Blanch v Workers' Compensation Regulator [2021] QIRC 408
QUEENSLAND INDUSTRIAL RELATIONS COMMISSION
CITATION: Blanch v Workers' Compensation Regulator
[2021] QIRC 408
PARTIES: Blanch, Terry
(Appellant)
v
Workers' Compensation Regulator
(Respondent)
CASE NO.: WC/2021/34
PROCEEDING: Appeal against decision of Workers'
Compensation Regulator
DELIVERED ON: 2 December 2021
HEARING DATE: 22 September 2021
MEMBER:
HEARD AT:
Power IC
Brisbane
ORDERS: 1. The appeal is allowed.
2. That the decision of the Workers'
Compensation Regulator be set aside.
3. That the Appellant be paid benefits as a
worker with a terminal condition
pursuant to Chapter 3, Part 3, Division
4 of the Workers' Compensation and
Rehabilitation Act 2003 (Qld).
4. Failing agreement on costs, to be the
subject of a further application to the
Commission.
5. Liberty to apply.
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2
CATCHWORDS: WORKERS' COMPENSATION –
ENTITLEMENT TO COMPENSATION –
entitlements of worker with terminal condition –
meaning of terminal condition – whether
appellant suffered a terminal condition pursuant
to s 39A of the Workers' Compensation and
Rehabilitation Act 2003 (Qld) – interpretation of
s 39A of the Workers' Compensation and
Rehabilitation Act 2003 (Qld) – appellant
entitled to compensation
LEGISLATION: Acts Interpretation Act 1954 (Qld), s 14B
Workers' Compensation and Rehabilitation Act
2003 (Qld), ss 5, 39A, 128A, 128B, 128C, 190
and 234
Workers' Compensation and Rehabilitation Act
and Other Act Amendment Act 2005 (Qld),
sch 3, s 4
Workers' Compensation and Rehabilitation and
Other Acts Amendment Bill 2005 (Qld)
Workers' Compensation and Rehabilitation and
Other Legislation Amendment Act 2019 (Qld),
ss 36 and 732
Workers' Compensation and Rehabilitation and
Other Legislation Amendment Bill 2019 (Qld)
CASES: Alcan (NT) Alumina Pty Ltd v Commissioner of
Territory Revenue (2009) 239 CLR 27
Certain Lloyd's Underwriters v Cross [2012]
HCA 56
Federal Commissioner of Taxation v
Consolidated Media Holdings Limited (2012)
250 CLR 503
Mondelez Australia Pty Ltd v Automotive, Food,
Metals, Engineering, Printing and Kindred
Industries Union [2020] HCA 29
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3
Project Blue Sky Inc v Australian Broadcasting
Authority [1998] HCA 28
R v Anderson: ex parte IPEC-Air Pty Ltd [1965]
HCA 27
R v Lavender [2005] HCA 37
Schipp & Anor v The Star Entertainment Qld
Limited [2019] ICQ 009
SZTAL v Minister for Immigration and Border
Protection; SZTGM v Minister for Immigration
and Border Protection [2017] HCA 34
APPEARANCES: Mr G.W. Diehm QC of Counsel instructed by
Maurice Blackburn Lawyers for the Appellant.
Mr S.A. McLeod of Counsel directly instructed
by the Respondent.
Reasons for Decision
Introduction
[1] Mr Terry Blanch ('the Appellant') appeals a decision of the Workers' Compensation
Regulator ('the Respondent') to confirm an earlier decision of XtraCare ('the Insurer') to
reject the Appellant's request for terminal latent onset lump sum compensation in
accordance with the Workers' Compensation and Rehabilitation Act 2003 (Qld)
('the WCR Act').
[2] On 25 May 2020, the Appellant made a request for terminal benefits pursuant to s 128B
of the WCR Act. This request was rejected by the Insurer, and following an application
for review, the Respondent confirmed the decision to reject the request. The Appellant
subsequently filed a notice of appeal to the Queensland Industrial Relations Commission
('the Commission') appealing the decision of the Respondent.
Background
[3] The Appellant's submissions provide an unchallenged background to this matter.
Between about 2003 and about 2013, the Appellant was exposed to respirable coal and
silica dust in the course of his employment including with Glencore at the Oaky North
Mine.
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4
[4] In about 2015, the Appellant developed a persistent cough and began to experience
shortness of breath. Since this time, his cough has persisted and his shortness of breath
has slowly worsened over the years.
[5] The Appellant initially underwent a chest x-ray on or about 20 March 2017 and
underwent a chest CT-scan on or about 4 April 2018, which demonstrated abnormalities.
[6] On or about 6 July 2018, Dr James McKeon, thoracic physician, diagnosed the Appellant
with chronic bronchitis, chronic obstruction pulmonary disease ('COPD') and
emphysema.
[7] The Appellant was previously a light smoker who commenced smoking when he was
approximately 22 years of age and abstained from smoking for seven years before finally
ceasing when he was approximately 60 years of age.
