Board of Trustees of the State Public Sector Superannuation Scheme v Gomez [2018] QCA 67 [2018] 16 QLR
SUPREME COURT OF QUEENSLAND
CITATION: Board of Trustees of the State Public Sector Superannuation
Scheme v Gomez [2018] QCA 67
PARTIES: BOARD OF TRUSTEES OF THE STATE PUBLIC
SECTOR SUPERANNUATION SCHEME
(appellant/cross-respondent)
v
EDWIN GOMEZ
(respondent/cross-appellant)
FILE NO/S: Appeal No 6321 of 2017
SC No 1535 of 2015
DIVISION: Court of Appeal
PROCEEDING: General Civil Appeal
ORIGINATING
COURT: Supreme Court at Brisbane – [2017] QSC 98
DELIVERED ON: 13 April 2018
DELIVERED AT: Brisbane
HEARING DATE: 17 November 2017
JUDGE: Sofronoff P and Fraser JA and Henry J
ORDERS: 1. The Board’s appeal is dismissed.
2. Mr Gomez’s cross-appeal is dismissed.
3. If the parties have not reached agreement as to costs
within two weeks of judgment:
(a) within three weeks of judgment the parties will each
file and serve written submissions, not exceeding
four pages, as to the appropriate costs order(s) in
the appeal and cross-appeal;
(b) within four weeks of judgment the parties may file
and serve replies to their opponent’s submissions,
not exceeding two pages.
CATCHWORDS: EQUITY – TRUSTS AND TRUSTEES – PROCEEDINGS
BETWEEN TRUSTEES AND BENEFICIARIES OR THIRD
PARTIES – where the respondent/cross-appellant claimed
a total and permanent disablement (“TPD”) benefit under the
superannuation scheme administered by the appellant/cross-
respondent – where the claim for a TPD benefit under the
superannuation scheme was rejected on the basis the claim did
not satisfy the definition of TPD – where the trial judge ordered
a reconsideration of the Board’s decision to decline payment –
whether the decisions made by the Board and the Board’s
delegate were open on the evidence – whether the Trustee’s
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duty to give properly informed consideration was met –
whether the delegation to the Board’s delegate was effective
APPEAL – PRACTICE AND PROCEDURE – QUEENSLAND
– POWERS OF COURT – COSTS – where costs were awarded
on the basis that the best outcome the respondent/cross-
appellant could achieve was remitter back to the Trustee –
where the trial judge considered costs were unnecessarily
incurred in preparation for trial
Superannuation (State Public Sector) Act 1990 (Qld)
Superannuation (State Public Sector) Deed 1990 (Qld)
Supreme Court of Queensland Act 1991 (Qld)
Alcoa of Australia Retirement Plan Pty Ltd v Frost (2012)
36 VR 618; [2012] VSCA 238, applied
Birdsall v Motor Trades Association of Australia Superannuation
Fund Pty Ltd (2015) 89 NSWLR 412; [2015] NSWCA 104,
cited
Chammas v Harwood Nominees Pty Ltd (1993) 7 ANZ Ins
Cas 61-175, cited
Edington v Board of Trustees of the State Public Sector
Superannuation Scheme [2016] QCA 247, applied
Finch v Telstra Super Pty Ltd (2010) 242 CLR 254; [2010]
HCA 36, followed
Gilberg v Maritime Super Pty Ltd [2009] NSWCA 325,
applied
Hannover Life Re of Australasia Ltd v Colella (2014) 47 VR
1; [2014] VSCA 205, applied
Jones v Dunkel (1959) 101 CLR 298; [1959] HCA 8, cited
Jones v United Super Pty Ltd [2016] NSWSC 1551, cited
McLean Bros & Rigg Ltd v Grice (1906) 4 CLR 835; [1906]
HCA 1, cited
Repatriation Commission v Hill (2005) 142 FCR 88; [2005]
FCAFC 7, cited
TAL Life Ltd v Shuetrim; Metlife Insurance Ltd v Shuetrim
(2016) 91 NSWLR 439; [2016] NSWCA 68, cited
Weissensteiner v The Queen (1993) 178 CLR 217; [1993]
HCA 65, cited
Wells v Australian Aviation Underwriting Pool [2004] QCA 43,
applied
COUNSEL: L Kelly QC, with R Morton, for the appellant/cross-respondent
G Mullins with R Nichols for the respondent/cross-appellant
SOLICITORS: Mills Oakley for the appellant/cross-respondent
Maurice Blackburn for the respondent/cross-appellant
[1] SOFRONOFF P: I agree with the reasons of Henry J and the orders his Honour
proposes.
[2] FRASER JA: I agree with the reasons for judgment of Henry J and the orders
proposed by his Honour.
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[3] HENRY J: Edwin Gomez injured his shoulder when working as a registered nurse
in the intensive care unit of the Princess Alexandra Hospital. He asserts this caused
him to become totally and permanently disabled.
[4] If his assertions are correct then, as a member of the State Public Sector
Superannuation Scheme, he would be entitled to payment pursuant to his insurance
under the scheme in respect of such disablement.
[5] However, the scheme’s Board of Trustees (“the Board”) does not consider Mr Gomez
is totally and permanently disabled, a view manifest in decisions:
1. on 9 January 2013, by the Board’s delegate, rejecting Mr Gomez’s claim
for payment under the Scheme (“the first decision”);
2. on 26 June 2014, by the Board, affirming the first decision (“the second
decision”); and
3. on 10 June 2016, by the Board’s delegate, concluding additional material
did not indicate a reasonable possibility of a different result and
affirming the refusal to pay a total and permanent disablement benefit
(“the third decision”).
[6] In a claim before the Supreme Court Mr Gomez challenged all three decisions,
seeking declarations that the decisions were void and that he was entitled to a total
and permanent disablement benefit.
[7] The learned trial judge concluded there was no utility in determining the challenge to
the first decision, about which no complaint is made in this appeal. His Honour
rejected the challenge to the second decision but set aside the third decision and
ordered Mr Gomez’s application for reconsideration of the Board’s decision to
decline payment be remitted to the Board to be considered according to law.
[8] Before this Court the Board appealed his Honour’s finding against it in respect of the
third decision. Mr Gomez cross-appealed his Honour’s finding against Mr Gomez in
respect of the second decision. Mr Gomez also cross-appealed some specific findings
as to the validity of a delegation by the Board and orders as to costs. Those
components of the appeals are addressed in the following sequence in these reasons:
1. appeal against trial judge’s decision re second decision;
2. appeal against trial judge’s decision re third decision;
3. appeal re delegation issue;
4. appeal re costs.
Background
[9] Mr Gomez was born and raised in the Philippines. He there completed his degree in
Bachelor of Science and Nursing in 1994. He worked there as a Registered Nurse
until 2002. He then taught tertiary studies in nursing for 12 months, initially as
a clinical instructor to fourth year level nursing students in nursing skills in intensive
care and emergency and subsequently as a college instructor to third year level
nursing students in theoretical nursing in the clinical area.
[10] Mr Gomez immigrated to Australia in 2003, working predominantly in hospitals in
New South Wales and Victoria, before commencing employment as a Registered
Nurse in the Intensive Care Unit of the Princess Alexandra Hospital in December 2007.
[11] He was working part-time at the Princess Alexandra Hospital when he sustained a
shoulder injury lifting a patient on 2 September 2011. He returned to work on a six-
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week light work program but aggravated his condition when his shoulder struck an
obstacle at work. He has not worked at the Princess Alexandra Hospital since
30 March 2012.
[12] His injury was diagnosed variously as an aggravation of joint osteoarthritis in the
right shoulder’s acromioclavicular joint1 and as distal clavicle oedema.2
[13] The injury caused significant persistent pain with secondary consequences such as
difficulty in sleeping and concentrating. The secondary consequences may also have
included some anxiety and depression which gradually eased.3 The most material
consequence of Mr Gomez’s injury was an inability to raise his arm above shoulder
level or to apply material force with it.
[14] The preponderance of medical opinion was that his symptomatology would likely be
relieved by a surgical operation, namely an AC joint excision.4 Mr Gomez was unwilling
to undergo surgery because of his perception of the risk associated with intubation.
[15] His workplace was unable to identify an alternative role to place him in and he was
designated as an employee requiring placement. He was given the opportunity of
a voluntary redundancy or the opportunity of pursuing transfer opportunities within
Queensland Health. On 5 July 2013 Mr Gomez opted for voluntary redundancy.
[16] The medical professionals who assessed him noted some improvement over time in
his condition, including the level of distracting pain and secondary problems
associated with the injury, although in the absence of surgery it was considered the
slow improvement in his shoulder’s condition would taper off by the end of 20135
and his physical condition would become chronic.6
[17] By the time of the second and third decisions on his application for payment of total
permanent disablement insurance, it appeared, despite the earlier optimism of some
examining practitioners, that Mr Gomez was unlikely ever to be physically fit to work
1 Eg report to QSuper of Dr David Douglas, Consultant Occupational Physician, 11 December 2012,
AR Vol 1 p 250; report to WorkCover of 20 February 2012 of Dr Hugh English, Orthopaedic Surgeon,
AR Vol 1 pp 257-258.
2 Eg letter of Dr John Scott of 13 April 2012, AR Vol 1 p 265.
3 In a report to Carter Capner of 16 October 2012 Consultant Psychiatrist Dr Eric De Leacy opined that
Mr Gomez suffered from an adjustment disorder with anxiety and depressed mood (AR Vol 1 p 338).
However, even assuming that was an accurate assessment, it is tolerably clear that Mr Gomez’s
psychological state improved. Consultant Psychiatrist Dr Ljubisavljevic reported to Suncorp on
23 October 2013 that he had found no evidence of major mental illness, no evidence of depression or
anxious mood and no evidence of any identifiable DSM-4 diagnosis (AR Vol 2 pp 413-414).
Moreover, in a report dated 23 March 2016 Consultant Psychiatrist Dr Wasim Shaikh noted that while
Mr Gomez may once have suffered symptoms reflective of an adjustment disorder in response to pain
as well as relationship disturbances, “this no longer appears to be the case”. He noted Mr Gomez
continued to receive some psychological treatment but that was in relation to coping with his pain
rather than for a psychiatric disorder. He opined a diagnosis of adjustment disorder or any other
psychiatric condition was not appropriate and that if Mr Gomez had earlier suffered from an adjustment
disorder, it was of mild severity and temporary in nature (AR Vol 2 pp 498-499).
