Injured worker not entitled to massage and chiro as will foster “sick mentality”

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The following Administrative Appeals Tribunal (AAT) legal case found that an injured worker was not eligible for paid massage and chiropractic treatment because such treatment is transient and may work against the injured worker’s recovery from stress by fostering a ‘sick mentality’. WTF!

Injured worker not entitled to massage and chiro as will foster “sick mentality”

The case goes back to 2003, when Comcare accepted liability for a Centrelink injured woker’s adjustment and anxiety disorder. Comcare and paid all the injured worker’s medical and like expenses, which included doctors’ appointments, medication, massage, chiropractic and naturopathic care.

However, in 2005, Comcare decided that it was not liable to fund the injured worker’s massage or chiropractic treatments because they were” not reasonable treatments” as defined by s16(1) of the Safety, Rehabilitation and Compensation Act 1988.
The injured worker subsequent appealed the decision in the AAT, stating that the physical sequelae for which she had been receiving massage and chiropractic treatments were related to the injured worker’s original compensable stress condition.

Treatment will foster sick mentality

In the AAT, Dr Stillger (GP) and Dr Stanton (chiropractor) stated that the injured/ill worker’s compensable adjustment and anxiety disorder had caused a fibromyalgia syndrome (= muscle and connective tissue pain) and that massage and chiropractic treatment was reasonable.
The AAT was however more convinced by the evidence of Dr Kostos (rheumatologist and hired gun), Dr Ratcliff (psychiatrist) and Dr Sale (psychiatrist). They all argued that the benefits of on-going massage and chiropractic treatment were ‘transient’ (or short-lived) given the psychiatric — not physical — nature of the injured/ill worker’s condition and that such treatment may be counter-productive in that it could foster a ‘sick role’ mentality and a dependence on such treatment at the expense of undergoing beneficial long-term treatment in the form of medication, psychotherapy and an active exercise program.
The AAT also rejected Dr Stanton’s evidence that the injured/ill wiorker suffered from fibromyalgia syndrome on the basis that he was not a qualified medical practitioner. It was more convinced by Dr Kostos who, as a specialist rheumatologist in musculoskeletal medicine, argued that the injured/ill worker did not display any of the clinical signs of fibromyalgia syndrome that would be consistent with those identified within the accepted diagnostic criteria of the American College of Rheumatology.
‘For these reasons the Tribunal is unable to accept that it was reasonable for Mrs Nolan to continue to receive massage and chiropractic treatment beyond November 2005. The evidence was that such treatment should only be offered in the short-term. Dr Kostos suggested for a period of up to a maximum of two months beyond the date of injury. Whilst such treatment may have provided temporary relief, it cannot constitute reasonable treatment for Mrs Nolan’s condition in that such treatment has no long-term benefit in actually treating a psychiatric condition such as Mrs Nolan’s. The treatment(s) therefore cannot be considered reasonable treatment(s) within the meaning of section 16(1). The Tribunal accordingly affirms the decisions under review.


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