Nature of Appeal
[8] The appeal to the Commission is conducted by way of a hearing de novo in which the
Appellant bears the onus of proof.1 The questions to be answered in the determination of
the appeal are:
(a) whether the Appellant's latent onset injury is a terminal condition certified by a
doctor as being a condition that is expected to terminate the Appellant's life in
accordance with s 39A(1) of the WCR Act; and
(b) whether the medical diagnosis of the terminal nature of the condition should be
accepted in accordance with s 39A(2) of the WCR Act.
Matters not in dispute
[9] The following issues are not in dispute in this matter:
(a) the Appellant was a worker who sustained an injury;
(b) the Appellant's injury is a 'latent onset injury' being COPD;
(c) section 190 of the WCR Act does not prevent the Appellant from obtaining
additional compensation by virtue of ss 128B and 128C of the WCR Act in
circumstances where his personal injury meets the definition of 'terminal condition';
(d) the medical condition arose after 31 January 2015 and, by virtue of s 732(1) of the
Workers' Compensation and Rehabilitation and Other Legislation Amendment Act
2019 (Qld) ('the WCR Amendment Act 2019'), the current version of s 39A of the
WCR Act applies to this matter; and
1 Qantas Airways Limited v Q-Comp (2006) 181 QGIG 301.
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(e) on the basis that no challenge was made in the proceedings to the diagnoses, the
Appellant has been diagnosed with a condition that is expected to terminate his life.
Matter in dispute
[10] The issue in dispute is whether the Appellant has a 'terminal condition' pursuant to s 39A
of the WCR Act. The relevant section is outlined as follows:
39A Meaning of terminal condition
(1) A terminal condition, of a worker, is a condition certified by a doctor as being a
condition that is expected to terminate the worker’s life.
(2) A condition is a terminal condition only if the insurer accepts the doctor's diagnosis
of the terminal nature of the condition.
Medical Evidence
[11] Dr McKeon opined on 8 May 2020 in a further supplementary medicolegal report that:
…
In my opinion, Mr Blanche's health will deteriorate in the future due to his chronic obstructive
pulmonary disease (COPD). I have enclosed a table labelled "Functional Performance Status" which
sets out his dependency status.
Mr Blanch is currently in a stage of low dependency which will probably last for about eight years.
He will then probably move into a period of moderate dependence for about six years. He will then
probably move into a period of high dependence for four years during which time he will require
home oxygen therapy. He is likely to be in a period of complete dependence for the last one month
of his life.
Mr Blanch is predicted to live to the age of eighty four years, according to New South Wales Life
Tables, 2016 to 2018. In my opinion, his chronic obstructive pulmonary disease (COPD) and
emphysema are likely to reduce his life expectancy by about two years meaning that he is likely to
die before the age of eighty two years.
…
Mr Blanch is likely to develop gradually worsening shortness of breath on exertion which will
interfere with his ability to do yard work, home maintenance and heavy housework. He is also likely
to suffer from recurrent lower respiratory tract infections causing acute bronchitis and pneumonia.
He is likely to require hospitalisation for significant respiratory infection every couple of years. It
will probably take six to eight weeks to recover from acute respiratory infections.
…
Yes, chronic obstructive pulmonary disease (COPD) is a divisible condition in the sense that each
and every exposure to cold dust Mr Blanch experienced made a small contribution to his overall
disease.
…
On the balance of probabilities, in my opinion, Mr Blanch will probably die of his chronic
obstructive pulmonary disease (COPD).
…
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Based on data provided by the Australian institute of Health and Welfare in a review published on
20 May 2010 entitled "Asthma, chronic obstructive pulmonary disease and other respiratory
diseases in Australia", it is likely that Mr Blanch's chronic obstructive pulmonary disease (COPD)
will reduce his life expectancy by about two years…2
[12] The 'Functional Performance Status' table as enclosed in Dr McKeon's medicolegal report
which sets out the Appellant's dependency status is reproduced below:3
DEPENDENCY
STAGE
FUNCTIONAL
PERFORMANCE STATUS
SELF CARE
TASKS (modified
Barthel Index)
TIME
ESTIMATED
NIL Independent with all usual self
care and domestic chores. Fully
independent accessing
community.
INDEPENDENT Not
Applicable
LOW
DEPENDENCE
At this stage the person is
capable of almost all self care;
most domestic tasks and is
generally able to manage light
property, lawn and garden
maintenance. Requires
assistance with heavy and
exertive activities such as heavy
digging, lifting and pushing in
the garden, and spring cleaning.
Probable assistance with
transport.
MINIMAL/SLIGHT
DEPENDENCE
8 Years
MODERATE
DEPENDENCE
At this stage, person requires
either direct or indirect
assistance with self care (and if
living alone, will probably need
community support) and may
only manage sedentary to light
domestic chores. Generally
unable to manage property,
lawn or garden maintenance,
and car cleaning. Community
participation is minimal and
transport assistance is likely.
MODERATE
DEPENDENCE
6 Years
HIGH
DEPENDENCE
During this period, a person
requires more supervision
during the day and a high level
to full assistance with self care
activities. They do not
participate in community or
domestic activities and are less
able to attend medical
appointments. Medical care
(including nursing) is generally
administered at home.