4 Eg report of 20 February 2012 of Dr Hugh English, Orthopaedic Surgeon, to WorkCover, AR Vol 1
p 258; letter of Dr John Scott of 13 April 2012, AR Vol 1 p 266; letter of Dr John Scott to WorkCover
of 23 April 2012, AR Vol 1 p 268; report of Dr Greg Gillette, Orthopaedic Surgeon dated 29 May
2012 to Carter Capner, AR Vol 1 p 328.
5 Eg report to Suncorp of Consultant Occupational Physican Dr Blair Christian of 18 March 2013,
AR Vol 1 p 371.
6 Eg report of Dr David Fitzgerald, Consultant Occupational Physician of 5 February 2013 to the
PA Hospital, AR Vol 1 p 346.
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as a nurse in intensive care or any area of nursing likely to require physical exertion
by the shoulder. The critical issue by then was whether he was reasonably qualified
by his nursing education, training and experience to be able to work in some kind of
sedentary nursing job.
The different nature of the levels of decision-making
[18] The nature of the Board’s decision-making in respect of that critical issue is different
from the nature of the court’s decision-making. It is prudent at the outset to identify
the different nature of those levels of decision-making.
The nature of the decision at Board level
[19] The Board, previously constituted as the Board of Trustees under the Superannuation
(Government and Other Employees) Act 1988 (Qld), was continued as the QSuper
Board pursuant to s 3 Superannuation (State Public Sector) Act 1990 (Qld) (“the Act”).
[20] Section 10 of the Act provided for the continuation of the State Public Sector
Superannuation Fund (“the fund”) and s 12 required the establishment by a deed of
“a scheme for the provision of superannuation, retirement, provident or other similar
benefits payable from the Fund” (“the scheme”).
[21] The deed so established is the Superannuation (State Public Sector) Deed 1990 (“the
deed”). Section 12 thereof charges the Board with the responsibility of administering
the scheme. The various powers conferred upon the Board by s 13 of the deed
predictably include the power to pay benefits out of the fund to persons entitled
thereto. Section 23I of the deed empowers the Board to provide insurance to
a member against “disablement”, which means “any mental or bodily injury, illness,
disease or infirmity”.7
[22] Section 23I provides that disablement includes disablement, that is “total and
permanent disablement” (“TPD”). TPD is defined in s 4 of the deed:
“Total and permanent disablement means disablement of a degree
which, in the opinion of the board after obtaining the advice of not
fewer than 2 medical practitioners, is such as to render the member
unlikely ever to be able to work again in a job for which the member
is reasonably qualified by education, training or experience.”
[23] Section 23J of the deed obliges the Board to decide the terms on which disablement
insurance is provided. Clause 9.1 of the insurance terms so decided relevantly provides:
“Upon receipt by the board of proof satisfactory to it that any insured
member has…suffered total and permanent disablement while an
insured member…the board will, subject to these insurance terms, pay
the amount of insurance cover in accordance with clause 4 at the date
of…total and permanent disablement of the insured member.”8
[24] The nature of the decision to be made by the Board when a member makes application
for payment of TPD insurance is informed by the context that the Board is trustee of
an employee superannuation scheme, not merely trustee of a discretionary trust.9 In
7 Per s 4 of the deed.
8 According to submissions below, see AR Vol 2 p 531 [23]. A copy of the insurance terms was not in
evidence. Neither party submitted the terms were relevant to any issue in this appeal.
9 Finch v Telstra Super Pty Ltd (2010) 242 CLR 254, 270-272.
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Finch v Telstra Super Pty Ltd10 limb (b) of the definition of TPD for Telstra’s
superannuation trust fund was similar to the definition in this case. The High Court
there observed:
“The Trustee … had a duty to distribute to those who fell within the
definition of “Total and Permanent Invalidity” and a duty not to
distribute to those who did not. That affected its role in relation to the
forming of its opinion under limb (b). Forming that opinion was not
a matter of discretionary power to think one thing or the other; it was
an ingredient in the performance of a trust duty. That duty was owed
to the Members, including the applicant.”11
In light of that context, the High Court concluded the Board has a duty to give
properly informed consideration to an application for payment.12
[25] The duty to give properly informed consideration also means it will not always be
appropriate for the Board to move directly to refusing an application on the basis the
Board has not received proof satisfactory to it13 that the applicant member is totally
and permanently disabled. Of course that may be appropriate where it is apparent the
lack of satisfactory proof merely reflects the fact TPD has not been suffered.
However, if information of substance received by the Board tends to indicate an
application may have merit but is inadequate for the purposes of the Board making
a properly informed decision, then the Board’s duty is to make reasonable inquiry
seeking additional information for the purposes of making a properly informed
decision.14 This duty is considered further below.
[26] Once the Board is able to give properly informed consideration to an application the
question for it to decide is whether the applicant member is disabled to a degree which
meets the definition of TPD in s 4 of the deed. Thus, the Board must decide whether,
in its opinion, the applicant’s degree of disablement “is such as to render the member
unlikely ever to be able to work again in a job for which the member is reasonably
qualified by education, training or experience”.15
[27] Subject to provision to the contrary, a member’s entitlement to payment of a TPD
benefit is not lost irrevocably if the member applies once and fails.16 The circumstances in
which the emergence of further information may warrant reconsideration of a previously
unsuccessful application was explained in Gilberg v Maritime Super Pty Ltd,17
a decision of the New South Wales Court of Appeal. Hodgson JA, with whom
Allsop P and Campbell JA agreed, observed that in an application to reconsider it is
relevant for the Trustee to take into account the trouble and expense involved in
obtaining further reports and the circumstance that the previous determination was
a purportedly final determination. However, he explained that if the further material
10 (2010) 242 CLR 254.
11 Ibid 270.
12 Ibid 280-281.
13 Per clause 9.1.
14 Alcoa of Australia Retirement Plan Pty Ltd v Frost (2012) 36 VR 618, 633, 636.
15 The meaning of these words was discussed by Leeming JA, with whom Beazley P and Emmett AJA
agreed, in TAL Life Ltd v Shuetrim; Metlife Insurance Ltd v Shuetrim (2016) 91 NSWLR 439, 459.
His Honour concluded that a real, rather than remote or speculative, chance of returning to work, albeit
less than a 50 per cent chance, will preclude a member being “unlikely ever” to return to relevant work.
The present case does not turn on whether the words of the definition convey that meaning and it is
sufficient to simply refer to the words used in the definition.
16 Gilbert v Maritime Super Pty Ltd [2009] NSWCA 325, [22].
17 [2009] NSWCA 325.
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provided in support of an application did indicate “a reasonable possibility of
a different result”, then that would justify the expense of seeking further reports.18
[28] That decision related to a different statutory scheme than the present, with more
specific requirements regarding the receipt of reports. However, the test it propounds
for determining whether to reconsider an application – a reasonable possibility of
a different result – should be applied here.19 That is because it derives logically from
the duty to give properly informed consideration to an application. If the further
information indicates a reasonable possibility of a different result then, until such time
as it is considered in addition to the earlier considered information, it can no longer
be said the Board has met its duty of giving properly informed consideration to the
application.
The nature of the Court’s decision
[29] Mr Gomez’s claim filed in the Supreme Court sought declarations that the first,
second and third decisions were “void and of no effect pursuant to s 8 of the Trusts
Act 1973 or pursuant to the general law”.20 Section 8 of the Trusts Act 1973 (Qld) confers
on persons aggrieved by decisions of trustees a right to apply to the court to review
the decision and empowers the court to make such orders “as the circumstances require”.
[30] The nature of the declarations sought necessarily required consideration of the
validity of the decisions below. They required review of those decisions, not
a consideration afresh of the merits of Mr Gomez’s applications for a TPD benefit.21
[31] Such a review has been said to require some attention to the requirements of natural
justice as part of the fairness and reasonableness in dealing with such a case.22 The
learned trial judge adopted the analysis of the relevant authorities by Bond J in
Edington v Board of Trustees of the State Public Sector Superannuation Scheme,23
observing:
“[19] It is open to a Court to set aside [the Trustee’s] decision if
satisfied that the decision:
1. was not made in good faith; or
2. was not made upon a real and genuine consideration of
the material before the Trustee; or
3. was not made in accordance with the purposes for which
the power to make a decision was conferred.
[20] Such a conclusion may be inferred by a Court if satisfied the
Trustee has come to a conclusion no reasonable person would
have come to on the evidence before it or that a real and genuine
18 Ibid [25]-[27].
19 The Board’s counsel did not submit otherwise (eg Appellant’s Outline of Argument [33]) and it was
in fact the test purportedly applied by the Board’s delegate.
20 AR 640. A declaration that Mr Gomez was entitled to a TPD benefit was also sought but only in
consequential connection with the declarations sought in respect of the decisions, on the premise the
Board should have been decided that Mr Gomez had suffered TPD.
21 It was therefore unremarkable that the trial below proceeded similarly to a hearing of an application
for judicial review, by reference to documentary evidence of the information which was before the
Board or its delegate as the case may be.
22 Chammas v Harwood Nominees Pty Ltd (1993) 7 ANZ Ins Cas 61-175, followed in Beverley v
Tyndall Life Insurance Co Ltd (1999) 21 WAR 327, pp 333, 338, 347-348.
23 [2015] QSC 245, [54-59] (This topic was not expressly considered in the appeal in that matter:
Edington v Board of Trustees of the State Public Sector Superannuation Scheme [2016] QCA 247).
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consideration of the issue required properly informed consideration
by the making of relevant inquiries…”24 (citations omitted)
[32] I respectfully agree with those considerations, although they are inevitably a non-
exhaustive list, given the requirements of the circumstances of each case will vary.
In any event they are considerations relevant to this court’s decision-making in this
appeal, it being an appeal by way of rehearing pursuant to r 765(1) Uniform Civil
Procedure Rules 1999 (Qld).
[33] Bearing the different nature of the decision-making tasks in mind I now turn to the
four separate components of the appeals.
Appeal against trial judge’s decision re second decision
Information before the Board for the second decision
[34] Subsequent to the first decision of 9 January 2013 by the Board’s delegate,
Mr Gomez’s solicitors by letter of 10 February 2014 sought a review of the decision,
enclosing new medical evidence and submitting that on the whole of the evidence
Mr Gomez satisfied the definition of TPD.25
[35] Much of the information before the Board went to uncontentious matters of the kind
already summarised under “Background” above. The more important materials for
present purposes were those going to whether there were sedentary jobs which
Mr Gomez was reasonably qualified by education, training or experience to work in.
The potential jobs, identified to varying extents in the materials, were General Practice
Nurse, Telephone Triage Nurse, Nursing Educator, Pathology Collector/Venepuncture
and Health and Safety Officer.
