is a statement by Mr Yandell dated 20 May 2025.[3] I will now refer to the relevant parts of that statement.
2. Mr Yandell stated that, in about November 2021, he was employed by Walpett as a trades assistant/labourer. Walpett conducts a metal fabrication business. Mr Yandell's duties included loading and unloading steel beams from trucks to worksites. He also performed spray-painting.
3. Mr Yandell stated that, on 7 December 2021, he and other workers were directed by Walpett to clear-up the work site within its warehouse. The task involved moving steel beams and Z purlins from one area of the site to another. Mr Yandell described the incident that caused his injuries on the above-mentioned date as follows:

"7. Another worker and I were required to move a stack of approximately 20 large Z purlins away from an entrance way. The Z purlins were approximately 1 metre wide and 8 metres long. They weighed approximately 50 kilograms each. They were stacked on top of a wooden pallet.

1. I assessed the top Z purlins to be crooked so I suggested to the crane driver to move that [sic] particular Z purlins on its [sic] own. The crane driver disagreed and gave me the crane strap to wrap under the pallet in order to lift the whole stack of Z purlins.
2. As I bent down to loop the crane strap underneath the pallet, the top Z purlins slid sideways and onto my left forearm. My arm became wedged between the Z purlins and another piece of steel that was sitting beside the stack I was working on.
3. I felt the skin tear and my ulna and radius fracture under the pressure of the weight.
4. My co-workers came to my aid and lifted the Z purlins off my arm."[4]
5. Mr Yandell stated that a work colleague drove him to Queanbeyan Hospital where, after being assessed, he was transferred to Canberra Hospital.
6. Mr Yandell stated that, whilst in Canberra Hospital, he came under the care of Dr Joseph Smith, orthopaedic surgeon. He was diagnosed as having suffered left open G3 (Gustilo type III) forearm fractures and underwent an open reduction and internal fixation by Dr Smith on 7 December 2021. The volar wound could not be closed due to left arm swelling. On 9 December 2021 and 15 December 2021, Dr Smith performed further surgery.
7. Mr Yandell stated that, in February 2022, it was discovered that he had also suffered a fracture of the left scaphoid. He was ultimately referred to Dr Mark Perko, orthopaedic surgeon. On 12 August 2022, Dr Perko determined that the medical imaging demonstrated a delayed union of the radial fracture and that bone grafting and re-fixation would be appropriate if the delayed union went unchanged. On 14 September 2022, Dr Perko performed a left ulnar revision plate fixation and bone graft surgery to Mr Yandell's left arm. Bone was taken from his left hip. On about 10 February 2023, Dr Perko advised him that the injury had stabilised and that he should not require any further surgery.
8. Mr Yandell stated that he had not returned to work since the incident on 7 December 2021.
9. Mr Yandell described the following ongoing disabilities caused by the work-related incident on 7 December 2021:

(a) pain and restriction in the left arm including stiffness, a sensation of pins and needles and numbness in the left hand and fingers of the left hand;

(b) left arm fatigue which interferes with the ability to attend to every day dexterous tasks;

(c) a decrease in the range of left elbow movement, particularly on rotation;

(d) left arm weakness;

(e) difficulty lifting, carrying and gripping objects with the left hand/arm;

(f) altered sensation in the left arm, often with severe pain, and

(g) diminished sensation in the left forearm leading to other skin injuries from sharp or hot objects.

1. Mr Yandell stated that he had been told by his treating doctors that the symptoms in his left arm are unlikely to resolve.
2. Mr Yandell stated that he had scarring all over his left forearm from the work-related incident on 7 December 2021, as well as from the surgical procedures he had undergone. He is very conscious of the scarring. He notices people looking at the scarring and is embarrassed by the disfigurement. He tries to wear long sleeves if he can. As a result of the bone graft surgery, the scarring is also located on his left thigh and left hip. He is also very aware of this scarring, does not like it and it embarrasses him. The scarring affects his activities. He avoids activities where the scarring is going to be visible to others.
3. Mr Yandell acknowledged having been assessed by Dr Leon Le Leu, occupational physician; Dr Richard Powell, orthopaedic surgeon; Dr Michael McGlynn, plastic surgeon; and Dr Paul Curtin, plastic surgeon.
4. In evidence there is a statement by Mr Yandell dated 29 July 2025.[5] I will now refer to the relevant parts of that statement.
5. In respect of Walpett's denial that Mr Yandell suffered a consequential loss of function in his left hand as a result of the accepted injuries to his left elbow, left forearm and left wrist, he stated that he continues to experience ongoing pain and restriction in his left arm, including stiffness and a sensation of pins and needles with numbness in his left hand and in the fingers of his left hand.
6. Mr Yandell stated that, when he was assessed by Dr Powell, the latter did not evaluate the sensations that he described in his left arm.
7. Mr Yandell stated that he has difficulty lifting, carrying and gripping objects with his left hand. He has altered sensation in his left arm and his pain levels are often severe. He has less sensation in his left forearm which has led to injuries to his skin from sharp or hot objects. When he attempts to hold items with his left hand, he gets a sensation in his left forearm that feels like a lactic acid build-up.
8. Mr Yandell stated that the injury to his left arm and left wrist have affected his ability to use his left hand for which he has required hand therapy. Left hand grip strength is much less than that of the right hand. He has difficulty flexing the fingers of his left hand into a grip. He has difficulty holding onto items with his left hand. Doing things with his left hand feels uncomfortable and he experiences difficulties moving objects with his fingertips.
9. Mr Yandell stated that other symptoms in his left hand include numbness in the left thumb, tingling over the rest of his left hand and limited mobility in the fingers of his left hand. He has diminished sensation in his left forearm over the area of the skin grafting and other areas of his forearm. The scarring on his left forearm is tender to touch.