SEVERE
DEPENDENCE
4 Years
COMPLETE
DEPENDENCE
Dependent on the prognosis,
should a person reach palliative
TOTAL
DEPENDENCE
1 Month
2 Exhibit 1, pages 89-92.
3 Ibid page 93.
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care stage, it is likely that he
will require 24 hour care for all
self care and daily living tasks,
as well as safety and medical
monitoring. Nursing care is
likely.
[13] Dr Robert Edwards, respiratory physician, provided a further supplementary medicolegal
report on 2 June 2020 stating that:
…
I do agree with Dr McKeon that Mr Blanch's health will most likely deteriorate as a result of his
COPD.
…
I do agree that Mr Blanch is likely to dies as a result of his COPD.
…
In my opinion, during the last year or two of his life Mr Blanch is likely to require home oxygen.
…
I consider that as his condition deteriorates, Mr Blanch will likely require assistance with his
activities of daily living.
…
I would agree with Dr McKeon's functional performance status that he has provided in his report
(i.e. Mr Blanch will be at a low level of dependence for about eight years, a moderate level of
dependence for six years, a high level of dependence for four years and complete dependence during
the last month of his life).
The reason for my current assessment and the fact that I agree with Dr McKeon is that people with
significant emphysema do have a slightly reduced life expectancy and I would agree that Mr
Blanch's life expectancy would be reduced by approximately two years due to the COPD.
There are no readily ascertainable additional facts or materials which would assist me in reaching a
more reliable conclusion. The opinions stated in this report are genuinely held by me.4
Consideration
[14] The decision to be made is whether the Appellant's condition satisfies the meaning of
'terminal condition' pursuant to s 39A of the WCR Act.
Section 39A(1)
[15] Section 39A(1) defines a 'terminal condition' as a condition certified by a doctor as one
that is expected to terminate the worker's life.
[16] As outlined above, Dr McKeon opined, and Dr Edwards agreed, that the Appellant is
likely to die as a result of his COPD and his life expectancy would be reduced by
approximately two years due to the underlying condition of COPD. The medical evidence
4 Ibid pages 95-96.
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supports the conclusion that the Appellant suffers from a condition that is expected to
terminate his life.
[17] In the decisions of both the Insurer and the Respondent, the diagnoses of Dr McKeon and
Dr Edwards were accepted. Further, the Respondent states in its response to the
Appellant's Statement of Facts and Contentions that it admits the following contentions
of the Appellant:5
2.3 Here there was the necessary certification by a doctor or doctors, being:
(a) On 8 May 2020, Dr McKeon, thoracic physician, opined that the Appellant will
"probably die of his Chronic Obstructive Pulmonary Disease" and the Appellant's
"Chronic Obstructive Pulmonary Disease will reduce his life expectancy by about two
years";
(b) On 2 June 2020, Dr Robert Edwards, thoracic physician, opined that the Appellant "is
likely to die as a result of his COPD" and that his "life expectancy would be reduced
by approximately two years due to his COPD".6
[18] The Respondent confirmed in oral submissions that it accepts that the evidence supports
a conclusion that the Appellant's latent onset injury is a condition expected to terminate
the Appellant's life for the purposes of s 39A(1) of the WCR Act.7 No contrary medical
evidence was obtained.
[19] I am satisfied that the evidence supports a conclusion that the Appellant's latent onset
injury is a terminal condition for the purposes of s 39A(1) of the WCR Act.
[20] For completeness, the pre-amended form of s 39A(1) stated that the terminal condition
of the worker is a condition certified by a doctor as being a condition that is expected to
terminate the worker's life within two years. The section was amended under s 36 of the
WCR Amendment Act 2019, with the words 'within 2 years after the terminal nature of
the condition is diagnosed' removed such that the section no longer refers to a time limit.
Accordingly, there are no other elements to s 39A(1) that need to be satisfied.
Section 39A(2)
[21] Although the Respondent accepted the Appellant's condition is one which has been
certified by a doctor as expected to terminate the Appellant's life, the Respondent did not
accept the doctor's diagnosis of the terminal nature of the condition pursuant to s 39A(2)
of the WCR Act.
[22] The Respondent confirmed that the diagnosis of Dr McKeon and Dr Edwards was
accepted. There was no challenge to this medical evidence or the qualifications of either
doctor to provide the prognosis. It seems that the Respondent is of the view that s 39A(2)
5 Respondent's Statement of Facts and Contentions [25].
6 Appellant's Statement of Facts and Contentions [2.3].
7 T1-11, ll 25-27.
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provides the Insurer with a discretion to not accept 'the doctor's diagnosis of the terminal
nature of the condition' on the basis of a number of other considerations.
[23] The consequence of the decision to not accept the doctor's diagnosis is that the Appellant
is determined not to have a 'terminal condition' for the purposes of ss 128A and 128B of
the WCR Act and so is not entitled to compensation for the latent onset injury calculated
under Chapter 3, Part 3, Division 4 of the WCR Act.
[24] The Appellant submits that the reason the Respondent has disputed the entitlement to the
benefit is because of some normative viewpoint as to when benefits should be payable
that is not consistent with the legislative definition of 'terminal condition', and the
Respondent seeks to hark back to the pre-amended definition.