[36] A report to the Princess Alexandra Hospital of 5 February 2013 by Dr David Fitzgerald,
Consultant Occupational Physician expressed the opinion Mr Gomez would not be
able to resume the full range of duties of his substantial position, observing:
“In terms of his capacity for work I feel he would probably be able to
manage sedentary clerical type duties on a graduated return or an
almost full-time basis. However he would be restricted physically in
terms of aggravation of his symptoms and should avoid any heavy
lifting of more than 10kg, any degree of overhead work or heavy
pulling or pushing. … Essentially he could be utilised in a clerical/audit
sense. He also has some skills I understand in teaching that might be
able to be utilised.”26
[37] More comprehensive suggestions of potential work were made in a report to QSuper
by Rehabilitation Advisor Karen Stewart on 12 February 2013. She did not examine
Mr Gomez for that report and prepared it from a review of file documents only. Her
review of Mr Gomez’s prior education and training noted there was no specific
comment on file regarding Mr Gomez’s English literacy and numeracy skills, but she
assumed them to be “at least average” based on his successful completion of an
overseas qualified nurse’s competency assessment course through the New South
Wales College of Nursing and his successful employment in Australia as a Registered
24 AR 712.
25 AR Vol 1 pp 271-283.
26 AR Vol 1 p 345, p 347.
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Nurse.27 She noted Mr Gomez had worked almost exclusively as a Registered Nurse
in public and private hospitals and aged care facilities and more recently had
specialised as an Intensive Care Nurse, although she noted he had also worked as
teacher/instructor to nursing students in the Philippines for approximately one year.28
[38] Ms Stewart opined that the occupation of General Practice Nurse was a suitable
alternative to Mr Gomez’s pre-disability role, but noted the physical requirements of
such a role in medical practices may vary, noting “further medical information will
be required to ascertain whether Mr Gomez’s functional capacity matches the duties”.29
She opined Mr Gomez had the required education, training and experience to be
a competitive applicant for the role of Telephone Triage Nurse, a role which is
entirely sedentary. She noted the overall labour market for that occupation was not
considered to be strong. Amongst the skills she listed as prerequisites for this position
was “strong communication skills”.30 She also opined that the position of Nursing
Educator was in keeping with Mr Gomez’s education, training and experience,
although she noted the labour market demand for such positions was not likely to be
high. She concluded:
“The vocational options of General Practice Nurse, Telephone Triage
Nurse and Nursing Educator were identified as being suitable in
consideration of Mr Gomez’s education, training and experience.
Further detail regarding the usual duties, physical demands and
remuneration has been detailed in this report. Additional medical opinion
is suggested to clarify this suitability from a functional perspective.”31
[39] Ms Stewart provided a supplementary report on 27 February 2013 in which she
identified the position of Pathology Collector/Venepuncture as a potential suitable
vocational option for Mr Gomez. She noted the minimum primary qualification for
Pathology Collectors/Phlebotomists in Australia was a certificate 3 or 4 in pathology
and a current senior first aid certificate. She noted some employers indicated the
correct qualification could be completed on the job through in-house training
programs. She considered it probable that Mr Gomez already had experience in blood
collection and cannulation. She opined the suitability of this occupation needed to be
confirmed “both from a functional capacity perspective and in consideration of the
policy definition”.32 In concluding her supplementary report she observed:
“Additional medical opinion is suggested to clarify the suitability of
the identified occupations (General Practice Nurse, Telephone Triage
Nurse, Nursing Educator and Pathology Collector) from a functional
perspective.”33
[40] In the report of Consultant Occupational Physician Dr Blair Christian to Suncorp of
18 March 2013, Dr Christian opined Mr Gomez was not currently able to undertake
work as a General Practice Nurse because, while it involved less physical exertion, it
still involved some medium and at times heavy physical activities. He opined Mr Gomez
was physically fit to work as a Telephone Triage Nurse, a Nursing Educator, a Ward
Clerk/Medical Receptionist and a Pathology Collector/Venepuncture.34 He noted of
27 AR Vol 1 p 351.
28 AR Vol 1 p 353.
29 AR Vol 1 pp 354-355.
30 AR Vol 1 p 355.
31 AR Vol 1 p 356.
32 AR Vol 1 p 360.
33 AR Vol 1 p 361.
34 AR Vol 1 pp 369-370.
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the latter role that some blood collecting trolleys are moderately large and require
forceful pushing and pulling, a problem which could be avoided by use of a well-
functioning smaller light blood collection trolley.35 Dr Christian also opined Mr Gomez
may in addition be well suited to work as a Health Promotion Officer, observing of
that role:
“In some ways the work role would be similar to that of a nursing
educator. Mr Gomez would undertake presentations to community
groups, regarding issues such as diabetes and so on.”36
[41] In a report to Mr Gomez’s solicitors of 3 June 2013 Dr Maria Salinas, Occupational
Health Physician, opined Mr Gomez was unfit to continue as a Registered ICU Nurse
or a General Nurse Practitioner in the A&E department or general wards. She opined:
“[H]e unfortunately will remain unfit for a suitable work within his
education, training and/or experience as an ICU Nurse. He can be re-
educated and be given additional training/s as a Nurse Supervisor,
Nurse Educator, Health and Safety Officer and/or go in a completely
different field.”37
[42] Rebecca Hague, Occupational Therapist, opined on 30 October 2013 in her report,
care of Mr Gomez’s solicitors, that Mr Gomez was not reasonably qualified by
education, training or experience to work as a Nursing Educator.38 She noted Mr Gomez
had reported he was not qualified for such work,39 that he had no Australian
qualification or experience as a Nursing Educator and had only been employed for
12 months in that field 10 years ago.40 She noted of a job vacancy she had located
for a Clinical Nurse Educator in aged care that the holding of a post graduate
qualification in education and/or management was an essential skill.41 Ms Hague
considered working as a Nurse in a medical practice was unsuitable for Mr Gomez
because of the need to still perform physical work, albeit lighter than in a hospital
setting, and also because of his lack of recent experience in working in a medical
practice.42 She acknowledged Mr Gomez would be physically able to work as
a Telephone Triage Nurse but noted his absence of prior training or experience in
such work and the limited availability of job vacancies in the field.43 She expressed
pessimism about Mr Gomez’s future employment prospects because it is common for
prospective employers to enquire about the injury and/or compensation history of
applicants for employment.44 She concluded of Mr Gomez:
“He is not reasonably qualified (in Australia) for work as a nursing
educator. He has no prior experience or training (in Australia) for
work as a nursing educator or registered nurse in a medical centre. He
has no prior experience or training for work as a telephone triage
nurse. He has no training, education or experience in lighter roles.
Related to his ongoing occupational restrictions he is no longer fit for
the occupations detailed above. At the date of my assessment and in
35 AR Vol 1 p 370.
36 AR Vol 1 p 370.
37 AR Vol 2 p 375.
38 AR Vol 2 p 397.
39 AR Vol 2 p 393.
40 AR Vol 2 p 393, p 397.
41 AR Vol 2 p 398.
42 AR Vol 2 p 398.
43 AR Vol 2 p 399.
44 AR Vol 2 p 399.
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my opinion this man is unfit for any occupation for which he is
reasonably qualified for by education, training or experience.”45
The second decision
[43] The request for review of the first decision, which was described as an appeal in some
of the correspondence between the parties, culminated in the communication of the
second decision by correspondence dated 26 June 2014, stating:
“The Board of Trustees has considered your client’s appeal at its
meeting on 26 June 2014. The Board has affirmed the Board Delegate’s
decision. …”46
[44] The enclosed statement of reasons reviewed the information before the Board and
ultimately concluded:
“25. Having regard to the evidence, the Board considers that
Mr Gomez is reasonably qualified by his education, training or
experience and fit to work as a Telephone Triage Nurse,
Nursing Educator, Pathology Collector and Health Promotion
Officer. In this regard, the Board prefers the reports of Ms Stewart,
Dr Christian and Dr Fitzgerald over the reports of Ms Hague
and Dr Salinas because of the consideration given to what
transferrable skills that Mr Gomez possesses and the analysis of
the capacity of Mr Gomez to work in alternate roles.
26. The Board also considers having regard to the evidence that
Mr Gomez is reasonably qualified and fit to work as a General
Practice Nurse performing duties such as wound care, administering
immunisations, venepuncture and diabetes management provided
there is no requirement to help with patient transfers or helping
patients in and out of wheelchairs.
27. The Board notes that Mr Gomez claims he is afraid to have
shoulder surgery which according to a number of Orthopaedic
Surgeons would provide a cure for his symptoms. As the Board
believes that there are other nursing related roles for which
Mr Gomez is reasonably qualified by his education, training or
experience and physically able to perform, the issue of Mr Gomez
not undertaking surgery is of no consequence to the TPD decision.
28. On review of the medical evidence, the Board is not satisfied
that Mr Gomez suffers from a disability which is such as to
render him unlikely ever to be able to work again in a job for which
he is reasonably qualified by education, training or experience.”47
The trial judge’s decision
[45] The learned trial judge concluded that on the material available to the Board the
second decision was reasonably open to the Board, exercising its powers in good faith
and having given a real and genuine consideration to the claim in accordance with its
duties and obligations under the deed.48
45 AR Vol 2 p 400.
46 AR Vol 1 p 294.
47 AR Vol 1 p 310.
48 AR Vol 2 p 721 [44].
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12
[46] His Honour found:
“[45] The material placed before the Board established that whilst the
plaintiff had an injury which caused him ongoing pain,
discomfort and limitation of movement, the plaintiff’s ongoing
physical disabilities did not prevent him from undertaking
sedentary type duties. Whilst the plaintiff complained of further
limitations, in terms of concentration and memory loss as
a consequence of his reliance upon narcotic medication and the
ongoing effects of constant pain on his sleeping patterns, the
material reasonably supported a conclusion that those issues
could be adequately and properly addressed to ensure the
plaintiff could physically undertake sedentary type occupations.
[46] There was identified in the material a number of occupations
which fitted that criteria. The issue for determination was not
whether those occupations were freely available. The issue was
whether those occupations were occupations for which the plaintiff
was reasonably qualified by education, training or experience.
[47] Limitations such as the plaintiff not having previously
undertaken such duties did not render those occupations which
the plaintiff could not undertake, having regard to his education,
training and experience. For example, whilst the plaintiff may
not have undertaken previously the duties of a triage nurse, he
had extensive experience as an intensive care nurse. That
experience would qualify him for undertaking an assessment of
a patient in order to assess which patient ought be attended to
first. Similarly, the plaintiff’s extensive experience as an intensive
care nurse rendered him qualified to administer needles and take
samples from a patient.