1. Mr Yandell presented at the Queanbeyan District Hospital on 7 December 2021, where he came under the care of the attending medical officer, Dr Ramachandra Dandu. He was diagnosed as having suffered a compound fracture of the left proximal shaft radius/ulnar as a result of a work injury where a heavy steel object fell directly onto his left arm. On examination, the attending medical officer observed proximal forearm swelling; a laceration to the proximal medio-dorsal forearm skin; a small laceration to the lateral aspect of the proximal forearm; and relatively clean wounds. An X-ray demonstrated a fracture of the proximal third of the shaft of the radius which was displaced and an ulnar fracture. Mr Yandell's wounds were cleaned and an above elbow back slab applied. Morphine and nitrous gas were administered. Mr Yandell was transferred by ambulance to Canberra Hospital for ongoing management.[6]
2. Later, on 7 December 2021, Mr Yandell was admitted to Canberra Hospital where it was recorded that he had presented with left open forearm injuries after impact of a steel bar onto his arm. The primary diagnosis was one of left open Gustilo type III both forearm fracture. He came under the care of Dr Joseph Smith, orthopaedic surgeon, who performed a washout, debridement and an open reduction and internal fixation.[7]
3. On 9 December 2021, Mr Yandell underwent a volar wound examination and washout by Dr Smith.[8]
4. On 15 December 2021, Mr Yandell underwent an excisional debridement of the left forearm and adjacent exudative wound over the medial condyle and a split-thickness skin graft combined with vacuum assisted closure therapy by Dr Faihadiel at Canberra Hospital.[9] Mr Yandell was discharged from Canberra Hospital on 15 December 2021.[10]
5. On 18 February 2022, Mr Matt Channon, physiotherapist of Queanbeyan Physiotherapy reported to Mr Yandell's general practitioners at the Rutledge Family Medical Centre.[11] Mr Channon confirmed that Mr Yandell had presented for assessment and treatment following a left arm injury sustained at work in December 2021 that resulted in an open reduction and internal fixation along with a skin graft. Mr Channon reported the active range of motion measured in respect of Mr Yandell's left elbow and left wrist. He also noted complaints of tightness in the entire forearm, stiffness in the radial ulnar joint and stiffness in the humeral ulnar joint. He did not note any complaints of symptoms in the left hand or in the fingers or thumb of the left hand. Mr Channon advised that early physiotherapy management would focus on restoring ranges of motion in the elbow and the wrist and then progress to strengthening and restoration of function to assist with return to work goals.
6. On 3 March 2022, Mr Yandell underwent a left wrist MRI scan by Dr Neha Singh, radiologist, on the referral of Dr Tosin Idowu, general practitioner of Rutledge Family Medical Centre. The clinical details provided to Dr Singh were that of a radial fracture and a potential scaphoid fracture. Dr Singh concluded that the scaphoid articular surface depression anteriorly at the triscaphe joint articulation was in keeping with a subacute or chronic osteochondral injury. A low-grade scapholunate ligament injury was noted. There was wrist capsular thickening of the extrinsic ligaments, dorsal-radial and also ulnocarpal diffusely that may have occurred post-injury.[12]
7. On 15 March 2022, Dr Idowu referred Mr Yandell back to Dr Smith regarding a probable left hand scaphoid fracture.[13]
8. On 28 March 2022, Dr Smith provided a report to Dr Idowu.[14] Dr Smith referred to Mr Yandell's workplace injury on 7 December 2021 when his left arm was crushed by heavy steel causing an open fracture of the left proximal radius and ulna. Dr Smith confirmed that Mr Yandell underwent an open reduction and internal fixation of the left radius and ulna and also confirmed that the volar wound was unable to be closed because of swelling in the left arm. Mr Yandell underwent a splint skin graft during his hospital admission. Dr Smith noted that Mr Yandell had been making satisfactory progress with regard to his left forearm but had been developing some pain overlying his left wrist with associated volar swelling and some tenderness overlying the ulna wound from the surgery.
9. On examination on 28 March 2022, Dr Smith observed some moderate tenderness overlying the anatomical snuffbox and scaphotrapezial articulation; tenderness overlying the volar aspect of the flex or carpi radialis; and some hypersensitivity and tenderness overlying the ulna wound. He measured Mr Yandell's left elbow and left wrist ranges of motion. He recommended that Mr Yandell rest his left wrist and use a thumb spica splint. Dr Smith stated that Mr Yandell could perform some gentle range of motion of his fingers and wrists but no heavy lifting or resistance. He recommended a repeat MRI scan and an X-ray of the left wrist and left forearm in six weeks, after which, he would consider when Mr Yandell could progress his physiotherapy.
10. On 26 April 2022, Ms Samantha Cawte, occupational therapist of Flexout Health, provided a report to Dr Idowu.[15] There is some doubt about whether the report was prepared on 26 April 2022 as it referred to an assessment on 2 June 2022. In any event, Ms Cawte noted that Mr Yandell had sustained a crush injury at work on 7 December 2021 as a result of a metal pole landing on his left arm causing fractures to his ulna and radius that required an open reduction and internal fixation and skin graft to the forearm. She noted that he also sustained a fracture to the scaphoid which was missed until February 2022. She observed that Mr Yandell had obvious signs of muscle wasting in the left arm. In respect of sensory issues, Ms Cawte noted numbness over the dorsum of the left thumb and tingling over the rest of the radio-dorsal aspect of the left hand, where the radial nerve innervates. On active range of movement a full functional fist was achieved. Strength was not tested due to pain on gripping. She noted that Mr Yandell had been wearing a long thumb spica splint since 29 March 2022. Ms Cawte recommended that, in addition to hand therapy and psychological treatment, Mr Yandell would benefit from exercise physiology.
11. On 26 April 2022, Ms Victoria Gorringe, physiotherapist, occupational therapist and hand therapist of Flexout Health, provided a report to iCare.[16] She noted that Mr Yandell had been fitted with a wrist thumb spica splint and given exercises to maintain movement and sensorimotor of the left hand, elbow and shoulder. Ms Gorringe also recommended that, in addition to hand therapy and psychological treatment, Mr Yandell undergo exercise physiology to maintain physical strength and conditioning whilst he was medically required to wear a splint on the left wrist for the scaphoid fracture to heal.
12. On 12 May 2022, Mr Yandell underwent X-rays of his left wrist and left forearm by Dr Jade Lee, radiologist, on the referral of Dr Idowu. Dr Lee found that internal plate and screw fixation of the proximal to mid-radial and ulna shaft fractures were demonstrated. There was mild bony remodelling involving the radial shaft fracture but the ulna shaft fracture lines remained readily discernible with no overt callus formation or bony remodelling. There was no significant widening of the distal radio-ulnar articulation. There was no new fracture of the ulna. There was grossly normal alignment of the elbow joint. There was no overt sclerosis or fragmentation involving the distal pole of the scaphoid site of the demonstrated osteochondral impaction fracture. The scapholunate interval was not widened.[17]
13. On 31 May 2022, Mr Yandell underwent a left wrist MRI scan by Dr Stephen Repse, radiologist, on the referral of Dr Idowu. Dr Repse concluded that there were two small concavities at the distal articular surface of the scaphoid that were less conspicuous than on previous imaging with mild associated local oedema, likely osteochondral defects or related to full-thickness chondral fissures. There was no new macro fracture. There was mild patchy bone stress response in the lunate. There was a subacute partial tear of the intercarpal ligaments at the distal-ulnar aspect of the scaphoid. There was likely a subacute small split tear of the dorsal band of the scapholunate ligament, through which a 6mm ganglion now protruded and that had developed since March 2022. There was a sprain of the dorsal radiocarpal ligament which remained contiguous. There was mild effusion about the carpus with mild features of synovitis, likely mechanical.[18]
14. On 2 June 2022, Ms Cawte provided a report to Dr Idowu.[19] In her report, Ms Cawte observed obvious signs of muscle wasting along the left arm and in respect of sensory symptoms, noted numbness over the dorsum of the thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates. On active range of movement a full functional fist was achieved. Strength was not tested due to pain on gripping. She noted that Mr Yandell had been wearing a long thumb spica splint since 29 March 2022. Ms Cawte also noted that the primary concern at that time was the ununited ulna fracture. Amongst other things, she again recommended referral to an exercise physiologist and specialist review to assess and develop a plan for the ulna fracture and other injuries.
15. On 6 June 2022, Dr Smith reported to Dr Idowu.[20] Dr Smith noted that Mr Yandell reported ongoing pain overlying the ulna fracture site. The left wrist had settled and there was no tenderness overlying the radius. He noted that recent imaging demonstrated a non-union of the ulna fracture. The radial fracture had progressed to union and the distal pole of the scaphoid demonstrated an osteochondral injury that was not symptomatic. He did not note any complaints of symptoms in the left hand or in the fingers or thumb of the left hand. Dr Smith recommended that Mr Yandell undergo a bone grafting of the ulna from the iliac crest.
16. On 12 August 2022, Dr Mark Perko, orthopaedic surgeon, provided a report to Dr Luke Franceschini, general practitioner of Rutledge Family Medical Centre.[21] Dr Perko took a history of injury that was consistent with the evidence. Dr Perko noted that Mr Yandell had resumed his day-to-day activities and did not have any pain at rest but that with activity, the left arm ached. He noted that Mr Yandell was right hand dominant. On examination, Dr Perko observed a well-healed anterior scar with skin grafting. There was altered sensation on the radial border of the left wrist and hand and mild dysaesthesia. There was good hand function. There was localised swelling and tenderness in the region of the ulna fracture. Grip strength was reduced in comparison to the opposite side. Dr Perko reviewed the medical imaging of May 2022 and noted that the radial fracture had united but that the fracture line for the ulna remained visible. Dr Perko recommended bone grafting and re-fixation of the left ulna if Mr Yandell's symptoms remained unchanged.
17. On 15 August 2022, Mr Yandell underwent an X-ray of his left forearm by Dr Lee on the referral of Dr Perko. Dr Lee found that the plate and screw fixation of the proximal to