[25] Consequently, this matter turns on the construction of s 39A(2) of the WCR Act, the plain
text of which is as follows:
(2) A condition is a terminal condition only if the insurer accepts the doctor's diagnosis of the
terminal nature of the condition.
[26] The Respondent is of the view that the construction of s 39A(2) permits an insurer to
accept that the worker had a condition that is expected to terminate the worker's life as
certified by a doctor, pursuant to s 39A(1), but to not accept 'the doctor's diagnosis of the
terminal nature of the condition' pursuant to s 39A(2).
[27] The Insurer concluded that it would be a manifestly absurd or unreasonable conclusion
to interpret s 39A to deem the Appellant's injury to be a 'terminal condition'.8 The Insurer
had regard to the explanatory memorandum and the first reading speech of the Minister
to determine that the legislative intention was to provide immediacy of lump sum
compensation to those with a life expectancy of greater than two years but with some
imminence during which time the workers may require palliative care to plan and attend
to financial needs and spend time with family.9 Pursuant to s 39A(2), the Insurer
determined that the Appellant did not suffer from a terminal condition.
[28] The Appellant submits that s 39A(2) does not permit the Insurer to insert an arbitrary
criteria relating to 'imminence' of death in order to reject the doctor's diagnosis.
[29] The Respondent has provided no evidence challenging the doctor's diagnosis that the
Appellant's latent onset injury will cause his death. The contention appears to be that the
diagnosis of the 'terminal nature' of the condition is not accepted on other grounds
including the Appellant's life expectancy and palliative care needs.
[30] In making the decision as to whether to accept 'the doctor's diagnosis of the terminal
nature of the condition' pursuant to section 39A(2), the Insurer must act reasonably.10 In
8 Exhibit 1, page 124.
9 Ibid.
10 Minister for Immigration v Li (2013) 249 CLR 332, 364 [66] (Hayne, Kiefel and Bell JJ).
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circumstances where more persuasive evidence exists, the Insurer could determine to not
accept the doctor's diagnosis. However, there is no evidence to the contrary in this matter.
Both the Respondent and the Insurer have accepted the two doctors' diagnosis of the
Appellant's condition.
[31] I consider the Respondent's decision that s 39A(2) allows for the doctor's diagnoses to
not be accepted on the basis of external considerations to lead to a result that is
unreasonable. Such an interpretation is not only inconsistent with the plain meaning of
s 39A(2), but may lead to an effective veto over terminal condition compensation based
on arbitrary considerations by insurers that are not outlined in the legislation.
[32] A consideration of the construction of s 39A is required to determine the correct
interpretation of this section.
Principles of statutory construction
[33] The modern approach to statutory construction as outlined by the High Court in SZTAL
v Minister for Immigration and Border Protection; SZTGM v Minister for Immigration
and Border Protection11 is as follows:
The starting point for the ascertainment of the meaning of a statutory provision is the text of the
statute whilst, at the same time, regard is had to its context and purpose. Context should be regarded
at this first stage and not at some later stage and it should be regarded in its widest sense. This is not
to deny the importance of the natural and ordinary meaning of a word, namely how it is ordinarily
understood in discourse, to the process of construction. Considerations of context and purpose
simply recognise that, understood in its statutory, historical or other context, some other meaning
of a word may be suggested, and so too, if its ordinary meaning is not consistent with the statutory
purpose, that meaning must be rejected.12
[footnotes omitted]
[34] In Project Blue Sky Inc v Australian Broadcasting Authority,13 the High Court found that
it was a court's duty 'to give the words of a statutory provision the meaning that the
legislature is taken to have intended them to have'.14 The purpose of legislation must be
derived from what the legislation says, and not from any assumption about the desired or
desirable reach or operation of relevant provision.15
[35] General principles of statutory interpretation have been outlined in a number of
authorities. The High Court said in Federal Commissioner of Taxation v Consolidated
Media Holdings Limited:16
"This Court has stated on many occasions that the task of statutory construction must begin with a
consideration of the [statutory] text". So must the task of statutory construction end. The statutory
11 [2017] HCA 34.
12 Ibid [14] (Kiefel CJ, Nettle and Gordon JJ).
13 [1998] HCA 28.
14 Ibid [78] (Mchugh, Gummow, Kirby and Hayne JJ).
15 Certain Lloyd's Underwriters v Cross [2012] HCA 56 [26] (French CJ and Hayne J).
16 (2012) 250 CLR 503.
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text must be considered in its context. That context includes legislative history and extrinsic
materials. Understanding context has utility if, and in so far as, it assists in fixing the meaning of
the statutory text. Legislative history and extrinsic materials cannot displace the meaning of the
statutory text. Nor is there examination an end in itself.17
[footnotes omitted]
[36] As outlined by Deputy President Merrell in Schipp & Anor v The Star Entertainment Qld
Limited,18 the following:
A consideration of the context of statutory text includes the legislative history and extrinsic
materials. The context should be considered at the first instance not at some later stage and context
includes things such as the existing state of the law and the mischief the statute intended to remedy.