[48] The plaintiff has not established that the second decision was a
decision made not in good faith. The plaintiff has also not
established that the decision was made without a real and
genuine consideration of the issues for determination by the
defendant, in accordance with its obligations and duties under
the Deed and the Act. The second decision also was not a decision
which was so unreasonable that no reasonable Trustee could
reach it on the material placed before the defendant.
[49] The plaintiff’s challenge to the second decision amounts to no
more than an assertion that a different decision was open on the
evidence. That is not a sufficient basis to set aside the decision
of the defendant. The defendant made a reasoned choice between
competing bodies of medical evidence, in accordance with its
obligations and duties to decide whether the plaintiff satisfied
the terms of the Deed. That choice was reasonably open to it.
Such a decision is not properly to be interfered with by a Court.”49
Discussion
[47] It is helpful to preface discussion of Mr Gomez’s grounds in this component of the
appeal with three observations about the practical implications of the earlier discussed
49 AR Vol 2 pp 721-722 [45]–[49].
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13
nature of the decision at Board level, particularly the Board’s duty to give an
application properly informed consideration.
[48] Firstly, the impact of that duty upon the extent and degree of detail in the information
required by the Board will inevitably vary with the circumstances of the case. Most
obviously it will vary depending upon how clear cut the disabling impact of the injury
is upon the member’s ability to work in the field for which the member is qualified.
To take an extreme example, the Board might readily accept that an applicant nurse
whose injury caused permanent blindness, severe brain damage and quadriplegia is
unlikely ever to be able to work again in a job for which the nurse is reasonably
qualified by education, training or experience. In such a catastrophic case, in meeting
its duty, the Board would be unlikely to require any more than the briefest of advices
of the minimum two medical practitioners made mandatory by the definition of TPD
in the deed. Contrast that example with the case of an applicant nurse with hitherto
excellent hearing in both ears whose injury causes say a permanent 25 per cent loss
of hearing in one ear only. In such a case the board would think it unlikely, in the
absence of comprehensive and detailed information to the contrary, that the extent of
disablement would preclude the nurse from working again in a nursing job.
[49] The present case falls between those opposing examples in the spectrum of potential
cases. At first blush the injury here presents as unlikely to have deprived Mr Gomez
of the ability to apply many of his expert nursing skills. As against this, consideration
of discrete transferable skills is far from determinative,50 for it is the collective
capacity of the injured worker to meet whole of job requirements which will better
inform the Board’s decision. This heralds the practical importance of the Board not
merely assuming there must be plenty Mr Gomez can still do in a job in the field of
nursing. Rather it is important to focus upon whether he is reasonably qualified by
education, training and experience to be able to meet the combined requirements of
any such job.
[50] Secondly, the extent to which the Board as a trustee ought make any further inquiries
in order to meet its duty to give properly informed consideration to an application
will also vary with the circumstances of the case. In Finch v Telstra Super Pty Ltd,
the High Court observed, in expanding upon the implication of the duty to give
properly informed consideration to applications:
“If the consideration is not properly informed, it is not genuine. … It
would be bizarre if knowingly to exclude relevant information from
consideration were not a breach of duty. And failure to seek relevant
information in order to resolve conflicting bodies of material, as here,
is also a breach of duty. …[T]here is because of the importance of the
[Trustee’s] opinion and its place in the Scheme a high duty on the
Trustee to make inquiries “for information, evidence and advice”
which the Trustee may consider relevant.”51
[51] Those observations ought not be taken to suggest that any lack of information or any
conflict in information before the Board will oblige it to make further inquiry. The
duty to give properly informed consideration does not oblige the board to inquire to
a point of factual perfection.52 Much will depend upon the significance of the lack of
50 See for example Jones v Untied Super Pty Ltd [2016] NSWSC 1551, [62].
51 (2010) 242 CLR 254, 280-281.
52 Alcoa of Australia Retirement Plan Pty Ltd v Frost (2012) 36 VR 618, 633; cited with implicit approval
in Edington v Board of Trustees of the State Public Sector Superannuation Scheme [2016] QCA 247, [64].
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14
information or conflict in information. The ultimate point of any further inquiry is to
enable the Board to meet its duty to give properly informed consideration to an
application. As was observed in Alcoa v Frost53 by Nettle JA (as he then was), with
whom Redlich JA and Davies AJA agreed:
“Superannuation fund trustees are bound to give properly informed
consideration to applications for entitlements and, if that necessitates
further inquiries, then they must make them.”54 (emphasis added,
citations omitted)
Thus, the Board has a duty to make further inquiry if such inquiry is necessary in
order to give properly informed consideration to an application.
[52] Thirdly, the merit or strength of the material advanced by an applicant member may
be influential in the Board’s consideration of whether or not further inquiries are
necessary. In submissions before this court Mr Gomez’s counsel was at pains to
emphasise there was no onus upon an applicant member to advance information
addressing or contradicting information before the Board adverse to the member’s
application. As a general proposition that is correct, given the nature of the Board’s
duty to all members, including applicant members.55 However, sight must not be lost
of the fact that ultimately it is necessary, pursuant to clause 9.1 of the terms, for the
Board to receive proof satisfactory to it that the member has suffered TPD before
paying out a claim.
[53] There is obviously an element of risk involved in a member merely sitting back and
hoping that the Board will regard information adverse to the application as
unconvincing and or warranting further inquiry. That risk may be low where the
member has already put forward comprehensive information of substance suggesting
a strong prima facie case of entitlement. In such a case the Board may be disinclined
to act upon information adverse to the application without making further inquiry.
However, if the information previously advanced by the member provides only
equivocal or incomplete support for the application and the member elects not to
advance information contradicting information adverse to the application, the risk
will be higher. That is particularly so where it is apparent that if such contradictory
information existed the member could procure it. In such a case the Board may
logically infer from the paucity of information supporting the application and the lack
of contradiction of information adverse to it that it can more safely act upon the
adverse information without further inquiry.56
[54] Mr Gomez’s grounds in respect of this component of the appeal are lengthy. With
one inconsequential exception,57 their factual focus is on Mr Gomez’s qualification
53 (2012) 36 VR 618.
54 Ibid 633.
55 Alcoa of Australia Retirement Plan Pty Ltd v Frost (2012) 36 VR 618,630 [47]. Compare TAL Life
Ltd v Shuetrim; Metlife Insurance Ltd v Shuetrim (2016) 91 NSWLR 439, 482 [207] which illustrates
the potential importance of the terms of instrument to this issue.
56 The logic underpinning such circumstantial reasoning is analogous to that discussed by the High Court
in different contexts in Jones v Dunkel (1959) 101 CLR 298 and Weissensteiner v The Queen (1993)
178 CLR 217.
57 The exception is an allegation in effect that the Board failed to make findings as to all of the non-
physical limitations caused by the injury and wrongly found the non-physical limitations were not such
as to impede his fitness for sedentary jobs (AR Vol 2 p 734). There is no substance to this complaint.
To the extent there once had been secondary consequences of the injury, the materials readily support
the conclusion those consequences had diminished over time and were not of such a degree as to have
a material bearing on Mr Gomez’s capacity to work in sedentary nursing jobs.
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15
for the sedentary jobs the Board concluded he was reasonably qualified for. In
summary the grounds complain the learned trial judge should have found:
(a) the Board’s conclusion was not reasonably supported by the material
before it; and
(b) the Board failed to give real and genuine consideration to Mr Gomez’s
claim, in that it did not ascertain relevant facts or resolve conflicts as to
relevant facts.
[55] An obstacle to Mr Gomez’s first complaint is that, as the above review of the
information before the Board shows, there was information before the Board which
supported its conclusion Mr Gomez was at least reasonably qualified by his
education, training or experience and fit to work as a Telephone Triage Nurse,
Pathology Collector and Health Promotion Officer (though not, for reasons explained
below, as a Nursing Educator).
[56] At best for Mr Gomez it can be said some of that information lacked supporting detail
and some of it was in conflict with other information. However, the presence of such
difficulties is hardly remarkable in factual disputes. It does not follow from their
presence that the totality of the information before the Board did not reasonably
support its conclusion. A lack of factual detail from one source of information may
wane as a concern when considered in combination with other supportive sources of
information. Similarly, a conflict in information may be readily resolved without
further inquiry where the overall information already available allows a properly
informed choice to be made as between rival sources of information.
[57] Whether a lack of detail is so significant as to mean relevant facts cannot be
ascertained and whether a conflict in information is so significant as to require further
information to resolve it is a matter of degree. In the absence of those features being
so significant as to preclude properly informed consideration of the application (as
they were for the position of Nursing Educator but not for the other three jobs) an
obstacle to Mr Gomez’s second complaint is the Board’s reasons show that, on the
face of it, the Board did give real and genuine consideration to the claim.
[58] Turning specifically to the four jobs identified by the Board’s reasons, it will be
recalled there were limited vacancies for some of those jobs. That is not a determinative
consideration. The test of TPD is not directed to the location or extent of vacancies
in jobs for which the member is reasonably qualified, it is directed to the member’s
ability to work in such jobs.58
[59] It could be readily inferred from the materials before the Board that Mr Gomez’s
degree of physical disablement would not deprive him of the physical capacity to
perform the positions of Telephone Triage Nurse, Nursing Educator, Pathology
Collector and Health Promotion Officer. To the extent the position of Pathology
Collector involves the pushing and pulling of trolleys it was open to conclude from
Dr Christian’s report that any physical capacity concerns could be adequately catered
for by the use of small trolleys.
[60] Because the four jobs could adequately accommodate Mr Gomez’s degree of disablement
the practical factual issue for the Board’s consideration was whether Mr Gomez was
reasonably qualified by education, training or experience to work in such jobs.
58 Wells v Australian Aviation Underwriting Pool [2004] QCA 43, [16]-[17]; Repatriation Commission
v Hill (2005) 142 FCR 88, [58]; Hannover Life Re Of Australasia Ltd v Colella (2014) 47 VR 1, [34].
-- 15 of 31 --
16
[61] Turning firstly to the position of Health Promotion Officer, the specific information
before the Board suggesting Mr Gomez was suited to that job appeared in the report
of Consultant Occupational Physician Dr Christian. He opined Mr Gomez “may be
well suited” to work in such a position. There was only a very brief explanation
advanced in support of this opinion. The report of Occupational Health Physician
Dr Salinas seemed to concede without explanation that Mr Gomez may be suited to
such work with re-education and or additional training. This was hardly a contradiction of
Dr Christian’s opinion. Moreover, the first report of Occupational Therapist Rebecca
Hague did not specifically address Mr Gomez’s suitability for such a job at all. Her
opinion, proffered at the conclusion of her first report, that Mr Gomez was unfit for
any occupation for which he was qualified, was so general and unrelated to specific
information as to carry little weight in isolation.