mid-radial and ulnar shafts were again demonstrated with no interval change in position of hardware. There was no evidence of hardware loosening or other complications. There was very mild callus formation seen along the radial aspect of the ulna fracture along with some sclerosis but the remaining fracture line remained readily discernible in keeping with features of a delayed union. There was stable alignment of the ulna shaft fracture.[22] 18. On 26 August 2022, Dr Perko provided a report to Dr Franceschini.[23] Dr Perko reported that Mr Yandell had consulted him that day and reported no change in his symptoms since his last review. Pain remained over the ulna. He had also developed some left shoulder pain. Medical imaging did not demonstrate any substantial change from the imaging in May 2022. The fracture line remained clearly visible although, some callus was evident. Dr Perko opined that there was no certainty that Mr Yandell's fracture would go on to union given his slow progress. Dr Perko opined that Mr Yandell required revision plating and bone grafting to manage the delayed union in the ulna. In respect of the left shoulder, Dr Perko recommended focus on a program of scapular stabilising and core exercises. Dr Perko noted that he would seek insurer approval for the proposed ulna revision plating and bone grafting. 19. On 14 September 2022, Mr Yandell underwent a left ulna revision plate fixation and bone grafting by Dr Perko at Mater Private Hospital.[24] On 15 September 2022, Mr Yandell underwent a post-surgical X-ray of his left arm.[25] 20. On 7 October 2022, Dr Perko provided a report to Dr Franceschini.[26] Dr Perko reported that Mr Yandell had consulted him that day and that he was recovering well. Both the iliac crest and left forearm wounds had healed well. Pain was settling and he was beginning to recover. He encouraged Mr Yandell to carry out only light day-to-day activities and advised that, once the pain had settled, he could commence a rehabilitation program with forearm strengthening and graduated exercises. 21. On 1 November 2022, Mr Yandell underwent a left forearm X-ray by Dr Himanshu Diwakar, radiologist, on the referral of Dr Perko. Dr Diwakar observed plate and screws in the radius and ulnar with callus formation at the site of the ulna fracture. There was more progressive callus formation seen on comparison with the previous study on 15 August 2022. There was no fracture of the radius identified.[27] 22. On 2 December 2022, Ms Cawte provided a report to Dr Idowu.[28] In her report, Ms Cawte observed, amongst other things, obvious signs of muscle wasting along the left arm and in respect of sensory symptoms, noted numbness over the dorsum of the thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates. On active range of movement a full functional fist was achieved. Grip strength was measured at 48kg on the right and 50kg on the left with pain at the centre of the left wrist and forearm rating 6/10. She again recommended referral to an exercise physiologist to build up the strength in his left arm and core. 23. On 19 December 2022, Mr Yandell underwent a left forearm X-ray by Dr Gunaratnam, radiologist, on the referral of Dr Perko. Dr Gunaratnam observed that the plate and screws traversed the shaft of the left radius and ulna. Alignment was satisfactory. There was near complete union at both sites although, a subtle fracture line was still visualised involving the left ulna mid-shaft. There had been moderate interval healing since November 2022.[29] 24. On 10 February 2023, Dr Perko provided a report to Dr Franceschini. Dr Perko reported that Mr Yandell had consulted him that day and that he had continued to recover with better strength although, it was still less than the opposite hand. Mr Yandell still reported some altered sensation in the left forearm and left hand. There was occasional swelling over the ulna plate but no longer any local tenderness. The most recent medical imaging was good and demonstrated that union was progressing. Dr Perko opined that Mr Yandell would, at best, have a permanent restriction requiring permanent modification for heavy work. He did not expect that Mr Yandell would require any further intervention but observed that there was a possibility that, if there were continued swelling and irritation from the plate to the subcutaneous border, the plate may require removal.[30] 25. On 28 April 2023, Mr Daniel Vandenbroucke, exercise physiologist, of Flexout Health provided a report to Dr Idowu.[31] Mr Vandenbroucke noted that Mr Yandell's capacity had increased significantly over the past two months. He was able to complete a maximum lift of 35kg without aggravation of the forearm pain to levels which prevented him in completing physical tasks. In respect of sensory symptoms, he noted numbness over the dorsum of the thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates. On active range of movement a full functional fist was achieved. Grip strength was measured at 48kg on the right and 50kg on the left with pain at the centre of the left wrist and forearm rating 6/10. 26. Mr Vandenbroucke was of the opinion that Mr Yandell had a good understanding of strengthening and exercise principles and that he was able to self-manage his rehabilitation. Mr Vandenbroucke noted that Mr Yandell was returning to work in the coming weeks where he would be required to lift a maximum of 20kg. He opined that Mr Yandell would be able to tolerate the physical tasks required of him in his new role and there were no concerns with his return to physical duties. He discharged Mr Yandell from exercise physiology treatment. 27. On 8 May 2023, Dr Franceschini issued Mr Yandell with a final certificate of capacity certifying him fit for pre-injury work from 15 May 2023 with a capacity for some type of work from 5 May 2023 to 14 May 2023 for 8 hours per day, five days per week. The only restriction referred to was driving as tolerated.[32]