Therefore it is permissible to have regard to extrinsic materials in order to identify the context and
purpose of a statutory provision, including the identification of any mischief to which the legislative
amendment was directed.19
[footnotes omitted]
Legislative history of s 39A
[37] In order to consider the context and purpose of a statutory provision, including the
identification of any mischief to which the legislative amendment was directed, I will
examine the legislative history of the section.
[38] As considered in R v Lavender,20 it is permissible when determining the meaning of a
continuing provision to refer to its legislative history.
[39] Chapter 3, Part 3, Division 4 of the WCR Act was initially introduced to the WCR Act
pursuant to the Workers' Compensation and Rehabilitation Act and Other Acts
Amendment Act 2005 (Qld) ('the WCR Amendment Act 2005'). The Explanatory Note to
the Workers' Compensation and Rehabilitation and Other Acts Amendment Bill 2005
(Qld) provide that:
The proposed Bill will achieve its objectives for the workers' compensation scheme primarily by:
…
• providing greater certainty on the payment of workers' compensation for latent onset injuries
and aligning the calculation of these benefits with the method used by the Courts;21
…
[40] Section 732 of the WCR Amendment Act 2019 provides that 'terminal conditions' under
s 36 of the WCR Act arising after 31 January 2015 are defined as 'a condition certified
by a doctor as being a condition that is expected to terminate the worker's life'.
17 Ibid [39] (French CJ, Hayne, Crennan, Bell and Gageler JJ).
18 [2019] ICQ 009.
19 Ibid [25].
20 [2005] HCA 37.
21 Explanatory Note, Workers' Compensation and Rehabilitation and Other Acts Amendment Bill 2005 (Qld) 2-3.
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[41] The meaning of 'terminal condition' was previously provided for under s 234, however,
was reallocated and renumbered as s 39A as a result of schedule 3, s 14 of the
WCR Amendment Act 2005. Section 234 of the WCR Act, prior to the section being
reallocated and renumbered, provided the following:
234 Meaning of terminal condition
(1) A terminal condition, of a worker, is a condition certified by a doctor as being a
condition that is expected to terminate the worker’s life within 2 years after the
terminal nature of the condition is diagnosed.
(2) A condition is a terminal condition only if the insurer accepts the doctor's diagnosis
of the terminal nature of the condition
[42] The amendment to section 39A(1) of the WCR Act, introduced pursuant to the
WCR Amendment Act 2019, was as follows:
A terminal condition, of a worker, is a condition certified by a doctor as being a condition that is
expected to terminate the workers life within two years after the terminal nature of the condition is
diagnosed.
[43] Section 39A(2) remained unchanged.
Extrinsic materials
[44] As permitted in matters where an interpretation may lead to a result that is unreasonable,
I will consider extrinsic material pursuant to s 14B of the Acts Interpretation Act 1954
(Qld).
[45] Section 14B of the Acts Interpretation Act 1954 (Qld) provides:
14B Use of extrinsic material in interpretation
(1) Subject to subsection (2), in the interpretation of a provision of an Act, consideration
may be given to extrinsic material capable of assisting in the interpretation—
(a) if the provision is ambiguous or obscure—to provide an interpretation of it; or
(b) if the ordinary meaning of the provision leads to a result that is manifestly
absurd or is unreasonable—to provide an interpretation that avoids such a
result; or
(c) in any other case—to confirm the interpretation conveyed by the ordinary
meaning of the provision.
(2) In determining whether consideration should be given to extrinsic material, and in
determining the weight to be given to extrinsic material, regard is to be had to—
(a) the desirability of a provision being interpreted as having its ordinary meaning;
and
(b) the undesirability of prolonging proceedings without compensating advantage;
and
(c) other relevant matters.
(3) In this section—
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extrinsic material means relevant material not forming part of the Act concerned,
including, for example—
(a) material set out in an official copy of the Act; and
(b) a report of a royal commission, law reform commission, commission or
committee of inquiry, or a similar body, that was laid before the Legislative
Assembly before the provision concerned was enacted; and
(c) a report of a committee of the Legislative Assembly that was made to the
Legislative Assembly before the provision was enacted; and
(d) a treaty or other international agreement that is mentioned in the Act; and
(e) an explanatory note or memorandum relating to the Bill that contained the
provision, or any other relevant document, that was laid before, or given to the
members of, the Legislative Assembly by the member bringing in the Bill
before the provision was enacted; and
(f) the speech made to the Legislative Assembly by the member when introducing
the Bill; and
Note—
See section 53 in relation to Bills introduced before the commencement
of that section.
(g) material in an official record of proceedings in the Legislative Assembly; and
(h) a document that is declared by an Act to be a relevant document for the
purposes of this section.
ordinary meaning means the ordinary meaning conveyed by a provision having
regard to its context in the Act and to the purpose of the Act.
[46] The overarching purpose of the WCR Act, as provided at s 5 of the WCR Act, is to
maintain a balance between providing fair and appropriate benefits to injured workers,
dependents, and other persons, and ensuring reasonable cost levels for employers.
