Reliance upon medical reports – consideration of context in disputing a workers compensation claim
The decision of a Tasmanian Tribunal to infer meaning from the omission of specific terms in a medical report sought to be relied upon by the employer is successfully appealed in the Supreme Court. The Court rules that individual statements/responses in medical reports and their omissions are to be read in the context of the entirety of the report.
- Does the omission of reference to ‘aggravation’ and/or ‘deterioration’ of a worker’s injury being a disease in a medical report relied upon by an employer, render that employer unable to rely upon that report to dispute the worker’s claim for an injury under the extended definition of injury provided in s 3(1) of the Workers Rehabilitation and Compensation Act 1988 (TAS) (“the Act”)?
The worker claimed compensation for an RSI injury allegedly arising from the worker’s employment at the State Department of Health (“the employer”) after increased mouse and keyboard work.
The decision at the Tribunal
The Tribunal found that the medical report of Dr Ruttenberg, relied upon by the employer, failed to sufficiently address the extended definition of injury as per s 3(1) of the Act – that is, whether the worker had suffered an injury that was a recurrence, aggravation, acceleration, exacerbation or deterioration of a pre-existing injury or disease of which the employment was the major or most significant contributing factor.
Dr Ruttenberg’s report stated that the worker’s injury does not appear to be an ‘acceleration’, ‘exacerbation’ or ‘recurrence’ of a pre-existing injury but omitted reference to ‘aggravation’ or ‘deterioration’. The Tribunal concluded that Dr Ruttenberg’s familiarity with the Act was such that his omission of ‘aggravation’ and ‘deterioration’ was unlikely to be inadvertent. Rather, its omission suggested that the worker’s injury did show signs of ‘aggravation’ and/or ‘deterioration’. As such, the employer was unable to dispute the worker’s claim for compensation as to an injury under the extended definition of injury.
The issues on appeal
Did the Tribunal err in finding that no reasonably arguable case existed due to the medical report relied upon by the employer not referring to ‘aggravation’ or ‘deterioration’?
The Decision on appeal
Pearce J allowed the appeal. His Honour found the Commissioner’s inference that the medical report had intentionally omitted reference to ‘aggravation’ and ‘deterioration’ when addressing the worker’s injury to be unduly technical and unjustified.
Rather, Dr Ruttenberg’s response is to be considered in the context of his report as a whole. Dr Ruttenberg had already expressed his opinion that the worker had suffered an injury which was a disease, without resort to the extended definition provided by s 3(1) of the Act. Thus, it is more likely that the absence of a reference to ‘aggravation’ or ‘deterioration’ in his response was inadvertent and arose because, in the context of his earlier responses, they were not issues he was required to address.
Implications for you
Individual statements/responses provided in medical reports that an employer intends to rely upon to dispute a claim of workers compensation are to be read in the context of the entirety of the report.
An omission of specific phrases or terms from a medical report that an employer intends to rely upon to dispute a claim for workers compensation may not automatically be inferred as intentional and therefore carrying meaning. Rather, the relevant statement/response is to be read in the context of the entirety of the report and what the overall opinion of the doctor was. As can be seen here, Dr Ruttenberg had already expressed an opinion as to the nature of the claimed injury and that there was no work causation, therefore his opinion covered off on all avenues for liability for the worker’s claim to be accepted. What this shows is that a consideration of the whole report from your doctor must be had to ensure all avenues are covered off and the expression of the doctor’s opinion meets the test as to a reasonably arguable case determination as to liability for the claim.