1. On 17 January 2024 and 24 January 2024, Mr Yandell consulted Dr Le Leu, occupational physician, at the request of his lawyers. In evidence, there are a reports by Dr Le Leu both dated 27 January 2024.[33] The six page report related to his assessment of WPI in respect of the left upper extremity. I will now refer to the relevant parts of those reports.
2. Dr Le Leu listed and provided brief summaries of the documents sent to him by Mr Yandell's lawyers.[34]
3. Dr Le Leu took a history of injury and a history of treatment thereafter that was consistent with Mr Yandell's evidence.
4. Dr Le Leu noted the current symptoms in Mr Yandell's left elbow, left forearm and left wrist. Included in the symptoms related to the left wrist, were very uncomfortable sensations of pins and needles with numbness in the left ulnar three fingers and sometimes, the left index finger.
5. Dr Le Leu conducted a physical examination of Mr Yandell's head/neck, bilateral elbows, bilateral wrists, bilateral forefingers, bilateral middle fingers, bilateral ring fingers, bilateral little fingers, lumbar spine and lower limbs. He tested grip strength and lateral pinch strength.
6. Dr Le Leu observed that Mr Yandell's left dominant forearm was 24cm in diameter compared with the right forearm at 26cm. He observed a pronounced muscular deficiency over the ulnar side of the left forearm immediately distal to the elbow. There was a marked allodynia and diminished sensation over the area of skin grafting and over the slightly rolled edges of the wound. He noted that, overall, there was an extensive reduction in sensation over the flexor aspect of the left forearm with allodynia extending a few centimetres proximal to the left elbow. Tinel's test was negative over the mid cubital fossa. Over the medial epicondyle, it resulted in tingling going down the ulnar side of the left forearm. At the wrist, it caused tingling to go into the four fingers but not the thumb. There was extensive herniation of the musculature and overlying tissue in the proximal part of the left forearm wound. Reflexes were depressed but symmetrical.
7. In respect of grip strength and lateral pinch strength, Dr Le Leu opined that there was a loss of normal left hand dominance.
8. Dr Le Leu opined that Mr Yandell suffered a compound fracture of the left radius and ulna, a rupture of the flexor carpi radialis and a left scaphoid fracture as a result of the impact of the Z purlin onto his left forearm on 7 December 2021.
9. Dr Le Leu opined that Mr Yandell's current disabilities arose from the significant weakness of his left arm and the severe allodynia with reduced sensation over the skin graft. In particular, Mr Yandell experienced difficulty in lifting, carrying, manipulating and gripping with his left arm and hand. The injuries were going to be permanent. The only foreseeable complication is further loss of tissue in the left arm due to disuse.
10. Dr Le Leu opined that Mr Yandell was totally unfit for his pre-injury occupation and could not perform work of a moderate to high physical nature. He could only perform light work using his right hand with a lesser contribution from his left hand with the following restrictions:

(a) no lifting, carrying, pushing or pulling greater than 10kg (or horizontal force equivalent);

(b) no requirement for a strong, reliable grip with the left hand;

(c) no requirement for precision manipulation with the left hand, and

(d) no work on ladders or at heights.

1. Dr Le Leu explained that he based his assessment of Mr Yandell's left upper extremity WPI on left elbow movement; left wrist movement; left finger movement (through altered function of flexor tendons through the forearm); and loss of and/or altered sensation. He assessed left upper extremity impairment at 24% WPI. He went on to assess skin - scarring on the table for the evaluation of minor skin impairment (TEMSKI) at 7% WPI but following an objection raised by EML's lawyers, scarring was separately assessed by Dr Michael McGlynn, hand, plastic and reconstructive surgeon on behalf of Mr Yandell.