[47] As outlined above, s 39A was amended by the WCR Amendment Act 2019. The
Explanatory Note to the Workers' Compensation and Rehabilitation and Other
Legislation Amendment Bill 2019 (Qld) ('the WCR Amendment Bill 2019') provide the
following reference to the amendment resulting in the current s 39A:
(d) Life expectancy to qualify for terminal condition lump sum
A worker with a terminal condition has an entitlement to the latent onset terminal lump sum
compensation of up to $743,041 under the WCR Act. The WCR Act currently defines a terminal
condition as a condition that is expected to terminate the workers life within two (2) years after the
terminal nature of the condition is diagnosed (section 39A). However, some workers are diagnosed
with a terminal work-related condition with a life expectancy greater than 2 years (for example 3 or
5 years) which means they are excluded from accessing this payment. The Bill amends the WCR
Act to extend entitlement to the latent onset terminal entitlements by removing the reference to two
years and replacing it with an assessment that the insurer is satisfied that the worker has a latent
onset condition that is terminal.22
[48] The Explanatory Note states that the amendment is intended to 'extend entitlement to the
latent onset terminal entitlements by removing the reference to two years'. This statement
confirms that the intention was to extend, not restrict, the entitlement. The
Explanatory Note continues that the reference to two years is to be removed and replaced
22 Explanatory Note, Workers' Compensation and Rehabilitation and Other Legislation Amendment Bill 2019
(Qld) 9.
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'with an assessment that the insurer is satisfied that the worker has a latent onset condition
that is terminal'. This appears to be erroneous in that, whilst the reference to two years
was removed, it was not 'replaced' with an assessment that the insurer is satisfied that the
worker has a latent onset condition that is terminal. Section 234(2) of the WCR Act, prior
to the relevant amendment, already contained the requirement that the condition only be
considered terminal if the insurer accepts the doctor's diagnosis. The section remains
exactly the same, with the only amendment being the removal of the reference to
two years under s 39A(1).
[49] The rationale for the amendment would seem to be that the time period of two years was
operating to exclude some workers from accessing compensation despite suffering from
a terminal condition, and hence the removal of the reference to a time limit.
[50] The Respondent submits that the legislature was quite deliberate in the wording of
s 39A(2) in that it does not say that the insurer must accept the doctor's diagnosis. The
Respondent submits that the second subsection should not be read as if once the
certification in (1) is in existence, then it must then follow that effectively (2) applies.
[51] The Respondent submits that the discretion provided by s 39A(2) as to whether to accept
the doctor's diagnosis allows for reasonable considerations to be taken into account when
exercising the discretion. These considerations in determining whether to accept the
diagnosis may include the nature of ongoing medical treatment and palliative care and
the worker's reduction of life expectancy.
[52] The Respondent submits that when one has regard to the particular circumstances of the
Appellant's position, this claim has respectfully been made too early having regard to the
intent of what s 39A is intended to achieve.
[53] The Respondent referred to the example in the Explanatory Note of the example given of
'3 or 5 years' as being in the range of compensable timeframes intended by the legislature:
However, some workers are diagnosed with a terminal work-related condition with a life expectancy
greater than 2 years (for example 3 or 5 years) which means they are excluded from accessing this
payment.23
[54] With respect to the use of explanatory notes and examples, I note Justice Edelman's
comments in the Commonwealth context in Mondelez Australia Pty Ltd v Automotive,
Food, Metals, Engineering, Printing and Kindred Industries Union:24
Having regard to their provenance and to the circumstances of their creation, explanatory
memoranda for Government Bills introduced into the Commonwealth Parliament can ordinarily be
taken by courts to be reliable guides to the policy intentions underlying Government sponsored
legislation. They can ordinarily be relied on by courts to explain the overall legislative design and
the intended practical operation of provisions and combinations of provisions. Their use of examples
of the contemplated operation of provisions can inform in both those respects. They can sometimes
23 Ibid.
24 [2020] HCA 29.
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even yield insight into the precise grammatical sense in which words appear in the texts of
provisions.
Lacking both the force of law and the precision of parliamentary drafting, however, an explanatory
memorandum cannot be taken to be an infallible and exhaustive guide to the legal operation of a
provision. Notoriously, explanatory memoranda sometimes get the law wrong. The potential for
error and examples of the contemplated operation of provisions set out in explanatory memoranda
is highlighted by the acknowledgement of the Parliament in s 15AD(b) of the Acts Interpretation
Act that even an enacted example of the operation of a provision might get the legal operation of the
provision wrong: "if the example is inconsistent with the provision, the provision prevails".25
[footnotes omitted]
[55] Although '3 or 5' years is given as an example of timeframes in which workers with a
diagnosis of life expectancy greater than two years had been excluded from benefits, it is
not an example, in my view, of the timeframe intended to apply to the amended section.
[56] The Appellant disputes the Respondent's view that other considerations may be taken into
account, submitting that the words of s 39A do not provide for a consideration as to how
the condition will play out between the time of diagnosis and date of death. Rather, it is
simply a diagnosis of the terminal nature of the condition, with the plain words of the
statute not calling for some other inquiry. The Appellant contends that the only test is
whether there is a diagnosis that the condition is expected to terminate the worker's life
under s 39A(2), and if the insurer accepts that medical diagnosis, the definition is
satisfied.