[62] While some decision makers might have sought more information about Mr Gomez’s
qualification to work as a Health Promotion Officer it was, in the circumstances,
reasonably open to the Board, informed by the largely uncontradicted opinion of
Dr Christian, to conclude Mr Gomez was qualified and able to work in such a job.
[63] As to the position of Telephone Triage Nurse, Karen Stewart, Rehabilitation Advisor,
opined, with reasons, that Mr Gomez is qualified for such a job. It was not a surprising
opinion given Mr Gomez’s experience as an intensive care nurse. She acknowledged
the position required strong communication skills. Mr Gomez’s counsel emphasised
there was no direct evidence Mr Gomez possessed such skills, although none of the
material, including the reports of specialists who communicated with him, suggested
a difficulty with communication. In any event though, the Board was not limited to
direct evidence and like any fact finder was entitled to draw inferences. It was
reasonable to infer from Mr Gomez’s experience as an intensive care nurse that, for
the purposes of communications about triage, he would possess strong communication
skills. Ms Stewart’s reports contained a qualifying clause suggesting “additional
medical opinion … to clarify the suitability of the identified occupations from a functional
perspective”. While not entirely clear, this appears to be a reference to the need to
confirm Mr Gomez’s physical capacity to function in the positions, which was
confirmed by Dr Christian’s report. Ms Hague did not directly contradict Ms Stewart’s
opinion regarding the position of Telephone Triage Nurse, although she noted
Mr Gomez had no prior training or experience and that the limited advertisements for
such positions suggest previous experience is preferred.
[64] On the face of the information available to the Board it was reasonable to infer
Mr Gomez was qualified and able to work as a Telephone Triage Nurse.
[65] Turning to the position of Pathology Collector, that title appears to be the Board’s
name for the job or jobs variously described in the reports as Pathology
Collector/Venepuncture and Phlebotomist. Ms Stewart opined that this job was
a potential suitable vocational option for Mr Gomez, although the foundation she
proffered for that opinion seemed speculative. Ms Stewart noted the job requires the
holding of some certificates which some employers would permit to be completed
through in-house training programmes. While she did not explain whether Mr Gomez’s
qualification, training and experience as a nurse already qualified him to the level
required by such certificates, she noted he probably had experience in blood
collection and cannulation. Ms Hague and Dr Salinas did not address his suitability
for such a job, so Ms Stewart’s opinion, with its apparently speculative foundation,
was uncontradicted.
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17
[66] The need for certificates in this job was a potentially concerning issue for the Board.
In Hannover Life Re Of Australasia v Colella59 Garde AJA, with whom Ashley JA
and Beach JA agreed, observed:
“It has been accepted that inability to perform work does not (apart
from a short qualifying or refresher course) require a claimant to
undergo a course of retraining in order to make him or her employable.
Rather the assessment of TPD takes into account any job or occupation
for which the claimant is reasonably fitted having regard to his then
current education, training or (sic-and) experience.”60 (citations omitted)
[67] In Hannover Life Re Of Australasia Ltd and Anor v Dargan,61 Bathurst CJ, with
whom MacFarlan JA, Meagher JA, Hoeben JA and Tobias JA agreed, reasoned that
the word “reasonably” informs the extent of existing qualification required.62 He
concluded an experienced former truck driver who had the education, training and
experience to capably pass a test required to hold a certificate to work as a taxi driver
was reasonably fitted by his education, training and experience to work as a taxi
driver.63 His Honour acknowledged the need for caution in referring to cases
involving differently worded tests - there the relevant words were “reasonably fitted
by education, training or experience”. However, his Honour’s reasoning adopted the
reasoning of Hodgson J in Chammas v Harwood Nominees Pty Ltd,64 where the
relevant words were, “reasonably qualified by education, training or experience”.
They are the same words as the test here.65
[68] In the present case, the absence of information contradicting Ms Stewart’s vaguely
explained opinion made it safer for the board to draw the borderline inference that
Mr Gonzales’ education, training and experience meant he could probably obtain the
requisite certificates by on the job training in work for which Mr Gomez was otherwise
probably qualified by his experience as a nurse. While another decision-maker may
have required further information on the point the conclusion Mr Gomez was reasonably
qualified by education, training or experience to work as a Pathology Collector was
reasonably open to the Board.
[69] Finally, as to the position of Nursing Educator, Ms Stewart noted Mr Gomez’s
previous teaching experience in nursing. She considered his education, training and
experience was in keeping with the requirements of an advertised position she had
located for tutors for the School of Nursing and Midwifery at Griffith University.
That position required a bachelor’s degree in nursing and current industry experience.
It will be recalled Occupational Health Physician Dr Salinas seemed to concede
without explanation that Mr Gomez may be suited to such work with re-education
and or additional training. Ms Hague noted Mr Gomez had no Australian qualifications
relating to working as a nursing educator and opined he was not qualified to work as
a nursing educator. In support of that opinion she referred to a job vacancy for the
position of “Clinical Nurse Educator-Aged Care” and its requirement the applicant
hold post graduate qualifications in education and or management.
59 (2014) 47 VR 1.
60 Ibid [32].
61 (2013) 83 NSWLR 246.
62 (2013) 83 NSWLR 246, 252.
63 Ibid 252-254.
64 (1993) 7 ANZ Ins Cas 61-175.
65 Compare Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd (2015)
89 NSWLR 412 where the relevant words were “reasonably capable of performing by reason of
education, training or experience”, which arguably appears to be a more liberal requirement than the
words “reasonably qualified by education, training or experience”.
-- 17 of 31 --
18
[70] The Board did not have sufficient information before it to make a properly informed
decision in respect of Mr Gomez’s qualification to work as a Nursing Educator. The
fact that Mr Gomez once worked in such a job in the Philippines is obviously
a relevant consideration, however holding proper educational qualifications is obviously
critical in determining whether a person is reasonably qualified to teach. Ms Stewart’s and
Ms Hague’s opposing opinions on this topic each ultimately turned upon reference to
the tertiary education qualifications mentioned in only two job advertisements, with
them referring to one such advertisement each. Such a conflict in opinions so
similarly and thinly premised compels the conclusion that on the information before
it the Board could not have given properly informed consideration to whether
Mr Gomez was reasonably qualified by education, training or experience to work as
a Nursing Educator.
[71] While this final conclusion is at odds with that of the learned trial judge it is academic
to the end result because the above conclusions in respect of the other three jobs are
not at odds with his Honour’s view that the Board’s second decision should not be
disturbed. The information before the Board was in the circumstances sufficient for
the Board to give properly informed consideration to whether Mr Gomez would ever
be able to and whether he was reasonably qualified to work as a Health Promotion
Officer, Telephone Triage Nurse and Pathology Collector. It was reasonably open to
the Board to conclude, as it did, that he is so qualified. It follows from the Board’s
conclusion that it could not hold the opinion required by the definition of TPD that
Mr Gomez’s degree of disablement is such as to render him unlikely ever to be able
to work again in a job for which he is reasonably qualified by education, training or
experience.
[72] This conclusion, favourable to the Board, makes it unnecessary in consideration of
this ground to deal with a complaint raised by the Board’s submissions that Mr Gomez’s
arguments in the appeal involved pursuit of an allegation, arguably66 abandoned
below, that the Board should have made further inquiries.
[73] The learned trial judge was correct in declining to interfere with the Board’s second
decision. Mr Gomez’s appeal against the trial judge’s decision in respect of the
Board’s second decision must fail.
Appeal against trial judge’s decision re third decision
Information before the Board’s delegate for the third decision
[74] By letter to the Board’s solicitors of 15 April 2016 Mr Gomez’s solicitors sought a
review of the second decision. The letter enclosed new medical and other evidence
in further support of Mr Gomez’s claim, submitting the material “supports that our
client meets the relevant Total and Permanent Disablement definition and that his
claim should be met”.67
66 “Arguably” in that it does not automatically follow from the pre-trial abandonment of a belated attempt
at the express pleading of the point that the existing content of Mr Gomez’s pleadings did not adequately
raise the point. There is a close connection at law between the duty to give properly informed consideration
and the duty to make further inquiry. Mr Gomez’s pleadings were complemented by the content of
further and better particulars replete with references to the Board taking no steps to resolve conflicts
(AR Vol 2 pp 658 [8(b)], 660 [6(a)], 662 [3(a)], 669 [8(b)], 670 [6(a)], 673 [3(a)]), allegations repeated
in Mr Gomez’s submissions below (AR Vol 2 pp 564 [171(b)], 566 [179(e)], 568 [190(b)], 575 [234(a)]).
Such allegations might be thought to impliedly relate to both duties.
67 AR Vol 2 p 418.
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19
[75] The additional material included a supplementary report care of Mr Gomez’s
solicitors by Occupational Therapist Rebecca Hague, dated 14 April 2016. As to the
position of Telephone Triage Nurse she noted on performing a job search she was
only able to find one vacancy for such a position in Brisbane and one in Sydney.