1. On 18 March 2024, Mr Yandell consulted Dr Powell, orthopaedic surgeon, at the request of EML's lawyers. In evidence, there is a report by Dr Powell dated 14 May 2024.[35] I will now refer to the relevant parts of that report.
2. Dr Powell provided a list of documents reviewed by him in the preparation of his report.[36]
3. Dr Powell took a history of injury and a history of treatment thereafter that was consistent with Mr Yandell's evidence.[37]
4. Dr Powell noted Mr Yandell's current symptoms as some persisting discomfort along the ulnar shaft of an aching character; dysesthesia that extended from just below the elbow to the wrist and then on to the ulnar three digits; and subjective loss of strength in the hand without complaint of any significant elbow, wrist or hand stiffness.
5. Dr Powell observed that Mr Yandell was a compliant and cooperative patient throughout the taking of history and examination. There was no suggestion of overreaction or exaggeration. He was not in any obvious discomfort during the examination.
6. On examination of Mr Yandell's left upper limb, Dr Powell observed a series of surgical scars over the volar and posterior aspects of the forearm with a healed volar split skin graft. There was reduced sensation to light touch involving the left upper limb below the elbow in a global fashion. There was no focal tenderness to palpation of the elbow, forearm, wrist or hand. Range of motion of the elbow was mildly restricted with supination 50° and pronation 50°. There was normal elbow flexion and extension. There was a full range of motion of the wrist and all digits in all planes. There were no definitive features of a peripheral nerve lesion. The elbow and wrist were ligamentously stable. Provocative testing of the triangular fibrocartilage complex and the distal radioulnar joint were negative.
7. Dr Powell had no investigations available for review.
8. Based on his examination of Mr Yandell and his review of the available documents, Dr Powell could find no evidence that Mr Yandell had sustained a specific injury to the index, middle, ring or little finger of the left hand. He noted that his examination of the left hand was unremarkable.
9. Dr Powell stated that he had reviewed Dr Le Leu's report and noted that they had reached similar assessments in relation to the left elbow. However, their assessments in relation to the left wrist and left hand were markedly different. Dr Powell stated that his clinical examination of Mr Yandell did not reveal any evidence of restrictions in range of motion of the left wrist and left hand and that, therefore, there was no assessable permanent impairment in relation to those areas.
10. Accordingly, the only impairment assessed by Dr Powell was in respect of Mr Yandell's left elbow, which he assessed at 2% WPI.

1. On 30 September 2024, Mr Yandell consulted Dr McGlynn, hand and plastic and reconstructive surgeon, at the request of his lawyers. In evidence, there are two reports by Dr McGlynn both dated 2 October 2024.[38] The 10 page report related to his assessment of WPI in respect of skin impairment (TEMSKI - scarring) and his calculation of WPI as lead assessor combining his assessment with the assessment of Dr Le Leu. I will now refer to the relevant parts of those reports.
2. Dr McGlynn took a history of injury and a history of treatment thereafter that was consistent with Mr Yandell's evidence.
3. Dr McGlynn noted that Mr Yandell was conscious of readily visible scarring caused by the subject injury and surgical treatment. The scarring attracted the attention of others and caused Mr Yandell embarrassment. The left forearm scarring had reduced sensation and was tender on touch or on the application of pressure.
4. Dr McGlynn provided a list of investigations and documents reviewed by him for the purposes of his report.[39]
5. Dr McGlynn's examination focused on Mr Yandell's scarring. He took measurements and provided the following descriptions of the scarring:

"There was an oval split-skin graft scar on left proximal anterior forearm 90mm x 40mm, hyperpigmented with speckled hypopigmentation causing easily identifiable colour contrast, with easily visible contour defect due to indentation and elevation together with meshed pattern of the skin graft. The graft was visibly thin and a trophic [sic], adherent to underlying muscle, with no visible suture marks.

At the proximal end of the left forearm skin graft, there was a transverse scar around the medial border of proximal forearm 50mm x 3mm, hypopigmented with noticeable colour contrast flat, with no visible suture marks, and no trophic features.

At the distal end of the left forearm skin graft, there was a longitudinal scar 50mm x 10mm, hypopigmented with noticeable colour contrast flat, with no visible suture marks, no adherence, and minimal trophic features.

On left lateral hip, there was an oblique scar at bone graft donor site 50mm x 3mm, slightly hyperpigmented with some colour contrast, slightly indented, with no visible suture marks, no adherence, and minimal trophic features.

On anterior thigh, and [sic] there was a rectangular split-skin graft donor site 100mm x 40mm, slightly hyperpigmented with noticeable colour contrast, flat, with no trophic features."[40]

1. Dr McGlynn opined that the scarring to Mr Yandell's left forearm, left thigh and left hip were caused by the work incident on 7 December 2021 and subsequent necessary surgical treatment.
2. Dr McGlynn assessed Mr Yandell's skin - scarring at 5% WPI on the TEMSKI table.

1. On 24 January 2025, Mr Yandell consulted Dr Curtin, hand and plastic surgeon, at the request of EML's lawyers. In evidence, there is a report by Dr Curtin dated 29 January 2025.[41] I will now refer to the relevant part of that report.
2. Dr Curtin provided a list of documents reviewed by him in the preparation of his report.[42]
3. Dr Curtin took a history of injury and a history of treatment thereafter that was consistent with Mr Yandell's evidence.
4. Dr Curtin's examination focused on Mr Yandell's scarring. He took measurements and provided the following descriptions of the scarring:

"There was an obvious deformity on the volar aspect of the left forearm due to an area of scarring extending for 13 x 4cm just distal to the elbow. The scarring represented the site where the fasciotomy wound had been closed with a skin graft, so that the scarring presented an irregular surface, with the underlying muscle bulging in the centre of the scar. The scarring was therefore adherent to deeper tissues, there were some visible suture marks, and there was a colour contrast between the scar and the surrounding skin due to pigmentation of the scar.

There was a further scar on the forearm, in this case a fine line scar extending for 12cm along the ulnar border. The scar was only faintly visible, with no obvious suture marks, and was not adherent.

There was also a small flat, curved scar extending for 4cm on the medial aspect of the left elbow.

There was altered sensation on the radial aspect of the hand and extending over the base of the thumb and index fingers.

Harvesting the bone graft had left a good quality, slightly indented, fine line scar extending for 5cm adjacent to the left iliac crest.

Harvesting the skin graft had resulted in a flat area of pale soft scarring extending for 10 x 5cm on the lateral aspect of the left thigh."[43]

1. Dr Curtin's diagnosis was one of noticeable scarring and disfigurement of the left forearm. There was altered sensation in the distribution of the terminal sensory branches of the left radial nerve.
2. Dr Curtin opined that Mr Yandell's scarring fell into the 5% to 9% WPI category of the TEMSKI table and provided the following reasons:

"The claimant is conscious of the scarring and is able to easily locate it on his body. The location of the scarring is usually and clearly visible with usual clothing, there is some adherence, and there is an easily visible contour defect. The skin graft covering forearm muscle is quite thin and may be more vulnerable to trauma, although there is no evidence that the area has been recently or frequently traumatised. There is a noticeable colour contrast due to pigmentary changes rather than a distinct colour contrast, and therefore the impairment falls towards the lower end of the range at 6% WPI."[44]

1. The parties made oral submissions at the arbitration hearing which were sound recorded. The sound recording is available to the parties. I will provide an outline of the parties' submissions below.