[57] In the first reading speech for the WCR Amendment Bill 2019 by the
Honourable Grace Grace MP stated the following:
The bill also makes some further amendments for regulatory simplification and clarification. I make
particular note of the amendment to extend access to the latent onset terminal payment entitlements
under the Workers' Compensation and Rehabilitation Act. The act currently provides that a worker
who has a terminal condition as a result of their employment, for example dust lung diseases such
as asbestosis, silicosis and coal workers' pneumoconiosis, or a work related cancer such as a
specified cancer sustained by a firefighter, has an entitlement to a statutory payment of up to
$743,041. The payment of this lump sum allows the worker to be provided with palliative care and
support and ensures that the worker can plan and attend to the financial needs of their family and
dependants. The worker retains their rights to seek common law damages for negligence
contributing to the workers terminal condition, however, for some workers the prompt assessment
and payment of this statutory entitlement may alleviate the need of the worker to seek common law
damages and allow the worker to spend more time with their family.
Under the act currently, a terminal condition is defined as a condition certified by a doctor as being
a condition, that is expected to end the workers life within two years after the terminal nature of the
condition is diagnosed. However, some workers are diagnosed with a terminal work related
condition with a life expectancy greater than two years which means they have been excluded from
accessing this payment. The amendment addresses this by removing the reference to the time period
restriction of two years. This is an important amendment for those who need it most and a great step
forward in that area.26
25 Ibid [71]-[72].
26 Hansard Record of proceedings First Session of the Fifty-Sixth Parliament 2019, p 2478; Exhibit 1, page 203.
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[58] The intention of the legislature, as evidenced by the first reading speech, is to ensure that
those workers who have been diagnosed with a work related condition are not excluded
from accessing this compensation because of an arbitrary timeframe regarding life
expectancy.
[59] The legislature removed the reference to 'two years' and did not replace it with another
timeframe, thereby dispensing with the temporal requirement altogether. In my view, to
interpret s 39A(2) in such a way as to allow an arbitrary time limit to be inserted by
the Insurer would be contrary to the legislative intention.
[60] In Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue,27 the plurality said:
This Court has stated on many occasions that the task of statutory construction must begin with a
consideration of the text itself. Historical considerations and extrinsic materials cannot be relied on
to displace the clear meaning of the text. The language which has actually been employed in the text
of legislation is the surest guide to legislative intention. The meaning of the text may require
consideration of the context, which includes the general purpose and policy of a provision, in
particular the mischief it is seeking to remedy.28
[footnotes omitted; emphasis added]
[61] The Appellant submits that the mischief s 39A(1) was directed to is obvious without
recourse to secondary materials. The Appellant submits that once a worker's injury is
terminal, as diagnosed by a doctor, with the Insurer accepting 'the doctor's diagnosis', the
worker has a terminal condition within the meaning of the WCR Act. There is no
additional requirement that the Insurer or the Respondent considers it right or just that
terminal condition benefits be payable to that worker.
[62] The Appellant submits that in removing the term 'within 2 years after the terminal nature
of the condition is diagnosed' at the end of section 39A(1), the purpose of the amendment
was to remove the limitation of any prognosticated time for workers with terminal
conditions until death, making the criteria less arbitrary and resulting in terminal
condition benefits being more accessible by workers.
[63] If the intention of the legislature had been to maintain a timeframe for workers to be
eligible for terminal condition benefits, one would expect the reference to 'two years' in
s 39A(1) would have simply been replaced with 'three years', 'five years', 'ten years' or
any other timeframe determined by the legislature. The fact that any reference to a
timeframe was removed entirely suggests that the legislature did not consider it to be an
appropriate consideration in determining the meaning of 'terminal condition'.
[64] The Insurer stated that the legislative intention referable to the amendment to the
definition of 'terminal condition' in the WCR Amendment Act 2019 is to provide
compensation to those with a terminal condition with a life expectancy of greater than
27 (2009) 239 CLR 27.
28 Ibid [47] (Hayne, Heydon, Crennan and Kiefel JJ).
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two years, but with 'some imminency', such as three to five years.29 I am not persuaded
that the explanatory memorandum and the first reading speech of the Minister indicates
that 'some imminence' is to be read into the section. The secondary materials in this matter
confirm the ordinary meaning of the provision of s 39A. The materials refer to the lack
of fairness in having an arbitrary two-year time limit, and rather than the legislature
imposing a new time period, it elected not to do so. To allow the Insurer to effectively
insert an arbitrary time frame would be to usurp the role of the legislature in making a
policy decision as to the appropriate time period within which compensation may be paid
for terminal conditions.
[65] The Respondent has not indicated that it disagrees with the medical evidence nor
identified any medical reasons as to why the doctor's diagnoses of the terminal nature of
the condition is not accepted. As the decision maker, the Respondent is required to act
reasonably and not capriciously or irrationally in coming to their conclusion. In
circumstances in which there is medical evidence to the contrary which is more
persuasive than that provided by an injured worker, it may be reasonable for an insurer
to reject or not accept the doctor's diagnosis. In other circumstances, an insurer may
determine not to accept the doctor's diagnosis if they do not accept that the doctor is
suitably qualified to offer the opinion. In this matter, however, there is no dispute as to
qualifications of the doctors nor was other evidence called challenging the reliability of
the diagnosis.
