An employee whose role required him to look at more than one computer screen claims he injured his neck, shoulder, and arm when he turned his head at work. 

The claim hinged on the injury meeting the definitions of the Safety, Rehabilitation and Compensation Act 1988 (Cth) to receive compensation under section 14, which was denied.

The Department of Human Services (DHS) engaged the employee to work in a Child Support Smart Centre in Brisbane and employed by the DHS since 9 February 2009. The work involved the employee turning his head from one computer screen to another, making notes and dealing with phone calls. 

On 13 August 2018, the employee completed a customer call when he turned his head to the left to make notes, and he felt pain in his upper arm and neck after turning his head. The first aid officer saw him straight away, and he was off the phone for a couple of hours before going home on sick leave. He submitted a workers’ compensation claim for an injured neck, shoulder and left arm on 28 August 2018.

The dispute

Whether the employee’s injury resulted in death, incapacity for work, or impairment and is entitled to compensation under section 14 of the Safety, Rehabilitation and Compensation Act 1988 (Cth). To determine that it was necessary to assess whether the employee’s injury met the definition of “injury” and “disease” in the Act, Section 5A(1)(b) that was significantly caused by employment.

What did the medical evidence say? 

Several medical opinions were sought with similar assessments. On 27 August 2018, an MRI on the employee’s cervical spine showed “spondylotic changes associated with the C5/6 level with mild disc bulge” and suspected “impingement of the C6 nerve roots.” 

On 10 October 2018, the employee was examined by an occupational physician, whose insight of the MRI films showed that the employee had “a degree of mild spondylosis present with disc bulge at C5/6 and C6/7 leading to some narrowing of the nerve root exits of the left C6 and C7 nerve roots.”

A separate orthopaedic surgeon’s report on 24 June 2019 concluded the employee “suffered from C5/6 cervical spondylosis with a prolapsed intervertebral disc which was pre-existing but asymptomatic.” 

Further to that, the employee’s doctor said, “the simple act of turning the head to the left would not ordinarily be expected to lead to cervical spine pain or irritation of the nerve roots in the spine without a degree of pre-existing spondylosis or disc bulge.” The orthopaedic surgeon also confirmed that when the employee turned his head at work, it caused an exacerbation of the symptoms and that the only connection with employment was the employee was at work at the time the incident occurred. 

In addition, a supplementary report on 18 July 2019 from the orthopaedic surgeon stated, “there was no work-related activity that would have had a significant relationship to the onset of the survival spondylotic symptoms.” 

There was a slight differing of opinion between a general practitioner that saw the employee immediately after the incident versus the orthopaedic surgeon who reported on 28 November 2019 the employee suffered a disc prolapse/disc protrusion rather than a disc bulge. 

The justice took the evidence of the orthopaedic surgeon over the general practitioner, given their respective training and experience. 

The findings 

The justice found the employee did not suffer an injury but an age-related disease, and the symptoms were experienced by the employee turning his head in a “normal movement”. “The applicant was in the unfortunate position of having degenerative changes caused by age” and over time “resulted in a disc bulge/prolapse, that was not employment-related.” 

The bottom line: an employee can sustain an injury at work. However, it does not mean it is an injury or disease as defined by the Act caused by employment that will be covered by worker’s compensation. A work injury may only be the tip of the iceberg, as in this case, and with further medical investigation, it was obvious that it was a pre-existing condition.

The judgment: Hook and Comcare (Compensation) [2020] AATA 1792 (17 June 2020)