Further, she noted she had conducted a follow-up telephone conversation with
Mr Gomez and explained his accent would be a barrier to such employment because
a Telephone Triage Nurse requires exceptional communication skills to provide clear
health advice and instructions to patients over the phone.68 Noting his absence of
prior experience, the limited number of available positions, the barrier presented by
his accent and his absence of additional qualifications that might otherwise advantage
him over other applicants with superior communication skills and prior experience,
she opined the likelihood of him acquiring work as Telephone Triage Nurse was poor.69
As to the position of Pathology Collector/ Venepuncture/Phlebotomist, Ms Stewart’s
report noted the need for a certificate 3 in Venepuncture and a minimum of three
years’ experience in venepuncture, qualifications Mr Gomez does not have. She also
noted he had never worked in pathology collection or as a Phlebotomist and opined
that he was not reasonably qualified or experienced for work as a Pathology Collector
or as a Phlebotomist.70 She reiterated her views previously expressed as to Mr Gomez’s
suitability for work as a Nursing Educator, adding that his teaching experience in the
Philippines would be considered outdated by the preponderance of employers. As to
the position of Health Promotion Officer she explained that it was a field involving
now recognised undergraduate qualifications in health promotion and public health
and in which professionals were required to have an understanding of health sector
policies and knowledge of the requirements for planning and implementing health
management programs with consideration of a wide range of stakeholders.71 She
opined Mr Gomez was not qualified or skilled for work in this field. She reiterated
her view that Mr Gomez is unfit for any occupation for which he is reasonably
qualified for by education, training or experience.72
[76] The additional material included a statement by Mr Gomez in which he stated he had
searched for Nurse Educator positions in Brisbane and found only one advertised and
that it required the applicant to have management experience, a post graduate
qualification and a minimum of five years’ experience within a surgical background,
none of which he has.73 He stated he had discussed the positions of Phlebotomist,
Health Promotion Officer, Telephone Triage Nurse and Nurse Educator with his Job
Search provider. He stated:
“She advised me that to be a Phlebotomist I need to complete a
qualification; that the position of Health Promotion Officer is rare and
you need to be already within the institution and be promoted as you
can’t directly apply externally; that the position of Telephone Triage
Nurse is a very, very rare position and I would need good computer
skills and be highly fluent in spoken English; I have only fairly basic
computer skills and poor keyboard/typing skills. My spoken English
is quite accented and could not be described as highly fluent.”74
68 AR Vol 2 p 439.
69 AR Vol 2 p 440.
70 AR Vol 2 p 440.
71 AR Vol 2 pp 441-442.
72 AR Vol 2 p 442.
73 AR Vol 2 p 449.
74 AR Vol 2 p 449.
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20
[77] Orthopaedic Surgeon Dr Hugh English, in a short additional report of 13 December
2015 care of Cooper Grace Ward Lawyers, opined, without any accompanying analysis:
“With appropriate treatment, Mr Gomez would remain fit to work as
a nurse supervisor, preadmission nurse, tele-health nurse, practice
nurse, nurse educator, pathology collector, medical receptionist and
general practice nurse. In terms of general nursing duties in a hospital,
he may have some minor restrictions in terms of heavy and repetitive
lifting. Nursing duties vary significantly from ward to ward and
position to position and this may need to be taken into account.”75
As with the earlier report of Dr Christian, Dr English’s opinion went to fitness and
not qualification for such positions.
Third decision
[78] By letter dated 10 June 2016 the Board’s solicitors relevantly advised:
“I advise that your request for a further review of the QSuper decision
to decline a TPD benefit for your client was considered by a Senior
Board Delegate on 10 June 2016.
The Senior Board Delegate has determined on a review of the
additional material provided by Maurice Blackburn since the last
Board decision on 26 June 2014 … that the new material on Mr Gomez’s
TPD claim does not indicate a reasonable possibility of a different result
to the Board’s decision made on 26 June 2014.
Therefore the Senior Board Delegate affirmed the refusal of
Mr Gomez’s TPD and that he is not entitled to a TPD benefit…
The Senior Board Delegate noted that the three reports by
Occupational Physicians, Dr Douglas (for QSuper), Dr Fitzgerald (for
Qld Health) and Dr Christian (for Suncorp) did not raise any
employment issues which might arise out of Mr Gomez’s accent. The
Senior Board Delegate also noted that the first report dated 30 October
2013 by Ms Hague, who is an Occupational Therapist, did not identify
any employment issues arising from Mr Gomez’s accent.
The Senior Board Delegate further noted the report dated 23 March
2016 of Dr Shaikh, Psychiatrist who examined Mr Gomez and
concluded that he did not currently suffer with a psychiatric condition
and that Dr Shaikh from a psychiatric perspective did not see any
restrictions in terms of Mr Gomez’s occupational capabilities for the
employment options set out in his report. …”76 (emphasis added)
[79] The test purportedly applied by the Board’s delegate was therefore the reasonable
possibility of a different result test, espoused in Gilberg v Maritime Super Pty Ltd,77
discussed above.
The learned trial judge’s decision
[80] In reviewing the third decision the learned trial judge referred to Gilberg v Maritime
Super Pty Ltd78 and proceeded to find:
75 AR Vol 2 p 487.
76 AR Vol 2 p 458.
77 [2009] NSWCA 325.
78 [2009] NSWCA 325.
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21
“[52] The further material provided to the defendant addressed not
merely the availability of other occupations for which the
plaintiff was qualified by relevant education, training or experience.
That material addressed the likelihood of a plaintiff having such
transferable skills, having regard to the need for particular
educational requirements and the ability to undertake certain
types of communication. They were matters which had not been
specifically considered by Ms Stewart or any of the medical
practitioners who had earlier provided opinions to the defendant.
[53] Those matters were relevant to a consideration of whether the
plaintiff, in truth, had the capacity to perform remunerative
work in those designated occupations as opposed to a capacity
to perform work tasks within those designated occupations. As
was observed in Jones v United Super Pty Ltd having some of
the requisite skills does not equate to having a capacity to
perform remunerative work.
[54] The defendant, consistent with its obligations and duties under
the Deed and Act, had to consider whether, having regard to the
plaintiff’s particular circumstances, the identified alternate
occupations were occupations the plaintiff had the capacity to
engage in having regard to his education, training or experience.
That consideration had to be more than a theoretical exercise
removed from reality. The additional material gave rise to that
very consideration. It put forward sufficient material to show
there was a case to be investigated further. That case justified
the seeking of further opinions from Ms Stewart and the relevant
medical practitioners.
[55] Had the Board’s delegate given consideration to that aspect of
the additional material, there was a reasonable possibility of
a different result being reached by the defendant to that of the
second decision. The delegate’s failure to consider the material
in that way breached the defendant’s obligation to reconsider its
second decision.
[56] That conclusion supports a finding that the defendant breached
its duty by failing to properly reconsider the application made
to it by the plaintiff for the payment of total and permanent
disability benefits. Whilst there remains in that event, a discretion
to decline to make an order that the Trustee properly consider
the application, the material placed before the defendant was of
such a nature that it cannot be concluded there is no reasonable
possibility that the defendant, acting reasonably, will accede to
the plaintiff’s application in the event of a reconsideration.”79
(citations omitted)
[81] The learned trial judge concluded that the plaintiff was entitled to an order “that the
defendant properly consider the application for the payment of total and permanent
disablement benefits”.80 He relevantly ordered:
79 AR Vol 2 p 723 [52]-[56].
80 AR Vol 2 p 724 [57].
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22
“1. The decision of the defendant made on 10 June 2016 be set aside.
2. The plaintiff’s application for reconsideration of the defendant’s
decision to decline his claim for total and permanent disablement
benefits be remitted to the defendant to be considered according
to law.”81
Discussion
[82] The reasoning of the learned trial judge and the conclusion he reached was sound.
The same conclusion is inevitable in this appeal by re-hearing.
[83] The Board’s grounds complain the learned trial judge erred in holding the additional
information raised a reasonable possibility that a different result to the second
decision would be reached and that the Board had breached its duty by failing to
properly reconsider the application. The below discussion of the undoubted significance
of the additional information received by the Board demonstrates there was no such error.
[84] The grounds were accompanied by subsidiary complaints that the learned trial judge
erred by substituting his own opinion on the merits, engaging in reasoning inconsistent
with his finding in respect of the second decision and not adequately identifying his
reasoning. His Honour’s reasoning was quite clear. His reasons indicated he was not
engaged in a merits review and his findings clearly focussed not upon the merit of the
additional information but its objective significance for the Board’s decision-making
process.
[85] That his Honour reached a different conclusion for different reasons in respect of the
third decision than he did in respect of the second decision is unsurprising in
circumstances where significant additional information was available by the time of
the third decision. Indeed, the obvious difficulty with the Board’s appeal is that the
nature of the additional material contained in Ms Hague’s further report included
material information, on topics clearly relevant to Mr Gomez’s capacity to work in
the posited jobs, which had not hitherto been before the Board.
[86] Firstly, in respect of the job of Health Promotion Officer, it will be recalled that it
was Dr Christian, not Ms Stewart, who had opined with only a very brief explanation
that Mr Gomez “may be well suited” to work in such a position. Ms Hague’s
supplementary report explained Mr Gomez’s experience as a Registered Nurse did
not mean he was qualified to work in health promotion, a field now recognised by
other graduate qualifications in Australia. More particularly, she explained that
professionals in this field must have an understanding of health sector policies and
knowledge of the requirements for planning and implementing health management
programs. She opined Mr Gomez does not possess the qualification or skills for work
in such a field. The effect of Ms Hague’s supplementary report was to provide information
about the specialist knowledge required for the position, a topic of obvious relevance
to whether Mr Gomez would be able to work in such a job. The limited information
which had hitherto been before the Board in respect of Mr Gomez’s suitability for
this job simply did not address that important topic at all.
[87] Secondly, as to the position of Telephone Triage Nurse, a position which, even according
to Ms Stewart, requires strong communication skills, Ms Hague’s supplementary report
explained she had conducted a follow-up telephone conversation with Mr Gomez. She
reported:
81 AR Vol 2 p 725.
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23
“In my view, this man’s accent will be a barrier to this employment.
A Telephone Triage Nurse obviously requires exceptional communication
skills to provide clear health advice and instructions to patients over
the phone. It would be critical that this communication is effective
given the nature of the advice (i.e. there is risk of poor health outcomes
if a patient is unable to clearly understand the advice given).”82
[88] While Ms Stewart’s report prior to the second decision noted the position of
Telephone Triage Nurse required strong communication skills, she did not express
a specific opinion about Mr Gomez’s oral communication skills. In fact she had not
ever met with him and prepared her report from file documents only. True it is some
of the medical practitioners who reported on their consultations with Mr Gomez did
not identify any particular communication difficulty but nor were they assessing his
communication skills for the purposes of acting as a Telephone Triage Nurse. Here
again, Ms Hague provided information about detail on a topic clearly relevant to
Mr Gomez’s ability to act as a Telephone Triage Nurse, which had not been
specifically addressed in any of the materials hitherto before the Board.
[89] Thirdly, as to the position of Pathology Collector, Ms Hague’s supplementary report
noted Ms Stewart had provided an example position for work as a Pathology Collector
which “dictates that the applicant must possess a Certificate III in Venepuncture and
a minimum of 3 years’ experience in Venepuncture.”83 Ms Hague noted Mr Gomez
does not hold such qualifications and has never worked in pathology collection or as
a Phlebotomist. She opined he was not reasonably qualified or experienced for such
work. Unlike the position in respect of the first two jobs discussed above, this was at
least a topic which had been addressed in the materials hitherto before the Board, in
the report of Ms Stewart. As earlier discussed, the need for certificates for the
position of Pathology Collector was a potentially concerning issue for the Board and
the foundation for Ms Stewart’s then uncontradicted opinion appeared vague. The
contradicting information provided by the supplementary report of Ms Hague clearly
undermined the force of the already borderline inference that the need to obtain
certificates did not preclude Mr Gomez being “reasonably qualified” to be a Pathology
Collector.