1. It is incumbent on Mr Yandell to satisfy the Commission that there has been a consequential condition to his left hand caused by the accepted injuries to his left elbow, left forearm and left wrist. Dr Le Leu did not provide any compelling opinion to satisfy the Commission of the claimed consequential condition of the left hand.
2. The longer of Dr Le Leu's two reports dated 27 January 2024 essentially, did not deal with Mr Yandell's left hand. However, the WPI report did and spoke of left finger movement and loss of and/or altered sensation. Dr Le Leu attempted to explain the loss and/or altered sensation. However, his attempt in this regard was speculative, in that, he said that the loss and/or altered sensation were not necessarily due to a direct injury to the medial and brachial cutaneous nerve and the musculocutaneous nerve but perhaps a combination of that injury to peripheral fibres plus the effects of the skin graft. On that evidence, it is difficult for the Commission to form the view that there has been a consequential condition to Mr Yandell's left hand.
3. Walpett relies on the contents of its dispute notices dated 17 May 2024 and 5 March 2025 and in particular, the references therein to parts of Dr Powell's report dated 14 May 2024. Walpett's denial of a consequential condition in Mr Yandell's left hand relied on Dr Powell's opinion that, based on his examination and review of the documents provided to him, he could find no evidence that Mr Yandell sustained a specific injury to the index, middle, ring or little finger of the left hand. Further, examination of the left hand was unremarkable.
4. Dr Powell noted that Mr Yandell reported a subjective loss of strength in the left hand but did not complain of any significant elbow, wrist or hand stiffness. On examination, Dr Powell observed that Mr Yandell had a full range of motion of the left wrist and all digits in all planes. There were no definitive features of a peripheral nerve lesion. Dr Powell opined that Mr Yandell had obtained an excellent result from a very severe injury. He had some minor stiffness and restriction in range of motion of the forearm rotation with some sensory changes involving the left upper limb below the elbow but otherwise, fairly normal function of the elbow, wrist and hand.
5. On 2 December 2022, Ms Cawte, in respect of active range of motion, observed that Mr Yandell achieved a left fully functional fist and noted numbness over the dorsum of the thumb and tingling over the rest of the radio-dorsal aspect of the hand. On 28 April 2023, Mr Vandenbroucke made the same observations. These observations were consistent with those of Dr Powell and reinforces the latter's opinion.
6. Perhaps, there may be subjective symptomatology in relation to the left hand, but what is such condition attributed to?
7. The only reference Mr Yandell made to his left hand in his statement dated 20 May 2025 was at [24] where he referred to experiencing numbness in his hand and fingers and in [28] where he referred to difficulties lifting, carrying and gripping objects with his left hand/arm. In his supplementary statement dated 29 July 2025, Mr Yandell went into a little more detail in respect of his left hand at [6], [7] and [9]-[12]. Mr Yandell's descriptions in this regard raised the spectre of perhaps radicular pain into the left hand and not necessarily injury to the left hand. On the evidence, it is unclear as to whether there has been a frank injury to the left hand or a consequential condition in the left hand.
8. The evidence on causation is unsatisfactory and does not provide the Commission with any comfort in making findings as to what it is that has caused symptoms in Mr Yandell's left hand. There is a complaint about tingling and numbness in the left hand with an unidentifiable cause on the evidence. The Commission would not be satisfied that there has been an injury to the left hand.

1. Mr Yandell's statement dated 29 July 2025 referred to the issues with his left hand. His evidence was that he had undergone hand therapy. Why would he be having hand therapy but for experiencing some loss of function in his left hand? Hand therapy indicates perfectly well that there was a loss of function in his left hand. Mr Yandell's statement in respect of his left hand cannot be discounted and indicates a loss of function in that hand. If his left hand symptoms were not a result of the injuries he sustained at work on 7 December 2021, what else would it be? There was no indication that there was anything wrong with his left hand before 7 December 2021.
2. On 28 March 2022, Dr Smith reported that Mr Yandell could perform some gentle range of motion of his fingers and wrists but no heavy lifting or resistance at that time.
3. On 26 April 2022, Ms Gorringe noted that Mr Yandell had been referred to hand therapy for splinting and rehabilitation. He had been fitted with a wrist thumb spica splint and given exercises to maintain movement and sensorimotor of his hand, elbow and shoulder.
4. On 26 April 2022, 2 June 2022 and 2 December 2022, Ms Cawte reported that Mr Yandell was receiving hand therapy. He was referred to hand therapy for splinting and rehabilitation. She noted numbness over the dorsum of the thumb and tingling over the rest of the

radio-dorsal aspect of the left hand where the radial nerve innervates. A full functional left fist was achieved. 5. On 28 April 2023, Mr Vandenbroucke noted numbness over the dorsum of the thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates. A full functional left fist was achieved. 6. On 27 January 2024, Dr Le Leu noted that Mr Yandell could experience very uncomfortable pins and needles with numbness in the ulnar three fingers and sometimes, the index finger. He had to keep his hand and wrist warm to reduce symptoms. The wrist and hand could become sweaty when he thought of things. Dr Le Leu assessed Mr Yandell's fingers and determined that there was loss of motion in the fingers. Dr Le Leu provided the cause of Mr Yandell's left hand symptoms when he assessed loss of left finger movement through altered function of flexor tendons through the forearm. 7. Whilst it was curious that Dr Powell found that Mr Yandell's left hand had a full range of motion, it does not really matter because there was a loss of motion when he was examined by Dr Le Leu, which suggests that there had been a problem with this hand since the

work-related injury. In those circumstances, Mr Yandell's left hand ought to be referred to a Medical Assessor to assess WPI. 8. On 29 January 2025, Dr Curtin reported that, on examination, there was altered sensation on the radial aspect of the left hand and extending over the base of the left thumb and index finger. 9. There have obviously been changes in Mr Yandell's left hand of a sensory nature. There has been measured impairment in terms of loss of motion by Dr Le Leu. Mr Yandell has complained of the difficulties he has experienced using his left hand since 7 December 2021 and there was no suggestion that he had any difficulties with his left hand beforehand. There is compelling evidence to include the left hand for referral to a Medical Assessor for a WPI assessment.