[66] The Respondent appears to have accepted the medical diagnoses of the terminal nature
of the condition, however they have then imposed a policy judgement over it to determine
that the worker should not receive the benefits in these particular circumstances. This was
not a judgement for them to make.
[67] The Insurer determined that the Appellant was not entitled to compensation on the
grounds that the intention of the section was not to provide such payments to 'a worker
of 64 years of age with minimal current symptoms, with a slowly progressive condition,
who is expected to live for a further 20 years with a slightly reduced life expectancy of
only 2 years'.30 In my view, this characterisation minimises the Appellant's condition,
with the report of Dr McKeon outlining the slow decline the Appellant is facing in the
coming years along with increasing dependence.
[68] The Appellant submits that the Respondent used a normative judgement to determine that
the outcome sought by the Appellant was absurd, stating:
To which one might say why is it absurd? A person, a worker, suffers an injury in the workplace
that as it emerges over time, being a latent onset injury, is going to take their life earlier than what
it would and put them through a whole bunch of pain and suffering as their condition deteriorates
over time, that it is something that occurs over a more prolonged period of time, and it might do
with mesothelioma or some other such condition like that, isn't – doesn't make it absurd that the
29 Exhibit 1, page 124.
30 Ibid.
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worker should receive such a benefit in those circumstances. It makes it perfectly understandable
that they would.31
[69] The medical prognosis is not that the Appellant will live a healthy life until the work-
related injury causes his death. The Functional Performance Status table produced by
Dr McKeon outlines the projected dependency stages and self care tasks for the Appellant
over the coming years. This assessment indicates that the Appellant will have low
dependence for eight years; moderate dependence for the following six years; high
dependence for the following four years and complete dependence in the final month of
his life. This does not include the pain and suffering associated with the increase in
dependency.
[70] A consideration of the extrinsic materials confirm the meaning of s 39A(2) that provides
that a condition is only a 'terminal condition' if the insurer accepts a doctor's diagnosis of
the terminal nature of the condition. Insurers, therefore, have the option to not accept a
doctor's diagnosis if they disagree with the terminal nature of the condition. The other
grounds upon which the Insurer decided not to accept the doctor's diagnosis in this matter,
including the Appellant's age, life expectancy and palliative care needs, are simply not
relevant to the decision required under this section. To interpret subsection (2) as allowing
insurers to not accept the diagnosis on the basis of arbitrary considerations may also lead
to inconsistent criteria being applied between insurers, contrary to the stated objective of
providing greater certainty. Allowing insurers the prerogative to reject any claim on
grounds not mentioned in the section is entirely inconsistent with the context and purpose
of s 39A. To interpret the section in such a way is inconsistent with the purpose of
maintaining a balance between providing compensation to workers and ensuring
reasonable costs for employers. It is also inconsistent with the beneficial character of the
legislation.
Conclusion
[71] Where a statute provides an unconfined discretion, that discretion ought not be exercised
capriciously, arbitrarily of inflexibly.32 In my view, the Insurer has exercised the
discretion to not accept the doctor's diagnosis of the terminal nature of the Appellant's
condition arbitrarily by importing a criteria that is beyond the scope of the legislative
provision. I do not accept that these arbitrary considerations are consistent with the
meaning of s 39A(2). The section refers to 'the doctor's diagnosis' and whether this is
accepted by the Insurer. There may be circumstances in which evidence is obtained that
challenges a doctor's diagnosis as put forward by the Appellant. A contest between
medical expert evidence is not uncommon within the workers' compensation jurisdiction.
However, to insert a criteria in addition to the doctor's diagnosis, and in this case a
criterion of 'imminence' of death in direct contrast to the amendment removing the time
limit in s 39A(1), is contrary to both the legislature's intention and the plain meaning of
the words in the section. In this matter, the legislature has removed the time limit in
s 39A(1) only to have the Insurer insert an arbitrary time limit in s 39A(2).
31 T 1-9, ll 7-14.
32 R v Anderson: ex parte IPEC-Air Pty Ltd [1965] HCA 27.
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[72] The Respondent has not disputed the diagnosis of Dr McKeon which clearly states that
the Appellant is likely to die from his COPD condition. Once the Respondent accepts the
doctor's diagnosis of the terminal nature of the Appellant's condition, on the proper
reading of s 39A of the WCR Act, there are no other grounds upon which the Insurer can
reject the claim.
Order
[73] I make the following orders:
1. The appeal is allowed.
2. That the decision of the Workers' Compensation Regulator be set aside.
3. That the Appellant be paid benefits as a worker with a terminal
condition pursuant to Chapter 3, Part 3, Division 4 of the Workers'
Compensation and Rehabilitation Act 2003 (Qld).
4. Failing agreement on costs, to be the subject of a further application to
the Commission.
5. Liberty to apply.
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Official source: https://www.sclqld.org.au/caselaw/QIRC/2021/408