[90] As is apparent from the earlier discussed authorities, the word “reasonably” in the
phrase “for which the member is reasonably qualified by education, training or
experience” may provide some latitude in respect of requirements for on-the-job
training and certification. Nonetheless, the phrase focusses upon the extent of the
member’s existing rather than future qualifications. The provision of Ms Hague’s
contradictory opinion, supported by an ostensibly straightforward explanation, should
have made it obvious to the Board’s delegate that at the time of the second decision
there had in truth been insufficient information available about the substance of what
was required for certification. On the whole of the evidence the true demands of the
certification requirement are unclear. In the absence of such information, properly
informed consideration could not be given to whether Mr Gomez was reasonably
qualified to work as a Pathology Collector.
[91] Finally, as to the fourth mooted job, that of Nursing Educator, this was an area in
which the shift in information available was less significant than in respect of the three
other positions. In substance, Ms Hague’s supplementary report merely reiterated her
earlier opinion about Mr Gomez’s unsuitability for such work. However, that is of
82 AR Vol 2 p 439.
83 AR Vol 2 p 440.
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24
no help to the Board’s position for I have already concluded that there was insufficient
material before the Board at the time of its second decision for it to have given
properly informed consideration to Mr Gomez’s suitability for work as a Nursing
Educator.
[92] It is unfortunate, and perhaps frustrating from the perspective of the Board or its
delegate, that the important relevant information provided in Ms Hague’s supplementary
report was not provided prior to the second decision. Nonetheless, as the above
analysis demonstrates, the additional information in respect of two of the posited jobs
went to important relevant topics bearing upon Mr Gomez’s suitability for those jobs
about which the earlier materials before the Board had been silent. In respect of the
third of the posited jobs, Ms Hague provided contradictory information of a kind
which meant that, in truth, there had not yet been properly informed consideration of
Mr Gomez’s suitability for that job.
[93] None of this is to suggest that as a result of the additional information the Board ought
ultimately arrive at a different conclusion but it obviously indicates there was
a reasonable possibility of a different result than the Board’s second decision. It was
information of such objective importance that the Board had a duty to consider it in
fulfilling its duty to give properly informed consideration to Mr Gomez’s application.
[94] The probability is that had the Board properly considered it, it would have made
further enquiry. However, it is unnecessary to reach a concluded view about that forecast
in circumstances where the decision under appeal was merely that the additional
material did not indicate a reasonable possibility of a different result to the second
decision. That was not a conclusion reasonably open on the materials before the
delegate. It could not have been made upon a real and genuine consideration of those
materials.
[95] It follows the learned trial judge was correct in concluding that the Board should be
ordered to properly consider Mr Gomez’s request for reconsideration of his application.
[96] As earlier mentioned the Board’s submissions complained Mr Gomez’s arguments in
the appeal involved pursuit of an allegation, arguably abandoned below, that the
Board should have made further inquiries. It appeared those submissions related
principally to Mr Gomez’s appeal against the trial judge’s decision in respect of the
second decision, in which context they became academic because Mr Gomez was
unsuccessful in that component of the appeal. To the extent the submissions related
to the present component of the appeal they are also academic. That is because the
decision under appeal was the erroneous decision that the additional material did not
indicate a reasonable possibility of a different result to the second decision. Any
failure to make inquiries was a step removed from that threshold error.
Appeal re delegation issue
[97] The plaintiff below submitted that the third decision was a nullity, both on the basis
there was no power for the defendant to delegate the decision-making process and
there was no effective delegation to the person who purported to make the decision.84
[98] On this issue the learned trial judge concluded:
“[T]he affidavit material relied upon by the defendant establishes the
decision was made pursuant to a delegation and by an approved
delegate.”85
84 AR Vol 2 p 720 [35].
85 AR Vol 2 p 722 [50].
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25
His Honour did not preface that conclusion with any discussion of the evidence or the
issue raised, presumably because he had already found in favour of Mr Gomez for
other reasons.
[99] Mr Gomez’s ground of appeal on this issue is:
“The learned Trial Judge erred in finding the affidavit material relied
upon by the appellant established the decisions made on 9 January
2013 and 10 June 2016 were made pursuant to a valid delegation and
by an approved delegate when the evidence did not support such a finding.”
[100] This ground only has relevance to the third decision, it being a decision made by a
purported delegate rather than by the Board. The Board has been unsuccessful in its
appeal against the learned trial judge’s decision to set aside the third decision and
order Mr Gomez’s application for reconsideration of the second decision be remitted
to the Board to be considered according to law. It is therefore unnecessary for this
ground of Mr Gomez’s cross-appeal to be determined. However, because there
appears to be substance to the point raised by Mr Gomez in respect of this ground and
because of the Board’s ongoing role in this matter, it is at least prudent to identify the
nature and force of the point raised.
[101] The third decision was made by Ms Sharyn Brennan, Acting Manager (Claims
Operations).86 At issue is whether she held a lawfully delegated power to make such
a decision. Section 6F (now s 6C) of the Act provided:
“Delegation by board
(1) The board may delegate its powers under this Act to the CEO,
a trustee or an appropriately qualified person.
(2) A delegation of a power may permit the subdelegation of the
power to the CEO, a trustee or an appropriately qualified person.”
[102] The Board’s submission in the present case is that the Board did delegate its power
to determine entitlement to a TPD benefit to the CEO who, in turn, sub-delegated it
to, inter alia, the Manager (Claims Operations), the position in which Ms Brennan
was acting at the time of the decision.
[103] Evidence adduced by the Board exhibited the schedules of delegations said to have
been in force at the time of the third decision. There are two schedules. The first is
the delegation schedule of the operational powers delegated by the Board of Trustees
to the CEO.87 The second schedule is the sub-delegation schedule of operational
powers sub-delegated by the CEO.88 The latter schedule records, in respect of “G14
total and permanent disablement insurance”, three sub-delegated authorities:
“(a) Authority to pay a total and permanent disablement insurance
benefit.
(b) Determination of entitlement to a total and permanent
disablement benefit and whether or not the disablement is
related to a pre-existing condition.
(c) Authority to cancel total and permanent disablement insurance
when a member elects to opt out.”89 (emphasis added)
[104] One of the sub-delegates clearly identified in the schedule in respect of that sub-
delegation of authority is the Manager (Claims Operations), the position in which
86 AR Vol 2 p 481.
87 AR Vol 1 p 100 et sequitur.
88 AR Vol 1 p 117 et sequitir.
89 AR Vol 1 p 122.
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26
Ms Brennan was acting when she made the third decision. It is arguable whether that
decision, which was only that there was no reasonable possibility of a different result
to the earlier determination, was itself a “determination of entitlement”. That argument
was not raised in the appeal.
[105] Implicit in the use of the terms “authority to pay” and “determination of entitlement”
in (a) and (b) above is a distinction as between the authority to pay a TPD benefit and
the determination of whether a person is entitled to such a benefit. In any event the
sub-delegated authority delegates both powers, so on the face of the sub-delegation
schedule there is no irregularity.
[106] There exists a presumption of regularity in the law described thus:
“It is a rule of very general application, that where an act is done which
can be done legally only after the performance of some prior act, proof
of the later carries with it a presumption of the due performance of the
prior act.”90
That rule suggests here that proof of the requisite sub-delegation power carries with
it a presumption that such a power was lawfully delegated. However, it is in the
nature of such a presumption that it can be displaced by the facts of the case.
[107] The presumption here appears to be displaced by evidence of the delegation schedule
of operational powers delegated by the Board of Trustees to the CEO, said to have
been in force at the time of the third decision. Its delegation of authority, relating to
“G14 total and permanent disablement (TPD) insurance”, only delegated two powers,
namely:
“Authority to pay a TPD insurance benefit.
Authority to cancel TPD insurance when a member elects to opt out.”91
[108] Those two powers co-relate to the powers listed at (a) and (c) in the sub-delegation
schedule of operational powers sub-delegated by the CEO, quoted above. That is, the
Board’s delegation to the CEO does not include the power which appears at (b) in the
sub-delegation schedule, namely “determination of entitlement to a total and permanent
disablement benefit and whether or not the disablement is related to a pre-existing
condition”.
[109] That the wording of the sub-delegation schedule makes separate reference to the
authority to pay a TPD benefit and the determination of entitlement to such a benefit,
suggests that in delegating these two purported powers the CEO treated them as
distinct powers. That is, the CEO did not sub-delegate the power to pay on the basis
the power to determine was inherent in the power to pay. If they are separate and
distinct powers then the CEO had no power to delegate the power to determine an
entitlement to a TPD insurance benefit. That is because there is no reference to the
power to determine an entitlement to a TPD benefit in the powers delegated to the
CEO. On the face of it that remains a determination only the Board can make.
[110] The point of substance to which the present ground therefore gives rise is whether the
power to pay a TPD insurance benefit includes the power to determine an entitlement
to a TPD insurance benefit. If it does, then it does not matter that the CEO purported
to delegate the power to pay by also specifically delegating the power to determine.
If it does not, then the CEO’s sub-delegation of the power to determine was invalid
90 Per Griffiths CJ in McLean Bros and Rigg Ltd v Grice (1906) 4 CLR 835, 850 citing Brewer J in Knox
County v Ninth National Bank (1893) 147 US 91, 97.
91 AR Vol 1 p 103.
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27
and Ms Brennan was not lawfully empowered to make the third decision (assuming
that decision was a purported “determination”). The reasons below and the parties’
submissions in the appeal did not specifically address this point. Moreover the
content of the terms on which TPD insurance is provided (terms decided by the Board
per s 233 of the deed), which may be relevant to the point, are not in evidence. Had
it been necessary to decide the present ground of appeal it would likely have at least
been necessary to require further argument addressing this point as well as the
question whether the decision was a determination.
Appeal re costs
The order below
[111] In considering costs below the learned trial judge reasoned:
“[11] Whilst the trial ultimately was conducted on the basis that this
Court would determine the issues in dispute between the parties
on the material placed before the defendant, with the best
outcome the plaintiff could achieve being a remitter back to the
Trustee to determine his application properly, substantial costs
were incurred by the defendant in preparation for trial on the
basis that the defendant was required to meet a claim that the
Court itself determine the plaintiff’s application for payment of
total and permanent disablement benefits. Witnesses were
arranged to be available on that basis. The plaintiff’s late
concession that such relief was not open, whilst shortening the
length of the trial, did not obviate the incurring of those costs.
That fact is a relevant matter in the consideration of any exercise
of the discretion in respect of costs.