1. On 27 January 2024, Dr Le Leu noted that, at the wrist, it caused tingling to go into the four fingers, not the thumb. He also noted that Mr Yandell had difficulty with the left arm when gripping. This indicates there is not a gripping problem with the hand but that it is the arm that causes the gripping problem.
2. On 24 April 2023, Mr Vandenbroucke reported that grip strength was 48kg on the right and 50kg on the left with pain in the centre of the wrist and forearm at 6/10. This indicates that the grip in the problematic left side is greater than the right side but that there is some pain at the centre of the wrist and forearm when he lifts that 50kg.
3. On the evidence, the Commission cannot find any identifiable pathology in the left hand other than tingling and numbness that seems to be referrable to what is going on in the left forearm. It could be an unrelated radicular type problem causing some tingling and numbness as opposed to the hand itself.
4. There is no explanation why Ms Gorringe had Mr Yandell undertake hand therapy other than to try and alleviate his claimed symptoms. However, there is no report from any other doctor recommending that he undergo hand therapy.

1. It is unnecessary for me to determine whether Mr Yandell's left hand symptoms are in themselves 'injuries' pursuant to s 4 of the 1987 Act: Moon v Conmah Pty Ltd (Moon),[45] Kumar v Royal Comfort Bedding Pty Ltd[46] (Kumar) and Bouchmouni v Bakos Matta t/as Western Red Services[47].
2. Further, s 9A of the 1987 Act does not apply to a condition that has resulted from an injury: Tiritabua v Bartter Enterprises Pty Ltd[48].
3. The onus of establishing a consequential condition as a result of an accepted injury falls on Mr Yandell and the standard of proof is on the balance of probabilities, meaning that I must be satisfied to a degree of actual persuasion or affirmative satisfaction: Department of Education and Training v Ireland_[49]_ (Ireland) and Nguyen v Cosmopolitan Homes[50] (Nguyen).
4. I am required to conduct a common sense evaluation of the causal chain to determine whether the left hand symptoms complained of by Mr Yandell have resulted from the accepted injuries to his left elbow, left forearm and left wrist on 7 December 2021: Kooragang Cement Pty Ltd v Bates[51] (Kooragang). This requires a careful analysis of the evidence and a careful analysis of the expert evidence: Kirunda v State of New South Wales (No 4)[52] (Kirunda). The causal relationship must be established on the balance of probabilities from evidence in an acceptable form: Munce v Thomson Cool Rooms Pty Ltd[53] (Munce).

