The following NT legal workcover case demonstrates (again) to what lengths workcover insurers will go to deny liability for an injury, more so in cases of psychiatric injury. A psychiatrist (IME) hired by the workcover insurer found the injured worker experienced symptoms of depression as a result of his “difficult circumstances”, as opposed to having major depressive disorder. The insurer stated that the injured worker did not have a psychological injury, or that in the case he did, it was not caused by his (primary) low back injury.
Injured worker wins compensation for psych injury & obesity
A NT injured his (right) knee and his lower back (disc prolapse) in a fall at his workplace, in 2008, for which liability was accepted by the workcover insurer.
The injured worker unfortunately continued to suffer from severe (nerve) pain is his (right) leg, hip area and buttock. Because of his injury (pain, use of neuropathic pain medication etc) he gained a huge amount of weight -92kg to as high as 150kg), became extremely depressed (even suicidal), lacked energy and had to resort to using a walking frame.
The injured worker subsequently claimed compensation (2nd claim) for a psychological injury, which the workcover insurer (and as such employer) disputed.
The case ended up in Court.
The Northern Territory Magistrates Court thankfully found the severe pain that resulted from the injured worker’s physical injury directly contributed to his psychiatric condition and awarded workers’ compensation for major depressive disorder.
The injured worker told the Court that after his workplace injury his weight “ballooned” from about 92kg to as high as 150kg (60 kg), that he had “greatly reduced” energy levels, and that he now needed to use a walking frame to get around.
The injured worker also told the Court that, since his workplace injury, he suffered/suffers from low self-esteem, low motivation, and that he felt/feels useless. In addition the injured worker stated that his medication also (negatively) affected his concentration and physical and mental endurance (or stamina).
The Northern Territory Magistrates Court also heard that the injured worker had tried to commit suicide, and that he had been diagnosed by his treating psychiatrist as having major depressive disorder.
This poor injured worker’s workcover insurer (and therefore also his employer) however contended that the injured worker did not have a psychological injury, or that in the event he did, it was not caused by his (primary) low back injury.
“The opinion of IME Psychiatrist Dr John Roberts was that [the injured worker] was experiencing depression but that this was a reaction to his circumstances arising from his severe neuropathic pain and was a symptom, not a diagnosis.”
To back up their so called “evidence”, they used the fact that a psychiatrist IME hired by the workcove insurer found that the injured worker experienced symptoms of depression as a result of his “difficult circumstances”, as opposed to having major depressive disorder. Of note too is that this IME stated that because the injured worker’s symptoms varied / fluctuated and that he was capable of engaging in ‘social activities’ proved that the injured worker did not have the mental disorder of major depression (WTF).
Thankfully the Court (Magistrate J Neill) did find that the injured worker was/is “quite profoundly depressed” and as a result of his work related back injury. The Magistrate also found that the injured worker was a high suicide risk, regularly feeling hopeless and worthless.
Of note is that the Magistrate also found that the IME (workcover) psychiatrist – Dr John Roberts – only examined the injured worker once, and never treated him, whereas the injured worker’s own psychiatrist had been treating him for over two years.
“I have no hesitation in preferring [the treating psychiatrist’s] assessment of her patient and his symptoms over that of [the employer’s psychiatrist]”
“I find that the severe neuropathic pain experienced by [the worker] over the years from 2008 directly and materially contributed to the development and persistence of the major depressive disorder.”
You can read the full text of the legal case here: PB v Andersfurn Pty Ltd  NTMC 027 (11 November 2014)