[12] Another relevant matter is that the plaintiff, until 13 May 2016,
was only seeking to challenge the first two decisions of the
defendant. The plaintiff offered to settle the proceedings in that
form on two occasions. First, on 6 October 2015, in accordance
with the principles of Calderbank v Calderbank. Second, by
formal offer to settle dated 22 February 2016. Both offers were
more favourable than the result ultimately achieved by the
plaintiff in that the plaintiff was unsuccessful in that aspect of
his claim. However, the plaintiff did ultimately succeed in
obtaining favourable relief on his amended claim.
[13] A further relevant matter is that whilst the plaintiff did not
ultimately succeed in having either the first or second decision
of the defendant set aside, the determination of those issues did
not substantially increase the length of trial as conducted by the
parties. Material relevant to those decisions would properly have
been placed before the Court in any event in its consideration of
the circumstances in which the defendant was called upon to
reconsider the second decision.
[14] Balancing all of those matters, I am satisfied determining costs
on the basis of success in respect of particular issues would not
be an appropriate exercise of the discretion. …
[15] Further, it would not be an appropriate exercise of the discretion
to order the plaintiff pay the defendant’s costs for some parts of
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28
the proceeding and for the defendant to pay the plaintiff’s costs
for other parts. That would not reflect the relevance of earlier
steps to the determination of issues at the hearing. In reaching
this conclusion, I have had regard to the offers made by the
defendant prior to the inclusion in the plaintiff’s claim of the
request for reconsideration of the second decision.
[16] The relevance of the earlier steps in earlier considerations to a
determination of the issues at the hearing also satisfy me it is
not appropriate to make a positive costs order in the defendant’s
favour, notwithstanding those offers. Such a determination would
not properly reflect the plaintiff’s ultimate success in obtaining
an order that his claim for benefits be reconsidered by the defendant.
[17] Instead, it is appropriate, in the exercise of the Court’s discretion, to
reflect those factors by awarding the plaintiff a part only of his
costs, both as to the stage from which costs are to be paid, and
the percentage thereof. Such an order reflects the plaintiff’s
ultimate limited success whilst factoring in that substantial costs
were unnecessarily incurred in preparation for trial.
[18] Having regard to those matters, I am satisfied it is appropriate
to order, in the exercise of my discretion, that the plaintiff not
recover any of his costs of the proceeding up to the filing of the
further amended statement of claim on 13 May 2016 wherein he
challenged, for the first time, the defendant’s refusal to
reconsider its second decision. The plaintiff’s limited success
thereafter is properly to be reflected by an order that the defendant
pay 40% of the plaintiff’s costs of the proceeding from 13 May
2016, to be assessed on a standard basis.”
[112] His Honour went on to observe that the parties agreed in respect of the plaintiff’s
unsuccessful application of 7 April 2017 that the plaintiff ought pay the defendant’s
costs of its appearance on that occasion.
[113] His Honour relevantly ordered:
“…3. The plaintiff pay the defendant’s costs of the defendant’s
appearance at the application on 7 April 2017, assessed on
a standard basis.
4. The defendant pay 40% of the plaintiff’s costs of the proceeding
from 13 May 2016 (except for the plaintiff’s appearance on
7 April 2017), assessed on a standard basis.
5. There otherwise be no order as to costs.”92
Grounds
[114] Mr Gomez complains the learned trial judge erred in the exercise of his discretion
concerning costs in that:
“(a) the learned Trial Judge proceeded on a misapprehension of the
facts by wrongly concluding the trial was conducted on the basis
that the best outcome the respondent could achieve was remitter
back to the Trustee to determine the application properly;
92 AR Vol 2 pp 727-729.
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29
(b) the learned Trial Judge wrongly determined that substantial
costs were unnecessarily incurred in preparation for trial in
circumstances where an argument against remitter was reasonably
open to the respondent notwithstanding the decision of the
respondent to consent to remitter at the commencement of trial;
(c) the learned Trial Judge’s conclusion that substantial costs were
incurred by the appellant in preparation for trial on the basis the
appellant was required to meet a claim that the Court itself
determine the application including arranging witnesses to be
available:
(i) was not supported by evidence tendered by the appellant;
and
(ii) evidence to the contrary was tendered by the appellant;
(d) the order as to costs was disproportionately made against the
respondent based on what was concluded to be the limited success
of the respondent in circumstances where it was acknowledged
by the learned Trial Judge this was not an appropriate case in
which to exercise a discretion to award costs in respect of
particular issues.”93
Discussion
[115] This ground of the cross-appeal falls for determination in circumstances where the
substantive grounds have failed. The question of whether in these circumstances
leave was required by s 64(2) of the Supreme Court of Queensland Act 1991 (Qld)
for this ground to be heard and determined was not raised in submissions. In the
absence of such submissions and given this ground in any event lacks merit it is
unnecessary to consider the question.94
[116] The appeal in respect of costs involves a challenge to an order that is discretionary in
nature and the principles in House v The King95 therefore apply.
[117] Grounds (a), (b) and (c) all relate to the topic of remitter. The outcome below
involved the remitting of the matter, rather than the learned trial judge deciding
Mr Gomez’s application for a TPD benefit. As recently as a review on the eve of the
hearing, Mr Gomez’s counsel informed his Honour “the plaintiff’s case has always
been that it was seeking both the setting aside of the decisions, and the determination
93 AR Vol 2 p 736.
94 Section 64(1) Supreme Court of Queensland Act 1991 (Qld) provides that an appeal only in relation
to costs lies to this court from the Trial division only by leave of the Judge below. Section 64(2)
provides an exception:
“(2) However, if, after an appeal to the Court of Appeal is properly started, the appeal
becomes an appeal only in relation to the costs of the original proceeding –
(a) subsection (1) does not apply; and
(b) the appeal may be heard and determined only by leave of the Court of Appeal.”
The predecessors to s 64 - s 255 Supreme Court Act 1995 (Qld) and s 9 Judicature Act 1876 - were
differently worded. Those earlier provisions prompted a divergent body of authority as to whether an
appellant requires leave to appeal against a costs order where the appeal is part of an otherwise
unsuccessful appeal against the substantive elements of the judgment below. Compare, for example,
Saunders v McKenna [1961] Qd R 425 (a decision which is consistent with the English approach
subsequently articulated in Wheeler v Somerfield [1966] 2 QB 94); Thorpe Nominees Pty Ltd v
Henderson & Lahey [1988] 2 Qd R 216; Re Golden Casket Art Union Office [1995] 2 Qd R 346 (which
did not follow the approach in Wheeler v Somerfield).
95 (1936) 55 CLR 499, 504-505.
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30
by the court, itself, as to the issue of entitlement to payment”.96 The former relief was
described in argument below as the first stage and the latter as the second stage. It is
clear that the parties had to that point prepared for the hearing in that understanding
of the plaintiff’s case. It was planned that witnesses would be called by the plaintiff97
and expected the hearing would take four days.98 His Honour was on that occasion
sceptical of whether there was a legitimate basis for him to determine the issue of
entitlement as well as of the need for witnesses to be called to contend for the setting
aside of the decision. It was unnecessary for his Honour to then rule on those issues
but his observations seemingly had some impact. By the outset of the hearing counsel
had agreed that the listed hearing ought deal with the first stage only and that no
witnesses would be called.
[118] The learned trial Judge was not strictly correct in observing counsel for Mr Gomez
had made a late concession the second stage of relief sought was not open. While the
observation was consistent with the course the case took there was no express
concession. How that slip supposedly grounds a proper basis to challenge the costs
decision is not apparent. Whether conceded or not, the point was evidently unarguable -
no cogent basis was advanced below or on appeal as to how the second stage of relief
was ever likely to have been an appropriate option. In the circumstances of this case
it was inevitable that at best for Mr Gomez the matter would be remitted.
[119] Mr Gomez’s approach to the litigation unnecessarily put the Board to the inevitably
substantial cost of preparing for argument and cross-examination of the plaintiff’s
witnesses at a hearing of the second stage of relief which did not eventuate and was
not ultimately pressed for by Mr Gomez. It was reasonable to infer, as the learned
trial judge did, that the Board’s preparation for the second stage would have included
arrangements to meet the potential need to call its own witnesses.99 These considerations
did not call for specific financial quantification. They were merely part of an array
of for and against considerations legitimately informing the exercise of the learned
trial judge’s discretion as to costs. There is no substance to grounds (a), (b) or (c).
[120] As for ground (d), it misconceives the order and the learned trial judge’s approach in
arriving at it. The complaint that the order was disproportionately made against
Mr Gomez is presumably a reference to the fact that the Board was only ordered to
pay 40 per cent of Mr Gomez’s costs as from the date of challenge to the third
decision. That complaint makes no allowance for the fact Mr Gomez was not ordered
to pay any of the Board’s costs, save for the costs of the occasion of Mr Gomez’s
failed attempt to seek leave to amend his pleadings. Further, his Honour did not, as
the ground suggests, act inconsistently with his view costs ought not be determined
on the basis of success on particular issues. Had he awarded costs on that
determinative basis Mr Gomez was unlikely to have received a better costs outcome
than the Board. The order actually made, which was more favourable to Mr Gomez
than the Board, is consistent with the learned trial judge’s reasoned consideration of
a variety of relevant considerations including, but not confined to, Mr Gomez’s
success in respect of the third decision.
96 AR Vol 1 p18 L5.
97 AR Vol 1 p19 L9.
98 AR Vol 1 p19 L15.
99 The very nature of the second stage of relief supports such an inference, as did, for example, a submission by
the Board’s counsel at the outset of the hearing, when it was apparent only the first stage was to be
heard, that such an approach “would also mean that no party would be calling the oral evidence that
was suggested” (AR Vol 1 p24 L20).
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31
[121] No error in the learned trial Judge’s reasoning has been demonstrated. Nor in the
circumstances of the case does the costs order of itself bespeak error in the exercise
of the costs discretion. The appeal in respect of costs must fail.
Orders
[122] The above conclusions have the consequence that neither party has succeeded in their
appeals. In a case of this kind there may exist some legitimate basis, of which the
court is presently unaware, to contend that costs should not follow the event as they
ordinarily would. Failing agreement between the parties as to costs, the court should
receive submissions from them as to costs.
[123] I would order:
1. The Board’s appeal is dismissed.
2. Mr Gomez’s cross-appeal is dismissed.
3. If the parties have not reached agreement as to costs within two weeks
of judgment:
(a) within three weeks of judgment the parties will each file and serve
written submissions, not exceeding four pages, as to the appropriate
costs order(s) in the appeal and cross-appeal;
(b) within four weeks of judgment the parties may file and serve
replies to their opponent’s submissions, not exceeding two pages.
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Official source: https://www.sclqld.org.au/caselaw/QCA/2018/067