1. The unchallenged evidence in respect of the mechanism of injury is that, on 7 December 2021, Mr Yandell was involved in moving steel beams and Z purlins from one area of Walpett's warehouse to another. Mr Yandell and another worker were required to move a stack of approximately 20 large Z purlins away from an entrance way. The Z purlins were about 1m wide and 8m in length. They weighed about 50kg each. They were stacked on top of a wooden pallet. Mr Yandell observed that the Z purlin at the top of the stack was crooked and suggested to the crane driver that it be moved on its own. The crane driver disagreed and provided Mr Yandell with a crane strap to wrap under the pallet to enable the whole stack of Z purlins to be lifted. As Mr Yandell bent down to loop the crane strap underneath the pallet, the top Z purlin slid sideways and onto his left forearm, crushing it between the Z purlin and another piece of steel that was sitting beside the stack he was working on.
2. The unchallenged medical evidence is that, as a result of the incident described above, Mr Yandell sustained a compound displaced proximal shaft fracture of the left radius; a compound left ulna fracture; a rupture of the left flexor carpi radialis; and a left scaphoid fracture (not diagnosed until about February 2022). On 7 December 2021, Mr Yandell underwent a washout, debridement and an open reduction and internal fixation of the left radius and left ulna. There were complications, in that, the volar wound was unable to be closed because of left arm swelling. On 9 December 2021, Mr Yandell underwent a volar wound examination and washout. On 15 December 2021, Mr Yandell underwent an excisional debridement of the left forearm fasciotomy wound and adjacent exudative wound over the medial condyle and a split-thickness skin graft (from the left thigh) combined with vacuum assisted closure therapy. There was a further complication, in that, there was delayed union of Mr Yandell's left ulna fracture. On 14 September 2022, Mr Yandell underwent a left ulna revision plate fixation and bone grafting (from the iliac crest).
3. In his evidentiary statements, Mr Yandell did not identify when he first experienced the onset of the symptoms in his left hand.
4. There was no reference to symptoms in Mr Yandell's left hand in the hospital discharge summaries or in the reports of the treating doctors and allied health care providers until about March 2022, which coincided with Dr Idowu's diagnosis of a probable scaphoid fracture of the left hand on 15 March 2022.
5. On 28 March 2022, Dr Smith noted that Mr Yandell had been developing some pain overlying his left wrist with associated volar swelling and some tenderness overlying the ulna wound from surgery. Dr Smith observed that the recent MRI scan of the left wrist demonstrated a distal pole injury of the scaphoid with a small depressed osteochondral fragment. He recommended that Mr Yandell rest the left wrist and organised a thumb spica splint. He also advised that Mr Yandell could perform some gentle range of motion of the fingers and wrist but no heavy lifting or resistance.
6. In April and/or June 2022, Ms Cawte, occupational therapist, noted that Mr Yandell, in respect of sensory issues, had numbness over the dorsum of the left thumb and tingling over the rest of the radio-dorsal aspect of the left hand, where the radial nerve innervates. She also noted that he had been wearing a thumb spica splint since 29 March 2022. Amongst other things, she recommended referral to a hand therapist.
7. On 26 April 2022, Ms Gorringe noted that Mr Yandell had been fitted with a wrist thumb spica splint and had been provided with exercises to maintain movement and sensorimotor of the left hand, elbow and shoulder. She recommended hand therapy and psychological treatment.
8. As noted by Ms Cawte on 2 June 2022, the primary concern, at that time, had been Mr Yandell's ununited ulna fracture.
9. On 12 August 2022, Dr Perko noted that there was altered sensation on the radial border of Mr Yandell's left wrist and hand and mild dysaesthesia. Whilst there was good hand function, there was localised swelling and tenderness in the region of the ulna fracture and grip strength was reduced in comparison to the opposite side.
10. On 2 December 2022, Ms Cawte again noted, amongst other things, numbness over the dorsum of the left thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates.
11. On 10 February 2023, Dr Perko observed that Mr Yandell's left hand strength was less than the opposite side and noted that Mr Yandell still reported some altered sensation in the left forearm and left hand.
12. On 28 April 2023, Mr Vandenbroucke noted that, in respect of sensory symptoms, Mr Yandell complained of numbness over the dorsum of the left thumb and tingling over the rest of the radio-dorsal aspect of the left hand where the radial nerve innervates.
13. Walpett submitted that Dr Le Leu did not provide any compelling opinion to satisfy the claimed consequential condition of Mr Yandell's left hand and that his opinion was speculative. I find such submission unconvincing for the reasons set out below.
14. On 27 January 2024, Dr Le Leu noted the current symptoms in Mr Yandell's left elbow, left forearm and left wrist. Included in the symptoms related to the left wrist, were very uncomfortable sensations of pins and needles with numbness in the left ulnar three fingers and sometimes, the left index finger. In respect of grip strength and lateral pinch strength, Dr Le Leu opined that there was a loss of normal left hand dominance. He opined that the loss of finger movement he detected in Mr Yandell's left hand was caused by the altered function of flexor tendons through the left forearm and that the sensory loss was due to damage to cutaneous nerves plus the effects of the skin graft and was a mixture of complete loss and allodynia. He further opined that those losses were in the territory of the medial and brachial cutaneous nerve in the musculocutaneous nerve but not necessarily due to direct injury to those nerves and perhaps a combination of that, peripheral fibres and the effects of the skin graft.
15. Rule 73(c) of the Personal Injury Commission Rules 2021 provides that "evidence based on speculation or unsubstantiated assumptions is unacceptable." Rule 73(d) of the Personal Injury Commission Rules 2021 provides that "unqualified opinions are unacceptable."
16. It is well established in the authorities such as Paric v John Holland (Constructions) Pty Ltd[54] (Paric); Makita (Australia) Pty Ltd v Sprowles[55] (Makita); South Western Sydney Area Health Service v Edmonds[56] (Edmonds); and Hancock v East Coast Timbers Products Pty Ltd[57] (Hancock); that there must be a "fair climate" on which a doctor can base an opinion. Whilst it is accepted that medical experts do not need to provide elaborate or detailed explanations for their conclusions, more than a mere "ipse dixit" (an assertion without proof) is required.
17. Dr Le Leu prepared detailed reports and conducted an extensive clinical examination of Mr Yandell. He recorded his findings in detail. Dr Le Leu explained, albeit concisely, the actual path of reasoning by which he arrived at his opinion. In NSW Police Force v Hahn,[58] DP King SC observed that, often, experts also use their experience and medical intuition, and when they arrive at an opinion, it cannot always be elaborated and explained at length. This common sense approach leads me to the conclusion that Dr Le Leu's opinion is a satisfactory one and, in my view, was expressed as more than an assertion without proof or mere speculation.
18. On 14 May 2024, Dr Powell noted Mr Yandell's current symptoms as some persisting discomfort along the ulnar shaft of an aching character; dysesthesia that extended from just below the elbow to the wrist and then on to the ulnar three digits; and subjective loss of strength in the hand without complaint of any significant elbow, wrist or hand stiffness. Contrary to Dr Le Leu, Dr Powell observed, on examination of the left upper limb, a full range of motion of the wrist and all digits in all planes and no definitive features of a peripheral nerve lesion. Dr Powell stated that he could find no evidence that Mr Yandell had sustained a specific injury to the index, middle, ring or little finger of the left hand. However, Dr Powell did not engage with the subject issue of a consequential condition in Mr Yandell's left hand and fingers as a result of the accepted injuries to the left elbow, left forearm and left wrist on 7 December 2021. In such circumstances, I prefer the opinions of Dr Le Leu over that of Dr Powell.
19. On 29 January 2025, Dr Curtin, who was engaged by Walpett, noted that there was altered sensation on the radial aspect of Mr Yandell's left hand that extended over the base of the thumb and index finger. The altered sensation was in the distribution of the terminal sensory branches of the left radial nerve.
20. I accept and find that, at some time following the incident on 7 December 2021, Mr Yandell experienced symptoms in his left hand as referred to in his evidentiary statements and I accept that he continues to suffer from symptoms in his left hand.
21. There was no evidence that Mr Yandell experienced any symptoms in his left hand prior to the incident on 7 December 2021. Caution must always be taken in relying on an absence of reference in clinical material as proof of the absence of any symptomology in a given body part. The absence of complaints of symptoms in the left hand in the reports of treating doctors and allied health professionals prior to March 2022 is not surprising in circumstances where the preponderance of the medical evidence demonstrated that the focus of treatment was on Mr Yandell's severe accepted injuries and in particular, the delayed union of the left ulna fracture.
22. Walpett submitted that Mr Yandell's descriptions of symptoms and restrictions in his left hand and fingers raised the spectre of perhaps unrelated radicular pain into the left hand and not necessarily injury to the left hand. I find such submission not only unconvincing but also speculative. There is no evidence to support the submission.
23. Having regard to the whole of the evidence, applying a common sense test and for the reasons referred to above, I am satisfied that Mr Yandell has discharged the onus of proving on the balance of probabilities that there is a sufficient causal chain connecting the condition of his left hand to the accepted injuries to the left elbow, left forearm and left wrist on 7 December 2021 and I find accordingly.

1. My determination and orders are set out in the Certificate of Determination attached to this Statement of Reasons.

[5] ALAD dated 30 July 2025 at pages 3-4.

[45] Moon v Conmah Pty Ltd [2009] NSWWCCPD 134 at [43], [45] and [50].

[46] Kumar v Royal Comfort Bedding Pty Ltd [2012] NSWWCCPD 8 at [35]-[49] and [61]).

[47] Bouchmouni v Bakos Matta t/as Western Red Services [2013] NSWWCCPD 4.

[48] Tiritabua v Bartter Enterprises Pty Ltd [2008] NSWWCCPD 145 at [47].

[49] Department of Education and Training v Ireland [2008] NSWWCCPD 134.

[50] Nguyen v Cosmopolitan Homes [2008] NSWCA 246.

[51] Kooragang Cement Pty Ltd v Bates (1994) 35 NSWLR 452; 10 NSWCCR 796.

[52] Kirunda v State of New South Wales (No 4) [2018] NSWWCCPD 45 at [136].

[53] Munce v Thomson Cool Rooms Pty Ltd [2017] NSWWCCPD 39 at [101].

[54] Paric v John Holland (Constructions) Pty Ltd [1985] HCA 58.

[55] Makita (Australia) Pty Ltd v Sprowles [2001] NSWCA 305; 52 NSWLR 705.

[56] South Western Sydney Area Health Service v Edmonds [2007] NSWCA 16; 4 DDCR 421.

[57] Hancock v East Coast Timbers Products Pty Ltd [2011] NSWCA 11; 80 NSWLR 43.

[58] NSW Police Force v Hahn [2017] NSWWCCPD 51 at [60].